[House Report 110-927]
[From the U.S. Government Publishing Office]



                                                 Union Calendar No. 600

110th Congress, 2d Session - -  -  -  -  -  -  -  - House Report 110-927

                           ACTIVITIES REPORT

                                 of the

                     COMMITTEE ON VETERANS' AFFAIRS

                        HOUSE OF REPRESENTATIVES

                       ONE HUNDRED TENTH CONGRESS

                               __________

                             first session

                        Convened January 4, 2007

                      Adjourned December 19, 2007

                             second session

                        Convened January 3, 2008

                       Adjourned January 3, 2009

                                     



 January 2, 2009--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                 -----
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                     COMMITTEE ON VETERANS' AFFAIRS

                    BOB FILNER, California, Chairman
CORRINE BROWN, Florida               STEVE BUYER, Indiana
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
PHIL HARE, Illinois                  GINNY BROWN-WAITE, Florida
SHELLEY BERKLEY, Nevada              MICHAEL R. TURNER, Ohio
JOHN T. SALAZAR, Colorado            BRIAN P. BILBRAY, California
CIRO RODRIGUEZ, Texas                DOUG LAMBORN, Colorado
JOE DONNELLY, Indiana                GUS M. BILIRAKIS, Florida
JERRY McNERNEY, California           VERN BUCHANAN, Florida
ZACHARY T. SPACE, Ohio               STEVE SCALISE, Louisiana
TIMOTHY J. WALZ, Minnesota
DONALD J. CAZAYOUX, Jr., Louisiana
                     Malcom Shorter, Staff Director




    January 4, 2007--Chairman Bob Filner and Ranking Minority Member 
Steve Buyer were appointed to the Committee.
    January 10, 2007--Reps. Cliff Stearns, Dan Burton of Indiana, Jerry 
Moran of Kansas, Richard H. Baker, Henry E. Brown, Jr. of South 
Carolina, Jeff Miller of Florida, John Boozman, Ginny Brown-Waite of 
Florida, Michael R. Turner, Brian P. Bilbray, Doug Lamborn, and Gus M. 
Bilirakis were appointed to the Committee.
    January 12, 2007--Reps. Corrine Brown of Florida, Vic Snyder, 
Michael H. Michaud, Stephanie Herseth, Harry E. Mitchell of Arizona, 
John J. Hall of New York, Phil Hare, Michael F. Doyle, John T. Salazar, 
Ciro D. Rodriguez, Joe Donnelly, Jerry McNerney and Zachary T. Space 
were appointed to the Committee.
    January 18, 2007--Rep. Shelley Berkley (to rank immediately after 
Michael F. Doyle) and Timothy J. Walz were appointed to the Committeee.
    March 12, 2007--Rep. Dan Burton of Indiana was removed from the 
Committee.
    March 12, 2007--Rep. Vern Buchanan was appointed to the Committee.
    April 1, 2007--Rep. Stephanie Herseth changed her name to Stephanie 
Herseth Sandlin.
    February 2, 2008--Rep. Richard H. Baker resigned from the Committee 
and the U.S. House of Representatives.
    May 14, 2008--Rep. Steve Scalise was appointed to the Committee.
    June 10, 2008--Rep. Michael F. Doyle resigned from the Committee.
    June 10, 2008--Rep. Donald J. Cazayoux, Jr. was appointed to the 
Committee.
       SUBCOMMITTEE ON DISABILITY ASSISTANCE AND MEMORIAL AFFAIRS

                    JOHN J. HALL, New York, Chairman
CIRO RODRIGUEZ, Texas                DOUG LAMBORN, Colorado, Ranking
PHIL HARE, Illinois                  MICHAEL R. TURNER, Ohio
SHELLEY BERKLEY, Nevada              GUS M. BILIRAKIS, Florida
                              ----------                              

                  SUBCOMMITTEE ON ECONOMIC OPPORTUNITY

          STEPHANIE HERSETH SANDLIN, South Dakota, Chairwoman
JOE DONNELLY, Indiana                JOHN BOOZMAN, Arkansas, Ranking
JERRY McNERNEY, California           JERRY MORAN, Kansas
JOHN J. HALL, New York               STEVE SCALISE, Louisiana
                              ----------                              

                         SUBCOMMITTEE ON HEALTH

                  MICHAEL H. MICHAUD, Maine, Chairman
CORRINE BROWN, Florida               JEFF MILLER, Florida, Ranking
VIC SNYDER, Arkansas                 CLIFF STEARNS, Florida
PHIL HARE, Illinois                  JERRY MORAN, Kansas
SHELLEY BERKLEY, Nevada              HENRY E. BROWN, Jr., South 
JOHN T. SALAZAR, Colorado                Carolina
DONALD J. CAZAYOUX, Jr., Louisiana   VERN BUCHANAN, Florida
                              ----------                              

              SUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS

                  HARRY E. MITCHELL, Arizona, Chairman
ZACHARY T. SPACE, Ohio               GINNY BROWN-WAITE, Florida, 
TIMOTHY J. WALZ, Minnesota               Ranking
CIRO D. RODRIGUEZ, Texas             CLIFF STEARNS, Florida
                                     BRIAN P. BILBRAY, California

----------
February 2, 2008--Rep. Richard H. Baker resigned from the Subcommittees 
on Economic Opportunity and Health at the same time he resigned from 
the U.S. House of Representatives.
June 11, 2008--Rep. Vern Buchanan was appointed to the Subcommittee on 
Health and Rep. Steve Scalise was appointed to the Subcommittee on 
Economic Opportunity.
July 9, 2008--Rep. Donald J. Cazayoux, Jr. was appointed to the 
Subcommittee on Health.
                            Committee Staff

              Malcom A. Shorter, Staff Director (1/22/07)
 Kingston E. Smith,\1\ Republican Staff Director and Chief Counsel (7/
                                 26/08)
      Kelly F. Craven, Republican Staff Director (1/3/07-4/22/07)
     James M. Lariviere, Republican Staff Director (1/3/07-7/25/08)
                    Tony J. Buckles, Chief of Staff
                   David M. Tucker,\2\ Chief Counsel

 Christopher R. Austin,\3\ Executive Assistant, Subcommittee on Health 
                           (2/20/07-7/24/08)
   Geoffrey G. Bestor, Staff Director, Subcommittee on Oversight and 
                             Investigations
 Michael F. Brink, Republican Staff Director, Subcommittee on Economic 
                              Opportunity
    Jeffrey A. Burdette, Executive Assistant, Subcommittee on Health
          Leah M. Caputo, Executive Assistant (1/3/07-4/29/07)
 Todd C. Chambers, Executive Assistant, Subcommittee on Oversight and 
                             Investigations
                                (6/2/08)
    Jonathan A. Clark, Republican Legislative Assistant, Disability 
     Assistance and Memorial Affairs and Subcommittee on Economic 
                              Opportunity
Deborah S. Collier, Republican Legislative Director, Full Committee and 
              Subcommittee on Oversight and Investigations
     Geoffrey K. Collver, Staff Director, Subcommittee on Economic 
                              Opportunity
                            (1/3/07-2/28/07)
         Kristal L. DeKleer, Communications Director (2/12/07)
              Bernadine N. Dotson, Financial Administrator
   Dolores A. Dunn, Republican Staff Director, Subcommittee on Health
  Sherie D. Ferrigno, Republican Executive Assistant, Full Committee, 
                                 Press
   Jacqueline Garrick, Professional Staff Director, Subcommittee on 
          Disability Assistance and Memorial Affairs (11/5/07)
 Mark F. Heyman, Professional Staff Member, Subcommittee on Health (8/
                             20/07-6/27/08)
   Thaddeus Hoffmeister, Staff Director, Subcommittee on Disability 
            Assistance and Memorial Affairs (1/3/07-8/29/07)
               Diane K. Kirkland, Printing Clerk (2/5/07)
 Juan Lara, Staff Director, Subcommittee on Economic Opportunity (3/23/
                                  07)
     Brian E. Lawrence, Republican Staff Director, Subcommittee on 
Disability Assistance and Memorial Affairs, Communications Director (9/
                                 18/07)
  Robert C. McCandless,\4\ Special Counsel to Chairman (6/6/07-8/1/07)
Javier D. Martinez, Professional Staff Member, Subcommittee on Economic 
                              Opportunity
                               (2/12/07)
                    Carol S. Murray, Office Manager
Caitlin R. Ostomel, Administrative Assistant, Subcommittee on Oversight 
                  and Investigations (2/7/07-5/23/08)
 Kristy A. Park, Professional Staff Member, Subcommittee on Health (8/
                                 11/08)
Jeffrey E. Phillips,\5\ Republican Communications Director, Republican 
  Staff Director, Subcommittee on Disability Assistance and Memorial 
                        Affairs (1/3/07-9/29/08)
    Kimberly W. Ross,\6\ Staff Director, Subcommittee on Disability 
               Assistance and Memorial Affairs (2/21/07)
Risa E. Salsburg, Republican Professional Staff Member, Subcommittee on 
                                 Health
 Sharon E. Schultze, Professional Staff Member, Subcommittee on Health
 Leonard A. Sistek, Jr., Staff Director, Subcommittee on Oversight and 
                             Investigations
                            (1/3/07-2/28/07)
               Deborah A. Smith, Legislative Coordinator
              Shannon L. Taylor, Committee Clerk (2/5/07)
 Dion S. Trahan, Professional Staff Member, Subcommittee on Oversight 
                      and Investigations (1/16/07)
   Orfa A. Torres,\7\ Executive Assistant, Subcommittee on Economic 
                         Opportunity (5/14/07)
    Timothy M. Welter, Republican Professional Staff Member (8/1/08)
 Cathleen C. Wiblemo,\8\ Staff Director, Subcommittee on Health (1/29/
                                  07)
  Megan A. Williams, Executive Assistant, Subcommittee on Disability 
                Assistance and Memorial Affairs (3/5/08)
  Arthur K. Wu,\9\ Republican Deputy Staff Director, Republican Staff 
         Director, Subcommittee on Oversight and Investigations
         Jian Iza C. Zapata,\10\ Executive Assistant (2/12/07)

----------
\1\ Republican Chief Counsel (1/3/07-7/25/08)
\2\ Staff Director, Subcommittee on Health (1/3/07-5/31/07)
\3\ Staff Assistant (2/20/07-4/29/07)
\4\ Special Assistant and Counsel (6/6/07-6/14/07)
\5\ Professional Staff Member (9/23/08-9/29/08)
\6\ Professional Staff Member, Subcommittee on Disability Assistance 
and Memorial Affairs (2/21/07-9/30/07)
\7\ Executive Assistant, Subcommittee on Disability Assistance and 
Memorial Affairs and Subcommittee on Economic Opportunity (5/14/07-3/2/
08)
\8\ Professional Staff Member, Subcommittee on Health (1/29/07-5/31/07)
\9\ Republican Staff Director, Subcommittee on Oversight and 
Investigations (1/3/07-7/25/08)
\10\ Executive Assistant, Subcommittee on Disability Assistance and 
Memorial Affairs and Subcommittee on Economic Opportunity (2/12/07-4/
29/07)
                          LETTER OF SUBMITTAL

                              ----------                              

                          House of Representatives,
                            Committee on Veterans' Affairs,
                                    Washington, DC, January 2, 2009

Hon. Lorraine Miller,
Clerk, House of Representatives,
Washington, DC.
    Dear Ms. Miller: In accordance with clause 1(d) of Rule XI 
of the Rules of the House of Representatives, I submit herewith 
the report of the Committee on Veterans' Affairs setting forth 
its activities in reviewing and studying the application, 
administration, and execution of those laws, the subject matter 
of which is within the jurisdiction of our committee.
            Sincerely,
                                                Bob Filner,
                                                           Chairman
                                FOREWORD

                              ----------                              

    The House Committee on Veterans' Affairs set an aggressive 
agenda for the 110th Congress which culminated in the passage 
of comprehensive legislation to improve health care and expand 
benefits for America's veterans. The Department of Veterans 
Affairs (VA) provides patient care and benefits for veterans 
and works to provide a seamless transition for those service 
members returning home from battle. There are hundreds of 
thousands of new veterans from Operation Enduring Freedom, 
Operation Iraqi Freedom, and other military operations around 
the world. The VA also serves veterans from past conflicts, 
including World War II, Vietnam, Korea, Desert Shield, and 
Desert Storm. The 110th Congress delivered significant 
accomplishments and made progress in meeting the needs of 
returning service members while keeping the promises that have 
been made to our Nation's heroes of the past, present, and 
future.
    The 110th Congress oversaw the largest investment in 
veterans' health care in American history. This unprecedented 
increase in funding included the largest single year increase 
in funding of the 77-year history of the VA. As a result, 
veterans health care services are more comprehensive, 
accessible, and timely. In the past two years, the health care 
system has been strengthened for the 5.8 million veterans who 
receive health care services from the VA, while providing more 
resources in order to specifically address the needs of 
veterans suffering from post-traumatic stress disorder (PTSD) 
and traumatic brain injuries (TBI).
    Congress crafted and passed the greatest overhaul of the 
G.I. Bill in more than 20 years--finally providing a G.I. Bill 
for the 21st Century veteran. The law fully restores education 
benefits for veterans to World War II levels, recognizes the 
sacrifice of the 1.8 million Reserve and National Guard troops 
by better aligning their education benefits with their length 
of service, and allows unused education benefits to be 
transferred to spouses and children. The Post 9/11 G.I. Bill 
provides tuition to veterans of the Iraq and Afghanistan wars 
based on the tuition of the most expensive four-year public 
university in the individual veteran's state.
    Addressing the housing needs of veterans was a top priority 
in the 110th Congress, as service members and veterans faced 
continued stress after returning home following deployment. 
Congress passed sweeping legislation to prohibit home 
foreclosure for nine months after military service, increase 
the loan limit for the VA home loan program, and enable more 
veterans to refinance their existing high-risk loans with VA 
loans. Congress also focused greater attention on preventing 
homelessness and providing increased services for those 
veterans already experiencing homelessness. The number of 
homeless veterans today is a national disgrace and I anticipate 
further enhancement of these services in the 111th Congress.
    During this session, Congress took action to clean up the 
disgraceful backlog of disability compensation and benefits 
claims. Legislation was enacted to provide essential reforms to 
bring the claims processing system up-to-date which allows for 
more accurate and timely delivery of benefits to veterans, 
families, and survivors. As a result of funding increases, VA 
has hired 3,000 additional claims processors to address the 
backlog. Benefits were also increased during the 110th 
Congress.
    Oversight of the Department of Veterans Affairs is 
paramount. The VA does not always provide the services to our 
veterans as well as it could--and should. Many times, 
bureaucratic obstacles prevent veterans from receiving the care 
they need. During this Congress, we increased the resources 
available for the VA to be more responsive to veterans' needs. 
Vigilant oversight by the House Committee on Veterans' Affairs 
will continue in the 111th Congress in order to ensure that 
these increased resources are spent efficiently and 
effectively.
    Budget and Appropriations--When the new 110th Congress was 
sworn in, the VA budget had been frozen for months, straining 
its ability to provide health care and benefits to the veterans 
who earned them. Congress pledged to never forget about the 
cost of the warrior when considering the growing cost of war 
and as a result, funding for veterans' programs increased 
dramatically during the 110th Congress. Over the two years, an 
additional $16.3 billion was provided to the VA for veterans' 
health care and services. In Fiscal Year 2008 alone, the 
largest increase in veterans' health care and benefits was 
enacted in the history of the VA.
    The 110th Congress passed three annual VA budgets. The 
Revised Continuing Appropriations Resolution for 2007 (Public 
Law 110-5) provided a $3.4 billion budget increase for the VA 
and was signed into law on February 15, 2007. The Consolidated 
Appropriations Act of 2008 (Public Law 110-161) increased 
funding for veterans health care and benefits by $6.6 billion, 
the single largest increase in the 77-year history of the VA 
and was signed into law on December 26, 2008. The Consolidated 
Security, Disaster Assistance, and Continuing Appropriations 
Act of 2009 (Public Law 110-329) provided a $4.5 billion budget 
increase and was signed into law on September 30, 2008.
    Congress also passed a supplemental appropriations bill to 
fund ongoing military operations which included funding to care 
for the returning service members. The U.S. Troops Readiness, 
Veterans' Care, Katrina Recovery, and Iraq Accountability 
Appropriations Act of 2007 (Public Law 110-28) provided $1.8 
billion for veterans, including funding to address the 
increased demand for VA services among service members 
returning from Iraq and Afghanistan, including mental health 
care, readjustment care, and polytrauma care. The bill was 
signed on May 25, 2007.
    The increased funding will improve health care and expand 
health services provided by the Veterans Health Administration 
which expects to treat more than 5.8 million patients in 2009, 
including more than 333,275 veterans of Iraq and Afghanistan 
(40,000 more than 2008). The increased budgets also make needed 
investments in advancing mental health care, assisting homeless 
veterans, improving VA long-term care, constructing and 
modernizing VA facilities, and hiring additional claims 
processors to alleviate the backlog of benefits claims.
    Major Committee Legislation: Health Care--The Veterans' 
Mental Health Care and Other Care Improvements Act of 2008 
(Public Law 110-387) addresses the many needs of our veterans 
and wounded warriors. This comprehensive health care law 
expands mental health services, increases research through the 
National Center for Post-Traumatic Stress Disorder, provides 
much needed counseling for families of veterans, and 
establishes a program to help rural veterans get the health 
care they need closer to home. Provisions were included to 
prevent homelessness and provide increased services for 
veterans experiencing homelessness by expanding and extending a 
valuable joint VA andDepartment of Labor program of referral 
and counseling services, ensuring that the VA domiciliary program is 
capable of meeting the needs of the growing female veteran population, 
and providing necessary support to low-income veteran families that 
have made the transition to permanent housing.
    The Joshua Omvig Veterans Suicide Prevention Act (Public 
Law 110-110) addresses the troubling increase of suicide in our 
veteran community. It offers comprehensive services to veterans 
and establishes a 24-hour toll-free suicide hotline. In its 
first year of operation, the hotline had served more than 
30,000 veterans, family members, and friends, and provided 
immediate help to individuals who were judged to be at imminent 
risk.
    Provisions from the Wounded Warrior Assistance Act (H.R. 
1538) were included in the National Defense Authorization Act 
for Fiscal Year 2008 (Public Law 110-181). This legislation 
represents a cooperative effort between the Committees on Armed 
Services and Veterans' Affairs to address the problems facing 
wounded veterans and eliminate the bureaucratic obstacles that 
confront returning service members when they transition from 
the Department of Defense (DoD) to the VA. This comprehensive 
new law provides an additional three years of VA health care 
eligibility for returning Iraq and Afghanistan veterans (for a 
total of five years) and expands VA's ability to care for 
returning Iraq and Afghanistan veterans suffering from 
traumatic brain injury. The law also provides plans for a 
cooperative approach for consolidating the disability and 
medical evaluation process for a more seamless transition from 
military duty to veteran status.
    Major Committee Legislation: Benefits--The Veterans 
Benefits Improvement Act of 2008 (Public Law 110-389) increases 
veterans' benefits and also provides essential reforms to bring 
the claims processing system up-to-date for more accurate and 
timely delivery of benefits to veterans, families, and 
survivors. Public Law 110-389 also includes a pilot program 
that dramatically alters the way claims are processed for 
veterans. Fully-developed claims certified by a Veterans 
Service Officer are eligible for expedited processing allowing 
veterans to receive their benefit without waiting months and 
months. The new law also strengthens a key housing benefit and 
makes home loans more accessible to veterans by easing 
restrictions on the VA home loan guaranty program, increasing 
loan amounts for purchase and refinancing, and eliminating the 
equity requirements for refinancing in response to the 
declining home values which prohibit many veterans from 
qualifying for the benefit.
    The Veterans' Compensation Cost-of-Living Adjustment Act of 
2007 (P.L. 110-111) and the Veterans' Compensation Cost-of-
Living Adjustment Act of 2008 (P.L. 110-324) increased the 
rates of disability compensation for veterans with service-
connected disabilities and dependency and indemnity 
compensation for the survivors of certain disabled veterans.
    The 110th Congress passed the Housing and Economic Recovery 
Act of 2008 (Public Law 110-298) which contained provisions to 
address housing needs for veterans. Public Law 110-298 
prohibits foreclosure of property owned by a service member for 
nine months following a period of military service and provides 
funding for a VA grant program that assists disabled veterans 
needing to adapt their homes to accommodate their disabilities.
    Oversight--During the 110th Congress, the House Committee 
on Veterans' Affairs conducted 108 hearings to better 
understand the needs of America's heroes on a wide-range of 
topics that affect veterans and passed 75 quality veterans 
bills to address those needs. The joint hearings process was 
reinstated, allowing veterans and military service 
organizations to appear before the Senate and House Committees 
to offer testimony on the annual budget request for the VA. A 
series of symposiums was implemented to raise the level of 
awareness on issues important to our Nation's veterans and 
their dependents. This unprecedented style of meeting allowed 
interested stakeholders an opportunity to present new and 
unique ways of addressing veterans' issues and engage in a 
dialogue with experts on a wide range of subject matters. The 
Committee held a Stakeholder's Summit, two roundtable 
discussions on the claims backlog, a symposium on traumatic 
brain injury, and a symposium on post-traumatic stress 
disorder.
    Implementation of Post 9/11 G.I. Bill--When the VA 
announced it was outsourcing the administrative implementation 
of the new G.I. Bill, the Committee held hearings to get to the 
facts. The Committee scrutinized the initial plan and raised 
concerns about using a contractor for the project. VA officials 
later unveiled a two-part strategy which includes an interim 
plan to meet the requirements of benefits delivery by August 1, 
2009. A long-term solution to develop a permanent rules-based 
automated system was also presented. The Committee will 
continue its vigilant oversight over the implementation of this 
most important new benefit for our troops and veterans.
    New Cooperative Approaches and Continuum of Care--
Transmission of electronic medical records between the Pentagon 
and VA is critical for the continuum of care of our wounded 
warriors. This Congress mandated that VA and DoD establish 
electronic medical records that can be quickly and easily 
shared, and made tremendous strides increasing cooperation 
between these two federal agencies to improve benefits and 
services for active duty service members and veterans. Although 
this problem is hardly new, the 110th Congress made significant 
progress to accelerate a seamless transition for service 
members and veterans.
    Acknowledgments--Special thanks are in order for my 
distinguished colleagues who guided and developed the key 
measures of the 110th Congress. I would like to thank Honorable 
Steve Buyer, the Ranking Minority Member of the Committee, for 
his dedication to our Nation's veterans and their loved ones. I 
want to thank the Chairs and Ranking Minority Members of the 
Subcommittees for all of their highly effective work: Honorable 
John J. Hall and Honorable Doug Lamborn of the Subcommittee on 
Disability Assistance and Memorial Affairs; Honorable Stephanie 
Herseth Sandlin and Honorable John Boozman of the Subcommittee 
Economic Opportunity; Honorable Michael H. Michaud and 
Honorable Jeff Miller of the Subcommittee on Health; and 
Honorable Harry E. Mitchell and Honorable Ginny Brown-Waite of 
the Subcommittee on Oversight and Investigations.
    Our legislative success was only possible due to the 
cooperation of our counterparts in the Senate, Honorable Daniel 
Akaka, Chairman, and Honorable Richard Burr, Ranking Member, of 
the Senate Committee on Veterans' Affairs. On behalf of 
veterans and their families, I would also like to thank the 
Honorable Larry Craig, former Ranking Member, who is retiring. 
I would like to thank the Senate Committee and their expert 
professional staff for their work to better the lives of 
veterans.
    Finally, I want to thank the staff of the House Committee 
on Veterans' Affairs for their hard work and dedication to our 
Nation's veterans and their families.
    George Washington had it right 200 years ago when he said, 
``The willingness with which our young people are likely to 
serve in any war, no matter how justified, shall be directly 
proportional as to how they perceive the Veterans of earlier 
wars were treated and appreciated by their country.'' If we get 
this right, we are not only helping our veterans but also 
supporting the troops fighting today.

                                                Bob Filner,
                                                           Chairman
                            C O N T E N T S

                              ----------                              
                                                                   Page

Jurisdiction of the House Committee on Veterans' Affairs.........     1

Veterans programs:
    Department of Veterans Affairs...............................     2
        Veterans Health Administration...........................     3
            Medical care.........................................     3
            Medical and prosthetic research......................     4
        Veterans Benefits Administration.........................     5
            Compensation and pension.............................     5
            Education............................................     5
            Home loan assistance.................................     6
            Insurance............................................     6
            Vocational Rehabilitation............................     6
        National Cemetery Administration.........................     6
    Department of Labor..........................................     7
    American Battle Monuments Commission.........................     7
    Arlington National Cemetery..................................     8

Rules of the Committee on Veterans' Affairs......................     8

Legislation enacted into law:
    Public Law 110-45, Redesignate the Federal building in 
      Albuquerque, New Mexico, as the ``Raymond G. Murphy 
      Department of Veterans Affairs Medical Center,'' 7/5/2007..    14
    Public Law 110-110, Joshua Omvig Veterans Suicide Prevention 
      Act, 11/5/2007.............................................    15
    Public Law 110-111, Veterans' Compensation Cost-of-Living 
      Adjustment Act of 2007, 11/5/2007..........................    16
    Public Law 110-112, Designate the VAMC in August, Georgia, as 
      the ``Charlie Norwood Department of Veterans Affairs 
      Medical Center,'' 11/8/2007................................    17
    Public Law 110-117, Designate the VAMC in Asheville, North 
      Carolina, as the ``Charles George Department of Veterans 
      Affairs Medical Center,'' 11/6/2007........................    17
    Public Law 110-118, Name the VA medical facility in Iron 
      Mountain, Michigan, as the ``Oscar G. Johnson Department of 
      Veterans Affairs Medical Facility,'' 11/16/2007............    17
    Public Law 110-145, Designate the VAOPC in Green Bay, 
      Wisconsin, as the ``Milo C. Huempfner Department of 
      Veterans Affairs Outpatient Clinic,'' 12/21/2007...........    18
    Public Law 110-156, Designate the VAOPC in Tulsa, Oklahoma, 
      as the ``Ernest Childers Department of Veterans Affairs 
      Outpatient Clinic,'' 12/26/2007............................    18
    Public Law 110-157, Dr. James Allen Veteran Vision Equity 
      Act, 12/26/2007............................................    18
    Public Law 110-168, Authorize major medical facility project 
      to modernize inpatient wards at the VAMC in Atlanta, 
      Georgia, 12/26/2007........................................    20
    Public Law 110-292, Name the VAOPC in Ponce, Puerto Rico, as 
      the ``Euripides Rubio Department of Veterans Affairs 
      Outpatient Clinic,'' 7/30/2008.............................    20
    Public Law 110-302, Designate the VAOPC in Wenatchee, 
      Washington, as the ``Elwood `Bud' Link Department of 
      Veterans Affairs Outpatient Clinic,'' 8/12/2008............    20
    Public Law 110-304, Name the VAMC in Miami, Florida, as the 
      ``Bruce W. Carter Department of Veterans Affairs Medical 
      Center,'' 8/12/2008........................................    21
    Public Law 110-324, Veterans' Compensation Cost-of-Living 
      Adjustment Act of 2008, 9/24/08............................    21
    Public Law 110-332, Designate the VA Clinic in Alpena, 
      Michigan, as the ``Lieutenant Colonel Clement C. Van 
      Wagoner Department of Veterans Affairs Clinic,'' 9/30/08...    22
    Public Law 110-387, Veterans' Mental Health and Other Care 
      Improvements Act of 2008, 10/10/08.........................    22
    Public Law 110-389, Veterans' Benefits Improvement Act of 
      2008, 10/10/08.............................................    26
    Public Law 110-410, Designate the Department of Veterans 
      Affairs Outpatient Clinic in Hermitage, Pennsylvania, as 
      the ``Michael A. Marzano Department of Veterans Affairs 
      Outpatient Clinic,'' 10/14/08..............................    30

Activities of the Committee......................................    30

Activities of the Subcommittees:
    Subcommittee on Disability Assistance and Memorial Affairs...    47
    Subcommittee on Economic Opportunity.........................    59
    Subcommittee on Health.......................................    73
    Subcommittee on Oversight and Investigations.................    90

Summary of action by the Committee...............................   104
Hearings and Executive Sessions..................................   105
Committee Web sites..............................................   115
Oversight Plan for 110th Congress................................   116
Report on the budget proposed for fiscal year 2008...............   124
Report on the budget proposed for fiscal year 2009...............   157
Messages from the President and other Executive communications...   199
Statistical data--war veterans and dependents....................   209
                                                 Union Calendar No. 600
110th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 2d Session                                                     110-927

======================================================================



 
ACTIVITIES OF THE COMMITTEE ON VETERANS' AFFAIRS FOR THE 110TH CONGRESS

                                _______
                                

 January 2, 2009--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

Mr. Filner, from the Committee on Veterans' Affairs, pursuant to Clause 
              1(d) of the Rule XI, submitted the following

                              R E P O R T

                              JURISDICTION

    Rule X of the Rules of the House of Representatives 
establishes the standing committees of the House and their 
jurisdiction. Under that rule, all bills, resolutions, and 
other matters relating to the subjects within the jurisdiction 
of any standing committee shall be referred to such committee. 
Clause 1(s) of Rule X establishes the jurisdiction of the 
Committee on Veterans' Affairs as follows:

          (1) Veterans' measures generally.
          (2) Cemeteries of the United States in which veterans 
        of any war or conflict are or may be buried, whether in 
        the United States or abroad (except cemeteries 
        administered by the Secretary of the Interior).
          (3) Compensation, vocational rehabilitation, and 
        education of veterans.
          (4) Life insurance issued by the Government on 
        account of service in the Armed Forces.
          (5) Pensions of all the wars of the United States, 
        general and special.
          (6) Readjustment of service members to civil life.
          (7) Servicemembers' civil relief.
          (8) Veterans' hospitals, medical care, and treatment 
        of veterans.

    The Committee on Veterans' Affairs was established on 
January 2, 1947, as a part of the Legislative Reorganization 
Act of 1946 (60 Stat. 812), and was vested with jurisdiction 
formerly exercised by the Committee on World War Veterans' 
Legislation; Invalid Pensions; and, Pensions. Jurisdiction over 
veterans' cemeteries administered by the Department of Defense 
was transferred from the Committee on Interior and Insular 
Affairs on October 20, 1967, by H. Res. 241, 90th Congress. The 
Committee during the 110th Congress had 28 members; 16 members 
in the majority and 12 members in the minority.

                           VETERANS PROGRAMS


                     Department of Veterans Affairs

    The Department of Veterans Affairs (VA) is responsible for 
providing Federal health care and benefits to veterans and 
their families. The Department is headed by the Secretary of 
Veterans Affairs and is the second largest of the 15 cabinet 
departments. The VA operates nationwide programs for health 
care, financial assistance and burial benefits.
    The Department of Veterans Affairs was established on March 
15, 1989, succeeding the Veterans Administration, which had 
been formed in 1930, consolidating several government agencies 
that provided services to veterans. At that time, VA had 54 
hospitals and 31,600 employees, and the nation had 4.7 million 
veterans. Today, VA employs more than 235,000 men and women who 
serve a large portion of the nation's 23.4 million veterans. 
About half of VA's male employees are themselves, veterans.
    Health care is available to nearly 8 million patients that 
are enrolled for health care in 153 medical centers, nearly 750 
community-based outpatient clinics, and hundreds of other sites 
of care. Annually, the Department's inpatient facilities treat 
more than 800,000 patients, and its outpatient clinics register 
more than 75 million visits. In addition, VA has become a 
health care industry leader in research, rehabilitation, use of 
technology and patient safety.
    Approximately a quarter of the nation's population is 
potentially eligible for VA benefits and services because they 
are veterans, family members or survivors of veterans. The 
Department provides $39.8 billion in disability compensation, 
death compensation and pensions to 3.7 million people. More 
than 554,000 spouses, children and parents of deceased veterans 
also receive VA benefits. In addition to guaranteeing home 
loans valued at over $220 billion, VA supervises the 
Servicemembers' Group Life Insurance and the Veterans' Group 
Life Insurance programs. Together, these programs provide some 
$1.3 trillion in insurance to 4 million service members and 
veterans, plus 3.1 million family members.
    The Department maintains 125 national cemeteries in 39 
states and Puerto Rico. With the largest national cemetery 
expansion since the Civil War underway, by 2010, VA will serve 
90 percent of veterans with a national or state veterans 
cemetery within 75 miles of their homes. The Department also 
manages the Presidential Memorial Certificate program, which 
provides next of kin or loved ones with certificates signed by 
the President to commemorate honorably discharged, deceased 
veterans.

                     VETERANS HEALTH ADMINISTRATION

Medical Care

    Perhaps the most visible of all VA benefits and services is 
health care. From 54 hospitals in 1930, VA's health care system 
now includes 153 medical centers, with at least one in each 
State other than New Hampshire, Puerto Rico, District of 
Columbia and Hawaii. VA operates more than 1,400 sites of care, 
including 153 hospitals, 852 ambulatory care and community-
based outpatient clinics, 135 nursing homes, 50 residential 
rehabilitation treatment programs, currently 225 Veterans 
Centers and 5 mobile outpatient clinics. VA health care 
facilities provide a broad spectrum of medical, surgical and 
rehabilitative care.
    More than 5.6 million people received care in VA health 
care facilities in 2008. By the end of FY 2007, approximately 
32 percent of all veterans had enrolled with VA for health 
care; 69 percent of these enrolled veterans were treated by VA. 
In 2007, VA inpatient facilities treated 800,000 patients. VA's 
outpatient clinics registered more than 75 million visits.
    VA manages the largest medical education and health 
professions training program in the United States. VA 
facilities are affiliated with 107 medical schools, 55 dental 
schools and more than 1,200 other schools across the country. 
Each year, about 83,000 health professionals are trained in VA 
medical centers. More than half of the physicians practicing in 
the United States had some of their professional education in 
the VA health care system.
    VA's medical system serves as a backup to the Defense 
Department during national emergencies and as a Federal support 
organization during major disasters.
    During the last 6 years, VA has put its health care 
facilities under 21 networks, which provide more medical 
services to more veterans and family members than at any time 
during VA's long history.
    VA has experienced unprecedented growth in the medical 
system workload over the past few years. The number of patients 
treated increased by 90 percent from 4.1 million in 2001 to 
more than 7.8 million in 2008.
    To receive VA health care benefits, most veterans must 
enroll. The VA health care system had 7.8 million veterans who 
were enrolled as of July 2008. When they enroll, they are 
placed in priority groups or categories that help VA manage 
health care services within budgetary constraints and ensure 
quality care for those enrolled.
    Some veterans are exempted from having to enroll. People 
who do not have to enroll include veterans with a service-
connected disability of 50 percent or more, veterans with a 
service-connected disability of 50 percent or more, veterans 
who were discharged from the military within one year but have 
not yet been rated for a VA disability benefit and veterans 
seeking care for only a service-connected disability.
    Veterans with service-connected disabilities receive 
priority access to care for hospitalization and outpatient 
care.
    Since 1979, VA's Readjustment Counseling Service has 
operated Vet Centers, which provide psychological counseling 
for war-related trauma, community outreach, case management and 
referral activities, plus supportive social services to 
veterans and family members. There are currently 225 Vet 
Centers.
    Since the first Vet Center opened, approximately 2 million 
veterans have been helped. Every year, the Vet Centers serve 
over 130,000 veterans and provide more than 1 million visits to 
veterans and family members.
    Vet Centers are open to any veteran who served in the 
military in a combat theater during wartime or anywhere during 
a period of armed hostilities. Vet Centers also provide trauma 
counseling to veterans who were sexually assaulted or harassed 
while on active duty, and bereavement counseling to the 
families of service members who die on active duty.
    VA provides health care and benefits to more than 100,000 
homeless veterans each year. While the proportion of veterans 
among the homeless is declining, VA actively engages veterans 
in outreach, medical care, benefits assistance and transitional 
housing. VA has made more than 307 grants for transitional 
housing, service centers and vans for outreach and 
transportation to state and local governments, tribal 
governments, non-profit community and faith-based service 
providers.
    Programs for alcoholism, drug addiction and post-traumatic 
stress disorder have been expanded in recent years, along with 
attention to environmental hazards.
    Indispensable to providing America's veterans with quality 
medical care are more than 134,000 volunteers in VA's Voluntary 
Service who donate 13 million hours each year to bring 
companionship and care to hospitalized veterans.

Research

    In 2007, estimated funding for VA research is $510 million. 
Another $442 million from VA's medical care account will 
support research efforts. Funding from non-VA sources, such as 
the National Institutes of Health, other government agencies 
and pharmaceutical companies, will contribute another $961 
million to VA research. VA currently supports approximately 
3,200 research staff, and its Career Development program 
provides young scientists and opportunity to develop skills as 
clinician-researchers.
    While providing high quality health care to the nation's 
veterans, VA also conducts an array of research on some of the 
most difficult challenges facing medical science today. VA has 
become a world leader in such research areas as aging, women's 
health, AIDS, post-traumatic stress disorder and other mental 
health issues. VA research has improved medical care for 
veterans and the nation.
    VA researchers played key roles in developing the cardiac 
pacemaker, the CT scan, radioimmunoassay and improvements in 
artificial limbs. The first liver transplant in the world was 
performed by a VA surgeon-researcher. VA clinical trials 
established the effectiveness of new treatments for 
tuberculosis, schizophrenia and high blood pressure. The 
``Seattle Foot'' developed in VA allows people with amputations 
to run and jump. VA contributions to medical knowledge have won 
VA scientists many awards, including the Nobel Prize and the 
Lasker Award.
    Nearly 70 percent of VA researchers are practicing 
physicians. Because of their dual roles, VA research often 
immediately benefits patients. Functional electrical 
stimulation, a technology using controlled electrical currents 
to activate paralyzed muscles, is being developed at VA 
clinical facilities and laboratories throughout the country. 
Through this technology, paraplegic patients have been able to 
grasp objects, stand and even walk short distances.
    Special VA ``centers of excellence'' throughout the nation 
conduct research in rehabilitation, health services and medical 
conditions, including AIDS, alcoholism, schizophrenia, stroke 
and Parkinson's disease. Multi-center clinical trials 
investigate the best therapy for various diseases. Current 
projects include testing aspirin therapy for heart patients, 
surgical treatment to reduce the risk of stroke and treatment 
options for prostate cancer.
    VA investigators continue to make major contributions to 
the understanding of post-traumatic stress disorder and Agent 
Orange exposure, both research areas resulting from the Vietnam 
War. VA has conducted a number of Gulf War-related research 
projects and has two environmental hazards research centers 
focusing on the possible health effects of environmental 
exposures among Gulf War veterans.

                    VETERANS BENEFITS ADMINISTRATION

Compensation and Pension

    Disability compensation is a monetary benefit paid to 
veterans who are disabled by injury or disease incurred or 
aggravated during active military service. Veterans with low 
incomes who are permanently and totally disabled may be 
eligible for monetary support through VA's pension program. In 
FY 2008, VA provided $38.9 billion in disability compensation, 
death compensation and pension to 3.7 million people. About 3.1 
million veterans received disability compensation or pensions 
from VA. Also receiving VA benefits were 554,700 spouses, 
children and parents of deceased veterans. Among them are 
170,144 survivors of Vietnam-era veterans and 235,000 survivors 
of World War II veterans.

Education and Training

    Since 1944, when the first GI Bill began, more than 21.8 
million veterans, service members and family members have 
received $83.6 billion in GI Bill benefits for education and 
training. The number of GI Bill recipients includes xx million 
veterans from World War II, 2.4 million from the Korean War and 
8.2 million post-Korean and Vietnam era veterans, plus active 
duty personnel. Since the dependent's program was enacted in 
1956, VA also has assisted in the education of more than 
784,078 dependents of veterans whose deaths or total 
disabilities were service-connected. Since the Vietnam-era, 
there have been approximately 2.7 million veterans, service 
members, reservists and National Guardsmen who have 
participated in the Veterans' Educational Assistance Program, 
established in 1977, and the Montgomery GI Bill, established in 
1985.
    In 2008, VA helped pay for the education or training of 
336,527 veterans and active-duty personnel, 106,092 reservists 
and National Guardsmen and 80,079 survivors.

Home Loan Assistance

    From 1944, when VA began helping veterans purchase homes 
under the original GI Bill, through September 2008, more than 
18.4 million VA home loan guarantees have been issued, with a 
total value of $967 billion. VA ended FY 2008 with almost 2.1 
million active home loans, reflecting amortized loans totaling 
$220.8 billion.
    In FY 2008, VA guaranteed 180,000 loans valued at $36.1 
billion. VA's programs for specially adapted housing helped 
about 1,018 disabled veterans with grants totaling more than 
$36.3 million last year.

Insurance

    VA operates one of the largest life insurance programs in 
the world. VA directly administers six life insurance programs. 
In addition, VA supervises the Servicemembers' Group Life 
Insurance and the Veterans' Group Life Insurance programs. 
These programs provide $1.3 trillion in insurance coverage to 4 
million veterans, active-duty members, reservists and 
Guardsmen, plus 3.1 million spouses and children.
    The Traumatic Injury Protection program under 
Servicemembers' Group Life Insurance provides coverage for 
losses incurred due to traumatic injuries. Benefit amounts 
range from $25,000 to $100,000, depending on the loss. This 
program covers 2.4 million members.
    In 2007, the VA life insurance programs returned $354 
million in dividends to 1 million veterans holding some of 
these VA life insurance policies, and paid an additional $1.1 
billion in death claims and other disbursements.

Vocational Rehabilitation

    VA's Vocational Rehabilitation and Employment Program 
provides services to enable veterans with service-connected 
disabilities to achieve maximum independence in daily living, 
and, to the maximum extent feasible, to obtain and maintain 
employment. From FY 1999 through 2008, 86,893 program 
participants achieved rehabilitation by obtaining and 
maintaining suitable employment. Additionally, during that same 
period, 21,108 participants achieved rehabilitation through 
maximum independence in daily living.

                    NATIONAL CEMETERY ADMINISTRATION

VA's National Cemeteries

    In 1973, the Army transferred 82 national cemeteries to VA, 
which now manages them through its National Cemetery 
Administration. Currently, VA operates 125 national cemeteries 
in 39 states and Puerto Rico and 33 soldiers' lots and monument 
sites.
    In 2007, VA national cemeteries conducted 100,000 
interments. That number is likely to increase to 111,000 in 
2010. In 2008, VA provided 360,455 headstones or markers for 
veterans' graves. Since taking over the veterans cemetery 
program in 1973, VA has provided more than 9.9 million 
headstones and markers.
    Between 2001 and 2007, VA opened six new national 
cemeteries serving Atlanta, GA; Detroit, MI; Oklahoma City, OK; 
Pittsburgh, PA; Sacramento, CA; and Palm Beach, FL. By the end 
of 2009, VA plans to open six additional national cemeteries 
near Sarasota, FL; Jackson, FL; Birmingham, AL; Columbia, SC; 
Bakersfield, CA; and Southeastern Pennsylvania (see page 7).
    VA administers the Presidential Memorial Certificate 
program, which provides gold embossed certificates signed by 
the president to commemorate honorably discharged, deceased 
veterans. They are sent to the veteran's next of kin and loved 
ones. VA provided 511,353 certificates in 2008.
    VA also administers the State Cemetery Grants Program, 
which encourages development of state and tribal government 
veterans cemeteries. VA provides up to 100 percent of the funds 
to develop, expand or improve veterans cemeteries operated and 
maintained by the states. More than $344 million has been 
awarded for 72 operation veterans cemeteries in 36 states, Guam 
and Saipan. Five state cemeteries are under construction. In 
2008, state cemeteries that received VA grants buried 25,000 
eligible veterans and family members.

                          Department of Labor


                   VETERANS' EMPLOYMENT AND TRAINING

    The Veterans' Employment and Training Service (VETS) of the 
Department of Labor provides employment and training services 
to eligible veterans through non-competitive Jobs for Veterans 
State Grants Program. Under this grant program, funds are 
allocated to State Workforce Agencies in direct proportion to 
the number of veterans seeking employment within their state.

                  American Battle Monuments Commission

    The American Battle Monuments Commission (ABMC), created by 
an Act of Congress in 1923, is a Federal agency responsible for 
the construction and permanent maintenance of military 
cemeteries and memorials on foreign soil, as well as certain 
memorials in the United States. Its principal functions are to 
commemorate, through the erection and maintenance of suitable 
memorial shrines, the sacrifices and achievements of the 
American armed forces where they have served since April 6, 
1917; to design, construct, operate, and maintain permanent 
American military burial grounds and memorials in foreign 
countries; to control the design and construction on foreign 
soil of U.S. military monuments and markers by other U.S. 
citizens and organizations, both public and private; and to 
encourage U.S. government agencies and private individuals and 
organizations to maintain adequately the monuments and markers 
erected by them on foreign soils. ABMC also provides 
information and assistance, on request, to relatives and 
friends of the war dead interred or commemorated at its 
facilities.
    In performance of its functions, ABMC administers, operates 
and maintains 24 permanent American military cemetery memorials 
and 22 monuments, memorials, markers and separate chapels in 14 
foreign countries, the Commonwealth of the Northern Mariana 
Islands, Gibraltar, and three memorials in the United States. 
When directed by Congress, ABMC develops and erects national 
military monuments in the United States, such as the Korean War 
Veterans Memorial and most recently, the World War II National 
Memorial.

                      Arlington National Cemetery

    Arlington Mansion and 200 acres of ground immediately 
surrounding it were designated as a military cemetery on June 
15, 1864, by Secretary of War Edwin M. Stanton. With more than 
300,000 people buried, Arlington National Cemetery has the 
second largest number of people buried of any national cemetery 
in the United States. Arlington National Cemetery is 
administered by the Department of the Army.
    Veterans from all the Nation's wars and conflicts are 
buried in the cemetery, from the American Revolution through 
Operation Iraqi Freedom. The cemetery conducts approximately 
6,400 burials each year. In addition to in-ground burial, the 
cemetery has a large columbarium for cremated remains. Seven 
courts are currently in use, each with 38,500 niches. Arlington 
is the site of many non-funeral ceremonies, and approximately 
3,700 such ceremonies are conducted each year. Arlington is 
expected to continue to provide burials through the year 2060 
with its recently approved capital investment plan.

              RULES OF THE COMMITTEE ON VETERANS' AFFAIRS


                       Rule 1--General Provisions

    (a) Applicability of House Rules.--The Rules of the House 
are the rules of the Committee on Veterans' Affairs and its 
subcommittees so far as applicable, except that a motion to 
recess from day to day, and a motion to dispense with the first 
reading (in full) of a bill or resolution, if printed copies 
are available, are non-debatable privileged motions in 
Committees and subcommittees.
    (b) Subcommittees.--Each subcommittee of the Committee is a 
part of the Committee and is subject to the authority and 
direction of the Committee and to its rules so far as 
applicable.
    (c) Incorporation of House Rule on Committee Procedure.--
Rule XI of the Rules of the House, which pertains entirely to 
Committee procedure, is incorporated and made part of the rules 
of the Committee to the extent applicable. Pursuant to clause 
2(a)(3) of Rule XI of the Rules of the House, the Chairman of 
the full Committee is directed to offer a motion under clause 1 
of Rule XXII of the Rules of the House whenever the Chairman 
considers it appropriate.
    (d) Vice Chairman.--Pursuant to clause 2(d) of Rule XI of 
the Rules of the House, the Chairman of the full Committee 
shall designate the Vice Chairman of the Committee and a Vice 
Chairman of each subcommittee established under Rule 5(a)(1).

                Rule 2--Regular and Additional Meetings

    (a) Regular Meetings.--The regular meeting day for the 
Committee shall be at 10 a.m. on the second Wednesday of each 
month in such place as the Chairman may designate. However, the 
Chairman may dispense with a regular Wednesday meeting of the 
Committee.
    (b) Additional Meetings.--The Chairman of the Committee may 
call and convene, as he considers necessary, additional 
meetings of the Committee for the consideration of any bill or 
resolution pending before the Committee or for the conduct of 
other Committee business. The Committee shall meet for such 
purpose pursuant to the call of the Chairman.
    (c) Notice.--The Chairman shall notify each member of the 
Committee of the agenda of each regular and additional meeting 
of the Committee at least 24 hours before the time of the 
meeting, except under circumstances the Chairman determines to 
be of an emergency nature. Under such circumstances, the 
Chairman shall make an effort to consult the ranking minority 
member, or in such member's absence, the next ranking minority 
party member of the Committee.

                Rule 3--Meetings and Hearings Generally

    (a) Open Meetings and Hearings.--Meetings and hearings of 
the Committee and each of its subcommittees shall be open to 
the public unless closed in accordance with clause 2(g) of Rule 
XI of the Rules of the House.
    (b) Announcement of Hearing.--The Chairman, in the case of 
a hearing to be conducted by the Committee, and the 
subcommittee Chairman, in the case of a hearing to be conducted 
by a subcommittee, shall make public announcement of the date, 
place, and subject matter of any hearing to be conducted on any 
measure or matter at least one week before the commencement of 
that hearing unless the Committee or the subcommittee 
determines that there is good cause to begin the hearing at an 
earlier date. In the latter event, the Chairman or the 
subcommittee Chairman, as the case may be, shall consult with 
the ranking minority member and make such public announcement 
at the earliest possible date. The clerk of the Committee shall 
promptly notify the Daily Clerk of the Congressional Record and 
the Committee scheduling service of the House Information 
Resources as soon as possible after such public announcement is 
made.
    (c) Wireless Telephone Use Prohibited.--No person may use a 
wireless telephone during a Committee or subcommittee meeting 
or hearing.
    (d) Media Coverage.--Any meeting of the Committee or its 
subcommittees that is open to the public shall be open to 
coverage by radio, television, and still photography in 
accordance with the provisions of clause 4 of House rule XI.
    (e) Requirements for Testimony.--
          (1) Each witness who is to appear before the 
        Committee or a subcommittee shall file with the clerk 
        of the Committee, at least 48 hours in advance of his 
        or her appearance, a written statement of his or her 
        proposed testimony. Each witness shall, to the greatest 
        extent practicable, also provide a copy of such written 
        testimony in an electronic format prescribed by the 
        Chairman. Each witness shall limit any oral 
        presentation to a summary of the written statement.
          (2) Pursuant to clause 4 of Rule XI of the Rules of 
        the House, in the case of a witness appearing in a non-
        governmental capacity a written statement of proposed 
        testimony shall include a curriculum vitae and a 
        disclosure of the amount and source (by agency and 
        program) of any Federal grant (or subgrant thereof) or 
        contract (or subcontract thereof) received during the 
        current fiscal year or either of the two preceding 
        fiscal years by the witness or by an entity represented 
        by the witness.
    (f) Calling and Questioning Witnesses.--
          (1) Committee and subcommittee members may question 
        witnesses only when they have been recognized by the 
        Chairman of the Committee or subcommittee for that 
        purpose, and only for a 5-minute period until all 
        members present have had an opportunity to question a 
        witness. The 5-minute period for questioning a witness 
        by any one member may be extended only with the 
        unanimous consent of all members present. The 
        questioning of witnesses in both Committee and 
        subcommittee hearings shall be initiated by the 
        Chairman, followed by the ranking minority party member 
        and all other members alternating between the majority 
        and minority. Except as otherwise announced by the 
        Chairman at the beginning of a hearing, members who are 
        present at the start of the hearing will be recognized 
        before other members who arrive after the hearing has 
        begun. In recognizing members to question witnesses in 
        this fashion, the Chairman shall take into 
        consideration the ratio of the majority to minority 
        members present and shall establish the order of 
        recognition for questioning in such a manner as not to 
        disadvantage the members of the majority.
          (2) Notwithstanding the provisions of paragraph (1) 
        regarding the 5-minute rule, the Chairman after 
        consultation with the ranking minority member may 
        designate an equal number of members of the Committee 
        or subcommittee majority and minority party to question 
        a witness for a period not longer than 30 minutes. In 
        no event shall the Chairman allow a member to question 
        a witness for an extended period under this rule until 
        all members present have had the opportunity to ask 
        questions under the 5-minute rule. The Chairman after 
        consultation with the ranking minority member may 
        permit Committee staff for its majority and minority 
        party members to question a witness for equal specified 
        periods of time.
          (3) When a hearing is conducted by the Committee or a 
        subcommittee on any measure or matter, the minority 
        party members on the Committee shall be entitled, upon 
        request to the Chairman of a majority of those minority 
        members before the completion of the hearing, to call 
        witnesses selected by the minority to testify with 
        respect to that measure or matter during at least one 
        day of the hearing thereon.
    (g) Subpoenas.--Pursuant to clause 2(m) of Rule XI of the 
Rules of the House, a subpoena may be authorized and issued by 
the Committee or a subcommittee in the conduct of any 
investigation or series of investigations or activities, only 
when authorized by a majority of the members voting, a majority 
being present.

      Rule 4--Quorum and Record Votes; Postponement of Proceedings

    (a) Working Quorum.--A majority of the members of the 
Committee shall constitute a quorum for business and a majority 
of the members of any subcommittee shall constitute a quorum 
thereof for business, except that two members shall constitute 
a quorum for the purpose of taking testimony and receiving 
evidence.
    (b) Quorum for Reporting.--No measure or recommendation 
shall be reported to the House of Representatives unless a 
majority of the Committee was actually present.
    (c) Record Votes.--A record vote may be demanded by one-
fifth of the members present or, in the apparent absence of a 
quorum, by any one member. With respect to any record vote on 
any motion to amend or report, the total number of votes cast 
for and against, and the names of those members voting for and 
against, shall be included in the report of the Committee on 
the bill or resolution.
    (d) Prohibition Against Proxy Voting.--No vote by any 
member of the Committee or a subcommittee with respect to any 
measure or matter may be cast by proxy.
    (e) Postponing Proceedings.--Committee and subcommittee 
chairmen may postpone further proceedings when a record vote is 
ordered on the question of approving a measure or matter or on 
adopting an amendment, and may resume proceedings within two 
legislative days on a postponed question after reasonable 
notice. When proceedings resume on a postponed question, 
notwithstanding any intervening order for the previous 
question, an underlying proposition shall remain subject to 
further debate or amendment to the same extent as when the 
question was postponed.

                         Rule 5--Subcommittees

    (a) Establishment and Jurisdiction.--
          (1) There shall be four subcommittees of the 
        Committee as follows:
                  (A) Subcommittee on Disability Assistance and 
                Memorial Affairs, which shall have legislative, 
                oversight and investigative jurisdiction over 
                compensation; general and special pensions of 
                all the wars of the United States; life 
                insurance issued by the Government on account 
                of service in the Armed Forces; cemeteries of 
                the United States in which veterans of any war 
                or conflict are or may be buried, whether in 
                the United States or abroad, except cemeteries 
                administered by the Secretary of the Interior; 
                burial benefits; the Board of Veterans' 
                Appeals; and the United States Court of Appeals 
                for Veterans' Claims.
                  (B) Subcommittee on Economic Opportunity, 
                which shall have legislative, oversight and 
                investigative jurisdiction over education of 
                veterans, employment and training of veterans, 
                vocational rehabilitation, veterans' housing 
                programs, readjustment of servicemembers to 
                civilian life, and servicemembers civil relief.
                  (C) Subcommittee on Health, which shall have 
                legislative, oversight and investigative 
                jurisdiction over veterans' hospitals, medical 
                care, and treatment of veterans.
                  (D) Subcommittee on Oversight and 
                Investigations, which shall have oversight and 
                investigative jurisdiction over veterans' 
                matters generally, and over such matters as may 
                be referred to the subcommittee by the Chairman 
                of the full Committee for its oversight or 
                investigation and for its appropriate 
                recommendations. The subcommittee shall only 
                have legislative jurisdiction over such bills 
                or resolutions as may be referred to it by the 
                Chairman of the full Committee.
          (2) Each subcommittee shall have responsibility for 
        such other measures or matters as the Chairman refers 
        to it.
    (b) Vacancies.--Any vacancy in the membership of a 
subcommittee shall not affect the power of the remaining 
members to execute the functions of that subcommittee.
    (c) Ratios.--On each subcommittee, there shall be a ratio 
of majority party members to minority party members which shall 
be consistent with the ratio on the full Committee.
    (d) Referral to Subcommittees.--The Chairman of the 
Committee may refer a measure or matter, which is within the 
general responsibility of more than one of the subcommittees of 
the Committee, as the Chairman deems appropriate. In referring 
any measure or matter to a subcommittee, the Chairman of the 
Committee may specify a date by which the subcommittee shall 
report thereon to the Committee.
    (e) Powers and Duties.--
          (1) Each subcommittee is authorized to meet, hold 
        hearings, receive evidence, and report to the full 
        Committee on all matters referred to it or under its 
        jurisdiction. Subcommittee chairmen shall set dates for 
        hearings and meetings of their respective subcommittees 
        after consultation with the Chairman of the Committee 
        and other subcommittee chairmen with a view toward 
        avoiding simultaneous scheduling of Committee and 
        subcommittee meetings or hearings whenever possible.
          (2) Whenever a subcommittee has ordered a bill, 
        resolution, or other matter to be reported to the 
        Committee, the Chairman of the subcommittee reporting 
        the bill, resolution, or matter to the full Committee, 
        or any member authorized by the subcommittee to do so 
        shall notify the Chairman and the ranking minority 
        party member of the Committee of the Subcommittee's 
        action.
          (3) A member of the Committee who is not a member of 
        a particular subcommittee may sit with the subcommittee 
        during any of its meetings and hearings, but shall not 
        have authority to vote, cannot be counted for a quorum, 
        and cannot raise a point of order at the meeting or 
        hearing.
          (4) Each subcommittee shall provide the Committee 
        with copies of such record votes taken in subcommittee 
        and such other records with respect to the subcommittee 
        as the Chairman of the Committee deems necessary for 
        the Committee to comply with all rules and regulations 
        of the House.

                Rule 6--General Oversight Responsibility

    (a) Purpose.--Pursuant to clause 2 of Rule X of the Rules 
of the House, the Committee shall carry out oversight 
responsibilities. In order to assist the House in--
          (1) Its analysis, appraisal, evaluation of--
                  (A) The application, administration, 
                execution, and effectiveness of the laws 
                enacted by the Congress, or
                  (B) Conditions and circumstances which may 
                indicate the necessity or desirability of 
                enacting new or additional legislation, and
          (2) Its formulation, consideration and enactment of 
        such modifications or changes in those laws, and of 
        such additional legislation, as may be necessary or 
        appropriate, the Committee and its various 
        subcommittees, consistent with their jurisdiction as 
        set forth in Rule 5, shall have oversight 
        responsibilities as provided in subsection (b).
    (b) Review of Laws and Programs.--The Committee and its 
subcommittees shall review and study, on a continuing basis, 
the applications, administration, execution, and effectiveness 
of those laws, or parts of laws, the subject matter of which is 
within the jurisdiction of the Committee or subcommittee, and 
the organization and operation of the Federal agencies and 
entities having responsibilities in or for the administration 
and execution thereof, in order to determine whether such laws 
and the programs thereunder are being implemented and carried 
out in accordance with the intent of the Congress and whether 
such programs should be continued, curtailed, or eliminated. In 
addition, the Committee and its subcommittees shall review and 
study any conditions or circumstances which may indicate the 
necessity or desirability of enacting new or additional 
legislation within the jurisdiction of the Committee or 
subcommittee (whether or not any bill or resolution has been 
introduced with respect thereto), and shall on a continuing 
basis undertake future research and forecasting on matters 
within the jurisdiction of the Committee or subcommittee.
    (c) Oversight Plan.--Not later than February 15 of the 
first session of a Congress, the Committee shall meet in open 
session, with a quorum present, to adopt its oversight plans 
for that Congress for submission to the Committee on House 
Administration and the Committee on Oversight and Government 
Reform, in accordance with the provisions of clause 2(d) of 
Rule X of the Rules of the House.
    (d) Oversight by Subcommittees.--The existence and 
activities of the Subcommittee on Oversight and Investigations 
shall in no way limit the responsibility of the other 
subcommittees of the Committee on Veterans' Affairs for 
carrying out oversight duties.

                  Rule 7--Budget Act Responsibilities

    (a) Budget Act Responsibilities.--Pursuant to clause 
4(f)(1) of Rule X of the Rules of the House, the Committee 
shall submit to the Committee on the Budget not later than six 
weeks after the President submits his budget, or at such time 
as the Committee on the Budget may request--
          (1) Its views and estimates with respect to all 
        matters to be set forth in the concurrent resolution on 
        the budget for the ensuing fiscal year that are within 
        its jurisdiction or functions; and
          (2) An estimate of the total amounts of new budget 
        authority, and budget outlays resulting therefrom, to 
        be provided or authorized in all bills and resolutions 
        within its jurisdiction that it intends to be effective 
        during that fiscal year.

                   Rule 8--Records and Other Matters

    (a) Transcripts.--There shall be a transcript made of each 
regular and additional meeting and hearing of the Committee and 
its subcommittees. Any such transcript shall be a substantially 
verbatim account of remarks actually made during the 
proceedings, subject only to technical, grammatical, and 
typographical corrections authorized by the person making the 
remarks involved.
    (b) Records.--
          (1) The Committee shall keep a record of all actions 
        of the Committee and each of its subcommittees. The 
        record shall contain all information required by clause 
        2(e)(1) of Rule XI of the Rules of the House and shall 
        be available for public inspection at reasonable times 
        in the offices of the Committee.
          (2) There shall be kept in writing a record of the 
        proceedings of the Committee and each of its 
        subcommittees, including a record of the votes on any 
        question on which a recorded vote is demanded. The 
        result of each such record vote shall be made available 
        by the Committee for inspection by the public at 
        reasonable times in the offices of the Committee. 
        Information so available for public inspection shall 
        include a description of the amendment, motion, order 
        or other proposition and the name of each member voting 
        for and each member voting against such amendment, 
        motion, order, or proposition, and the names of those 
        members present but not voting.
    (c) Availability of Archived Records.--The records of the 
Committee at the National Archives and Records Administration 
shall be made available for public use in accordance with Rule 
VII of the Rules of the House. The Chairman shall notify the 
ranking minority member of any decision, pursuant to clause 3 
or clause 4 of Rule VII of the Rules of the House, to withhold 
a record otherwise available, and the matter shall be presented 
to the Committee for a determination on written request of any 
member of the Committee.
    (d) Availability of Publications.--Pursuant to clause 
2(e)(4) of Rule XI of the Rules of the House, the Committee 
shall make its publications available in electronic form to the 
maximum extent feasible.

                      LEGISLATION ENACTED INTO LAW

                                ------                                


                           Public Law 110-45


    Raymond G. Murphy Department of Veterans Affairs Medical Center


                                (S. 229)

    Title: To redesignate a Federal building in Albuquerque, 
New Mexico, as the ``Raymond G. Murphy Department of Veterans 
Affairs Medical Center''.

    Public Law 110-45 will:
    Redesignate the Federal building in Albuquerque, New 
Mexico, as the ``Raymond G. Murphy Department of Veterans 
Affairs Medical Center''.

    Legislative History:
          Apr. 12, 2007: Passed the Senate by Unanimous 
        Consent.
          Jun. 25, 2007: Passed the House by unanimous voice 
        vote.
          Jul. 5, 2007: Signed by the President, P.L. 110-45.
                                ------                                


                           Public Law 110-110


              Joshua Omvig Veterans Suicide Prevention Act


                         (H.R. 327, AS AMENDED)

    Title: To amend title 38, United States Code, to direct the 
Secretary of Veterans Affairs to develop and implement a 
comprehensive program designed to reduce the incidence of 
suicide among veterans.

    Public Law 110-110 will:
          --Direct the Department of Veterans Affairs (VA) to 
        develop and implement a comprehensive program to reduce 
        the incidence of suicide among veterans.
          --Require the VA to provide education and training 
        for VA staff, contractors, and medical personnel who 
        have interaction with veterans.
          --Direct VA to regularly screen and monitor all 
        veterans who receive medical care in the VA health care 
        system for risk factors for suicide and to provide for 
        referral of veterans at risk for suicide for 
        appropriate counseling and treatment.
          --Direct VA to provide for referral of veterans at 
        risk for suicide for appropriate counseling and 
        treatment.
          --Require VA to designate a suicide prevention 
        counselor at each VAMC.
          --Mandate VA to research the best practices for 
        suicide prevention among veterans, including best 
        practices for helping veterans who have experienced 
        military sexual trauma.
          --Require VA to work with HHS, NIH, CDC, and the 
        Substance Abuse and Mental Health Service 
        Administration when conducting research.
          --Require VA to conduct mental health research on 
        veterans who have experienced military sexual trauma.
          --Require VA to provide for the availability of 24-
        hour mental health care for veterans.
          --Provide for a toll-free hotline to be available at 
        all times.
          --Provide outreach and education for veterans and 
        their families to promote mental health.
          --Create a peer support-counseling program where 
        veterans can volunteer as peer counselors to assist 
        other veterans with mental health and readjustment 
        problems.
          --Require the VA to report within 90 days of 
        implementation on status, timeline and costs for 
        complete implementation within two years, and 
        recommendations for further legislation to improve 
        suicide prevention programs.

    Cost: CBO estimates that implementing this bill will have 
little, if any, cost because VA already has or soon will 
implement all the specific requirements of the bill. Enacting 
the bill would not affect direct spending or receipts.

    Legislative History:
          Mar. 13, 2007: Subcommittee on Health Markup.
          Mar. 15, 2007: Ordered reported, as amended, by the 
        Committee on Veterans' Affairs.
          Mar. 20, 2007: Reported, as amended, H. Rept. 110-55.
          Mar. 21, 2007: Passed the House by the Yeas and Nays: 
        423-0 (Roll No. 174)
          Sep. 27, 2007: Passed the Senate with an amendment by 
        Unanimous Consent.
          Oct. 23, 2007: Passed the House by the Yeas and Nays: 
        417-0 (Roll No. 987)
          Nov. 5, 2007: Signed by the President, P.L. 110-110.
                                ------                                


                           Public Law 110-111


      Veterans' Compensation Cost-of-Living Adjustment Act of 2007


                              (H.R. 1284)

    Title: To increase, effective as of December 1, 2007, the 
rates of compensation for veterans with service-connected 
disabilities and the rates of dependency and indemnity 
compensation for the survivors of certain disabled veterans.

    Public Law 110-111 will:
    Increase rates of Disability Compensation and Dependency 
and Indemnity Compensation:
    Amounts to be Increased--
          Wartime disability compensation
          Additional compensation for benefits
          Clothing allowance
          Dependency and indemnity compensation to surviving 
        spouse
          Dependency and indemnity compensation to children
    Determination of Increase--
    Percentage--Except as provided in paragraph (2), each 
dollar amount described in subsection (b) shall be increased by 
the same percentage as the percentage by which benefit amounts 
payable under title II of the Social Security Act (42 U.S.C. 
401 et seq.)
    Rounding--Each dollar amount increased under paragraph (1), 
if not a whole dollar amount, shall be rounded to the next 
lower whole dollar amount.

    Legislative History:
          Mar. 13, 2007: Subcommittee on Disability Assistance 
        and Memorial Affairs Markup.
          Mar. 15, 2007: Ordered reported by the Committee on 
        Veterans' Affairs.
          Mar. 20, 2007: Reported, H. Rept. 110-56.
          Mar. 21, 2007: Passed the House by the Yeas and Nays: 
        418-0 (Roll No. 176)
          Oct. 18, 2007: Passed the Senate by Unanimous 
        Consent.
          Nov. 5, 2007: Signed by the President, P.L. 110-111.
                                ------                                


                           Public Law 110-112


     Charlie Norwood Department of Veterans Affairs Medical Center


                              (H.R. 1808)

    Title: To designate the Department of Veterans Affairs 
Medical Center in Augusta, Georgia, as the ``Charlie Norwood 
Department of Veterans Affairs Medical Center''.

    Public Law 110-112 will:
    Designate the Department of Veterans Affairs Medical Center 
in Augusta, Georgia, as the ``Charlie Norwood Department of 
Veterans Affairs Medical Center''.

    Legislative History:
          Oct. 23, 2007: Passed the House by the Yeas and Nays: 
        417-0 (Roll No. 988)
          Oct. 31, 2007: Passed the Senate by Unanimous 
        Consent.
          Nov. 8, 2007: Signed by the President, P.L. 110-112.
                                ------                                


                           Public Law 110-117


      Charles George Department of Veterans Affairs Medical Center


                              (H.R. 2546)

    Title: To designate the Department of Veterans Affairs 
Medical Center in Ashville, North Carolina, as the ``Charles 
George Department of Veterans Affairs Medical Center''.

    Public Law 110-117 will:
    Designate the Department of Veterans Affairs Medical Center 
in Ashville, North Carolina, as the ``Charles George Department 
of Veterans Affairs Medical Center''.

    Legislative History:
          Jun. 25, 2007: Passed the House by the Yeas and Nays: 
        381-0 (Roll No. 550)
          Nov. 1, 2007: Passed the Senate by Unanimous Consent.
          Nov. 6, 2007: Signed by the President, P.L. 110-117.
                                ------                                


                           Public Law 110-118


    Oscar G. Johnson Department of Veterans Affairs Medical Facility


                              (H.R. 2602)

    Title: To name the Department of Veterans Affairs medical 
facility in Iron Mountain, Michigan, as the ``Oscar G. Johnson 
Department of Veterans Affairs Medical Facility''.

    Public Law 110-118 will:
    Name the Department of Veterans Affairs medical facility in 
Iron Mountain, Michigan, as the ``Oscar G. Johnson Department 
of Veterans Affairs Medical Facility''.

    Legislative History:
          Jun. 25, 2007: Passed the House by unanimous voice 
        vote.
          Nov. 7, 2007: Passed the Senate by Unanimous Consent.
          Nov. 16, 2007: Signed by the President, P.L. 110-118.
                                ------                                


                           Public Law 110-145


   Milo C. Huempfner Department of Veterans Affairs Outpatient Clinic


                              (H.R. 2408)

    Title: To designate the Department of Veterans Affairs 
Outpatient Clinic in Green Bay, Wisconsin, as the ``Milo C. 
Huempfner Department of Veterans Affairs Outpatient Clinic''.

    Public Law 110-145 will:
    Designate the Department of Veterans Affairs Outpatient 
Clinic in Green Bay, Wisconsin, as the ``Milo C. Huempfner 
Department of Veterans Affairs Outpatient Clinic''.

    Legislative History:
          Oct. 23, 2007: Passed the House by unanimous voice 
        vote.
          Dec. 13, 2007: Passed the Senate by Unanimous 
        Consent.
          Dec. 21, 2007: Signed by the President, P.L. 110-145.
                                ------                                


                           Public Law 110-156


    Ernest Childers Department of Veterans Affairs Outpatient Clinic


                               (H.R. 366)

    Title: To designate the Department of Veterans Affairs 
Outpatient Clinic in Tulsa, Oklahoma, as the ``Ernest Childers 
Department of Veterans Affairs Outpatient Clinic.''

    Public Law 110-156 will:
    Designate the Department of Veterans Affairs Outpatient 
Clinic in Tulsa, Oklahoma, as the ``Ernest Childers Department 
of Veterans Affairs Outpatient Clinic.''

    Legislative History:
          Jun. 25, 2007: Passed the House by unanimous voice 
        vote.
          Dec. 18, 2007: Passed the Senate by Unanimous 
        Consent.
          Dec. 26, 2007: Signed by the President, P.L. 110-156.
                                ------                                


                           Public Law 110-157


           Dr. James Allen Veteran Vision Equity Act of 2007


                               (H.R. 797)

    Title: To amend title 38, United States Code, to improve 
compensation benefits for veterans in certain cases of 
impairment of vision involving both eyes, and for other 
purposes.

    Public Law 110-157 will:
          --Allow veterans who receive veteran's disability 
        compensation for impairment of vision in one eye to be 
        eligible to receive additional disability compensation 
        for impairment of vision in the eye that is not 
        service-connected, where the impairment in each eye is 
        to a visual acuity of 20/200 or less or of a peripheral 
        field loss of 20 degrees or less (the definition of 
        ``legal blindness'' adopted by all 50 states and the 
        Social Security Administration.)
          --Authorize the Secretary of Veterans Affairs and the 
        Secretary of Health and Human Services (HHS), until 
        September 30, 2011, to match and compare VA's needs-
        based pension benefits data, parents' dependency and 
        indemnity compensation data, health-care services data, 
        and unemployability compensation data with the National 
        Directory of New Hires maintained by HHS, for the 
        purpose of determining eligibility for such benefits 
        and services (as recommended by GAO study GAO-06-309).
          --Extend authorization of the veterans' work study 
        program until 2010.
          --Authorize VA to furnish, in lieu of a headstone or 
        marker, a medallion or other device to signify a 
        deceased's status as a veteran to be affixed to a 
        headstone or marker purchased at private expense.
          --Repeal the two-year limit during which a state can 
        request a reimbursement for interment costs related to 
        the unclaimed remains of a veteran and would make the 
        repeal retroactive to October 1, 2006, and authorize VA 
        to provide up to $5 million per year for establishing, 
        expanding, improving, operating, and maintaining state 
        veterans cemeteries.
          --Repeal the December 31, 2007, termination date of 
        the VA's authority to furnish a government headstone or 
        marker for the grave of certain veterans buried in 
        private cemeteries, notwithstanding that the grave is 
        marked by a headstone or marker furnished at private 
        expense.

    Cost: The Congressional Budget Office has indicated that 
the text of the resolution (making amendments to H.R. 797) 
would result, overall, in cost savings of $8 million over 5 
years and $1 million over 10 years.

    Legislative History:
          Mar. 15, 2007: Ordered reported, as amended, by the 
        Committee on Veterans' Affairs.
          Mar. 20, 2007: Reported, as amended, H. Rept. No. 
        110-57.
          Mar. 21, 2007: Passed the House by the Yeas and Nays: 
        424-0 (Roll No. 175)
          Nov. 2, 2007: Passed the Senate with an amendment 
        under unanimous consent.
          Dec. 11, 2007: House agreed to Senate amendment with 
        amendments pursuant to H. Res. 855.
          Dec. 17, 2007: Senate agreed to House amendments to 
        Senate amendment by Unanimous Consent.
          Dec. 26, 2007: Signed by the President, P.L. 110-157.
                                ------                                


                           Public Law 110-168


Modernization Project at Department of Veterans Affairs Medical Center 
                          in Atlanta, Georgia


                               (S. 1396)

    Title: A bill to authorize a major medical facility project 
to modernize inpatient wards at the Department of Veterans 
Affairs Medical Center in Atlanta, Georgia.

    Public Law 110-168 will:
    Allow the Secretary of Veterans Affairs to carry out a 
major medical facility project for modernization of inpatient 
wards at the Department of Veterans Affairs Medical Center in 
Atlanta, Georgia, in an amount not to exceed $20,534,000.

    Legislative History:
          Dec. 13, 2007: Passed the Senate by Unanimous 
        Consent.
          Dec. 19, 2007: Passed the House by Unanimous Voice 
        Vote.
          Dec. 26, 2007: Signed by the President, P.L. 110-168.
                                ------                                


                           Public Law 110-292


    Euripides Rubio Department of Veterans Affairs Outpatient Clinic


                              (H.R. 4289)

    Title: To name the Department of Veterans Affairs 
outpatient clinic in Ponce, Puerto Rico, as the ``Euripides 
Rubio Department of Veterans Affairs Outpatient Clinic.''

    Public Law 110-292 will:
    Name the Department of Veterans Affairs Outpatient Clinic 
in Ponce, Puerto Rico, as the ``Euripides Rubio Department of 
Veterans Affairs Outpatient Clinic.''

    Legislative History:
          Jun. 24, 2008: Passed the House by voice vote.
          Jul. 11, 2008: Passed the Senate by Unanimous 
        Consent.
          Jul. 30, 2008: Signed by the President, P.L. 110-292.
                                ------                                


                           Public Law 110-302


   Elwood `Bud' Link Department of Veterans Affairs Outpatient Clinic


                              (H.R. 2245)

    Title: To designate the Department of Veterans Affairs 
outpatient clinic in Wenatchee, Washington, as the Elwood 
``Bud'' Link Department of Veterans Affairs Outpatient Clinic.

    Public Law 110-302 will:
    Designate the Department of Veterans Affairs outpatient 
clinic in Wenatchee, Washington, as the Elwood ``Bud'' Link 
Department of Veterans Affairs Outpatient Clinic.

    Legislative History:
          Jun. 26, 2008: Passed the House by voice vote.
          Aug. 1, 2008: Passed the Senate by Unanimous Consent.
          Aug. 12, 2008: Signed by the President, P.L. 110-302.
                                ------                                


                           Public Law 110-304


     Bruce W. Carter Department of Veterans Affairs Medical Center


                              (H.R. 4918)

    Title: To name the Department of Veterans Affairs medical 
center in Miami, Florida, as the ``Bruce W. Carter Department 
of Veterans Affairs Medical Center.''

    Public Law 110-304 will:
    Name the Department of Veterans Affairs medical center in 
Miami, Florida, as the ``Bruce W. Carter Department of Veterans 
Affairs Medical Center.''

    Legislative History:
          Jun. 26, 2008: Passed the House by voice vote.
          Aug. 1, 2008: Passed the Senate by Unanimous Consent.
          Aug. 12, 2008: Signed by the President, P.L. 110-304.
                                ------                                


                           Public Law 110-324


      Veterans' Compensation Cost-of-Living Adjustment Act of 2008


                               (S. 2617)

    Title: To increase, effective as of December 1, 2008, the 
rates of compensation for veterans with service-connected 
disabilities and the rates of dependency and indemnity 
compensation for the survivors of certain disabled veterans

    Public Law 110-324 will:
    Increase rates of Disability Compensation and Dependency 
and Indemnity Compensation:
    Amounts to be Increased--
          Wartime disability compensation
          Additional compensation for benefits
          Clothing allowance
          Dependency and indemnity compensation to surviving 
        spouse
          Dependency and indemnity compensation to children
    Determination of Increase--
          Percentage--Except as provided in paragraph (2), each 
        dollar amount described in subsection (b) shall be 
        increased by the same percentage as the percentage by 
        which benefit amounts payable under title II of the 
        Social Security Act (42 U.S.C. 401 et seq.)
          Rounding--Each dollar amount increased under 
        paragraph (1), if not a whole dollar amount, shall be 
        rounded to the next lower whole dollar amount.

    Legislative History:
          Jun. 26, 2008: Ordered reported, as amended, by the 
        Senate Committee on Veterans' Affairs.
          Jul. 24, 2008: Reported, as amended, S. Rept. 110-
        430.
          Jul. 30, 2008: Passed the Senate, as amended, by 
        Unanimous Consent.
          Sept. 10, 2008: Passed the House by the Yeas and 
        Nays: 418-0 (Roll No. 579)
          Sept. 24, 2008: Signed by the President, P.L. 110-
        324.
                                ------                                


                           Public Law 110-332


   Lieutenant Colonel Clement C. Van Wagoner Department of Veterans 
                             Affairs Clinic


                               (S. 2339)

    Title: A bill to designate the Department of Veterans 
Affairs clinic in Alpena, Michigan, as the ``Lieutenant Colonel 
Clement C. Van Wagoner Department of Veterans Affairs Clinic.''

    Public Law 110-332 will:
    Designate the Department of Veterans Affairs clinic in 
Alpena, Michigan, as the ``Lieutenant Colonel Clement C. Van 
Wagoner Department of Veterans Affairs Clinic.''

    Legislative History:
          Dec. 13, 2007: Passed the Senate by Unanimous 
        Consent.
          Sep. 17, 2008: Passed the House by the Yeas and Nays: 
        412-0 (Roll No. 603).
          Sep. 30, 2008: Signed by the President, P.L. 110-332.
                                ------                                


                           Public Law 110-387


    Veterans' Mental Health and Other Care Improvements Act of 2008


                               (S. 2162)

    Title: To improve the treatment and services provided by 
the Department of Veterans Affairs to veterans with post-
traumatic stress disorder and substance use disorders, and for 
other purposes.

    Public Law 110-387 will:
  --Pay tribute to Justin Bailey, who, after redeploying from 
    Operation Iraqi Freedom (OIF), died in a VA domiciliary 
    facility while receiving care for Post-Traumatic Stress 
    Disorder (PTSD) and substance use disorder.
  --List findings of Congress on Substance Use Disorders and 
    Mental Health.
  --Define ``full continuum of care'' with respect to substance 
    use disorders and require that all VA medical centers 
    provide ready access to a full continuum of care for 
    substance use disorders.
  --Require the Secretary to ensure that treatment for 
    substance use disorders and a co-morbid mental health 
    disorder is provided concurrently through a health 
    professional with training and expertise in the treatment 
    of both disorders, by separate services for each disorder, 
    or by a team of experienced clinicians.
  --Require the Secretary to carry out a two-year pilot program 
    to test the feasibility and advisability of providing 
    assessment, education and treatment via the Internet to 
    veterans with substance use disorders at VA medical centers 
    that have established ``Centers for Excellence for 
    Substance Abuse Treatment and Education'' or ``Substance 
    Abuse Program Evaluation and Research Centers.''
  --Require the Inspector General at the VA to conduct a review 
    of all residential mental health care facilities, including 
    domiciliary facilities not later than six months after the 
    enactment of this Act and another review not later than two 
    years after completing the first review.
  --Require the Secretary to implement a 3-year pilot program 
    in at least 3 VISNs providing peer outreach, peer support, 
    readjustment and mental health services to OEF/OIF veterans 
    through contracts with community mental health centers and 
    the Indian Health Services.
  --Direct the Secretary to carry out a program of research 
    into co-morbid PTSD and substance use disorder through the 
    National Center for Posttraumatic Stress Disorder.
  --Extend authorization for the Special Committee on Post-
    Traumatic Stress Disorder through 2012.
  --Clarify VA's authority to provide marriage and family 
    counseling within authorized mental health services and 
    remove the requirement that counseling must be initiated 
    during the veterans' hospitalization and is essential to 
    permit the discharge of the veteran from the hospital.
  --Direct the Secretary to carry out, through a non-VA entity, 
    a three-year pilot program (with an authorized one-year 
    extension) to assess the feasibility and advisability of 
    providing readjustment and transition assistance to 
    veterans and their families in cooperation with ten Vet 
    Centers.
  --Amend the federal veterans' benefits provisions to repeal a 
    requirement that the Secretary of Veterans Affairs adjust 
    the amounts deducted from payments or allowances made by 
    the VA for beneficiary travel expenses in connection with 
    health care whenever the payment or allowance is adjusted. 
    Require the Secretary to use the mileage reimbursement rate 
    for the use of privately owned vehicles by government 
    employees on official business.
  --Require the Secretary to reimburse a veteran for the costs 
    of emergency treatment received in a non-VA facility prior 
    to transfer to a VA facility.
  --Require the Secretary to establish a pilot program that 
    allows a highly rural veteran, residing in five VISNs and 
    who is enrolled in the system of patient enrollment at the 
    start date of the pilot, to receive health care in 
    facilities other than VA.
  --Direct the Secretary to designate at least four but not 
    more than six VA health care facilities as locations for 
    epilepsy centers of excellence.
  --Establish the qualifications for peer specialist appointees 
    as follows: (1) A veteran who has recovered or is 
    recovering from a mental health condition; and, (2) 
    Certified as having met the criteria for such position.
  --Require the VA to establish up to seven consolidated 
    patient accounting centers (CPACs) within the next five 
    years.
  --Eliminate a rule prohibiting VA from conducting widespread 
    testing for HIV infection in the population of veterans who 
    use VA health care facilities.
  --Authorize the Department of Veterans Affairs (VA) to expand 
    the health care benefits provided to the children, born 
    with spina bifida, of certain veterans.
  --Prohibit the VA from collecting copayments for hospice 
    care.
  --Direct the VA to develop and implement a comprehensive 
    policy on the management of pain experienced by veterans 
    enrolled for health care services provided by the VA.
  --Increase authorization of appropriations for comprehensive 
    service programs from $130 million to $150 million.
  --Revise provisions establishing a demonstration program of 
    referral and counseling services for at-risk veterans 
    transitioning from institutional living to: (1) remove the 
    ``demonstration'' designation; (2) require the program to 
    be carried out in at least 12 (currently, six) locations; 
    and, (3) extend the program through fiscal year 2012.
  --Require the Secretary to ensure that VA domiciliary care 
    programs are adequate, with respect to capacity and safety, 
    to meet the needs of women veterans.
  --Direct the Secretary to provide financial assistance to 
    private nonprofit organizations or consumer cooperatives to 
    provide and coordinate supportive services for very low-
    income (less than 50 percent of the median income for the 
    area) veteran families residing in permanent housing.
  --Authorize medical facility projects for fiscal year 2009 
    major medical facility projects as follows:
         $54,000,000 to construct a facility to replace 
        a seismically unsafe acute psychiatric inpatient 
        building in Palo Alto, California.
         $66,000,000 to construct a state-of-the-art 
        polytrauma healthcare and rehabilitation center in San 
        Antonio, Texas.
         $225,900,000 to make seismic corrections at a 
        VA medical center in San Juan, Puerto Rico.
  --Modify authorization for major medical facility 
    construction projects previously authorized as follows:
         $625,000,000 for restoration, new 
        construction, or replacement of the medical care 
        facility for the VA medical center at New Orleans, 
        Louisiana.
         $568,400,000 for the replacement of the VA 
        medical center at Denver, Colorado.
         $131,800,000 for an outpatient clinic in Lee 
        County, Florida.
         $136,700,000 to correct patient privacy 
        deficiencies at the VA medical center in Gainesville, 
        Florida.
         $600,400,000 to construct a new VA medical 
        center in Las Vegas, Nevada.
         $656,800,000 to construct a new VA medical 
        center in Orlando, Florida.
         $295,600,000 to consolidate campuses at the 
        University Drive and H. John Heinz III Divisions in 
        Pittsburgh, Pennsylvania.
  --Authorize fiscal year 2009 major medical facility leases as 
    follows:
         $4,326,000 for an outpatient clinic in 
        Brandon, Florida.
         $10,300,000 for a community-based outpatient 
        clinic in Colorado Springs, Colorado.
         $5,826,000 for an outpatient clinic in Eugene, 
        Oregon.
         $5,891,000 to expand an outpatient clinic in 
        Green Bay, Wisconsin.
         $3,731,000 for an outpatient clinic in 
        Greenville, South Carolina.
         $2,212,000 for a community-based outpatient 
        clinic in Mansfield, Ohio.
         $6,276,000 for a satellite outpatient clinic 
        in Mayaguez, Puerto Rico.
         $5,106,000 for a community-based outpatient 
        clinic in Southeast Phoenix, Mesa, Arizona.
         $8,636,000 for interim research space in Palo 
        Alto, California.
         $3,168,000 to expand a community-based 
        outpatient clinic in Savannah, Georgia.
         $2,295,000 for a community-based outpatient 
        clinic in Northwest Phoenix, Sun City, Arizona.
         $8,652,000 for a primary care annex in Tampa, 
        Florida.
         $3,600,000 for an outpatient clinic in Peoria, 
        Illinois.
  --Authorize appropriations:
         $345,900,000 for the aforementioned list of 
        major medical facility projects authorized for fiscal 
        year 2009.
         $1,493,495,000 for the aforementioned list of 
        major medical facility construction projects previously 
        authorized.
         $70,019,000 for the aforementioned list of 
        major facility leases authorized for fiscal year 2009.
  --Increase the threshold for major medical facility leases 
    requiring Congressional approval from $600,000 to 
    $1,000,000.
  --Authorize the city of Aurora, Colorado, to donate non-
    Federal land on the Fitzsimons campus for use by the 
    Secretary of Veterans Affairs to construct a veterans' 
    medical facility no later than 60 days after the enactment 
    of this section.
  --Require the Secretary of Veterans Affairs to submit a 
    report on facilities administration no later than 60 days 
    after the date of the enactment of this section.
  --Require an annual report on outpatient clinics no later 
    than the date on which the budget for the next fiscal year 
    is submitted to the Congress under section 1105 of title 
    31.
  --Name the VA spinal cord injury center in Tampa, Florida, 
    ``Michael Bilirakis Department of Veterans Affairs Spinal 
    Cord Injury Center.''
  --Repeal the December 31, 2008, sunset on the inclusion of 
    non-institutional extended care services in the definition 
    of medical services.
    Sec. 802--Extend the recovery audit authority for fee basis 
contracts and other medical services contracts in non-VA 
facilities from September 30, 2008, under current law to 
September 30, 2013.
  --Provide permanent authority for the provision of hospital 
    care, medical services, and nursing home care to veterans 
    who participated in certain chemical and biological testing 
    conducted by the Department of Defense.
  --Extend the expiring collections authorities for the 
    following:
         Health care copayments, which expire on 
        September 30, 2008, under current law, to September 30, 
        2010; and,
         Medical care cost recovery, which expires on 
        October 1, 2008, under current law, to October 1, 2010.
  --Extend the authority to provide nursing home care to 
    veterans with service-connected disability, which expires 
    on December 31, 2008, under current law, to December 31, 
    2013.
  --Provide permanent authority to establish research 
    corporations.
  --Extend the requirement to submit an annual report on the 
    committee on care of severely chronically mentally ill 
    veterans through 2012.
  --Provide a permanent requirement for the biannual report by 
    the women's advisory committee on the needs of women 
    veterans including compensation, health care, 
    rehabilitation, outreach, and other benefits and programs 
    administered by the VA.
  --Extend the pilot program on improvement of caregiver 
    assistance services for a three-year period through fiscal 
    year 2009.
  --Provide for a number of amendments, technical in nature, to 
    title 38.

    Legislative History:
          Nov. 14, 2007: Ordered reported, as amended, by the 
        Senate Committee on Veterans' Affairs.
          Apr. 8, 2008: Reported, as amended, S. Rept. 110-281.
          Jun. 3, 2008: Passed the Senate, as amended, by 
        Unanimous Consent.
          Jun. 4, 2008: Referred to House Committee on 
        Veterans' Affairs.
          Sept. 24, 2008: Passed the House, as amended, by 
        voice vote.
          Sept. 27, 2008: Senate agreed to the House amendment 
        and passed the bill by Unanimous Consent.
          Oct. 10, 2008: Signed by the President, P.L. 110-387.
    Provisions of H.R. 1527, H.R. 2623, H.R. 2818, H.R. 2874, 
H.R. 3819, H.R. 4053, H.R. 4264, H.R. 5554, H.R. 5729, H.R. 
5856, and H.R. 6445, H.R. 6802, and H.R. 6832 are included in 
this legislation.
                                ------                                


                           Public Law 110-389


               Veterans' Benefits Improvement Act of 2008


                               (S. 3023)

    Title: To amend title 38, United States Code, to improve 
and enhance compensation and pension, housing, labor and 
education, and insurance benefits for veterans, and for other 
purposes.

    Public Law 110-389 will:
          --Require VA to promulgate regulations that specify 
        the information and evidence required in the Veterans 
        Claims Assistance Act (VCAA) notices sent to claimants.
          --Authorize the United States Court of Appeals for 
        the Federal Circuit to review VA adoption or revision 
        of the Schedule for Rating Disabilities in the same 
        manner as other actions of the Secretary are reviewed.
          --Eliminate the requirement that severance pay for a 
        disability incurred in a combat zone be deducted from 
        disability compensation from VA.
          --Require VA to submit a report to Congress 
        describing its progress in addressing the causes for 
        any unacceptable variances in compensation payments to 
        veterans between its 57 Regional Offices.
          --Extend VA authority through December 31, 2012, to 
        use appropriated funds for the purpose of contracting 
        with non-VA providers to conduct disability 
        examinations.
          --Add osteoporosis diagnosed in veterans who have 
        previously been diagnosed with Post-Traumatic Stress 
        Disorder (PTSD) to the list of disabilities presumed to 
        be service-connected in former prisoners of war.
          --Codify various provisions for temporary ratings for 
        qualified veterans and service members within 365 days 
        of application who have stabilized medical conditions.
          --Allow a qualified dependent survivor to substitute 
        for the deceased veteran and to pursue the claim for 
        benefits at the point the claim had progressed at the 
        time of the claimant's death and submit additional 
        evidence.
          --Require VA to report to Congress the results of 
        studies examining the appropriate compensation to be 
        provided to veterans for loss of earning capacity and 
        loss of quality of life caused by service-related 
        disabilities and examining long-term transition 
        payments to veterans undergoing rehabilitation.
          --Require VA to establish an 18-member Advisory 
        Committee on Disability Compensation to consist of 
        leading experts who will guide the Secretary on 
        revising and readjusting the VA Schedule for Rating 
        Disabilities.
          --Require VA to conduct two pilot programs: one for 
        expediting fully-developed claims; and another for the 
        development and use of a checklist as part of the VCAA 
        notices.
          --Create a new office within VA to focus on assisting 
        survivors. The office shall have the authority to 
        explore the delivery of benefits and investigate issues 
        to ensure that VA is meeting its mission to care for 
        widows and orphans.
          --Require the Comptroller General to report to 
        Congress on the adequacy of Dependency and Indemnity 
        Compensation (DIC) to replace income and maintain 
        survivors of veterans who die from service-connected 
        disabilities.
          --Require VA to contract for an annual quality 
        assurance assessment that measures a statistically 
        valid sample of VBA employees and their work product 
        for accuracy, consistency, and reliability, and to 
        track trends.
          --Require VA to redevelop its certification exam to 
        test appropriate VBA employees and managers and to 
        include appropriate input from interested stakeholders 
        in its development.
          --Require VA to conduct a study and report to 
        Congress on VBA's work credit system focusing on 
        improving the quality, performance, accuracy of claims, 
        and information technology.
          --Require an information technology plan for all 
        aspects of the VBA disability claims processing system, 
        which shall include web portals, rule-based expert 
        systems, and decision support software and ensures the 
        reduction of claims processing time.
          --Require VA to evaluate the use of medical 
        professionals to assist VBA employees and to focus on 
        improving communication between the VBA and VHA.
          --Reform of the USERRA complaint process.
          --Modify and expand reporting requirements with 
        respect to enforcement of Uniformed Services Employment 
        and Reemployment Rights Act (USERRA).
          --Train executive branch human resources personnel on 
        employment and reemployment rights of members of the 
        uniformed services.
          --Report on the employment needs of Native American 
        veterans living on tribal lands.
          --Strikes ``may use'' and inserts ``shall use, in any 
        case in which the court determines it is appropriate'' 
        for equity powers.
          --Waive residency requirement for Directors for 
        Veterans' Employment and Training.
          --Modify the special unemployment study to cover 
        veterans of Post 9/11 Global Operations.
          --Modify the period of eligibility for Survivors' and 
        Dependents' Educational Assistance of certain spouses 
        of individuals with service-connected disabilities 
        total and permanent nature.
          --Repeal the requirement for a report to the 
        Secretary of Veterans Affairs on prior training.
          --Modify waiting period before affirmation of 
        enrollment in a correspondence course.
          --Change programs of education at the same 
        educational institution.
          --Repeal certification requirement with respect to 
        applications for approval of self-employment on-the-job 
        training.
          --Coordinate approval activities in the 
        administration of education benefits.
          --Waive the 24-month limitation of program of 
        independent living services and assistance for veterans 
        with a severe disability incurred in the Post 9/11 
        Global Operations period.
          --Increase the cap of the number of veterans 
        participating in the independent living program from 
        2,500 to 2,600.
          --Report on measure to assist and encourage veterans 
        in completing vocational rehabilitation.
          --Require the Secretary to submit a longitudinal 
        study of the Department of Veterans Affairs on 
        vocational rehabilitation programs.
          --Report on inclusion of severe and acute post-
        traumatic stress disorder among conditions covered by 
        traumatic injury protection coverage under 
        Servicemembers' Group Life Insurance (SGLI).
          --Treat stillborn children as insurable dependents 
        under SGLI.
          --Define eligibility for SGLI coverage for Ready 
        Reservists and members the Individual Ready Reserve and 
        modify termination dates of SGLI coverage between 
        dependents and separating service members.
          --Allow administrative costs for the Service-Disabled 
        Veterans Insurance (S-DVI) program to be paid for by 
        premiums instead of from the VA's General Operating 
        Expenses account.
          --Temporarily increase the maximum loan guaranty 
        amount for certain housing loans guaranteed by the 
        Secretary of Veterans Affairs.
          --Report on the impact of mortgage foreclosures on 
        veterans.
          --Require regular updates to the handbook for design 
        furnished to veterans eligible for specially adapted 
        housing assistance by the Secretary of Veterans 
        Affairs.
          --Enhance refinancing of home loans by veterans. 
        Increase the maximum percentage of loan to value of 
        refinancing loans to 100 percent.
          --Extend certain veterans home loan guaranty 
        programs.
          --Temporarily increase the number of authorized 
        judges of the United States Court of Appeals for 
        Veterans Claims.
          --Protect privacy and security concerns in court 
        records.
          --Recall retired judges of the United States Court of 
        Appeals for Veterans Claims.
          --Annual reports on workload of the United States 
        Court of Appeals for Veterans Claims.
          --Strike the $30 cap on the amount of registration 
        fees that may be charged to individuals admitted to 
        practice before the Court.
          --Allow the Secretary to award grants to the United 
        States Paralympics, Inc. and conduct oversight of the 
        use of the grant, to help execute, establish and manage 
        an adapted sports program for disabled veterans and 
        disabled members of the Armed Forces.
          --Establish a Department of Veterans Affairs Office 
        of National Veterans Sports Programs and Special Events 
        to carry out programs and events.
          --Require the Comptroller General report, due on the 
        last day of fiscal year 2012, to include among other 
        things: the use of the grant provided by the Department 
        of Veterans Affairs to the United States Paralympics, 
        Inc. and the number of veterans who have benefitted 
        from such grant activities carried out by the Office of 
        National Veterans Sports Programs and Special Events.
          --Grant VA the authority to terminate the collection 
        of VA debts from service members who die while on 
        active duty in the armed forces and to provide a refund 
        to those estates.
          --Extend VA authority to obtain income information 
        from the IRS or the SSA until September 30, 2011.
          --Require VA to fund through 2011 the preservation 
        and marking of the research material from the 
        Affordable Family Health Services as recommended by the 
        Institute of Medicine (IOM).
          --Require VA to contract with IOM to conduct a study 
        to identify any increased risks for multiple sclerosis 
        and other neurological diseases, as a result of service 
        in the Southwest Asia theater of operations or in the 
        Post 9/11 Global Operations theaters.
          --Allow termination or suspension of contracts for 
        cellular telephone service for certain service members.
          --Provide penalties for violation of interest rate 
        limitation under the Servicemembers Civil Relief Act.
          --Extend the sunset date on the advisory committee 
        for five years from the current date of expiration, 
        until December 31, 2014.
          --Allow the Secretary of Veterans Affairs to 
        advertise to promote awareness of benefits under laws 
        administered by the Secretary.
          --Extend the eligibility for memorial headstones or 
        markers to a deceased veteran's remarried surviving 
        spouse, without regard to whether any subsequent 
        remarriage has ended.

    Legislative History:
          Jun. 26, 2008: Ordered reported, as amended, by the 
        Senate Committee on Veterans' Affairs.
          Sept. 9, 2008: Reported, as amended, S. Rept. 110-
        449.
          Sept. 16, 2008: Passed the Senate, as amended with an 
        amendment to the title, by Unanimous Consent.
          Sept. 24, 2008: Passed the House, as amended, by 
        voice vote.
          Sept. 27, 2008: Senate agreed to the House amendment 
        and passed the bill by Unanimous Consent.
          Oct. 10, 2008: Signed by the President, P.L. 110-389.
    Provisions of H.R. 67, H.R. 674, H.R. 3298, H.R. 3681, H.R. 
3889, H.R. 4255, H.R. 5664, H.R. 5892, H.R. 6221, H.R. 6225, 
H.R. 6731, and H.R. 6832 are included in this legislation.
                                ------                                


                           Public Law 110-410


  Michael A. Marzano Department of Veterans Affairs Outpatient Clinic


                              (H.R. 1594)

    Title: To designate the Department of Veterans Affairs 
Outpatient Clinic in Hermitage, Pennsylvania, as the Michael A. 
Marzano Department of Veterans Affairs Outpatient Clinic.

    Public Law 110-410 will:
    Designate the Department of Veterans Affairs Outpatient 
Clinic in Hermitage, Pennsylvania, as the ``Michael A. Marzano 
Department of Veterans Affairs Outpatient Clinic.''

    Legislative History:
          Sep. 17, 2008: Passed the House by the Yeas and Nays: 
        410-0 (Roll No. 604).
          Sep. 30, 2008: Passed the Senate by Unanimous 
        Consent.
          Oct. 14, 2008: Signed by the President, P.L. 110-410.

                      ACTIVITIES OF THE COMMITTEE


                         LEGISLATIVE ACTIVITIES

First Session

Full Committee Markup of H.R. 327, Joshua Omvig Veterans Suicide 
        Prevention Act; H.R. 797, Dr. James Allen Veteran Vision Equity 
        Act of 2007; and, H.R. 1284, Veterans' Compensation Cost-of-
        Living Adjustment Act of 2007

    On March 15, 2007, the full Committee met and marked up 
three bills which were ordered reported favorably to the House 
by voice vote: H.R. 327 (see H. Rept. 110-55); H.R. 797, as 
amended (see H. Rept. 110-57); and, H.R. 1284 (see H. Rept. 
110-56).
    On March 21, 2007, the House agreed to suspend the rules 
and pass: H.R. 327, as amended, by a vote of 423-0 (Roll No. 
174); H.R. 797, as amended, by a vote of 424-0 (Roll No. 175); 
and, H.R. 1284 by a vote of 418-0 (Roll No. 176).
    On September 27, 2007, the Senate passed H.R. 327 with an 
amendment by unanimous consent.
    On October 18, 2007, the Senate passed H.R. 1284 without 
amendment by unanimous consent.
    On October 23, 2007, the House agreed to suspend the rules 
and agree to the Senate amendment on H.R. 327 by a vote of 417-
0 (Roll No. 987).
    On November 2, 2007, the Senate struck all after the 
enacting clause of H.R. 797 and substituted the language of S. 
1163, as amended, and passed by unanimous consent.
    On November 5, 2007, H.R. 327, as amended, became Public 
Law 110-110 and H.R. 1284 became Public Law 110-111.
    On November 30, 2007, sent letter to the Committee on Ways 
and Means requesting a waiver of consideration to subsection 
(a) of section 301 of the amendment to H.R. 797.
    On December 4, 2007, the Committee on Ways and Means waived 
consideration of the amendment to H.R. 797.
    On December 11, 2007, the House agreed to Senate amendment 
with amendments pursuant to H. Res. 855 (H.R. 797).
    On December 17, 2007, the Senate agreed to House amendments 
to Senate amendment of H.R. 797 and passed by unanimous 
consent.
    On December 26, 2007, H.R. 797, as amended, became Public 
Law 110-157.

Full Committee Markup of H.R. 1642, Homeless Veterans Housing at 
        Sepulveda Ambulatory Care Center Promotion Act

    On April 18, 2007, the full Committee met and marked up 
H.R. 1642, ordered reported favorably to the House by voice 
vote.
    On May 7, 2007, the House agreed to suspend the rules and 
pass the bill by voice vote.

Full Committee Markup of H.R. 612, Returning Servicemember VA 
        Healthcare Insurance Act of 2007; H.R. 67, Veterans Outreach 
        Improvement Act of 2007; H.R. 1660, to direct the Secretary of 
        Veterans Affairs to establish a national cemetery for veterans 
        in the southern Colorado region; H.R. 1470, Chiropractic Care 
        Available to All Veterans Act; H.R. 2199, Traumatic Brain 
        Injury Health Enhancement and Long-Term Support Act of 2007; 
        H.R. 2219, Veterans Suicide Prevention Hotline Act of 2007; 
        and, H.R. 2239, Early Access to Vocational Rehabilitation and 
        Employment Benefits Act

    On May 15, 2007, the full Committee met and marked up six 
bills which were ordered reported favorably to the House by 
voice vote: H.R. 612, as amended; H.R. 67, as amended; H.R. 
1660, as amended; H.R. 1470; H.R. 2199, as amended; and, H.R. 
2239, as amended. The Committee referred H.R. 2219 back to the 
Subcommittee on Health for further consideration.
    On May 23, 2007, the House agreed to suspend the rules and 
pass: H.R. 612, as amended, by a vote of 419-0 (Roll No. 411); 
H.R. 67, as amended, by a vote of 421-0 (Roll No. 410); H.R. 
1660, as amended, by voice vote; H.R. 1470 by a vote of 421-1 
(Roll No. 412); H.R. 2199, as amended, by a vote of 421-0 (Roll 
No. 413); and, H.R. 2239, as amended, by a vote of 414-0 (Roll 
No. 414).
    On December 6, 2007, provisions of H.R. 612 and provisions 
of section 2 of H.R. 2199 were included in P.L. 110-181, the 
National Defense Authorization Act of 2008.

Full Committee Markup of H.R. 2623, to amend title 38, United States 
        Code, to prohibit the collection of copayments for all hospice 
        care furnished by the Department of Veterans Affairs; H.R. 
        2874, Veterans' Health Care Improvement Act of 2007; H.R. 1315, 
        Veterans' Benefits Improvement Act of 2007; H.R. 760, Filipino 
        Veterans Equity Act of 2007; and, H.R. 23, Belated Thank You to 
        the Merchant Mariners of World War II Act of 2007

    On July 17, 2007, the full Committee met and marked up five 
bills which were ordered reported favorably to the House: H.R. 
2623, as amended (see H. Rept. 110-267) by voice vote; H.R. 
2874, as amended (see H. Rept. 110-268) by voice vote; H.R. 
1315, as amended (see H. Rept. 110-266) by voice vote; H.R. 
760, as amended by a vote of 15-12; and, H.R. 23, as amended 
(see H. Rept. 110-269, Part I) by voice vote.
    On July 30, 2007, the House agreed to suspend the rules and 
pass: H.R. 2623, as amended, by voice vote; H.R. 2874, as 
amended, by voice vote; H.R. 1315, as amended, by voice vote; 
and, H.R. 23, as amended, by voice vote.

Full Committee Markup of H.R. 3882, to amend title 38, United States 
        Code, to change the length of the obligated period of service 
        on active duty required for receiving certain education 
        benefits administered by the Secretary of Veterans Affairs, and 
        for other purposes

    On November 7, 2007, the full Committee met and marked up 
H.R. 3882, as amended, which was ordered reported to the House 
by voice vote.

Second Session

Full Committee Markup of H.R. 2790, to amend title 38, United States 
        Code, to establish the position of Director of Physician 
        Assistant Services within the office of the Under Secretary of 
        Veterans Affairs for Health; H.R. 3819, Veterans Emergency Care 
        Fairness Act of 2007; H.R. 5729, Spina Bifida Health Care 
        Program Expansion Act; H.R. 5554, Justin Bailey Veterans 
        Substance Use Disorders Prevention and Treatment Act of 2008; 
        H.R. 5856, Department of Veterans Affairs Medical Facility 
        Authorization and Lease Act of 2008; H.R. 3681, Veterans 
        Benefits Awareness Act of 2007; H.R. 3889, to amend title 38, 
        United States Code, to require the Secretary of Veterans 
        Affairs to conduct a longitudinal study of the vocational 
        rehabilitation programs administered by the Secretary; H.R. 
        4883, to amend the Servicemembers Civil Relief Act to provide 
        for a limitation on the sale, foreclosure, or seizure of 
        property owned by a servicemember during the one-year period 
        following the servicemember's period of military service; H.R. 
        4884, Helping Our Veterans to Keep Their Homes Act of 2008; 
        H.R. 4889, The Guard and Reserves Are Fighting Too Act of 2008; 
        H.R. 5664, to amend title 38, United States Code, to direct the 
        Secretary of Veterans Affairs to update at least once every six 
        years the plans and specifications for specially adapted 
        housing furnished to veterans by the Secretary; H.R. 5684, 
        Veterans Education Improvement Act of 2008; H.R. 5826, 
        Veterans' Compensation Cost-of-Living Adjustment Act of 2008; 
        and H.R. 5892, Veterans Disability Benefits Claims 
        Modernization Act of 2008

    On April 30, 2008, the full Committee met and marked up 14 
bills which were ordered reported favorably to the House: H.R. 
2790, as amended (see H. Rept. 110-642) by en bloc voice vote; 
H.R. 3819 (see H. Rept. 110-638) by en bloc voice vote; H.R. 
5729, as amended (see H. Rept. 110-645) by voice vote; H.R. 
5554, as amended (see H. Rept. 110-639) by en bloc voice vote; 
H.R. 5856 (see H. Rept. 110-648) by en bloc voice vote; H.R. 
3681, as amended (see H. Rept. 110-644) by voice vote; H.R. 
3889, as amended (see H. Rept. 110-640) by voice vote; H.R. 
4883, as amended, by voice vote; H.R. 4884, as amended, by 
voice vote; H.R 4889, as amended, by en bloc voice vote; H.R. 
5664, as amended (see H. Rept. 110-641) by en bloc voice vote; 
H.R. 5684, as amended, by voice vote; H.R. 5826 (see H. Rept. 
110-643) by voice vote; and, H.R. 5892 (see H. Rept. 110-789) 
by voice vote.
    On May 20, 2008, the House agreed to suspend the rules and 
pass: H.R. 2790, as amended, by voice vote; H.R. 5729, as 
amended, by voice vote; H.R. 5554, as amended, by voice vote; 
H.R. 3681, as amended, by voice vote; H.R. 3889, as amended, by 
voice vote; and, H.R. 5664, as amended, by voice vote.
    On May 21, 2008, the House agreed to suspend the rules and 
pass: H.R. 3819, as amended, by a vote of 412-0 (Roll No. 347); 
H.R. 5856 by a vote of 416-0 (Roll No. 349); and, H.R. 5826 by 
a vote of 417-0 (Roll No. 348).
    On July 30, 2008, provisions of H.R. 4883 and H.R. 4884 are 
included in P.L. 110-289, the Housing and Economic Recovery Act 
of 2008. House agreed to suspend the rules and pass H.R. 5892, 
as amended, by a vote of 429-0 (Roll No. 538).

Full Committee Markup of H.R. 2818, to provide for the establishment of 
        Epilepsy Centers of Excellence in the Veterans Health 
        Administration of the Department of Veterans Affairs

    On June 11, 2008, the full Committee met and marked up H.R. 
2818, as amended, which was ordered favorably reported to the 
House by voice vote (see H. Rept. 110-722). H.R. 2192 was 
pulled from the agenda for further consideration.
    On June 24, 2008, the House agreed to suspend the rules and 
pass H.R. 2818, as amended, by voice vote.

Full Committee Markup of H.R. 6445, to amend title 38, United States 
        Code, to prohibit the Secretary of Veterans Affairs from 
        collecting certain copayments from veterans who are 
        catastrophically disabled; H.R. 1527, Rural Veterans Access to 
        Care Act; H.R. 2192, to amend title 38, United States Code, to 
        establish an Ombudsman within the Department of Veterans 
        Affairs; H.R. 4255, United States Olympic Committee Paralympic 
        Program Act of 2008; H.R. 6225, Injunctive Relief for Veterans; 
        H.R. 6221, Veteran-Owned Small Business Protection and 
        Clarification Act of 2008; H.R. 674, to amend title 38, United 
        States Code, to repeal the provision of law requiring 
        termination of the Advisory Committee on Minority Veterans as 
        of December 31, 2009

    On July 16, 2008, the full Committee met and marked up 
seven bills which were ordered reported favorably to the House 
by voice vote: H.R. 6445, as amended to include H.R. 6114, H.R. 
6122, H.R. 6366, and H.R. 6439 (see H. Rept. 110-786); H.R. 
1527, as amended (see H. Rept. 110-817); H.R. 2192, as amended 
(see H. Rept. 110-773); H.R. 4255, as amended (see H. Rept. 
110-774); H.R. 6225, as amended to include H.R. 2910, as 
amended, H.R. 3298, as amended, H.R. 6070 (see H. Rept. 110-
778); H.R. 6221, as amended to include H.R. 6224 and H.R. 6272 
(see H. Rept. 110-785); and, H.R. 674 (see H. Rept. 110-772).
    On July 29, 2008, the House agreed to suspend the rules and 
pass H.R. 2192, as amended, by a vote of 398-0 (Roll No. 536).
    On July 30, 2008, the House agreed to suspend the rules and 
pass H.R. 6445, as amended, by a vote of 421-0 (Roll No. 541);
    On July 31, 2008, the House agreed to suspend the rules and 
pass: H.R. 4255, as amended, by voice vote; H.R. 6225, as 
amended, by voice vote; H.R. 6221, as amended, by voice vote; 
and, H.R. 674 by voice vote.
    On September 10, 2008, the House agreed to suspend the 
rules and pass H.R. 1527, as amended, by a vote of 417-0 (Roll 
No. 578).

Full Committee Markup of H.R. 6897, to authorize the Secretary of 
        Veterans Affairs to make certain payments to eligible persons 
        who served in the Philippines during World War II

    On September 17, 2008, the full Committee met and marked up 
H.R. 6897, as amended, which was ordered favorably reported to 
the House by voice vote.
    On September 23, 2008, the House agreed to suspend the 
rules and pass H.R. 6897, as amended, by a vote of 392-23 (Roll 
No. 624).

                          OVERSIGHT ACTIVITIES

First Session

Full Committee Hearing--The U.S. Department of Veterans Affairs Budget 
        Request for Fiscal Year 2008

    On February 8, 2007, the full Committee held a hearing on 
the proposed VA budget for FY 2008. The Administration 
requested a budget proposal for the U.S. Department of Veterans 
Affairs of $86.75 billion--$44.98 billion for entitlement 
programs and $41.77 billion for discretionary programs. The 
Administration requested an increase for VA medical care of 
$1.9 billion over the level provided in the Joint Funding 
Resolution for 2007 and an increase of $56 million for mental 
health initiatives.
    The Honorable R. James Nicholson, Secretary of the U.S. 
Department of Veterans Affairs, was accompanied by senior 
officials of the Department for his testimony to the Committee 
in support of the President's proposed budget. Also, 
representatives of major veterans service organizations 
presented their views on the proposed budget. Finally, 
representatives of the Independent Budget presented their 
proposal for the FY 2008 veterans' budget. See The U.S. 
Department of Veterans Affairs Budget Request for Fiscal Year 
2008, Serial No. 110-1.

Full Committee Meeting--Stakeholders Roundtable

    On February 12, 2007, the full Committee held a roundtable 
meeting to discuss important issues facing veterans and to 
develop a legislative agenda for the 110th Congress.
    Staff of the Committee on Appropriations, Subcommittee on 
Military Construction, Veterans Affairs, and Related Agencies; 
Members of the Committee on Veterans' Affairs; and, veterans 
service organizations provided ideas for the Committee's 
agenda.

Full Committee Hearing--Equity for Filipino Veterans

    On February 15, 2007, the full Committee held a hearing on 
H.R. 760, ``The Filipino Veterans Equity Act of 2007.'' 
Filipino service members played a critical role in the victory 
in the Pacific during World War II, serving under the direct 
command of General Douglas MacArthur. In 1946, Congress 
mandated that Filipino soldiers were not to be considered 
active military for the purposes of veterans' benefits.
    A number of witnesses delivered testimony before the 
Committee, including the following Members of Congress: Michael 
Honda, Madeleine Bordallo and Mazie Hirono. Also testifying at 
the hearing: Under Secretary for Benefits of the U.S. 
Department of Veterans Affairs, Ronald R. Aument; Charge 
d'Affaires Embassy of the Philippines, Victor Soretta; and, 
representatives from Filipino veterans associations and 
veterans service organizations. See Equity for Filipino 
Veterans, Serial No. 110-3.

Site Visit to San Diego, California

    From February 21-23, 2007, majority staff and Chairman Bob 
Filner traveled to San Diego, California, to attend an event at 
the Veterans Village of San Diego with U.S. Department of 
Veterans Affairs Secretary R. James Nicholson. The Veterans 
Village of San Diego is dedicated to extending assistance to 
needy and homeless veterans of all wars and their families by 
providing housing, food, clothing, substance abuse recovery, 
job training and job search assistance.

Site Visit to Los Angeles, California

    From April 2-3, 2007, majority staff and Chairman Bob 
Filner visited the Sepulveda Ambulatory Care Center and met 
with staff from the VA Greater Los Angeles Health Care System 
(GLA) as well as local veterans organizations. Topics discussed 
at these meetings included future plans for the site and 
housing issues.
    Specifically, Enhanced Use Lease at Sepulveda, updating 
health care equipment, accounting for income derived by movie 
studios and other outside sources, and well as spending for 
other ancillary services for veterans were discussed. In 
addition, staff attended a public forum on Veterans' Healthcare 
with other guests, including the VA GLA Chief of Staff. These 
panels discussed a variety of issues dealing with research at 
the West Los Angeles VA facility, as well as issues facing 
veterans. Lastly, staff attended another public forum at an 
American Legion Post addressing a variety of veterans issues. 
Present were representatives of The American Legion, AMVETS, 
VFW, VA GLA Health Care System, Iraq and Afghanistan Veterans 
of America, Vietnam Veterans of America, Filipino American 
Service Group, Inc., and the Korean American Veterans 
Association, to name a few.

Site Visit to Nashville, Tennessee

    On April 11, 2007, majority and minority staff of the 
Committee visited the U.S. Department of Veterans Affairs 
Regional Office in Nashville, Tennessee. Staff met with key 
personnel including the Veterans Service Center management team 
and received a tour of the facility that included an 
explanation of VA's adjudication process. The staff also 
received an extensive briefing from VBA personnel on the 
progress of VETSNET. VETSNET is an information technology 
program that VBA has created to assist in payments to veterans 
once a disability rating has been assigned. VETSNET is intended 
to provide a greater amount of statistical and other 
information that will assist VBA staff in examining 
productivity requirements of each regional office. Nashville is 
a test site for the VETSNET suite of applications and all 
awards were populated in VETSNET at the Nashville office at the 
time of the visit. The staff was encouraged by the work being 
done by VBA to finally implement this IT application after many 
years of delay.

Full Committee Hearing--H.R. 23, the ``Belated Thank You to the 
        Merchant Mariners of World War II Act of 2007''

    On April 18, 2007, the full Committee held a hearing on 
H.R. 23, to thank the Merchant Mariners of World War II. The 
United States Merchant Mariners played a critical role in the 
U.S. victory during World War II, delivering troops, tanks, 
food, airplanes, fuel and other needed supplies to every 
theater of the war. The Merchant Mariners were the necessary 
link between the supplies and equipment that were manufactured 
in the United States and used overseas. The Merchant Mariners 
took part in every invasion from Normandy to Okinawa and 
suffered the highest casualty rate of any of the branches of 
the Armed Forces. Despite their service, the United States 
Merchant Marines were not included in the 1944 G.I. Bill of 
Rights. In 1988, they were finally granted veteran status, but 
some portions of the G.I. Bill have never been made available 
to the Merchant Marines and the lost benefits can never be 
recouped.
    A number of witnesses delivered testimony before the 
Committee, including Merchant Mariners and the Director of 
Compensation and Pension Service of the Veterans Benefits 
Administration, U.S. Department of Veterans Affairs, Mr. 
Bradley G. Mayes. See H.R. 23, the ``Belated Thank You to the 
Merchant Mariners of World War II Act of 2007,'' Serial No. 
110-12.

Full Committee Hearing--The Results of the President's Task Force on 
        Returning Global War on Terror Heroes

    On May 9, 2007, the full Committee held a hearing to 
examine the report of the President's Task Force on Returning 
Global War on Terror Heroes. President Bush created the 
Interagency Task Force on Returning Global War on Terror Heroes 
on March 6, 2007. The Task Force was given 45 days to review 
all government services upon which veterans and service members 
rely when they return home. The membership of this Task Force 
consisted of the Secretaries of Veterans Affairs, Defense, 
Labor, Health and Human Services, Housing and Urban 
Development, and Education, plus the Director of the Office of 
Management and Budget, the Administrator of the Small Business 
Administration, and the Director of the Office of Personnel 
Management.
    The Honorable R. James Nicholson, Secretary of the U.S. 
Department of Veterans Affairs, accompanied by Honorable 
Patrick W. Dunne, RADM (Ret.), Assistant Secretary for Policy, 
Planning and Preparedness, provided testimony. See The Results 
of the President's Task Force on Returning Global War on Terror 
Heroes, Serial No. 110-22.

Full Committee Meeting--PTSD Health Care Symposium

    On May 16, 2007, the full Committee held a symposium on 
mental health care. The purpose of the meeting was to get 
different perspectives on the provision of mental health care, 
delivery methodologies of care for post-traumatic stress 
disorder, and recommendations of possible solutions.
    Members of the Committee and the following provided 
valuable insight: Robert L. Bray, Ph.D., LCSW, CTS, TFTdx, 
Thought Field Therapy Center of San Diego; Linda Rosenberg, 
President and CEO, National Council for Community Behavioral 
Healthcare; James Henry Scully, Jr., M.D., Medical Director, 
American Psychiatric Association; Saul Rosenberg, Ph.D., 
Clinical & Forensic Psychology; Beth Hudnall Stamm, Ph.D., 
AABC, Director of Telehealth and Principal Investigator, 
Institute of Rural Health, Idaho State University; John Melia, 
Executive Director and Founder, Wounded Warriors Project; and, 
Sally Satel, M.D., American Enterprise Institute.

Full Committee Meeting--VA Disability Claims Roundtable: Looking for a 
        Solution

    On May 23, 2007, the full Committee held a U.S. Department 
of Veterans Affairs Disability Claims Roundtable to discuss 
various ideas to reduce the claims backlog and improve the 
current process.
    The following joined the Members of the Committee to find 
new and unique ways of looking at the claims backlog: the U.S. 
Department of Veterans Affairs; U.S. Government Accountability 
Office; Congressional Research Service; American Federation of 
Government Employees; National Veterans Legal Services Program; 
Iraq & Afghanistan Veterans of America; National Association of 
County Veterans Service Officers; Paralyzed Veterans of 
America; John F. Kennedy School of Government; Veterans 
Assistance Program; Vietnam Veterans of America; Commission on 
the Future for America's Veterans; and, Disabled American 
Veterans.

Full Committee Joint House and Senate Meeting on Issues Facing Veterans 
        in Rural Areas of the Appalachia, Dover, Ohio

    On May 29, 2007, the full Committee held a meeting in New 
Philadelphia, Ohio, with the Senate Committee on Veterans' 
Affairs to discuss issues facing rural veterans. Researchers 
have studied the rural health care experience, including a 
number of articles that looked at VA rural health care. Three 
studies have found that veterans living in rural areas tend to 
be slightly older, and more likely to qualify in priority group 
5 which are non-service connected, zero percent service 
connected, and low income. These same veterans were also less 
likely to be employed. The studies agree that rural veterans 
had slightly more physical health problems but fewer mental 
health conditions--as compared to suburban and urban veterans.
    Local veterans service organizations; Harrison Community 
Hospital; and, the U.S. Department of Veterans Affairs 
presented testimony. See Issues Facing Veterans in Rural Areas 
of the Appalachia, Senate Hearing Print Serial No. 110-146.

Full Committee Hearing--Priority Group 8 Veterans

    On June 20, 2007, the full Committee held a hearing on 
Priority Group 8 veterans. The hearing focused on the impact of 
the decision on veterans and the U.S. Department of Veterans 
Affairs (VA) health care system to ban enrollment of Priority 
Group 8 veterans. The Committee also discussed whether the VA 
should continue this enrollment ban and the effect of 
potentially bringing Priority Group 8 veterans back into the VA 
health care system.
    Stephanie J. Woolhandler, M.D., M.P.H., of the Harvard 
Medical School; several veterans service organizations; and, 
the Honorable Michael J. Kussman, M.D., M.S., M.A.C.P., Under 
Secretary for Health of the U.S. Department of Veterans Affairs 
provided testimony. See Priority Group 8 Veterans, Serial No. 
110-29.

Full Committee Field Hearing--The Future of VA Health Care in South 
        Louisiana, New Orleans, Louisiana

    On July 9, 2007, the full Committee held a hearing to 
explore the challenges faced by VA and other health care 
facilities to provide high quality, safe health care to 
veterans and other citizens of New Orleans, Louisiana. On the 
morning of August 29, 2005, Hurricane Katrina made landfall 
near the Louisiana-Mississippi border, causing significant 
destruction to a 90,000 square mile area of the Southeastern 
United States. In the three-state area of Louisiana, 
Mississippi and Alabama, VA facilities affected included the 
Gulfport, Mississippi, and New Orleans medical centers; New 
Orleans regional benefits office; five community-based 
outpatient clinics along the Gulf Coast; and, the Biloxi VA 
National Cemetery. The hurricane had a major impact on the 
overall health care delivery system in Southeastern Louisiana 
and nearly two years later, the delivery of health care remains 
in flux as leaders struggle to come to some agreement on both 
the best location and the best partnerships to forge in order 
to provide timely, safe, high-quality health care to veterans 
and others.
    Interested stakeholders testified on the planning and 
future of VA health care in Southeastern Louisiana: the Mayor 
of the City of New Orleans; the Secretary of the Louisiana 
Department of Health and Hospitals; LSU Health Care Services 
Division, Acting Chief Medical Officer; Tulane University, 
Interim Senior Vice President for Health Sciences; veterans 
service organizations; and, the Deputy Director of VISN 16 of 
the U.S. Department of Veterans Affairs. See The Future of VA 
Health Care in South Louisiana, Serial No. 110-32.

Full Committee Meeting--Traumatic Brain Injury Symposium

    On July 18, 2007, the full Committee held a Traumatic Brain 
Injury (TBI) Symposium to explore new and innovative ideas in 
the treatment, access and delivery of care to those who suffer 
from a TBI. TBI is considered by many to be the signature 
injury of the war. Among veterans and service members from OEF/
OIF treated at Walter Reed for injuries of any type, 
approximately 65 percent have TBI as a primary or co-morbid 
diagnosis.
    The following joined the Members of the Committee to 
provide open discussion to the treatment, access and delivery 
of care: National Academy of Neuropsychology; Brain Injury 
Association of America; University of Pittsburgh School of 
Medicine, Department of Physical Medicine & Rehabilitation; 
Brain Matters, Inc.; Wounded Warriors Project; Northeast Center 
for Special Care; Weill Medical College of Cornell University; 
Bob Woodruff Family Fund for Traumatic Brain Injury; Division 
of Cerebrovascular Diseases, Columbia University Medical 
Center; and, U.S. Department of Veterans Affairs.

Full Committee Hearing--Post-Traumatic Stress Disorder and Personality 
        Disorders: Challenges for the U.S. Department of Veterans 
        Affairs

    On July 25, 2007, the full Committee held a hearing to 
examine how the U.S. Department of Veterans Affairs (VA) 
addresses the military diagnosis of Personality Disorder. In 
the last sixyears, the military discharged over 22,500 service 
members due to Personality Disorders. The Committee found that once a 
service member is diagnosed with a Personality Disorder, he or she has 
a much more difficult time receiving benefits and treatment at the VA.
    A number of witnesses provided testimony including the U.S. 
Department of Veterans Affairs, Brooke Army Medical Center, 
American Enterprise Institute, and the Medical University of 
South Carolina. See Post-Traumatic Stress Disorder and 
Personality Disorders: Challenges for the U.S. Department of 
Veterans Affairs, Serial No. 110-37.

Site Visit to San Antonio, Del Rio, Laredo, Roma, Donna, Brownsville, 
        and South Padre Island, Texas

    From August 3-7, 2007, majority staff toured the burn unit, 
the Warrior and Family Support Center at Brooke Army Medical 
Center, and visited the Center for the Intrepid. In addition, 
staff met with local officials and veterans groups, such as 
Webb County Veterans, Zapata County & Starr County Veterans, 
and Rio Grande Valley Veterans regarding health care 
accessibility.
    In particular, legislation was discussed regarding whether 
the needs of veterans for acute inpatient hospital care in 24 
counties comprising Far South Texas shall be met through: (1) a 
public-private venture to provide such services and long-term 
care to veterans in an existing facility in Far South Texas; 
(2) a project for construction of a new full-service, 50-bed 
hospital with a 125-bed nursing home in Far South Texas; or, 
(3) a sharing agreement with a military treatment facility in 
Far South Texas. These recommendations were eventually drafted 
into H.R. 538, the South Texas Veterans Access to Care Act of 
2007, introduced by the Honorable Solomon P. Ortiz.

Disabled American Veterans Convention--New Orleans, Louisiana

    From August 12-14, 2007, majority and minority staff spoke 
at the ``Service & Legislative Seminar'' of the Disabled 
American Veterans Convention to discuss the legislative 
priorities of the Committee on Veterans' Affairs.

Site Visit to New Orleans, Louisiana

    On August 15, 2007, minority staff toured the old New 
Orleans U.S. Department of Veterans Affairs (VA) Medical Center 
and temporary outpatient clinic that VA operates at that 
location. In addition, staff also toured the proposed downtown 
New Orleans site that the city has offered to the VA as a 
replacement site for the hospital, as well as an alternate site 
in Jefferson Parish. VA officials stated that the VA will 
continue to lease space in various locations around New Orleans 
to provide outpatient services until at least 2012, when the 
new hospital is projected to be operational.

The American Legion Convention--Reno, Nevada

    From August 25-26, 2007, majority and minority staff spoke 
at the ``Legislation & Rules'' segment at The American Legion 
Convention to discuss the legislative priorities of the 
Committee on Veterans' Affairs.

Full Committee CODEL to Kuwait, Iraq, Afghanistan, Pakistan, and 
        Germany

    Chairman Bob Filner led a Congressional delegation to visit 
the combat theaters of operation to observe the medical 
evacuation routes of wounded service members from August 20 to 
August 26, 2007. Accompanying Chairman Filner were Subcommittee 
on Economic Opportunity Ranking Member, John Boozman; Chief of 
Staff of the Committee, Tony Buckles; the Secretary of the U.S. 
Department of Veterans Affairs, The Honorable R. James 
Nicholson; and, Chief of Staff to the Secretary of the U.S. 
Department of Veterans Affairs, Thomas Bowman.
    The purpose of the delegation was to obtain a 
familiarization with the current situation in both areas of 
conflict--Iraq and Afghanistan--with particular interest in the 
casualty evacuation and processing methods from injury to 
return to the United States. Briefings were provided on the 
transition of medical records between medical facilities; 
treatment of Post-Traumatic Stress Disorder (PTSD); Traumatic 
Brain Injuries (TBI); and, initiatives to address preparation 
of personnel returning to the United States from a combat zone.
    The delegation gathered several findings. Medical treatment 
of our troops is setting the standard for trauma medicine 
throughout the world. In addition, the management and sharing 
of medical records has advanced significantly with the 
electronic sharing of medical records between commands and 
agencies progressing at a rapid pace. Moreover, PTSD and TBI 
both are being vested with command emphasis in stressing the 
need for an understanding, identification, and treatment of 
these two injuries in theater and at the home station.
    It was also found that civil considerations focus on the 
absence of adequate success on the part of the civil 
authorities and government agencies to make political progress 
at the national level in Iraq. Moreover, Department of Defense 
personnel are being asked to perform numerous tasks normally 
not associated with war fighting such as roles that exist for a 
wide range of ``other government agencies''--in Iraq and 
Afghanistan--to assist in the nation building aspects of 
bringing stability to both regions. Lastly, specific attention 
was drawn to the threat being generated in a ``cyber war'' 
being waged by terrorist organizations throughout the world and 
how resources should be allocated to engage and defeat this new 
front in the war on terror.

Full Committee Hearing--State of the U.S. Department of Veterans 
        Affairs

    On September 18, 2007, the full Committee held a hearing to 
appraise the current state of the U.S. Department of Veterans 
Affairs (VA). The Secretary provided testimony on the programs 
within the VA that address the issues facing today's veterans, 
including the Advisory Committee on Operation Enduring Freedom 
and Operation Iraqi Freedom Veterans, VET Centers, Mental 
Health Initiatives and the transformation of the Information 
Technology structure. The Secretary also addressed the 
challenges at the VA, including the backlog of disability and 
pension claims. The issue of health care delivery was also 
discussed during the hearing to include the need for VA to rise 
to the challenge of addressing access to care issues, 
especially in the areas of Traumatic Brain Injury, Post-
traumatic Stress Disorder, and specialized services.
    The Honorable R. James Nicholson, Secretary of the U.S. 
Department of Veterans Affairs, and The Honorable Michael J. 
Kussman, M.D., M.S., M.A.C.P., Under Secretary for Health; The 
Honorable Daniel L. Cooper, RADM (Ret.), Under Secretary for 
Benefits; The Honorable William F. Tuerk, Under Secretary for 
Memorial Affairs; Paul J. Hutter, Acting General Counsel; and, 
Robert J. Henke, Assistant Secretary for Management provided 
testimony to the Committee. See State of the U.S. Department of 
Veterans Affairs, Serial No. 110-42.

Full Committee Hearing--Findings of the President's Commission on Care 
        for America's Returning Wounded Warriors

    On September 19, 2007, the full Committee held a hearing to 
address the findings and recommendations of the President's 
Commission on Care for America's Returning WoundedWarriors. The 
Commission was established in March 2007 and was charged with the task 
of examining the effectiveness of returning wounded service members' 
transition from deployment in support of the Global War on Terror to 
returning to productive military service or civilian society, and 
recommend needed improvements. The Commission issued its final report 
in July 2007 and offered six recommendations to improve and modernize 
the structure of veterans' benefits programs.
    The Honorable Donna E. Shalala and The Honorable Bob Dole 
served as co-chairs of the Commission and appeared before the 
Committee to provide further detail about their research and 
findings. See Findings of the President's Commission on Care 
for America's Returning Wounded Warriors, Serial No. 110-43.

Full Committee Hearing--The U.S. Department of Veterans Affairs 
        Information Technology Reorganization: How Far Has VA Come?

    On September 26, 2007, the full Committee held a hearing to 
explore the progress of the U.S. Department of Veterans Affairs 
in its efforts to be the ``gold standard'' of information 
security among federal agencies and in centralizing its IT 
efforts. In October 2005, VA began a major information 
technology transformation and consolidation in the realm of 
information privacy and security. A 2006 security breach 
focused the attention of veterans and Congress when a laptop 
containing personal data of millions of veterans was lost. In 
December 2006, Congress directed VA to implement a centralized 
IT security program, provide credit monitoring to veterans 
whose private information was disclosed and provide Congress 
with immediate reports of any significant disclosure of 
personal information. The realignment program is predicted to 
be completed by July 2008.
    Witnesses from the U.S. Government Accountability Office 
and the U.S. Department of Veterans Affairs provided testimony 
to the Committee. See The U.S. Department of Veterans Affairs 
Information Technology Reorganization: How Far Has VA Come?, 
Serial No. 110-47.

Full Committee Hearing--Funding the U.S. Department of Veterans Affairs 
        of the Future

    On October 3, 2007, the full Committee held a hearing to 
examine alternative options to the current funding process for 
veterans' health care at the U.S. Department of Veterans 
Affairs (VA). Currently there are nearly 25 million veterans in 
the United States. The VA health care system has an enrolled 
veteran population of nearly 8 million and expects to treat 5.7 
million in the current year. In 2008, the number of veterans 
receiving treatment is expected to rise to 5.8 million, and 
will include an estimated 263,000 veterans of Operations 
Enduring Freedom and Iraqi Freedom (OEF/OIF). Many veterans 
service organizations have supported mandatory funding for VA 
health care, and have in the past year proposed advanced 
appropriations for VA health care.
    The Partnership for Veterans Health Care Budget Reform, The 
Brookings Institution, the Center on Budget and Policy 
Priorities, and the U.S. Department of Veterans Affairs 
provided testimony on the funding process for the VA. See 
Funding the U.S. Department of Veterans Affairs of the Future, 
Serial No. 110-49.

Full Committee Hearing--Findings of the Veterans' Disability Benefits 
        Commission

    On October 10, 2007, the full Committee held a hearing to 
review the findings of the Veterans' Disability Benefits 
Commission. The Commission was established in the National 
Defense Authorization Act of 2004 out of concern for a variety 
of issues pertinent to disabled veterans, disabled service 
members, their survivors, and their families. The Commission is 
comprised of 13 members, 12 of whom are veterans and nine of 
whom are combat veterans. The Commission convened more than 50 
public business sessions with interested stakeholders that 
included receipt of public comments, statements and testimony. 
The final report was released on October 3, 2007, and is a 
culmination of work performed by the Members of the Commission 
and its staff, advisors and experts with analytical support 
from the Institute of Medicine and the Center for Naval 
Analysis Corporation. The Commission issued 114 recommendations 
for updating and improving the system of providing benefits and 
services to our nation's veterans.
    The Chairman of the Veterans' Disability Benefits 
Commission, James Terry Scott, LTG, USA (Ret.) testified before 
the Committee. See Findings of the Veterans Disability Benefits 
Commission, Serial No. 110-52.

Full Committee Hearing--Long-Term Costs of Current Conflicts

    On October 17, 2007, the full Committee held a hearing to 
examine the long-term costs of the current conflicts in Iraq 
and Afghanistan. The hearing focused on how the U.S. Department 
of Veterans Affairs (VA) is addressing and preparing for the 
added costs of caring for these veterans, especially in the 
area of medical care for post-traumatic stress disorder and 
traumatic brain injuries. The Committee also focused on the 
ability of the VA to treat these veterans in the coming years 
while not forgetting the needs of veterans from previous 
conflicts.
    Witnesses from the U.S. Department of Veterans Affairs, the 
Congressional Research Service, and the Congressional Budget 
Office provided testimony before the Committee. See Long-Term 
Costs of Current Conflicts, Serial No. 110-54.

American Ex-Prisoners of War Conference--Springfield, Illinois

    From October 18-19, 2007, minority staff spoke at the 
``Legislative Outlook Seminar'' of the American Ex-Prisoners of 
War Conference to discuss the legislative priorities of the 
Committee on Veterans' Affairs.

Full Committee Hearing--Stopping Suicides: Mental Health Challenges 
        Within the U.S. Department of Veterans Affairs

    On December 12, 2007, the full Committee held a hearing to 
examine mental health care provided by the U.S. Department of 
Veterans Affairs (VA). The hearing focused on how best the VA 
should address the mental health care needs of returning active 
duty forces, including the National Guard and Reserves. There 
are approximately 25 million veterans in the United States and 
5 million veterans currently receive health care through the 
Veterans Health Administration (VHA). VHA estimates that there 
are approximately 1,000 suicides per year among veterans 
receiving care through VHA and as many as 5,000 suicides per 
year among all living veterans. VA has reported that of the 
263,909 separated OEF/OIF veterans who have obtained VA health 
care since FY 2002, 38 percent have received a diagnosis of a 
possible mental disorder. Of that population, 48 percent have a 
possible diagnosis of PTSD.
    The Committee heard testimony from Mike and Kim Bowman; two 
authors of books dealing with post-traumatic stress disorder 
and suicide; veterans service organizations; Office of the 
Inspector General of the U.S. Department of Veterans Affairs; 
and, the U.S. Department of Veterans Affairs. See Stopping 
Suicides: Mental Health Challenges Within the U.S. Department 
of Veterans Affairs, Serial No. 110-61.

Second Session

Full Committee Hearing--U.S. Department of Veterans Affairs Budget 
        Request for Fiscal Year 2009

    On February 7, 2008, the full Committee held a hearing on 
the proposed VA budget for FY 2008. The VA requested an 
increase for VA Medical Care of $2 billion, for a total of 
$42.2 billion, including collections. The Independent Budget 
recommended an additional $1.6 billion.
    The Honorable James B. Peake, M.D., Secretary of the U.S. 
Department of Veterans Affairs, was accompanied by senior 
officials of the Department for his testimony to the Committee 
in support of the President's proposed budget. Also, 
representatives of major veterans service organizations 
presented their views on the proposed budget. Finally, 
representatives of the Independent Budget presented their 
proposal for the FY 2008 veterans' budget. See U.S. Department 
of Veterans Affairs Budget Request for fiscal Year 2009, Serial 
No. 110-67.

Full Committee Hearing--Ending Homelessness for our Nation's Veterans

    On April 9, 2008, the full Committee held a hearing to 
examine the effectiveness of the U.S. Department of Veterans 
Affairs homeless programs. Research tells us that veterans are 
over represented in the homeless population. VA operates a wide 
variety of homeless veterans programs designed to provide 
outreach, supportive services, health care as well as 
counseling and treatment for mental health and substance use 
disorders. They rely heavily on their partnerships with the 
community and faith based organizations to provide these 
services. The hearing focused on the need to improve direct 
service programs designed to help veterans with self-
sufficiency and prevention programs that identify vulnerable 
veterans and service members.
    Witnesses from veterans service organizations, the 
Congressional Research Service, several homeless outreach 
providers, and the U.S. Department of Veterans Affairs provided 
testimony. See Ending Homelessness for our Nation's Veterans, 
Serial No. 110-80.

Full Committee Hearing--The Truth About Veterans' Suicides

    On May 6, 2008, the full Committee held a hearing to learn 
the truth about veterans' suicides in an attempt to get a 
better idea of the scope of the problem and what the VA is 
doing to address the problem.
    The U.S. Department of Veterans Affairs; Interim Head and 
Associate Professor of Biostatistics,Department of Epidemiology 
and Biostatistics,University of Georgia; Distinguished 
Professor Emeritus, Past Director of Suicide Center, Adjunct 
Professor of Psychiatry, and Adjunct Professor of Family 
Medicine, University of South Carolina, School of Medicine, 
Columbia, South Carolina; Professor and Chair of Texas Tech 
University; and, the Office of the Inspector General of the 
U.S. Department of Veterans Affairs, provided testimony. See 
The Truth about Veterans' Suicides, Serial No. 110-86.

Full Committee Hearing--Implementing the Wounded Warrior Provisions of 
        the National Defense Authorization Act for Fiscal Year 2008

    On June 11, 2008, the full Committee held a hearing to 
examine the progress that has been made in implementing the 
wounded warrior provisions in the National Defense 
Authorization Act of 2008. The hearing also explored barriers 
to implementation and analyzed what additional actions need to 
be taken by the U.S. Department of Defense and the U.S. 
Department of Veterans Affairs to enhance the care given to 
wounded service members and veterans.
    Witnesses from the RAND Corporation, the U.S. Department of 
Veterans Affairs, and the U.S. Department of Defense, provided 
testimony before the Committee. See Implementing the Wounded 
Warrior Provisions of the National Defense Authorization Act 
for Fiscal Year 2008, Serial No. 110-91.

National Association of County Veterans Service Officers--Charleston, 
        South Carolina

    From June 19-20, 2008, minority staff spoke at the 
``Legislative Panel'' to address issues facing our nation's 
veterans and their families, as well as to provide an overview 
of legislative issues for the 110th Congress.

Full Committee Hearing--Why Does the VA Continue to Give a Suicide-
        Inducing Drug to Veterans with PTSD?

    On July 9, 2008, the full Committee conducted an oversight 
hearing in response to recent events concerning a smoking 
cessation study at the U.S. Department of Veterans Affairs 
(VA). The hearing focused on the risks to veterans enrolled in 
the study and the failure to properly alert study participants 
of the latest relevant safety information about pharmaceutical 
drugs used in ongoing research.
    Witnesses from the U.S. Department of Veterans Affairs, the 
Food and Drug Administration, Office of the Inspector General 
of the U.S. Department of Veterans Affairs, Pfizer Inc., among 
other witnesses, delivered testimony before the Committee. See 
Why Does the VA Continue to Give a Suicide-Inducing Drug to 
Veterans with PTSD?, Serial No. 110-96.

Full Committee Meeting--Commission on the Future for America's Veterans

    On July 30, 2008, the full Committee held a closed meeting 
with the Commission on the Future for America's Veterans. The 
purpose of the roundtable discussion was to allow the members 
of the Commission on the Future for America's Veterans to 
present their findings and recommendations.
    Members of the Committee on Veterans' Affairs and members 
of the Commission participated in the roundtable discussion.

Disabled American Veterans Convention--Las Vegas, Nevada

    From August 9-11, 2008, majority and minority staff spoke 
at the ``Service & Legislative Seminar'' of the Disabled 
American Veterans Convention to discuss the legislative 
priorities of the Committee on Veterans' Affairs.

Site Visit to Las Vegas, Nevada

    On August 12, 2008, minority staff conducted a site visit 
to the U.S. Department of Veterans Affairs (VA) construction 
site for the future VA Health Care complex in North Las Vegas. 
The tour was led by the Honorable Shelley Berkley and the 
Honorable Jon Porter with the Secretary of the VA, The 
Honorable James B. Peake, M.D., also in attendance. The future 
937,000 square foot facility, which is slated to open in 2011, 
will serve southern Nevada's 250,000 veterans.

Full Committee Meeting--CRISIS: The VA Shreds Veterans' Confidence

    On November 19, 2008, the full Committee held a roundtable 
to discuss the recent reports of documents being shredded at VA 
regional offices.
    The following joined the Members of the Committee to 
provide open discussion on the possible solutions to the 
problem of shredding documents: veterans service organizations; 
the U.S. Department of Veterans Affairs; American Federation of 
Government Employees; National Veterans Legal Services Program; 
and the National Organization of Veterans Advocates, Inc.

 ACTIVITIES OF THE SUBCOMMITTEE ON DISABILITY ASSISTANCE AND MEMORIAL 
                                AFFAIRS


                         LEGISLATIVE ACTIVITIES

First Session

Subcommittee Markup of H.R. 1284 and H.R. 797

    On March 13, 2007, the Subcommittee met and marked up H.R. 
1284, the Veterans' Compensation Cost-of-Living Adjustment Act 
of 2007, introduced by the Honorable John J. Hall on March 1, 
2007, and H.R. 797, the Blinded Veterans Paired Organ Act of 
2007, introduced by the Honorable Tammy Baldwin on February 5, 
2007. Both bills were forwarded to the full Committee by voice 
vote.

Subcommittee Legislative Hearing--H.R. 67, H.R. 1435, H.R. 1444 and 
        H.R. 1490

    On April 17, 2007, the Subcommittee conducted a legislative 
hearing on H.R. 67, the Veterans Outreach Improvement Act of 
2007, introduced by the Honorable Mike McIntyre on January 4, 
2007; H.R. 1435, the Department of Veterans Affairs Claims 
Backlog Reduction Act of 2007, introduced by the Honorable Joe 
Baca on March 9, 2007; H.R. 1444, the Interim Benefit Payments 
for Certain Remanded Claims, introduced by the Honorable John 
J. Hall on March 9, 2007; and, H.R. 1490, the Service 
Connection Presumption for Certain Claims, introduced by the 
Honorable Joe Donnelly on March 13, 2007.
    The Subcommittee heard testimony from Members of Congress 
on their respective bills; representatives of the veterans' 
service field; veterans' service organizations; North Carolina 
Central University School of Law; National Organization of 
Veterans Advocates; and, the U.S. Department of Veterans 
Affairs. See Legislative Hearing on H.R. 67, H.R. 1435, H.R. 
1444 and H.R. 1490, Serial No. 110-11.

Subcommittee Markup of H.R. 1660

    On April 24, 2007, the Subcommittee met and marked up H.R. 
1660, to direct the Secretary of Veterans Affairs to establish 
a national cemetery for veterans in the southern Colorado 
region, introduced by the Honorable John T. Salazar. H.R. 1660 
was forwarded to the full Committee by unanimous consent.

Subcommittee Markup of H.R. 67

    On May 8, 2007, the Subcommittee met and marked up H.R. 67, 
the Veterans Outreach Improvement Act of 2007, introduced by 
the Honorable Mike McIntyre. This bill would require the U.S. 
Department of Veterans Affairs to partner with state and local 
governments, through grant opportunities, to reach out to 
veterans and their families to ensure receipt of benefits for 
which they are eligible and assist them in completing their 
benefit claims. H.R. 67 was forwarded to the full Committee by 
unanimous consent.

Subcommittee Legislative Hearing--H.R. 156, H.R. 585 and H.R. 704

    On June 19, 2007, the Subcommittee held a legislative 
hearing to consider three bills: H.R. 156, which would change 
the date of eligibility for Disability and Indemnity 
Compensation (DIC) payments to survivors of former Prisoners of 
War (POWs) to include those who died before September 30, 1999, 
introduced by the Honorable Tim Holden; H.R. 585, which would 
expand the Traumatic Servicemembers' Group Life Insurance 
(TSGLI) to provide retroactive payments to all qualifying 
service members who served since October 7, 2001, regardless of 
location, introduced by the Honorable Stephanie Herseth 
Sandlin; and, H.R. 704, which would reduce from 57 to 55 the 
age after which the remarriage of the surviving spouse of a 
deceased veteran shall not result in termination of DIC 
payments otherwise payable to that spouse, introduced by the 
Honorable Gus M. Bilirakis.
    The Subcommittee heard testimony from The Honorable Tim 
Holden; the U.S. Department of Veterans Affairs; several 
veterans' service organizations; Wounded Warrior Project; and, 
Iraq and Afghanistan Veterans of America. See Legislative 
Hearing on H.R. 156, H.R. 585 and H.R. 704, Serial No. 110-28.

Subcommittee Legislative Hearing--H.R. 674, H.R 1273, H.R. 1900, H.R. 
        1901, H.R. 2346, H.R. 2696, and H.R. 2697

    On July 31, 2007, the Subcommittee held a legislative 
hearing on the following bills: H.R. 674, which would repeal 
the sunset provisions in current law eliminating the VA 
Advisory Committee on Minority Veterans, introduced by the 
Honorable Luis Gutierrez; H.R. 1273, which would extend 
eligibility for a $300 plot allowances to certain populations 
of veterans buried in private cemeteries, introduced by the 
Honorable Shelley Berkley; H.R. 1900 and 1901, which would 
extend eligibility for low-income pension benefits to veterans 
who received an Armed Forces Expeditionary Medal or who served 
during specified time periods, respectively, both introduced by 
the Honorable Nick Rahall; H.R. 2346, which would direct the 
Department of Veterans Affairs to establish a process to 
determine whether a geographic area is sufficiently served by 
the veterans' cemeteries located there, introduced by the 
Honorable Vito Fossella; H.R. 2696, which would increase burial 
benefits and authorize additional grants to be awarded for 
state cemeteries, introduced by the Honorable Doug Lamborn; 
and, H.R. 2697, which would extend eligibility for Veteran's 
Mortgage Life Insurance (VMLI) to members of the Armed Forces, 
introduced by the Honorable Doug Lamborn.
    The Subcommittee heard testimony from Members of Congress; 
veterans service organizations; International Cemetery, 
Cremation and Funeral Association; and, the U.S. Department of 
Veterans Affairs. See Legislative Hearing on H.R. 674, H.R 
1273, H.R. 1900, H.R. 1901, H.R. 2346, H.R. 2696, and H.R. 
2697, Serial No. 110-40.

Subcommittee Legislative Hearing--H.R. 1137, H.R. 3047, H.R. 3249, H.R. 
        3286, H.R. 3415, H.R. 3954, and H.R. 4084

    On November 8, 2007, the Subcommittee conducted a 
legislative hearing on H.R. 1137, which would increase the 
Medal of Honor special pension, introduced by the Honorable 
Henry Brown on February 16, 2007; H.R. 3047, The Veterans 
Claims Processing Innovation Act of 2007, introduced by the 
Honorable Doug Lamborn on July 16, 2007; H.R. 3249, The 
Veterans Burial Benefits Improvement Act of 2007, introduced by 
the Honorable Shelley Berkley on July 31, 2007; H.R. 3286, 
which would alter the time period for which a veteran must be 
rated totally disabled to receive certain death benefits, 
introduced by the Honorable Bob Filner on August 1, 2007; H.R. 
3415, which would authorize domestic memorial markers for 
individuals buried in American Battle Monument Commission 
cemeteries, introduced by the Honorable James Langevin on 
August 3, 2007; H.R. 3954, Providing Military Honors for our 
Nation's Heroes Act, also introduced by the Honorable Bob 
Filner on October 24, 2007; and H.R. 4084, the VeteransQuality 
of Life Study Act of 2007, introduced by the Honorable John J. Hall on 
November 6, 2007.
    The Subcommittee heard testimony from veterans service 
organizations and the U.S. Department of Veterans Affairs. See 
Legislative Hearing on H.R. 1137, H.R. 3047, H.R. 3249, H.R. 
3286, H.R. 3415, H.R. 3954, and H.R. 4084, Serial No. 110-60.

Second Session

Subcommittee Markup of H.R. 5892

    On Thursday April 24, 2008, the Subcommittee met and marked 
up H.R. 5892, introduced by the Honorable John J. Hall on April 
24, 2008. A bill to comprehensively modernize the Veterans 
Benefits Administration's (VBA) system by which it adjudicates 
claims for service-connected disability compensation submitted 
by disabled veterans or their survivors. H.R. 5892 was 
forwarded to the full Committee by voice vote.

Subcommittee Legislative Hearing--H.R. 1197, H.R. 3008, H.R. 3795, H.R. 
        4274, H.R, 5155, H.R. 5448, H.R. 5454, H.R. 5709, H.R. 5954, 
        H.R. 5985, and H.R. 6032

    On June 12, 2008, the Subcommittee held a legislative 
hearing on H.R. 1197, Prisoner of War Benefits Act of 2007, 
introduced by the Honorable Gus M. Bilirakis; H.R. 3008, Rural 
Veterans Services Outreach and Training Act, introduced by the 
Honorable David Wu; H.R. 3795, You Were There, You Get Care Act 
of 2007, introduced by the Honorable Bob Filner; H.R. 4274, 
Gold Star Parents Annuity Act of 2007, introduced by the 
Honorable James T. Walsh; H.R. 5155, Combat Veterans Debt 
Elimination Act of 2008, introduced by the Honorable Carol 
Shea-Porter; H.R. 5448, Full Faith in Veterans Act of 2008, 
introduced by the Honorable Thomas H. Allen; H.R. 5454, to 
establish a presumption of service connection of amyotrophic 
lateral sclerosis (ALS) for purposes of the laws administered 
by the Secretary of Veterans Affairs, introduced by the 
Honorable Henry E. Brown, Jr.; H.R. 5709, Veterans Disability 
Fairness Act, introduce by the Honorable Zachary T. Space; H.R. 
5954, to provide veterans for presumptions of service 
connection for purposes of benefits under laws administered by 
Secretary of Veterans Affairs for diseases associated with 
service in the U.S. Armed Forces and exposure to biological, 
chemical, or other toxic agents as part of Project 112, 
introduced by the Honorable Mike Thompson; H.R. 5985, 
Compensation for Combat Veterans Act, introduced by the 
Honorable Bruce L. Braley; and, H.R. 6032, to direct the 
Secretary of Veterans Affairs to provide wartime disability 
compensation for certain veterans with Parkinson's Disease, 
introduced by the Honorable Bob Filner. This hearing examined 
these bills which focused on establishing presumptions for 
service connected injuries.
    The Subcommittee heard testimony from Members of Congress 
on their respective bills; Institute of Medicine, National 
Academy of Sciences; Congressional Research Service; veterans' 
service organizations; a disabled veteran on behalf of The ALS 
Association; and, the U.S. Department of Veterans Affairs. See 
Legislative Hearing on H.R. 1197, H.R. 3008, H.R. 3795, H.R. 
4274, H.R, 5155, H.R. 5448, H.R. 5454, H.R. 5709, H.R. 5954, 
H.R. 5985 and H.R. 6032, Serial No. 110-92.

                          OVERSIGHT ACTIVITIES

First Session

Subcommittee Hearing--The Impact of Operation Iraqi Freedom/Operation 
        Enduring Freedom on the U.S. Department of Veterans Affairs 
        Claims Process

    On March 13, 2007, the Subcommittee held a hearing on the 
impact of Operation Iraqi Freedom/Operation Enduring Freedom 
(OIF/OEF) on the U.S. Department of Veterans Affairs (VA) 
Claims Process. The purpose of this hearing was to examine 
whether the VA benefits claims process is properly equipped to 
handle the influx of service members returning from OIF/OEF.
    The Subcommittee heard testimony from the U.S. Government 
Accountability Office; John F. Kennedy School of Government; 
Veterans for America; Iraq and Afghanistan Veterans of America; 
National Association of County Veterans Service Officers; 
VoteVets; and, the U.S. Department of Veterans Affairs. See The 
Impact of Operation Iraqi Freedom/Operation Enduring Freedom 
(OIF/OEF) on the U.S. Department of Veterans Affairs Claims 
Process, Serial No. 110-8.

Subcommittee Hearing--Helping Those Left Behind: Are We Doing Enough 
        for the Parents, Spouses and Children of Veterans?

    On April 24, 2007, the Subcommittee held a hearing 
addressing benefits for relatives of veterans and to explore 
whether the federal government is effectively and efficiently 
providing the families of veterans with the benefits earned 
through the service of their loved ones.
    In addition to the testimony provided by the Honorable Brad 
Ellsworth, who spoke on behalf of a caregiver of a child of a 
veteran, and the Honorable Tom Latham, the Subcommittee heard 
the experiences of several dependants currently affected by the 
veterans' benefits process. The Subcommittee also heard 
testimony from representatives from the Gold Star Wives of 
America; National Military Families Association; National 
Veterans Legal Services Program; and, the U.S. Department of 
Veterans Affairs. See Helping Those Left Behind: Are We Doing 
Enough for the Parents, Spouses and Children of Veterans?, 
Serial No. 110-16.

Subcommittee Hearing--Veterans Cemeteries: Honoring Those Who Served

    On May 8, 2007, the Subcommittee held a hearing to examine 
several issues relating to memorial benefits and veterans' 
cemeteries including policies for headstones and markers, 
funding issues, burial and plot allowances, and delays in 
internment due to high volume of demand.
    The Director of the National Park Service; the 
Superintendent of Arlington National Cemetery; the Executive 
Director of the American Battle Monuments Commission; AMVETS; 
National Funeral Directors Association; National Association of 
State Directors of Veterans Affairs; the U.S. Department of 
Veterans Affairs provided testimony. See Veterans Cemeteries: 
Honoring Those Who Served, Serial No. 110-19.

Subcommittee Hearing--The Challenges Facing the U.S. Court of Appeals 
        for Veterans Claims

    On May 22, 2007, the Subcommittee held an oversight hearing 
to examine the challenges and issues surrounding the U.S. Court 
of Appeals for Veterans Claims with a particular focus on a 
measure to decrease the backlog and increase efficiency to 
provide a swifter appeals process for veterans.
    The Subcommittee heard testimony from Chief Judge William 
P. Greene, Jr., U.S. Court of Appeals for Veterans Claims; Bart 
Stichman, Joint Executive Director of the National Veterans 
Legal Services; Robert Chisholm, Former President of the 
National Organization of Veterans' Advocates; Brian Lawrence, 
Assistant National Legislative Director of the Disabled 
American Veterans; and, The Honorable James P. Terry, Chairman, 
Board of Veterans' Appeals. See The Challenges Facing the U.S. 
Court of Appeals for Veterans Claims, Serial No. 110-24.

Subcommittee on Disability Assistance and Memorial Affairs and 
        Subcommittee on Health Joint Hearing--Issues Facing Women and 
        Minority Veterans

    On July 12, 2007, the Subcommittees conducted a joint 
hearing on issues facing women and minority veterans. This 
hearing addressed the centers within the VA intended to ensure 
that women and minority veterans encounter no disparities in 
treatment or access to benefits, health care and other 
services. The Subcommittees also examined if appropriate 
outreach exists to ensure the inclusion of women and minorities 
in VA programs.
    The Honorable Heather Wilson; Advisory Committee on Women 
Veterans; veterans' service organizations; and, interested 
stakeholders provided testimony. See Joint Hearing on Issues 
Facing Women and Minority Veterans, Serial No. 110-33.

Subcommittee Hearing--Board of Veterans' Appeals Adjudication Process 
        and the Appeals Management Center

    On September 25, 2007, the Subcommittee held a hearing on 
the adjudication process, policies and current backlog of the 
Board of Veterans' Appeals adjudication process and the Appeals 
Management Center. The purpose of this hearing was to examine 
these entities and assess whether the processes currently in 
place were helping reduce the veterans' claims backlog and 
improve the experience of veteran claimants.
    The Subcommittee heard testimony from veterans service 
organizations; National Veterans Legal Services Program; 
National Organization of Veterans Advocates; the U.S. 
Department of Veterans Affairs; and the Board of Veterans' 
Appeals. See Board of Veterans' Appeals Adjudication Process 
and the Appeals Management Center, Serial No. 110-46.

Subcommittee Field Hearing--Personal Costs of the U.S. Department of 
        Veterans Affairs Claims Backlog, New Windsor, New York

    On October 9, 2007, the Subcommittee held a hearing on the 
impact of the VA disability claims backlog, the impact of the 
extended wait times on the personal lives and financial well-
being of veterans, and to address the performance of the New 
York City regional office, which was behind the national 
average.
    This hearing focused on four local veterans and their 
experiences with filing a disability benefits claim with the 
VA: Alex Lazos, John Rowan on behalf of veteran Ted Wolf, Eddie 
Senior, and Eddie Ryan. The Subcommittee also heard testimony 
from the Orange County Veterans Agency; Vietnam Veterans of 
America; The American Legion; and, Michael Walcoff, Associate 
Deputy Under Secretary for Field Operations of the U.S. 
Department of Veterans Affairs. See Personal Cost of the U.S. 
Department of Veterans Affairs Claims Backlog, New Windsor, NY, 
Serial No. 110-51.

Site visit to St Petersburg, Florida

    From December 9-10, 2007, majority and minority staff 
attended the St. Petersburg Veterans Service Center Manager 
Training Conference (VSCM). The VSCM training is a bi-annual 
event attended by managers from each of the Veterans Benefits 
Administration service centers. The purpose of the training is 
to inform managers of new VA policies and practices, 
legislation, and court decisions. By attending this conference, 
staff members were able to gain valuable knowledge of efforts 
being made by the VA to better train their employees.

Site Visit to Baltimore, Maryland

    On December 11, 2007, the majority staff attended an 
informational briefing and tour with the Veterans Benefits 
Administration (VBA) Training Academy Director and several 
staff members to examine VA's standardized training regimen and 
practices. Staff also met with employees attending training as 
well as those employees providing training assistance and 
supervision. The visit provided greater insight on challenges 
and successes of the VBA's efforts to establish more structured 
and mandatory training requirements including, but not limited 
to, online training.

Site Visit to Baltimore, Maryland

    On December 18, 2007, majority staff traveled to Baltimore 
for an oversight visit at the U.S. Department of Veterans 
Affairs Regional Office (RO). The visit to the Baltimore RO 
gave staff the opportunity to review the claims processing in 
place within the Veterans Benefits Administration (VBA) and to 
see how those processes are operationalized in the field.
    The Baltimore RO operates all five of the VBA business 
lines (compensation and pension, vocational rehabilitation and 
employment, home loan, education, and insurance). Additionally, 
it has 140 FTE with about 100 in the Service Center, of those 
staff, there are 23 Rating Veterans Service Representatives 
with 11 still in training status. There is a rating inventory 
of 6,100 cases which is 1.5 percent of the national workload. 
There are approximately 1,000 new claims a month and 
approximately 800 claims ready to be rated; therefore, about 
200 will be brokered to another RO. Some claims have upward of 
30 issues. The Baltimore backlog is at 132 days. Approximately 
10 percent (100 cases) of their decisions are appeals with 50 
percent (50 cases) of those going to the Board and 20 percent 
(5-8 cases) are remanded. Overall the Baltimore RO seems to be 
doing fairly well. The staff is continuously trying to revamp 
and improve their claims processing system for a more efficient 
and effective way of processing claims.

Second Session

Site Visit to Philadelphia, Pennsylvania

    On January 25, 2008, majority and minority staff had the 
opportunity to visit the Philadelphia U.S. Department of 
Veterans Affairs Regional Office (RO). The visit gave staff the 
opportunity to review operations at the Insurance Center and 
tour the RO.
    In addition to Philadelphia, Pennsylvania has a RO in 
Pittsburgh. The Philadelphia RO services 40 of the eastern 
counties and seven counties in New Jersey with approximately 
7,300 pending claims to be rated. It operates all five of the 
Veterans Benefits Administration business lines (compensation 
and pension, vocational rehabilitation and employment, home 
loan, education, and insurance). In addition, the Pension 
Maintenance Center serves constituents residing in 21 eastern 
states of the United States, Puerto Rico, and all foreign 
countries with the exception of Central and South America. 
Overall the Philadelphia RO is trying to implement a system to 
better process claims in the most effective way.

Subcommittee Hearing--The Use of Artificial Intelligence to Improve the 
        VA's Claims Processing System

    On January 29, 2008, the Subcommittee held a hearing to 
examine the issues surrounding the use of artificial 
intelligence technology in hopes of improving the Department of 
Veterans Affairs (VA) claims processing system. For several 
years the VA has come under harsh scrutiny with the paper based 
and labor intensive way it processes claims. With the use of 
artificial intelligence, it could potentially reduce the 
800,000 pending claims backlog and the 183-day processing time.
    The Subcommittee heard testimony from many different people 
including veterans; the Wounded Warrior Project; Carnegie 
Mellon University; Vanderbilt University School of Medicine; 
QTC Medical Services, Inc.; Stratizon Corporation; Unum; the 
U.S. Department of Veterans Affairs; and, several veterans' 
service officers. See the Use of Artificial Intelligence to 
Improve VA's Claims Processing System, Serial No. 110-66.

Subcommittee Hearing--Examining the U.S. Department of Veterans Affairs 
        Claims Processing System

    On February 14, 2008, the Subcommittee held a hearing to 
examine the U.S. Department of Veterans Affairs (VA) claims 
processing system at VA's 57 regional offices (RO). The hearing 
looked at ways to handle the thousands of backlogged claims 
that are currently being processed by the RO. There are nearly 
650,000 claims that have not been processed. Additionally, the 
hearing served as a way to highlight the problems in the 
appeals process, beginning with the failure to develop and 
adjudicate original claims within the RO.
    The Subcommittee heard testimony from, among others, the 
CNA Corporation; Committee on Medical Evaluation of Veterans 
for Disability Benefits Board on Military and Veterans Health, 
Institute of Medicine; U.S. Government Accountability Office; 
National Veterans Legal Services Program; American Federation 
of Government Employees; veterans' service organizations; 
Wounded Warrior Project; the U.S. Department of Veterans 
Affairs; and, the John F. Kennedy School of Government, Harvard 
University. See Examining the U.S. Department of Veterans 
Affairs Claims Proceeding System, Serial No. 110-70.

Subcommittee Hearing--The U.S. Department of Veterans Affairs Schedule 
        for Rating Disabilities

    On February 26, 2008, the Subcommittee held a hearing to 
examine the changes needed to improve the disability rating 
system and to find ways to ensure that veterans are adequately 
compensated for their losses. Through studies done by the 
Veterans' Disability Benefits Commission, they found that the 
Rating Schedule is out-of-date in certain areas, does not 
always use the most up-to-date medical knowledge, and does not 
include certain factors when rating veterans.
    The Subcommittee heard testimony from the U.S. Department 
of Defense; the U.S. Department of Veterans Affairs; veterans' 
service organizations; Veterans' Disability Benefits 
Commission; Institute of Medicine (IOM) Committee on Medical 
Evaluation of Veterans for Disability Benefits; IOM Committee 
on Evaluation of the Presumptive Disability; Center for Health 
Research and Policy; American Academy of Disability Evaluating 
Physicians; NationalVeterans Legal Services Program; and, the 
IOM Committee on Mental Healthcare for Veterans and Military Personnel 
and Their Families. See the U.S. Department of Veterans Affairs Rating 
Disability, Serial No. 110-71.

Site Visit to Newark, New Jersey

    On March 27, 2008, majority and minority staff visited the 
Newark U.S. Department of Veterans Affairs Regional Office 
(RO). The visit gave staff the opportunity to review the claims 
processes in place within the Veterans Benefit Administration 
(VBA) and to see how those processes are carried out in the 
field.
    The Newark RO is a smaller office and operates all five of 
the VBA business lines (compensation and pension, vocational 
rehabilitation and employment, home loan, education, and 
insurance). The RO has 95 FTE with about 63 in the Veterans 
Service Center of those staff, there are about 29 Rating 
Veterans Service Representatives (RVSR), with about ten new 
employees in training status. Their rating inventory is 3,450 
cases, which is less than 1 percent of the national workload. 
There are approximately 500 new claims a month. Additionally, 
there are approximately 650 claims that are ready to rate; 
therefore, about 250 will be brokered to another RO. Their 
backlog is at 142 days, but that is down from 159 days last 
year. Their accuracy rating is at 83 percent below the 90 
percent target. Approximately 21 percent of their decisions are 
avoidable remands, which is a slight increase from last year's 
19.8 percent and their 17 percent target. Currently, there were 
three remands on station; 70-80 percent of those cases are sent 
to the Appeals Management Center. Overall the Newark RO is 
improving its overall claims processing system.

Subcommittee Hearing--Legislative Hearing on the Veterans Disability 
        Benefits Claims Modernization Act of 2008

    On April 10, 2008, the Subcommittee held a legislative 
hearing to comprehensively modernize the Veterans Benefits 
Administration's system by which it adjudicates claims for 
service-connected disability compensation submitted by disabled 
veterans or their survivors. The current backlog of disability 
claims is approximately 650,000 and VA expects to receive one 
million additional compensation and pension claims by the end 
of 2008. Currently, the average time it takes for VA to process 
a claim is 183 days, up from 177 days in 2006. The Subcommittee 
examined the growing backlogs at both the Court of Appeals for 
Veterans Claims and the Board of Veterans Appeals.
    The Subcommittee heard testimony from the U.S. Court of 
Appeals for Veterans Claims; veterans' service organizations; 
the National Veterans Legal Services Program; the Board of 
Veterans Appeals; and, the U.S. Department of Veterans Affairs. 
See Legislative Hearing on the Veterans Disability Benefits 
Claims Modernization Act of 2008, Serial No. 110-81.

Subcommittee Field Hearing--Is the VA Cemetery Construction Policy 
        Meeting the Needs of Today's Veterans and their Families?, 
        Colorado Springs, Colorado

    On May 2, 2008, the Subcommittee held a hearing on the 
policy of the U.S. Department of Veterans Affairs for 
constructing cemeteries. The hearing examined VA's current 
policy regarding the construction of new national cemeteries. 
VA has determined that new national cemeteries will be 
established in areas with an un-served veteran population 
threshold of 170,000 within a 75-mile service radius.
    The Subcommittee heard testimony from the Gold Star Wives 
in Colorado; an Iraq war widow; El Paso County National 
Cemetery Committee; El Paso County Board of Veterans; The 
American Legion Department of Colorado; Colorado stakeholders; 
and, the U.S. Department of Veterans Affairs. See the Is the VA 
Cemetery Construction Policy Meeting the Needs of Today's 
Veterans and their Families?, Serial No. 110-85.

Subcommittee Hearing--Examining the Effectiveness of the VBA Outreach 
        Efforts

    On May 22, 2008, the Subcommittee held a hearing to 
investigate the programs and strategic plan developed by the 
Veterans Benefits Administration to conduct outreach to 
veterans, families, and survivors to educate them on the 
Federal Benefits available to them and the application 
processes.
    The Subcommittee heard testimony from the National 
Association of State Directors of Veterans Affairs; National 
Association of County Veteran Service Officers; veterans' 
service organizations; the Ad Council; the U.S. Department of 
Veterans Affairs; and, the U.S. Department of Defense. See 
Examining the Effectiveness of the Veterans Benefits 
Administration Outreach Efforts, Serial No. 110-89.

Site visit to Seattle, Washington

    From August 13-15, 2008, majority and minority staff 
traveled to the Veterans Benefits Administration Leadership 
Conference in Seattle to attend informational sessions convened 
by the Veterans Benefits Administration (VBA) leadership. Staff 
was afforded the opportunity to hear from veterans assembled by 
VA, as well as leadership personnel from VBA field operations. 
Break-out sessions were conducted on recent studies pertaining 
to state variances of disability payments, the Veterans' 
Disability Benefits Commission and related Institute of 
Medicine Study findings, OIF/OEF priority processing needs, 
attorney representation, VA succession planning, and education, 
insurance and loan guaranty issues. The visit was productive as 
it allowed Committee staff to talk directly to VBA leadership 
and to receive insightful information on recently released and 
pending reports regarding improving the disability claims 
processing system.

Site Visit to Western Pacific

    From August 24-30, 2008, majority and minority staff 
attended a staff delegation site visit to the Western Pacific. 
The purpose of this trip was to assess how the relocation from 
Japan to Guam of approximately 8,000 Marines and sailors, 3,000 
soldiers and airman, along with 9,000 family members from 2010 
until 2014 could potentially affect the Veterans Benefits 
Administration's (VBA) claims processing workload and its need 
to realign its transition activities. A particular focus of the 
visit was on the VBA Transition Assistance program, the 
Disabled Transition Assistance Program, and the Benefits 
Delivery at Discharge program for the region, especially for 
Operation Enduring Freedom and Operation Iraqi Freedom 
veterans. The trip gave the staff the opportunity to talk to 
veterans, active duty military, and veterans' service 
organizations to see what type of potential impact this 
transition would have on the military.

Subcommittee Hearing--Examining the Effectiveness of the Veterans 
        Benefits Administration's Training, Performance Management and 
        Accountability

    On September 18, 2008, the Subcommittee held a hearing to 
investigate how well the VA trains its newly-hired Veterans 
Service Representatives and Rating Veterans Service 
Representatives. New employees are to follow a national 
standardized training curriculum at one of the 57 Regional 
Offices to which they are assigned. This hearing focused on how 
well these employees are being trained, what improvements need 
to be made to the training process, and how effective the 
training is after completion.
    The Subcommittee heard testimony from the U.S. Government 
Accountability Office; a Decision Review Officer, Cleveland 
Regional Office; National Veterans Legal Services Program; 
Human Resources Research Organization; U.S. Department of 
Veterans Affairs and, several veterans' service organizations. 
See Examining the Effectiveness of the Veterans Benefits 
Administration's Training, Performance Management and 
Accountability, Serial No. 110-105.

Site Visit to Winston-Salem, North Carolina

    On November 6, 2008, majority and minority staff had the 
opportunity to visit the Winston-Salem U.S. Department of 
Veterans Affairs Regional Office (RO) in North Carolina. The 
staff had the opportunity to review the Benefits Delivery at 
Discharge (BDD) program and paperless pilot project being 
conducted at the RO.
    The Winston-Salem RO operates all five of the VBA business 
lines (compensation and pension, vocational rehabilitation and 
employment, home loan, education, and insurance). There are 525 
FTE with 437 in the Service Center and of that number; there 
are 70 Rating Veterans Service Representatives (RVSR) with many 
in trainee status. There is a rating inventory of 20,022 cases 
and approximately 6,000 claims that are ready to rate; 
therefore, about 600 will be brokered to another RO since the 
station is having capacity issues and does not have enough 
RVSRs to adjudicate the ready to rate claims. (This is the 
highest amount of ready to rate claims in a RO visited by the 
Subcommittee to date). They do not broker the BDD claims and 
some of the newer claims have upward of 30 issues. They are 
making about 4,000 rating decisions a month. The overall 
accuracy rate for the RO is 88.8 percent--below its 90 percent 
target for FY 2008. The national accuracy target is 90 percent, 
however, their accuracy target is expected to increase as more 
FTE are trained. It takes the RO 197 days to complete a claim, 
the target is 174 days. Approximately 15 percent of their 
decisions are on appeal and 15 percent are remanded.
    The Winston-Salem RO is one of two centralized regional 
offices that are processing BDD claims from 23 other ROs that 
have multiple intake sites at military installations. (Salt 
Lake City, Utah, is the other BDD facility.) The BDD claims 
take the Winston-Salem RO an average of 86 days to complete 
processing in their paperless environment, known as Virtual VA. 
The target number of days to complete a BDD claim is still 60 
days. There were 2,192 pending claims at the time of the site 
visit, representing 20 percent of the RO workload. Appeals are 
being worked virtually as well.
    Overall, the Winston-Salem office seems to be doing well. 
With the paperless claims processing in place, it looks like 
this could be a good way to handle the backlog of claims.

Site Visit to Nashville, Tennessee

    On November 24, 2008, the majority and minority staff of 
the Disability Assistance and Memorial Affairs and Oversight 
and Investigations Subcommittees, visited the Nashville U.S. 
Department of Veterans Affairs Regional Office (RO) and the VA 
Quality Assurance Program. The visit was an opportunity for 
Committee staff to review the claims processing operations and 
to visit with VBA Quality Assurance Program leadership who 
administer the Systemic Technical Accuracy Review (STAR) and 
Compensation and Pension Exam Program (CPEP). STAR and CPEP are 
measurement tools used primarily to assess the quality and 
accuracy of disabilitybenefits claims and of medical 
examinations conducted by the VHA for the VBA Compensation and Pension 
Service, respectively.
    The RO visit was productive. Staff was able to meet with 
the RO Director as well as to meet with VSO and union 
representatives. Staff also was able to receive an extensive 
briefing on the expansion of the VBA quality assurance staff 
and types of claims. Subcommittee staff was encouraged by the 
level of productivity of the Quality Assurance (QA) staff, but 
was concerned that the number of full-time employees assigned 
to VA QA office was not consistent with funds appropriated. 
Staff was also encouraged that CPEP leadership, which is based 
in the Veterans Health Administration, was working with VBA 
staff as it was making changes to its review process as well as 
to ensure rating consistency and lessen disconnects between the 
VBA and the VHA as it pertains to disability examinations and 
forms.

Site Visit to Rome, Netherlands, Belgium, France, and England

    From December 14-23, 2008, majority and minority staff, 
along with Sidath Panangala from the Congressional Research 
Service, traveled on a staff delegation to conduct oversight of 
six American Battle Monuments Commission (ABMC) cemeteries 
where 124,909 U.S. war dead are interred. The Commission 
administers, operates, and maintains 24 permanent American 
burial grounds on foreign soil. CDR Glen Diehl, Navy LL 
provided staff escort. Specifically, the staff visited the 
Sicily-Rome, Margraten, Henri-Chapelle, Normandy and Cambridge 
Cemeteries from World War II, and the Pointe du Hoc Memorial 
and Brookwood Cemetery from World War I. A highlight of the 
trip involved meeting with citizens on Margraten, Netherlands 
who have implemented a long-standing, formalized and unique 
program for adopting the 8,302 gravesites of American WWII 
veterans (also includes British, Canadian and Mexican Allied 
Forces members) interred in the Margraten cemetery, the only 
ABMC site in the Netherlands region.
    The cemetery visits were very valuable and allowed staff to 
directly view and experience the only overseas Visitors' Center 
located at the Normandy Cemetery, to meet and talk with 
overseas staff and caretakers, and to gain a first-hand and 
practical understanding of the ABMC's interpretative program 
expansion plans and its integral relationship to its overall 
goals and mission. Additionally, the staff visited the Naval 
Hospital Naples in Italy and Landstuhl Regional Medical Center 
in Germany to examine the compensation and physical examination 
discharge processes. This portion of the trip was productive on 
many fronts as it allowed staff to witness the actual progress, 
as well as the many remaining hurdles to implementation of a 
single DoD/VA exam process for determining fitness for duty and 
degree of disability of servicemembers and related transition 
issues for which legislation might be needed.

         ACTIVITIES OF THE SUBCOMMITTEE ON ECONOMIC OPPORTUNITY


                         LEGISLATIVE ACTIVITIES

First Session

Subcommittee Legislative Hearing--H.R. 1750, H.R. 1824, H.R. 1598, H.R. 
        1315, H.R. 1240, H.R. 675, H.R. 513, H.R. 2259, H.R. 2475, H.R. 
        1632, H.R. 112, H.R. 2579 and H.R. 1370

    On June 21, 2007, the Subcommittee conducted a legislative 
hearing on H.R. 1750, to amend the Servicemembers Civil Relief 
Act to extend from 90 days to one year the period after release 
of a member of the Armed Forces from active duty during which 
the member is protected from mortgage foreclosure under that 
Act, introduced by the Honorable Albert Russell Wynn on March 
28, 2007; H.R. 1824, to amend title 38, United States Code, to 
expand the scope of programs of education for which accelerated 
payments of educational assistance under the Montgomery GI Bill 
may be used, and for other purposes, introduced by the 
Honorable Michael H. Michaud on April 26, 2007; H.R. 1598, the 
Servicemembers Credit Protection Act, introduced by the 
Honorable Steve Israel on April 13, 2007; H.R. 1315, to amend 
title 38, United States Code, to provide specially adaptive 
housing assistance to certain disabled members of the Armed 
Forces residing temporarily in housing owned by a family 
member, introduced by the Honorable Stephanie Herseth Sandlin 
on March 5, 2007; H.R. 1240, to direct the Secretary of 
Veterans Affairs to establish a scholarship program for 
students seeking a degree or certificate in the areas of visual 
impairment and orientation and mobility, introduced by the 
Honorable Sheila Jackson Lee on February 28, 2007; H.R. 675, 
Disabled Veterans Adaptive Housing Improvement Act, Introduced 
by the Honorable Stephanie Herseth Sandlin on January 24, 2007; 
H.R. 513, National Heroes Credit Protection Act, introduced by 
the Honorable Robert A. Brady on January 17, 2007; H.R. 2259, 
to ensure that members of the National Guard and Reserves are 
able to fully participate in the benefits delivery at discharge 
program administered jointly by the Secretary of Defense and 
the Secretary of Veterans Affairs to provide information and 
assistance on available benefits and other transition 
assistance to members of the Armed Forces who are separating 
from the Armed Forces, introduced by the Honorable Peter Welch 
on May 9, 2007; H.R. 2475, Veteran Home Equity Conversation 
Mortgage Act of 2007, introduced by the Honorable Michael H. 
Michaud on May 24, 2007; H.R. 1632, Improving Veterans' 
Reemployment Act of 2007, Introduced by the Honorable David G. 
Reichert on March 21, 2007; H.R. 112, G.I. Advanced Education 
in Science and Technology Act, introduced by the Honorable Jo 
Ann Davis on January 4, 2007; H.R. 2579, to amend title 38, 
United States Code, to authorize the use of funds in the 
Department of Veterans Affairs readjustment benefits accounts 
and funds appropriated for such purpose to provide funding for 
State approving agencies, introduced by the Honorable John 
Boozman on June 6, 2007; H.R. 1370, Disabled Veterans Sports 
and Special Events Promotion Act of 2007, introduced by the 
Honorable Steve Buyer on March 7, 2007.
    The Members of Congress testified on their respective 
bills. See Legislative Hearing on H.R. 1750, H.R. 1824, H.R. 
1598, H.R. 1315, H.R. 1240, H.R. 675, H.R. 513, H.R. 2259, H.R. 
2475, H.R. 1632, H.R. 112, and H.R. 1370, Serial No. 110-30.

Subcommittee Markup of H.R. 1315, H.R. 1750, H.R. 1240, and H.R. 1632

    On June 29, 2007, the Subcommittee met and marked up H.R. 
1315, Veterans' Benefits Improvement Act of 2007, introduced by 
the Honorable Stephanie Herseth Sandlin on March 5, 2007; H.R. 
1750, introduced by the Honorable Albert Russell Wynn on March 
28, 2007; H.R. 1240, Visions Impairment Specialist Training 
Act, introduced by the Honorable Sheila Jackson-Lee on February 
28, 2007; and H.R. 1632, Improving Veterans' Reemployment Act 
of 2007, introduced by the Honorable David G. Reichert on March 
21, 2007. H.R. 1750, H.R. 1240, and H.R.1632 were amended and 
favorably reported to the full Committee.

Subcommittee Markup of H.R. 513 and H.R. 3882

    On October 25, 2007, the Subcommittee met and marked up 
H.R. 513, The National Heroes Credit Protection Act, introduced 
by the Honorable Robert A. Brady on January 17, 2007, and H.R. 
3882, introduced by the Honorable Timothy J. Walz on October 
17, 2007. Both bills were favorably reported to the full 
Committee.

Second Session

Subcommittee Legislative Hearing--H.R. 4883, H.R. 4884, H.R. 4889, H.R. 
        4539, H.R. 3646, H.R. 5664, H.R. 3798, H.R. 3393, H.R. 3298, 
        H.R. 3467, H.R. 3889, H.R. 3681 and H.R. 5684

    On April 16, 2008, the Subcommittee conducted a legislative 
hearing on H.R. 4883, to amend the Servicemembers Civil Relief 
Act to provide for a limitation on the sale, foreclosure, or 
seizure of property owned by a service member during the one-
year period following the service member's period of military 
service, introduced by the Honorable Bob Filner on December 19, 
2007; H.R. 4884, Helping Our Veterans to Keep Their Homes Act 
of 2008, introduced by the Honorable Bob Filner on December 19, 
2007; H.R. 4889, The Guard and Reserves Are Fighting Too Act of 
2008, introduced the Honorable Bob Filner on December 19, 2007; 
H.R. 4539, Department of Veterans Affairs Loan Guaranty Cost 
Reduction Act of 2007, introduced by the Honorable Steve Buyer 
on December 13, 2007; H.R. 3646, to direct the Secretary of 
Veterans Affairs and the Secretary of Labor to conduct a joint 
study on the fields of employment for which the greatest need 
for employees exists in various geographic areas, introduced by 
the Honorable Cliff Stearns on September 24, 2007; H.R. 5664, 
To amend title 38, United States Code, to direct the Secretary 
of Veterans Affairs to update at least once every six years the 
plans and specifications for specially adapted housing 
furnished to veterans by the Secretary, introduced by the 
Honorable Ciro D. Rodriguez on March 31, 2008; H.R. 3798, 
National Guard Employment Protection Act of 2007, introduced by 
the Honorable Robin Hayes on October 10, 2007; H.R. 3393, 
Reservist Access to Justice Act of 2007, introduced by the 
Honorable Artur Davis on August 3, 2007; H.R. 3298, 21st 
Century Servicemembers Protection Act, Introduced by the 
Honorable Patrick J. Murphy on August 1, 2007; H.R. 3467, 
Second Chance for America's Veterans Act, Introduced by the 
Honorable John A. Yarmuth on August 4, 2007; H.R. 3889, to 
amend title 38, United States Code, to require the Secretary of 
Veterans Affairs to conduct a longitudinal study of the 
vocational rehabilitation programs administered by the 
Secretary, introduced by the Honorable John Boozman on October 
18, 2007; H.R. 3681, Veterans Benefits Awareness Act of 2008, 
introduced by the Honorable John Boozman on September 27, 2007; 
and H.R. 5684, Veterans Education Improvement Act of 2008, 
introduced by the Honorable Stephanie Herseth Sandlin on April 
2, 2008.
    Members of Congress testified on their respective bills and 
in addition, the following provided testimony before the 
Committee: veterans services organizations; U.S. Department of 
Labor; U.S. Department of Defense; and, the U.S. Department of 
Veterans Affairs. See Legislative Hearing on H.R. 4883, H.R. 
4884, H.R. 4889, H.R. 4539, H.R. 3646, H.R. 5664, H.R. 3798, 
H.R. 3393, H.R. 3298, H.R. 3467, H.R. 3889, H.R. 3681 and H.R. 
5684, Serial No. 110-83.

Subcommittee Markup of H.R. 5684, H.R. 4884, H.R. 4883, H.R. 4889, H.R. 
        3681, H.R. 3889, and H.R. 5664

    On April 23, 2008, the Subcommittee met and marked up H.R. 
5684, Veterans Education Improvement Act of 2008; H.R. 4884, 
Helping Our Veterans to Keep Their Homes Act of 2008; H.R. 
4883, to provide for a limitation on the sale, foreclosure, or 
seizure of property owned by a servicemember during the one-
year period following the servicemember's period of military 
service; H.R. 4889, The Guard and Reserves Are Fighting Too Act 
of 2008; H.R. 3681, Veterans Benefits Awareness Act of 2007; 
H.R. 3889, to require the Secretary of Veterans Affairs to 
conduct a longitudinal study of the vocational rehabilitation 
programs administered by the Secretary; and, H.R. 5664, to 
direct the Secretary of Veterans Affairs to update at least 
once every six years the plans and specifications for specially 
adapted housing furnished to veterans by the Secretary. All 
seven bills were reported favorably to the full Committee. H.R. 
5684, H.R. 4884, H.R. 4889, H.R. 3889, and H.R. 5664 were 
amended and favorably reported to the full Committee.

Subcommittee Legislative Hearing--H.R. 2721, H.R. 3786, H.R. 6070, H.R. 
        4255, H.R. 6221, H.R. 6224, H.R. 6225, H.R. 6272

    On June 19, 2008, Subcommittee held a hearing on H.R. 4255, 
United States Olympic Committee Paralympic Program Act of 2007, 
introduced by the Honorable Bob Filner; H.R. 3786, 
Servicemembers Telecom Contract Relief Act, introduced by the 
Honorable Zoe Lofgren; H.R. 2721, to amend title 10, United 
States Code, to require the Secretary of Veterans Affairs to 
develop, and the Secretary of Defense to distribute to members 
of the Armed Forces upon their discharge or release from active 
duty, information in a compact disk read-only memory format 
that lists and explains the health, education, and other 
benefits for which veterans are eligible under the laws 
administered by the Secretary of Veterans Affairs, introduced 
by the Honorable Dennis Cardoza; H.R. 6070, Military Spouses 
Residency Relief Act, introduced by the Honorable John R. 
Carter; H.R. 6272, SMOCTA Reauthorization Act of 2008, 
introduced by the Honorable Peter Welch; H.R. 6221, Veteran-
Owned Small Business Protection and Clarification Act of 2008, 
introduced by the Honorable John Boozman; H.R. 6224, Pilot 
College Work Study Programs for Veterans Act of 2008, 
introduced by the Honorable Stephanie Herseth Sandlin; and, 
H.R. 6225, Injunctive Relief for Veterans Act of 2008, 
introduced by the Honorable Stephanie Herseth Sandlin.
    Members of Congress testified on their respective bills and 
in addition, the following provided testimony before the 
Committee: U.S. Olympic Committee; CTIA--The Wireless 
Association; veterans service organizations; and, the U.S. 
Department of Veterans Affairs. See Legislative Hearing on H.R. 
2721, H.R. 3786, H.R. 6070, H.R. 4255, H.R. 6221, H.R. 6224, 
H.R. 6225, H.R. 6272, Serial No. 110-93.

Subcommittee Markup of H.R. 4255, H.R. 2910, H.R. 3298, H.R. 2721, H.R. 
        6225, H.R. 6224, H.R. 6272, H.R. 6221, and H.R. 6070

    On June 26, 2008, the Subcommittee met and marked up H.R. 
4255, United States Olympic Committee Paralympic Program Act of 
2007; H.R. 2910, Veterans Education Tuition Support Act of 
2007; H.R. 3298, 21st Century Servicemembers Protection Act; 
H.R. 2721, to require the Secretary of Veterans Affairs to 
develop, and the Secretary of Defense to distribute to members 
of the Armed Forces upon their discharge or release from active 
duty, information in a compact disk read-only memory format 
that lists and explains the health, education, and other 
benefits for which veterans are eligible under the laws 
administered by the Secretary of Veterans Affairs; H.R. 6225, 
Improving SCRA and USERRA Protections Act of 2008; H.R. 6224, 
Pilot College Work Study Programs for Veterans Act of 2008; 
H.R. 6272, SMOCTA Reauthorization Act of 2008; H.R. 6221, 
Improving Veterans' Opportunity in Education and Business Act 
of 2008; and, H.R. 6070, Military Spouses Residency Relief Act. 
All nine bills were reported favorably to the full Committee. 
H.R. 4255, H.R. 2910, H.R. 3298, and H.R. 2721 were amended in 
Subcommittee.

                          OVERSIGHT ACTIVITIES

First Session

Subcommittee Hearing--Performance Review of Education Loan Guaranty, 
        Vocational Rehabilitation and Employment and Veterans Affairs, 
        and Veterans' Employment and Training Service Programs

    On March 7, 2007, the Subcommittee conducted a hearing to 
examine the performance, staffing and services provided by the 
Education, Loan Guaranty, and Vocational Rehabilitation and 
Employment programs of the U.S. Department of Veterans Affairs, 
and Veterans' Employment and Training Service of the U.S. 
Department of Labor. The Subcommittee intends to advance its 
bipartisan legislative strategy to improve employment and on-
job training/apprenticeship programs, and expand 
entrepreneurial opportunities, as well as promote recently 
separated servicemembers and veterans as a unique national 
resource and a ready and qualified labor pool.
    The Subcommittee heard testimony from the U.S. Department 
of Labor and the U.S. Department of Veterans Affairs. See 
Performance Review of Education, Loan Guaranty, Vocational 
Rehabilitation and Employment, and Veterans' Employment and 
Training Service Programs, Serial No. 110-6.

Subcommittee Hearing--Education Benefits for National Guard and Reserve 
        Members of the U.S. Armed Forces

    On March 22, 2007, the Subcommittee held a hearing to 
provide a comprehensive review of sections 1606 and 1607 under 
title 10, United States Code (Selected Reserve programs). 
Specifically, the Subcommittee explored the effectiveness of 
various possible improvements as a means to increase the use of 
education benefits, as well as improving recruiting and 
retention in the U.S. Armed Forces.
    The Subcommittee heard testimony from the U.S. Department 
of Veterans Affairs; U.S. Department of Defense; veterans 
service organizations; National Guard Bureau; Arkansas National 
Guard; and, the Military Officers Association of America. See 
Education Benefits for National Guard and Reserve Members of 
the U.S. Armed Forces, Serial No. 110-10.

Subcommittee Hearing--State Approving Agencies

    On April 19, 2007, the Subcommittee held a hearing on State 
Approving Agencies. State Approving Agencies have partnered 
with the U.S. Department of Veterans Affairs in the 
administration of veterans educational and training programs 
for nearly 60 years. Through the program approval and 
supervision process, they provide assistance in reducing the 
opportunities for fraud, waste and abuse throughout the system.
    The Subcommittee heard testimony from the U.S. Government 
Accountability Office; National Association of State Approving 
Agencies; and, the Veterans' Employment and Training Service 
for the U.S. Department of Labor. See State Approving Agencies, 
Serial No. 110-15.

Subcommittee Hearing--Accelerated Education Benefits for Veterans

    On May 3, 2007, the Subcommittee held a hearing to 
determine: (1) if the process time is adequate and meeting the 
needs of the servicemembers, (2) if expansion of the eligible 
programs is warranted, and (3) if expansion beyond MGIB-AD 
Chapter 30 is warranted.
    The Honorable Michael H. Michaud; Truckload Carriers 
Association; North American Training Management Institute; 
veterans service organizations; U.S. Department of Veterans 
Affairs; and, the National Veterans Business Development 
Corporation, The Veterans Corporation testified. See 
Accelerated Education Benefits for Veterans, Serial No. 110-18.

Site Visit to Colorado Springs, Colorado

    Majority and minority staff traveled to Colorado Springs, 
Colorado, from May 3-7, 2007. The purpose of this visit was to 
review the current program for veteran physical and social 
rehabilitation using sports and to tour the facilities from the 
U.S. Olympic Committee (USOC) that provides support to the 
Paralympic Program.
    This program helps veterans learn how to use their new 
equipment which can range from a wheelchair to a prosthetic 
limb. They engage in recreational events to help hone their 
fine motor skills and social events so they can see how others 
are coping with similar disabilities. Many of the instructors 
are amputees and have a very positive mental attitude and 
outlook on life. They make good role models for the recently 
injured servicemembers. Some of these instructors are still on 
active duty and take personal time to train these recently 
injured veterans.

Subcommittee Hearing--Veterans Entrepreneurship and Self Employment

    On May 17, 2007, the Subcommittee held a hearing on 
Veterans Entrepreneurship and Self Employment and the need to 
act on behalf of Service-Disabled Veteran-Owned Small 
Businesses.
    Veterans service organizations; the U.S. Small Business 
Administration; Veterans Enterprise Training and Service Group, 
Inc.; Halfaker and Associates, LLC; Oak Grove Technologies; 
MicroTech, LLC; National Veterans Business Development 
Corporation, The Veterans Corporation; and, the U.S. Department 
of Veterans Affairs testified. See Veterans Entrepreneurship 
and Self Employment, Serial No. 110-23.

Subcommittee Hearing--Specially Adaptive Housing

    On June 7, 2007, the Subcommittee held a hearing to examine 
the two current programs to conclude if the grants are meeting 
the needs of disabled veterans and to conclude if the grants 
are meeting the needs they were designed to meet.
    During the hearing, the Subcommittee heard from the U.S. 
Department of Veterans Affairs; veterans service organizations; 
National Association of Home Builders; and, Homes for Our 
Troops. See Specially Adaptive Housing, Serial No. 110-25.

Subcommittee Hearing--Federal Procurement and the Three-Percent Set 
        Aside

    On July 12, 2007, the Subcommittee held a hearing to focus 
on the government-wide goal to set aside no less than three 
percent of the total value of all prime contracts and 
subcontracts each fiscal year and explore the current state and 
federal procurement problems.
    The subcommittee heard testimony from veteran-owned small 
businesses; the U.S. Small Business Administration; the U.S. 
Department of Defense; the U.S. Department of Veterans Affairs; 
Veterans Entrepreneurship Task Force, and National Association 
for Black Veterans; Office of Management and Budget; Oak Grove 
Technologies; and, MicroTech, LLC. See the Federal Procurement 
and the Three-Percent Set Aside, Serial No. 110-34.

Subcommittee Hearing--Contract Bundling Oversight

    On July 26, 2007, the Subcommittee held a hearing to 
explore the need to examine the effects of contract bundling on 
Service-Disabled Veteran-Owned Small Businesses. The 
Subcommittee received complaints about the three percent and 
lack of federal procurement knowledge by contract officers 
which led to this hearing.
    The Subcommittee heard testimony from MCB Lighting and 
Electrical; MicroTech, LLC; CSSS.NET; U.S. Small Business 
Administration; the U.S. Department of Defense; and, the U.S. 
Department of Veterans Affairs. See Contract Bundling 
Oversight, Serial No. 110-39.

Site Visit to San Diego, California

    From August 29-31, 2007, majority and minority staff 
attended the Department of Veterans Affairs Vocational 
Rehabilitation and Employment Conference in San Diego, 
California, to speak on legislative issues that may be 
affecting vocational rehabilitation and employment.
    Staff also attended a seminar on data and veteran 
entrepreneurship. While in San Diego staff visited the San 
Diego Regional Office and was impressed with their operation 
and services being offered to veterans. It was beneficial to 
learn that the San Diego Regional Office has a great working 
relationship with the adjacent military facilities.

Site Visit to Reno, Nevada

    Majority and minority staff traveled to Reno, Nevada, from 
August 24-26, 2007. The purpose of the visit was to meet with 
the leadership of The American Legion's National Economic 
Commission. The meeting was to share with the Legion the 
efforts of the House Veterans Affairs Committee and to give 
staff the opportunity to hear the concerns and interests of the 
Economic Commission leadership.
    The American Legion has been working to increase the 
visibility of the Economic Commission and raise awareness of 
its important component for veterans and returning 
servicemembers. The leadership of the Economic Commission is 
composed of senior members of the Legion from across the 
country and will carry back the accomplishments and requests to 
support efforts on behalf on veterans and returning 
servicemembers.

Subcommittee Hearing--Veterans Preference

    On September 6, 2007, the Subcommittee held a hearing to 
explore veteran's preference and the success or lack of success 
the agencies are having in recruiting veterans. Additionally, 
the Subcommittee conducted oversight on how veteran's 
preference has hurt veterans and how it has benefited them as 
well.
    The Subcommittee heard testimony from National Veterans 
Legal Services Program; a veteran; National Veterans Affairs of 
the American Federation of Government Employees; American 
Postal Workers Union; several veterans service organizations; 
U.S. Merit System Protection Board; U.S. Department of Defense; 
and, the U.S. Department of Agriculture. See Veterans 
Preference, Serial No. 110-41.

Subcommittee Hearing--Licensure and Certification of Transitioning 
        Veterans

    On September 20, 2007, the Subcommittee held a hearing to 
highlight the programs developed and instituted by the U.S. 
Department of Veterans Affairs, the U.S. Department of Defense, 
and the U.S. Department of Labor to track military training 
requirements and civilian equivalents.
    Several veterans service organizations; the U.S. Department 
of Labor; the U.S. Department of Defense; and, the U.S. 
Department of Veterans Affairs provided testimony. See 
Licensure and Certification of Transitioning Veterans, Serial 
No. 110-44.

Subcommittee Hearing--Updating the Montgomery G.I. Bill

    On October 18, 2007, the Subcommittee held a hearing aimed 
at understanding the concerns and impediments of education. The 
hearing allowed the Subcommittee to hear concerns and 
encouragements on the Total Force Montgomery GI Bill which 
would combine statutory authority for programs under the 
Department of Veterans Affairs by moving programs from the 
Department of Defense (Chapter 1606 of title 10 of the U.S. 
Code) and shifting oversight responsibility to the Committees 
on Veterans' Affairs from the Committees on Armed Services.
    The U.S. Department of Defense; the U.S. Department of 
Veterans Affairs; military and veterans service organizations; 
and, the U.S. Department of Education testified before the 
Subcommittee. See Updating the Montgomery G.I. Bill, Serial No. 
110-56.

Subcommittee Hearing--Department of Labor's Veterans Employment and 
        Training Service, Disabled Veterans' Outreach Program, and 
        Local Veterans' Employment Representative Program

    On October 25, 2007, the Subcommittee held an oversight 
hearing on the Veterans' Employment and Training Service, 
Disabled Veterans Outreach Program, and Local Veteran 
Employment Representative program to examine their 
effectiveness, implementation and function with the state. 
These programs are dedicated to assisting transitioning 
servicemembers and disabled veterans to the civilian workforce.
    The U.S. Department of Labor and several veterans service 
organizations provided testimony to the Subcommittee. See VETS 
DVOP/LVER Program, Serial No. 110-58.

Second Session

Subcommittee Hearing--Review of Pending Montgomery G.I. Bill 
        Legislation

    On January 17, 2008, the Subcommittee held a hearing to 
review legislation pending before the Subcommittee in reference 
to the Montgomery G.I. Bill. Bills before the Subcommittee 
include H.R. 2702, Post-9/11 Veterans Educational Assistance 
Act of 2007; H.R. 1102, Total Force Educational Assistance 
Enhancement and Integration Act of 2007; H.R. 2385, 21st 
Century G.I. Bill of Rights Act of 2007; H.R. 2247, the 
Montgomery G.I. Bill for Life Act of 2007; H.R. 1211, Resuming 
Education After Defense Service Act of 2007; H.R. 2910, 
Veterans Education Tuition Support Act of 2007; and, H.R. 1214, 
Veterans Survivors Education Enhancement Act.
    Military and veterans service organizations; U.S. 
Department of Defense; and, the U.S. Department of Veterans 
Affairs provided testimony on education. See Review of Pending 
Montgomery G.I. Bill Legislation, Serial No. 110-64.

Subcommittee Hearing--Review of Expiring Programs

    On February 13, 2008, the Subcommittee held a hearing to 
examine if the following expiring programs should continue to 
be funded: Incarcerated Veterans Transition Program; Office of 
Special Counsel and Department of Labor--Veterans Employment 
and Training Program Claim Referral Program; Apprenticeship and 
On-Job-Training; Demonstration Project on Adjustable Rate 
Mortgages; Demonstration Project on Hybrid Adjustable Rate 
Mortgages; Post-Vietnam Era Veterans' Educational Assistance 
Program; and Survivors and Dependents Educational Assistance.
    Tully Rinckey PLLC; veterans service organizations; U.S. 
Department of Labor; and, U.S. Department of Veterans Affairs 
provided testimony. See Review of Expiring Programs, Serial No. 
110-68.

Subcommittee Hearing--Subprime Mortgage Crisis and America's Veterans

    On February 28, 2008, the Subcommittee held a hearing to 
examine the causes and effects of the large number of subprime 
foreclosures that have occurred across the country, 
particularly among servicemembers and veterans. It also 
provided the Subcommittee the opportunity to see what 
strategies are available for addressing the problem and its 
impact on the veteran community.
    In addition to the U.S. Department of Veterans Affairs, the 
following provided testimony: UniCredit Markets and Investment 
Banking; Freddie Mac; National Association of Realtors, Center 
for Responsible Lending; and, HOPE NOW Alliance. See Subprime 
Mortgage Crisis and America's Veterans, Serial No. 110-74.

Subcommittee Hearing--U.S. Paralympic Military Program

    On March 13, 2008, the Subcommittee held a hearing to 
assess the ability of the paralympics program to rehabilitate 
disabled veterans and active duty servicemembers, to what 
capacity they are able to rehabilitate, and how it has 
benefited our nation's disabled veterans and disabled 
servicemembers.
    The Director of Sports and Recreation for the Paralyzed 
Veterans of America; Disabled American Veterans; a disabled 
veteran; Wounded Warrior Disabled Sports Project for Disabled 
Sports USA; U.S. Paralympics for the U.S. Olympic Committee; 
and, the U.S. Department of Veterans Affairs provided 
testimony. See U.S. Paralympic Military Program, Serial No. 
110-77.

Site Visit to Crane, Indiana

    Majority and minority staff traveled to Crane, Indiana, 
from March 24-25, 2008. The purpose of this site visit was to 
learn more about Crane Learning & Employment Center (CLEC). 
CLEC aims to assist veterans obtain the needed skills and 
education to gain employment at theNaval Surface Warfare Center 
in Crane, Indiana. Partnering with the military installation would 
allow veterans meet the needs of the base. Furthermore, during the site 
visit, staff learned that CLEC received a Lilly Endowment Grant of 
$400K to help initiate this pilot program which is scheduled to be 
completed on August 30, 2009.
    The goal is to recruit, train, educate, and employ severely 
disabled veterans first at the Naval Surface Weapons Center and 
then widen the program's reach into the surrounding regions as 
distant as St. Louis, MO. The program is a pilot with five 
disabled veterans enrolled with a goal of 20 disabled veterans 
per year for the first two years.

Site Visit to Boston, Massachusetts

    Majority staff traveled to Boston, Massachusetts, from 
March 26-28, 2008, to attend the 14th Annual Seminar for Senior 
Congressional and Executive Staff. The topic of discussion was 
``Regional Innovation--From Science to Technology, What Works, 
What Doesn't.''
    The purpose of the seminar was to review case studies to 
examine a broad range of recipes and identify common approaches 
for bringing technology to market. The seminar gave a great 
overview on what aspiring entrepreneurs had done in the past to 
bring their ideas to market, the government role in regional 
economic support, and the role of federal support for 
entrepreneurship start ups.

Site Visit to Tampa, Florida

    Majority and minority staff traveled to Tampa, Florida, 
from March 27-28, 2008. The purpose of the travel was to visit 
a Vocational Rehabilitation and Employment (VR&E) site. By 
attending, staff was able to meet with the out-stationed VR&E 
officers working for the Tampa office discussed various aspects 
of the VR&E program in general and some specific issues 
regarding the VR&E program.
    A presentation was made by Margarita Cocker, St. Pete VR&E 
Officer discussing various performance data related to the St. 
Pete VR&E program. During the meeting, VR&E staff discusses 
barrier to employment requirements and how various veterans may 
qualify.

Subcommittee Field Hearing--Transition Assistance Program for Guard and 
        Reserve Forces, South Bend, Indiana

    On May 16, 2008, the Subcommittee held a hearing to focus 
on how transition assistance programs impact Guard and Reserve 
forces with a focus to determine if the programs are meeting 
the needs of the Guard and Reserve Forces before, during and 
after activation. In addition, the Subcommittee reviewed the 
information being provided to service members and their 
families to be certain it is accurate and timely to make the 
activation as smooth as possible.
    The Indiana National Guard; military spouses; active duty 
Guard members; Department of Indiana American Legion; County 
Veterans Service Officer; U.S. Department of Labor; U.S. 
Department of Defense; and, the U.S. Department of Veterans 
Affairs provided testimony. See Transition Assistance Program 
for Guard and Reserve Forces, Serial No. 110-87.

Site Visit to Tampa, Florida

    Majority and minority staff traveled to Tampa, Florida, 
from June 23-24, 2008. The purpose of the site visit was to 
attend the Department of Veterans Affairs Vocational 
Rehabilitation and Employment (VR&E) training conference. The 
VR&E staff was interested in the content and possible ways the 
Post-9/11 Veterans Educational Assistance Act (S. 22) would 
affect the Vocational Rehabilitation program.
    During this conference, information about S. 22 was 
provided to the VR&E staff and concerns were raised about the 
possibility of a low rate of participants in the VR&E program 
due to the increase of entitlements in the new G.I. Bill.

Site Visit to Las Vegas, Nevada

    From July 7-8, 2008, majority staff visited Las Vegas, 
Nevada, to attend the Veterans Business Conference. The 
Conference by the Department of Veterans Affairs Center for 
Veterans' Enterprise had a conference to bring interested small 
business owners together to advise them about federal 
procurement. The Chairman had been invited to participate in a 
panel to update interested stakeholders on changes the 
Committee was doing to help veterans do business with the 
federal government.

Subcommittee Hearing--Independent Living Program

    On July 10, 2008, the Subcommittee held a hearing to focus 
on the Vocational Rehabilitation & Employment services and the 
Independent Living Program. The Independent Living Program 
assists severely disabled service members who, due to their 
disability, cannot pursue their vocational goal.
    Providing testimony were the National Council on 
Independent Living; a veteran; veterans service organizations; 
and, the U.S. Department of Veterans Affairs. See Independent 
Living Program, Serial No. 110-97.

Subcommittee Field Hearing--Transition Assistance Program, Rapid City, 
        South Dakota

    On July 28, 2008, the Subcommittee held a hearing to give 
stakeholders and constituents an opportunity to speak on their 
experiences with the Transition Assistance Program and 
recommend any needed improvements.
    The U.S. Department of Veterans Affairs; the U.S. 
Department of Defense; the U.S. Department of Labor; the spouse 
of a veteran; veterans service organizations; South Dakota 
State Approving Agency; South Dakota Department of Military and 
Veterans Affairs; and, active duty service members presented 
testimony. See Transition Assistance Program, Serial No. 110-
99.

Site Visit to San Diego, California

    From August 6-8, 2008, minority staff attended the first 
annual VA Summer Sports Clinic. The purpose of the program is 
to introduce disabled veterans to a wide range of sports as a 
means to increase their level of rehabilitation.

Subcommittee Field Hearing--Uniformed Services Employment and 
        Reemployment Rights Act and Servicemembers Civil Relief Act 
        Issues, Bentonville, Arkansas

    On August 18, 2008, the Subcommittee held a hearing to 
focus on the Uniformed Services Employment and Reemployment 
Rights Act and Servicemembers Civil Relief Act issues. Some 
service members have described problems with employers after 
returning from deployment such as being unable to get their 
jobs back; it has been a constant problem for both service 
members and employers.
    Family Readiness Coordinator for Headquarters 142d Fires 
Brigade of the Arkansas National Guard; Arkansas Field 
Committee, Employer Support of the Guard and Reserve; Arkansas 
University Small Business Development Center, Arkansas State 
University; Department of Arkansas American Legion; U.S. Office 
of Special Counsel; and, the U.S. Department of Labor provided 
testimony. See Uniformed Services Employment and Reemployment 
Rights Act and Servicemembers Civil Relief Act Issues, Serial 
No. 110-101.

Site Visit to Phoenix, Arizona

    Majority staff traveled to Phoenix, Arizona, from August 
22-24, 2008, to attend The American Legion Convention. Staff 
met with leadership from The American Legion's National 
Economic Commission.
    Staff shared the efforts of the House Veterans Affairs 
Committee and allowed the staff the opportunity to hear the 
concerns and interests of the Economic Commission leadership. 
Staff asked for the support of the membership and leadership in 
our efforts to increase the economic well being of veterans and 
returning service members.

Subcommittee Hearing--Oversight of G.I. Bill Implementation

    On September 11, 2008, the Subcommittee held an oversight 
hearing to examine how well the VA is doing in meeting the 
requirements of Public Law 110-252, Chapter 33 benefits, with a 
focus on the use of a private contractor and the ability to 
meet deadlines imposed by the law. The hearing also discussed 
alternative plans if the deadline cannot be met with various 
concerns on the VA's plan to contract.
    Keith Pedigo, Associate Deputy Under Secretary of the 
Office of Policy and Program Management of the Veterans 
Benefits Administration, U.S. Department of Veterans Affairs, 
testified before the Subcommittee. See Oversight of G.I. Bill 
Implementation, Serial No. 110-103.

Subcommittee Hearing--Follow-up Oversight of G.I. Bill Implementation

    On September 24, 2008, the Subcommittee conducted a follow-
up hearing on the oversight of the G.I. Bill implementation to 
gain understanding of how the implementation and outsourcing 
might potentially affect veterans.
    The Iraq and Afghanistan Veterans of America; The American 
Legion; AMVETS; Veterans of Foreign Wars; Military Officers 
Association of America; American Federation of Government 
Employees; Carnegie Mellon University; U.S. Department of 
Defense; and, the U.S. Department of Veterans Affairs expressed 
their views to the Subcommittee. See Follow-up Oversight of 
G.I. Bill Implementation, Serial No. 110-107.

Subcommittee Hearing--VA Short and Long-Term Strategies for 
        Implementing New G.I. Bill Requirements

    On November 18, 2008, the Subcommittee conducted a follow-
up hearing to analyze the Department of Veterans Affairs (VA) 
short and long-term plans to implement the IT requirements of 
P.L. 110-252. The Subcommittee seeks to work hand in hand with 
the VA to collaborate and assist with their efforts; allowing 
the Subcommittee to conduct the necessary oversight to better 
guarantee proper and timely implementation of the new Chapter 
33 benefits.
    The U.S. Department of Veterans Affairs provided testimony. 
See VA Short and Long-Term Strategies for Implementing New G.I. 
Bill Requirements, Serial No. 110-108.

Site Visit to Ft. Carson, Colorado; Las Vegas, Nevada; and, Palo Alto, 
        California

    From November 11-14, 2008, majority and minority staff 
traveled to Ft. Carson, Colorado; Nellis Air Force Base, 
Nevada; and, the VA polytrauma center in Palo Alto, California. 
The purpose of the travel was to visit various Transition 
Assistance Program (TAP) workshops.
    In general, the programs at Ft. Carson and Nellis AFB were 
acceptable. The Ft. Carson instructor was conducting the 
initial overview of what the members could expect to get from 
the program and therefore, the staff was not able to observe 
the more substantive modules of the course. However, the 
instructor appeared well-prepared and seemed to connect with 
the students. The facility was appropriate for the course and 
located just across the street from the U.S. Department of 
Veterans Affairs (VA) benefits office which housed the veteran 
service officers and VA staff. When Subcommittee staff queried 
the students about the Benefits Delivery at Discharge (BDD), 
not one of the 30 admitted to having any knowledge about the 
program. Subsequently, the staff questioned the VA supervisor 
who explained that he presents BDD at Fort Carson at least 
twice per month.
    Despite being listed on the national TAP schedule, U.S. 
Department of Labor representatives are not teaching TAP at 
Palo Alto and were not present during the staff's visit. The VA 
staff from the San Francisco Regional Office provides benefits 
briefings to the patients and family members but the hospital 
staff present during the briefing seemed unaware of other VA 
benefits such as the Vocational Rehabilitation and Employment 
program. Subcommittee staff suggested, and the VA Regional 
Office representative agreed, that it would be appropriate to 
provide the polytrauma staff a thorough briefing on the 
benefits programs administered by VBA.

Site Visit to Baumholder, Hohenfels, and Schweinfurt, Germany, and 
        Naples, Italy

    From November 29-December 5, 2008, majority and minority 
staff traveled to Baumholder, Hohenfels, and Schweinfurt, 
Germany and Naval Support Activity Naples, Italy. The purpose 
of the travel was to visit various Transition Assistance 
Program (TAP) workshops.
    The instructor from the Department of Labor (DOL) was a 
very motivated individual, was very well informed and had an 
abundance of work related materials for the separating service 
members for the site visit in Naples. The staff had concerns 
about Benefits Delivery at Discharge (BDD), very few 
individuals are aware of it. This is a key program for 
separating members who were injured and filing a claim for 
compensation from the U.S. Department of Veterans Affairs (VA). 
The VA needs to do a better job of informing separating service 
members about their benefits and to encourage spouses to attend 
these benefits briefing with the service member. Another 
concern the staff had is that soldiers had to be transported 
from Italy to Landstuhl, Germany, to receive their physical 
while Naples, Italy, has a very good medical facility from 
which to receive a medical examination. The other noted problem 
associated with the physical was the frequency of being 
transported to Germany to get the physical.
    In Baumholder, the staff was informed that the VA was 
instructed to cancel any seminars where less than ten service 
members signed up. Staff disagrees with this policy and 
inquired further as to why and who had made this decision. We 
encouraged them to conduct the seminar even though there may be 
times when there are less than ten service members.
    Subcommittee staff noted that the VA staff is generally 
sent to Germany on a rotation basis for six months, but staff 
is concerned that it generally takes instructors some time to 
get acclimated with the area and acquainted with the European 
staff. Subcommittee staff will be communicating with the VA 
regarding the rotation schedule and recommend it be made a 
permanent position or in the alternative, expand it to three 
years with a six month overlap for the replacement.
    While in Heidelburg, Germany, staff met with Brigadier 
General (BG) Gallagher, Commander Europe Regional Medical 
Command. Discussion focused on medical records and how 
Landstuhl, Germany, has now been completely paperless for one 
year. The staff received a demonstration of their system and 
its effectiveness. In meeting with BG Gallagher he expressed 
his concerns that there are only two VA representatives 
available to conduct seminars and suggested that having six 
would allow the seminars to be conducted in a timely manner.

                ACTIVITIES OF THE SUBCOMMITTEE ON HEALTH


                         LEGISLATIVE ACTIVITIES

First Session

Subcommittee Markup of H.R. 327 and H.R. 612

    On March 13, 2007, the Subcommittee met and marked up two 
bills which were ordered reported favorably to the full 
Committee by voice vote: H.R. 327, Joshua Omvig Veterans 
Suicide Prevention Act; and, H.R. 612, Returning Servicemember 
VA Healthcare Insurance Act of 2007.

Subcommittee Legislative Hearing--H.R. 92, H.R. 315, H.R. 339, H.R. 
        463, H.R. 538, H.R. 542, H.R. 1426, H.R. 1470, H.R. 1471, H.R. 
        1527, H.R. 1944, and Discussion Draft Rural Health Care Bill

    On April 26, 2007, the Subcommittee held a legislative 
hearing on H.R. 92, Veterans Timely Access to Health Care Act, 
introduced by the Honorable Ginny Brown-Waite on January 4, 
2007; H.R. 315, Help Establish Access to Local Timely 
Healthcare for Your Vets (HEALTHY Vets) Act of 2007, introduced 
by the Honorable Stevan Pearce on January 5, 2007; H.R. 339, 
Veterans Outpatient Care Access Act of 2007, introduced by the 
Honorable John J. Duncan, Jr., on January 9, 2007; H.R. 463, 
Honor Our Commitment to Veterans Act, introduced by the 
Honorable Steven R. Rothman on January 12, 2007; H.R. 538, 
South Texas Veterans Access to Care Act of 2007, introduced by 
the Honorable Solomon P. Ortiz on January 17, 2007; H.R. 542, 
to require the Department of Veterans Affairs to provide mental 
health services in languages other than English, as needed, for 
veterans with limited English proficiency, and for other 
purposes, introduced by the Honorable Hilda L. Solis on January 
17, 2007; H.R. 1426, Richard Helm Veterans' Access to Local 
Health Care Options and Resources Act, introduced by the 
Honorable Tom Latham on March 9, 2007; H.R. 1470, Chiropractic 
Care Available to All Veterans Act, introduced by the Honorable 
Bob Filner on March 12, 2007; H.R. 1471, Better Access to 
Chiropractors to Keep our Veterans Healthy Act (BACK Veterans 
Health Act), introduced by the Honorable Bob Filner on March 
12, 2007; H.R. 1527, Rural Veterans Access to Care Act, 
introduced by the Honorable Jerry Moran on March 14, 2007; H.R. 
1944, Veterans Traumatic Brain Injury Treatment Act of 2007, 
introduced by the Honorable Jason Altmire on April 19, 2007; 
and, a discussion draft on rural health care.
    Members of Congress testified on their respective bills and 
in addition, the following provided testimony before the 
Committee: veterans service organizations; and, the U.S. 
Department of Veterans Affairs. See Legislative Hearing on H.R. 
92, H.R. 315, H.R. 339, H.R. 463, H.R. 538, H.R. 542, H.R. 
1426, H.R. 1470, H.R. 1471, H.R. 1527, H.R. 1944, and 
Discussion Draft of the ``Rural Veterans Health Care Act of 
2007,'' Serial No. 110-17.

Subcommittee Markup of H.R. 1470 and H.R. 2199

    On May 10, 2007, the Subcommittee met and marked up two 
bills which were ordered reported favorably to the full 
Committee by unanimous consent: H.R. 1470, Chiropractic Care 
Available to All Veterans Act and H.R. 2199, Traumatic Brain 
Injury Health Enhancement and Long-Term Support Act of 2007.

Subcommittee Legislative Hearing--H.R. 1448, H.R. 1853, H.R. 1925, H.R. 
        2005, H.R. 2172, H.R. 2173, H.R. 2378, H.R. 2219, H.R. 2192, 
        and H.R. 2623

    On June 14, 2007, the Subcommittee held a legislative 
hearing on H.R. 1448, VA Hospital Quality Report Card Act of 
2007, introduced by the Honorable Nita M. Lowey on March 9, 
2007; H.R 1853, Jose Medina Veterans Affairs Police Training 
Act of 2007, introduced by the Honorable Diane E. Watson on 
March 29, 2007; H.R. 1925, to direct the Secretary of Veterans 
Affairs to establish a separate Veterans Integrated Service 
Network for the Gulf Coast region of the United States, 
introduced by the Honorable Jeff Miller on April 18, 2007; H.R. 
2005, Rural Veterans Health Care Improvement Act of 2007, 
introduced by the Honorable John T. Salazar on April 23, 2007; 
H.R. 2172, Amputee Veteran Assistance Act, introduced by the 
Honorable Silvestre Reyes on May 3, 2007; H.R. 2173, to 
authorize additional funding for the Department of Veterans 
Affairs to increase the capacity for provision of mental health 
services through contracts with community mental health 
centers, and for other purposes, introduced by the Honorable 
Ciro D. Rodriquez on May 3, 2007; H.R. 2378, Services to 
Prevent Veterans Homelessness Act, introduced by the Honorable 
Stephanie Herseth Sandlin on May 17, 2007; H.R. 2219, Veterans 
Suicide Prevention Hotline Act of 2007, introduced by the 
Honorable James P. Moran on May 8, 2007; H.R. 2192, to amend 
title 38, United States Code, to establish an Ombudsman within 
the Department of Veterans Affairs, introduced by the Honorable 
Paul W. Hodes on May 7, 2007; and, H.R. 2623, to prohibit the 
collection of copayments for all hospice care furnished by the 
Department of Veterans Affairs, introduced by the Honorable 
Jeff Miller on June 7, 2007.
    Members of Congress testified on their respective bills and 
in addition, the following provided testimony before the 
Committee: veterans service organizations; and, the U.S. 
Department of Veterans Affairs. See Legislative Hearing on H.R. 
1448, H.R. 1853, H.R. 1925, H.R. 2005, H.R. 2172, H.R. 2173, 
H.R. 2378, H.R. 2219, H.R. 2623, and H.R. 2192, Serial No. 110-
27.

Subcommittee Markup of H.R. 2623

    On June 28, 2007, the Subcommittee met and marked up H.R. 
2623, to amend title 38, United States Code, to prohibit the 
collection of copayments for all hospice care furnished by the 
Department of Veterans Affairs. H.R. 2874, Veterans' Health 
Care Improvement Act of 2007, was discussed by the Subcommittee 
and it was agreed that it would be marked up in a future 
hearing. H.R. 2623, as amended, was ordered reported favorably 
to the full Committee by voice vote.

Subcommittee Markup of H.R. 2874

    On July 11, 2007, the Subcommittee met and marked up H.R. 
2874, Veterans' Health Care Improvement Act of 2007, which was 
ordered reported favorably, as amended, to the full Committee 
by voice vote.

Second Session

Subcommittee Legislative Hearing--H.R. 2790, H.R. 3458, H.R. 3819, H.R. 
        4053, H.R. 4107, H.R. 4146, H.R. 4204, and H.R. 4231

    On January 17, 2008, the Subcommittee held a legislative 
hearing on H.R. 2790, to establish the position of Director of 
Physician Assistant Services within the office of the Under 
Secretary of Veterans Affairs for Health, introduced by the 
Honorable Phil Hare on June 20, 2007; H.R. 3458, to direct the 
Secretary of Veterans Affairs to carry out a pilot program on 
the provision of traumatic brain injury care in rural areas, 
introduced by the Honorable Shelley Moore Capito on August 4, 
2007; H.R. 3819, Veterans Emergency Care Fairness Act of 2008, 
introduced by the Honorable Zachary T. Space on October 10, 
2007; H.R. 4053, Mental Health Improvements Act of 2007, 
introduced by the Honorable Shelley Berkley on November 1, 
2007; H.R. 4107, Women Veterans Health Care Improvement Act, 
introduced by the Honorable Stephanie Herseth Sandlin on 
November 7, 2007; H.R. 4146, to amend title 38, United States 
Code, to clarify the availability of emergency medical care for 
veterans in non-Department of Veterans Affairs medical 
facilities, introduced by the Honorable Michael M. Honda on 
November 9, 2007; H.R. 4204, Veterans Suicide Study Act, 
introduced by the Honorable Leonard L. Boswell on November 15, 
2007; and H.R. 4231, Rural Veterans Health Care Access Act of 
2007, introduced by the Honorable Steve Kagen on November 15, 
2007.
    Members of Congress testified on their respective bills and 
in addition, the following provided testimony before the 
Committee: veterans service organizations; and, the U.S. 
Department of Veterans Affairs. See Legislative Hearing on H.R. 
2790, H.R. 3458, H.R. 3819, H.R. 4053, H.R. 4107, H.R. 4146, 
H.R. 4204, and H.R. 4231, Serial No. 110-63.

Subcommittee Legislative Hearing--H.R. 2818, H.R. 5554, H.R. 5595, H.R. 
        5622, H.R. 5729, and H.R. 5730

    On April 15, 2008, the Subcommittee held a legislative 
hearing on H.R. 2818, to provide for the establishment of 
Epilepsy Centers of Excellence in the Veterans Health 
Administration of the U.S. Department of Veterans Affairs, 
introduced by the Honorable Ed Perlmutter on June 21, 2007; 
H.R. 5554, Justin Bailey Veterans Substance Use Disorders 
Prevention and Treatment Act of 2008, introduced by the 
Honorable Michael H. Michaud on March 6, 2008; H.R. 5595, Make 
Our Veterans Smile Act of 2008, introduced by the Christopher 
P. Carney on March 12, 2008; H.R. 5622, Veterans Timely Access 
to Health Care Act, introduced by the Honorable Ginny Brown-
Waite on March 13, 2008; H.R. 5729, Spina Bifida Health Care 
Program Expansion Act, introduced by the Honorable Brad 
Ellsworth on April 8, 2008; and H.R. 5730, to direct the 
Secretary of Veterans Affairs to display in each prosthetic and 
orthotic clinic of the U.S. Department of Veterans Affairs an 
Injured and Amputee Veterans Bill of Rights, introduced by the 
Honorable Bob Filner on April 8, 2008.
    Members of Congress testified on their respective bills and 
in addition, the following provided testimony before the 
Committee: veterans service organizations; and, the U.S. 
Department of Veterans Affairs. See Legislative Hearing on H.R. 
2818, H.R. 5554, H.R. 5595, H.R. 5622, H.R. 5729, and H.R. 
5730, Serial No. 110-82.

Subcommittee Markup of H.R. 2790, H.R. 3819, H.R. 5554, H.R. 5729, and 
        H.R. 5856

    On April 23, 2008, the Subcommittee met and marked up five 
bills which were ordered reported favorably to the full 
Committee by voice vote: H.R. 2790, as amended, to establish 
the position of Director of Physician Assistant Services within 
the office of the Under Secretary of Veterans Affairs for 
Health; H.R. 3819, Veterans Emergency Care Fairness Act of 
2008; H.R. 5729, Spina Bifida Health Care Program Expansion 
Act; H.R. 5554, as amended, Justin Bailey Veterans Substance 
Use Disorders Prevention and Treatment Act of 2008; and, H.R. 
5856, Department of Veterans Affairs Medical Facility 
Authorization and Lease Act of 2008.

Subcommittee Legislative Hearing--H.R. 4089, H.R. 4463, H.R. 5888, H.R. 
        6114 and H.R. 6122

    On June 5, 2008, the Subcommittee held a legislative 
hearing on H.R. 4089, to improve the collective bargaining 
rights and procedures for review of adverse actions of certain 
employees of the Department of Veterans Affairs; H.R. 4463, 
Veterans Health Care Quality Improvement Act; H.R. 5888, to 
expand veteran eligibility for reimbursement by the Secretary 
of Veterans Affairs for emergency treatment furnished in a non-
Department facility; H.R. 6114, Simplifying and Updating 
National Standards to Encourage Testing of the Human 
Immunodeficiency Virus of 2008; and, H.R. 6122, Veterans Pain 
Care Act of 2008.
    Members of Congress testified on their respective bills and 
in addition, the U.S. Department of Veterans Affairs. See 
Legislative Hearing on H.R. 4089, H.R. 4463, H.R. 5888, H.R. 
6114, and H.R. 6122, Serial No. 110-90.

Subcommittee Markup of H.R. 2818 and H.R. 2192

    On June 5, 2008, the Subcommittee met and marked up two 
bills: H.R. 2192, to establish an Ombudsman within the 
Department of Veterans Affairs and H.R. 2818, to provide for 
the establishment of Epilepsy Centers of Excellence in the 
Veterans Health Administration of the Department of Veterans 
Affairs. H.R. 2818, as amended, was ordered reported to the 
full Committee by voice vote.
    On July 16, 2008, H.R. 2192 was discharged from the 
Subcommittee on Health.

Subcommittee Legislative Hearing--Veterans Healthcare Legislation

    On June 26, 2008, the Subcommittee held a legislative 
hearing on four draft bills. Respectively, the bills had the 
following purposes: to expand the authority of the Secretary of 
Veterans' Affairs to provide counseling for family members of 
veterans receiving non-service connected treatment; to direct 
the Secretary of Veterans Affairs to establish not more than 
seven consolidated patient accounting centers, and for other 
purposes; to prohibit the Secretary of Veterans' Affairs from 
collecting certain copayments from veterans who are 
catastrophically disabled; and, to modify and update provisions 
of law relating to nonprofit research and education 
corporations, and for other purposes.
    Members of Congress testified on their respective bills and 
in addition, the following provided testimony before the 
Committee: veterans service organizations; and, the U.S. 
Department of Veterans Affairs. See Veterans Healthcare 
Legislation, Serial No. 110-95.

Subcommittee Markup of H.R 1527, H.R. 6114, H.R. 6122, H.R. 6366, H.R. 
        6439, and H.R. 6445

    On July 10, 2008, the Subcommittee met and marked up six 
bills which were reported favorably to the full Committee by 
unanimous consent: H.R. 1527, to allow highly rural veterans 
enrolled in the health system of the Department of Veterans 
Affairs to receive covered health services through providers 
other than those of the Department, and for other purposes.; 
H.R. 6114, to amend the Veterans' Benefits and Services Act of 
1988 relating to testing for infection with the human 
immunodeficiency virus.; H.R. 6122, to direct the Secretary of 
Veterans Affairs to develop and implement a comprehensive 
policy on the management of pain experienced by veterans 
enrolled for health care services provided by the Department of 
Veterans Affairs, and for other purposes.; H.R. 6366, to direct 
the Secretary of Veterans Affairs to establish not more than 
seven consolidated patient accounting centers, and for other 
purposes.; H.R. 6439, toexpand the authority of the Secretary 
of Veterans Affairs to provide counseling for family members of 
veterans receiving non-service-connected treatment.; H.R. 6445, to 
prohibit the Secretary of Veterans Affairs from collecting certain 
copayments from veterans who are catastrophically disabled.

Subcommittee Legislative Hearing--H.R. 3051, H.R. 6153, and H.R. 6629

    On September 9, 2008, the Subcommittee held a legislative 
hearing on three bills: H.R. 3051, Heroes at Home Act of 2007; 
H.R. 6153, Veterans' Medical Personnel Recruitment and 
Retention Act of 2008; and, H.R. 6629, Veterans Health Equity 
Act of 2008.
    Members of Congress testified on their respective bills and 
in addition, the following provided testimony before the 
Committee: veterans service organizations; and, the U.S. 
Department of Veterans Affairs. See Legislative Hearing on H.R. 
3051, H.R. 6153, and H.R. 6629, Serial No. 110-102.

                          OVERSIGHT ACTIVITIES

Subcommittee Hearing--The U.S. Department of Veterans Affairs Fiscal 
        Year 2008 Health Budget

    On February 14, 2007, the Subcommittee held an oversight 
hearing with the purpose of examining the health budget of U.S. 
Department of Veterans Affairs for fiscal year 2008. VA 
requested an increase of $1.9 billion for health care in 
appropriated dollars over the FY 2007 amounts, representing a 
six percent increase. The budget included increases in fees and 
copayments and cuts in certain medical and prosthetic 
expenditures.
    The Subcommittee heard testimony from the U.S. Department 
of Veterans Affairs; American Psychological Association; 
American Thoracic Society; and, Iraq and Afghanistan Veterans 
of America. See The U.S. Department of Veterans Affairs Fiscal 
Year 2008 Health Budget, Serial No. 110-2.

Subcommittee Hearing--Polytrauma Center Care and the Traumatic Brain 
        Injury (TBI) Patient: How Seamless is the Transition Between 
        the U.S. Department of Veterans Affairs and Department of 
        Defense and are Needs Being Met?

    On March 15, 2007, the Subcommittee held an oversight 
hearing to examine the Veterans Health Administration 
Polytrauma System of Care and assess the interaction between 
the U.S. Department of Veterans Affairs and the U.S. Department 
of Defense and the existing barriers that prevent a smooth 
transition between the agencies and continuous care for the 
veteran.
    The Subcommittee heard testimony from the U.S. Department 
of Veterans Affairs; Lakeview Healthcare Systems, Inc; 
Department of Orthopaedics and Rehabilitation at the Brooke 
Army Medical Center, U.S. Department of Defense; Military One 
Source/Severely Injured Services; and, veterans service 
organizations. See Polytrauma Center Care and the Traumatic 
Brain Injury (TBI) Patient: How Seamless is the Transition 
Between the U.S. Department of Veterans Affairs and Department 
of Defense and are Needs Being Met?, Serial No. 110-9.

Subcommittee Hearing--Access to U.S. Department of Veterans Affairs 
        (VA) Health Care: How Easy is it for Veterans-Addressing the 
        Gaps

    On April 18, 2007, the Subcommittee held an oversight 
hearing to determine what gaps currently limit or preclude 
access to Community Based Outpatient Clinics and the overall 
provision of rural health services.
    The Subcommittee heard testimony from the U.S. Department 
of Health and Human Services; National Rural Health 
Association; The American Legion; Disabled American Veterans; 
and the U.S. Department of Veterans Affairs. See Access to U.S. 
Department of Veterans Affairs (VA) Health Care: How Easy is it 
for Veterans-Addressing the Gaps, Serial No. 110-13.

Subcommittee Hearing--the State of the U.S. Department of Veterans 
        Affairs' Long-Term Care Programs

    On May 9, 2007, the Subcommittee held an oversight hearing 
to examine the strategic plan for the future of long-term care 
services in the U.S. Department of Veterans Affairs. The 
hearing also explored ideas on innovative care and assessed how 
VA is addressing the needs of a growing aging veteran 
population as well as the newest generation of veterans from 
Operations Enduring Freedom and Iraqi Freedom.
    The Subcommittee heard testimony from the Maine Veterans' 
Homes; National Association of State Veterans' Liaison 
Committee and Administrator of the Oklahoma Veterans Center; 
veterans service organization; and, the U.S. Department of 
Veterans Affairs. See State of the U.S. Department of Veterans 
Affairs' Long-Term Care Programs, Serial No. 110-21.

Subcommittee on Health and Subcommittee on Disability Assistance and 
        Memorial Affairs Joint Hearing--Issues Facing Women and 
        Minority Veterans

    On July 12, 2007, the Subcommittees held an oversight 
hearing on the current programs for women, rural and other 
special populations of veterans in the U.S. Department of 
Veterans Affairs. The hearing examined ways in which VA can 
improve access to treatment for these populations, with 
particular attention to mental health care. As active duty 
populations become increasingly more diverse, it is critical 
that VA adapt to these changing demographics to ensure that it 
is equipped to address the special needs faced by women and 
minority veterans. The population of women in the military has 
risen to nearly 2 million.
    The Subcommittees heard testimony from the Honorable 
Heather Wilson; U.S. Department of Veterans Affairs, Advisory 
Committee on Minority Veterans and the Center for Women 
Veterans; veterans service organizations; and, the Center for 
Chronic Disease Outcomes Research at the Minneapolis VA Medical 
Center. See Joint Hearing on Issues Facing Women and Minority 
Veterans, Serial No. 110-33.

Subcommittee Hearing--Vet Centers

    On July 19, 2007, the Subcommittee held an oversight 
hearing to examine the strategic direction and plan for the 
future of readjustment counseling services provided to veterans 
through the Vet Center program at the U.S. Department of 
Veterans Affairs. Specific areas of focus were projected 
workload increases, professional staffing needs, additional 
funding, outreach, timeliness of services, gaps in services, a 
projected timeline for the new Vet Centers to be operational, 
and the different populations that Vet Centers serve.
    The Subcommittee heard testimony from the Depression and 
Bipolar Support Alliance; veterans service organizations; and, 
the U.S. Department of Defense. See Vet Centers, Serial No. 
110-35.

Subcommittee Hearing--Gulf War Exposures

    On July 26, 2007, the Subcommittee held a hearing to 
receive an update on Gulf War exposures in preparation for a 
report expected later in the year. Witnesses were asked to 
testify about the exposure of veterans who served in the Gulf 
War to Anthrax, the Incidence of Amyotrophic Lateral Sclerosis 
among Gulf War veterans, and how the U.S. Department of 
Veterans Affairs is performing in conducting research on Gulf 
War exposures and in providing health care services through the 
Office of Public Health and Environmental Hazards.
    The Subcommittee heard testimony from the Veterans of 
Modern Warfare; a Gulf War veteran with Amyotrophic Lateral 
Sclerosis; National Vietnam and Gulf War Veterans Coalition; a 
researcher affiliated with Mount Desert Island Hospital; 
Research Advisory Committee on Gulf War Veterans' Illnesses 
with the U.S. Department of Veterans Affairs; Office of Public 
Health and Environmental Agents Service. See Gulf War 
Exposures, Serial No. 110-38.

Site Visit to Chicago, Illinois

    From August 1-2, 2007, majority and minority staff traveled 
to the North Chicago U.S. Department of Veterans Affairs (VA) 
Medical Center and Great Lakes Naval Training Center, and the 
VA National Acquisition Center. The purpose of this visit was 
to gain a better understanding of the new James A. Lovell VA-
U.S. Department of Defense (DoD) Federal Health Care Facility, 
a unique health care facility combining the resources of the VA 
and DoD that will care for nearly 100,000 veterans, sailors, 
retirees and family members.

Site Visit to Minneapolis, Minnesota

    On August 29, 2007, majority and minority staff of the 
Subcommittee on Health accompanied the Subcommittee on Health 
Chairman, Michael H. Michaud, and the Honorable Betty McCollum 
on a visit to the Minneapolis Polytrauma Rehabilitation Center 
at the Minneapolis VA Medical Center. Staff and members 
received an overview of the VA Polytrauma System of Care and 
the Minneapolis VA Medical Center and were guided through the 
Polytrauma Rehabilitation Center (PRC), as well as 
Rehabilitation Services, the Prosthetics Clinic, the 
Transitional Unit and the Fisher House.
    The Minneapolis is one of four VA Polytrauma System of Care 
centers in the VA. Polytrauma care is for veterans and 
returning service members with injuries to more than one 
physical region or organ system. Generally, the injuries are 
life threatening and affect the physical, cognitive, 
psychological, or psychosocial impairments and functional 
disability. Any veteran entitled to benefits or an active duty 
military member who is medically stable is eligible for 
admission. In addition, the patient must meet the following 
criteria: have sustained multiple physical, cognitive, and/or 
emotional injuries secondary to trauma; not require one-to-one 
staffing for medical or behavioral reasons; not require a 
ventilator to breathe; have the potential to benefit from 
rehabilitation; or, need an initial, comprehensive 
rehabilitation evaluation and care plan.
    The Polytrauma System also provides logistical, clinical, 
and emotional support to patients' families. The Minneapolis VA 
Medical Center is enhanced with a Fisher House where families 
are lodged while visiting injured family service members. 
Fisher Houses provide families with a vital and necessary 
support system while patients undergo rehabilitation at the 
PRC.

Site Visit to Denver, Colorado

    From September 13-14, 2007, majority and minority staff of 
the Subcommittee on Health visited Brain Matters, Inc., where 
they were briefed and given a demonstration on the services and 
technology offered by the company. Brain Matters provides 
functional brain imaging using Single Photon Emission Computed 
Tomography (SPECT) technology.
    The staff also visited the current Denver VA Medical 
Center, where they were given a presentation on the hospital, 
the Eastern Colorado Care System (ECHS), and a tour of the 
facility. The facility has 120 inpatient beds in 650,000 square 
feet on 13 acres of land and employs 1,600 full-time employees. 
Issues addressed were waiting times (95 percent of patients 
making an appointment in primary care and specialty clinics are 
seen within 30 days), space deficiency (ECHS is experiencing a 
six percent growth in demand annually and with today's 
workload, is 60 percent space-deficient), grants the facility 
has received to enhance PTSD (ECHS has recently received 
several, but currently do not have sufficient space to 
effectively house these programs on-site), polytrauma and low-
vision services, the migration of the formerly co-located 
University of Colorado (UC) hospital (in June 2007, the UC 
hospital moved to a new location seven miles away), and air 
quality within the facility (since 2002, 53 immuno-deficient 
patients have been diverted to other VAMCs, specifically Salt 
Lake City, UT, due to poor quality).
    On September 14, 2007, staff toured the proposed site for 
the new Denver VAMC. The development of the new Denver VA 
Medical Center, called Project Eagle, is in the pre-design 
phase and is planned to be 1,570,000 square feet on 31 acres. 
It will house 240 beds (150 acute inpatient beds, 60 nursing 
home, and 30 spinal cord injuries) and will have approximately 
2,240 FTEs. This facility will be located on the Fitzsimmons 
Campus, which currently houses the UC Medical Center and Denver 
Children's Hospital, and, as of June 2008, will house the UC 
Health Sciences Center. These facilities plan to share 
resources such as orthopedics, radiation therapy and medical 
school faculty. The new facility will also have a low-vision 
program and will offer extensive mental health services. The 
current timeline for the opening of the facility is 2012. The 
projected budget for Project Eagle is $646 million.
    The staff was also given a briefing and a tour at the VA 
Health Administration Center (HAC). HAC administers health 
benefits to veterans and their families through Civilian Health 
and Medical Program of the Department of Veterans Affairs 
(CHAMPVA), the Foreign Medical Program (FMP), the Spina Bifida 
Program and Children of Woman Vietnam Veterans. HAC currently 
occupies 110,000 square feet of space and employs 580 civil 
servants.

Subcommittee Hearing--The U.S. Department of Veterans Affairs Grant and 
        Per Diem Program

    On September 27, 2007, the Subcommittee held a hearing to 
gain a better understanding of the U.S. Department of Veterans 
Affairs Homeless Providers Grant and Per Diem Program and to 
identify ways in which the program is working as well as areas 
for improvement.
    The Subcommittee heard testimony from the National 
Coalition for Homeless Veterans; Volunteers of America of 
Florida; Government Accountability Office; VA Advisory 
Committee on Homeless Veterans; and, the Homeless Veterans 
Programs of the U.S. Department of Veterans Affairs. See The 
U.S. Department of Veterans Affairs Grant and Per Diem Program, 
Serial No. 110-48.

Subcommittee Hearing--The U.S. Department of Veterans Affairs Research 
        Programs

    On October 4, 2007, the Subcommittee held an oversight 
hearing to better understand the U.S. Department of Veterans 
Affairs research programs and needs for the current Operation 
Enduring Freedom and Operation Iraqi Freedom conflicts and to 
explore ways in which these programs are making progress as 
well as areas in which more attention and resources should be 
focused.
    The Subcommittee heard testimony from Friends of VA Medical 
Care and Health Research; Military Advanced Training Center at 
Walter Reed Army Medical Center; Pain Care Coalition; veterans 
service organizations; and, the U.S. Department of Veterans 
Affairs. See The U.S. Department of Veterans Affairs Research 
Programs, Serial No. 110-50.

Subcommittee Hearing--Healthcare Professionals--Recruitment and 
        Retention

    On October 18, 2007, the Subcommittee held an oversight 
hearing to address the issue of recruitment and retention of 
healthcare professionals within the U.S. Department of Veterans 
Affairs. Current practices were examined, as well as associated 
problems and potential improvements.
    The Subcommittee heard testimony from American Physical 
Therapy Association; American Association of Medical Colleges; 
National Board for Certified Counselors, Inc. and Affiliates; 
CACI Strategic Communications; veterans service organizations; 
American Federation of Government Employees, AFL-CIO; and, the 
U.S. Department of Veterans Affairs. See Healthcare 
Professionals--Recruitment and Retention, Serial No. 110-55.

Subcommittee Hearing--The U.S. Department of Veterans Affairs 
        Construction Process

    On November 1, 2007, the Subcommittee held an oversight 
hearing to gain a better understanding of the VA construction 
process. Particular emphasis was placed on the strengths and 
limitations of the current process, determining what 
improvements can be made, and how VA is dealing with aging 
infrastructure.
    The Subcommittee heard testimony from Eglin Air Force Base; 
The Clarkson Group, L.L.C.; The Haskell Company; veterans 
service organizations; and, the U.S. Department of Veterans 
Affairs. See The U.S. Department of Veterans Affairs 
Construction Process, Serial No. 110-59.

Site Visit to Providence, Rhode Island, and White River Junction, 
        Vermont

    From November 28-30, 2007, majority and minority staff 
traveled to Providence, Rhode Island, and White River Junction, 
Vermont. Staff visited the VA Center for Restorative and 
Regenerative Medicine in Providence and the National Center for 
PTSD in White River Junction. The purpose of these visits was 
to gain a better understanding of VA programs for treatment of 
PTSD and research and development in the area of prosthetics.

Subcommittee on Health and Subcommittee on Oversight and Investigations 
        Hearing--Outpatient Waiting Times

    On December 12, 2007, the Subcommittees held a hearing to 
examine waiting times for outpatient appointments in the 
Veterans Health Administration.
    The Subcommittees heard testimony from Licking County 
Veterans' Service Commission, Newark, Ohio; Unum US; Office of 
Inspector General at the U.S. Department of Veterans Affairs; 
and the Deputy Under Secretary for Health of the U.S. 
Department of Veterans Affairs. See Outpatient Waiting Times, 
Serial No. 110-62.

Second Session

Site Visit to West Lafayette, Indiana

    From January 8-9, 2008, minority staff traveled to West 
Lafayette, Indiana, to accompany Ranking Republican Member 
Steve Buyer to a meeting at the Indiana Veterans' Home in West 
Lafayette where U.S. Department of Veterans Affairs (VA) leases 
space for a Community Based Outpatient Clinic. The purpose of 
the meeting was to develop a cooperative solution to more than 
double the capacity of the VA clinic and ensure the long-term 
co-location of veterans' services.

Site Visit to Harlingen, Texas

    From February 3-6, 2008, minority staff accompanied Ranking 
Republican Member Steve Buyer to South Texas to visit U.S. 
Department of Veterans Affairs facilities in Harlingen, Texas, 
and participate in a veterans' forum hosted by Congressmen 
Solomon Ortiz, Ruben Hinojosa, and Henry Cuellar.

Site Visit to Chicago, Illinois

    On February 11, 2008, majority and minority staff traveled 
to Chicago, Illinois, to visit the North Chicago VA Medical 
Center and Naval Hospital Great Lakes. The purpose of this 
visit was to gain a better understanding of the new James A. 
Lovell VA-DOD Federal Health Care Facility, a unique health 
care facility combining the resources of the VA and DOD that 
will care for nearly 100,000 veterans, sailors, retirees and 
family members.
    Staff found that a variety of problems could confront the 
joint facility. These problems may include difficulties in 
merging DoD and VA workforces, determining how much funding 
each are responsible for, and ensuring that veterans continue 
to receive attentive and full care.

Site Visit to Hinesville, Georgia

    From February 19-20, 2008, majority and minority staff 
traveled to Hinesville, Georgia, to visit the Fort Stewart 
military installation. The purpose of the visit was to observe 
the 76th Brigade of the Indiana National Guard, receive a pre-
deployment briefing from VA, and thereby gain a better 
understanding of VA's interaction with troops, specifically 
before they are deployed.

Subcommittee Hearing--U.S. Department of Veterans Affairs Construction 
        Authorization

    On February 27, 2008, the Subcommittee held an oversight 
hearing to review a discussion draft bill authorizing major VA 
construction projects and leases. The U.S. Department of 
Veterans Affairs requested an authorization of $1,871,900,000 
for major medical facility construction projects and 
$60,114,000 for major medical facility leases in 2009, for a 
total of $1,932,014,000. Title 38, U.S. Code, section 
8104(a)(2) requires statutory authorization for all major 
medical facility construction projects and major medical 
facility leases. The threshold for a major construction project 
is $10,000,000 and for a major facility lease, it is $600,000.
    The Subcommittee heard testimony from veterans service 
organizations and the Office of Construction and Facilities 
Management of the U.S. Department of Veterans Affairs. See U.S. 
Department of Veterans Affairs Construction Authorization, 
Serial No. 110-72.

Subcommittee Hearing--Mental Health Treatment for Families: Supporting 
        Those Who Support Our Veterans

    On February 28, 2008, the Subcommittee held an oversight 
hearing to examine the current authority to provide mental 
health services to family members of veterans and to determine 
whether this authority should be expanded in the U.S. 
Department of Veterans Affairs. Current regional level programs 
addressing the mental health needs of family members were also 
discussed.
    The Subcommittee heard testimony from the Commissioner of 
Veterans' Affairs in the State of Connecticut; the author of 
When the War Came Home: The Inside Story of Reservists and the 
Families They Leave Behind; Citizen Support Program National 
Demonstration; American Association for Marriage and Family 
Therapy; Mental Health America; American Group Psychotherapy 
Association, Inc; veterans service organizations; and the U.S. 
Department of Veterans Affairs. See Mental Health Treatment for 
Families: Supporting Those Who Support Our Veterans, Serial No. 
110-73.

Site Visit to Pensacola, Florida

    On March 10, 2008, majority and minority staff accompanied 
Health Subcommittee Chairman Michael H. Michaud, Ranking 
Republican Member Jeff Miller, and Congressmen Solomon Ortiz 
and Reuben Hinojosa to visit the Pensacola Joint Ambulatory 
Care Center and examine the collaborative model of care that 
the U.S. Department of Veterans Affairs and the U.S. Department 
of Defense has established.
    Subcommittee Hearing--Substance Abuse/Comorbid Disorders: 
Comprehensive Solutions to a Complex Problem
    On March 11, 2008, the Subcommittee held an oversight 
hearing to review the current programs for treatment of 
substance use disorders and comorbid conditions in the U.S. 
Department of Veterans Affairs. The hearing also focused on the 
latest research and treatment of substance use disorders as 
well as the quality and consistency of VA's substance abuse and 
co-morbid treatment programs across regions.
    The Subcommittee heard testimony from the National 
Association for Addiction Professionals; Center for Health Care 
Policy and Research at Case Western Reserve University; 
veterans service organizations; and the U.S. Department of 
Veterans Affairs. See Substance Abuse/Comorbid Disorders: 
Comprehensive Solutions to a Complex Problem, Serial No. 110-
75.

Site Visit to Guam

    From March 14-20, 2008, majority and minority staff 
traveled to the U.S territory of Guam to visit current and 
prospective U.S. Department of Defense (DoD) and U.S. 
Department of Veterans Affairs (VA) facilities. The purpose of 
the visit was to gain a better understanding of the current 
state of VA operations in Guam and to assess the feasibility 
and advisability of future partnerships between VA and DoD on 
the island.
    Although no accurate count exists, it has been estimated 
that there are approximately 15,000 veterans living on Guam. Of 
these, about 1,500 are actively enrolled in the U.S. VA 
Healthcare System. This number is expected to grow as Guam has 
the highest per capita enlistment rate in the United States and 
the Guam National Guard is currently at over 150 percent 
capacity.
    Currently, VA does not have any freestanding facilities of 
its own on Guam. Rather, it has entered into a sharing 
agreement whereby it reimburses DoD for the use of their 
facilities. VA has access only on a space available basis, but 
thus far, it has not been problematic. Other than a Naval 
Hospital, the only inpatient care on Guam is Guam Memorial 
Hospital which is unaccredited and chronically overcrowded. 
Currently, VA leases space for a Community Based Outpatient 
Clinic (CBOC) in a wing of the Naval Hospital, but they are in 
the process of constructing a freestanding CBOC.

Subcommittee Hearing--Post-Traumatic Stress Disorder Treatment and 
        Research: Moving Ahead Toward Recovery

    On April 1, 2008, the Subcommittee held an oversight 
hearing to review the current treatment and research programs 
for Post-Traumatic Stress Disorder (PTSD) at the U.S. 
Department of Veterans Affairs (VA). Treatments are most 
commonly done on an outpatient basis, but more intensive 
inpatient treatment is available as well. VA boasts the 
National Center for PTSD (NCPTSD), arguably the world's 
foremost PTSD research center.
    The Subcommittee heard testimony from Division of 
Psychiatry and Neuroscience, Walter Reed Army Institute of 
Research; American Occupational Therapy Association; Committee 
on Treatment of Posttraumatic Stress Disorder; Virtual Reality 
Medical Center; National PTSD and Substance Abuse Committee at 
Vietnam Veterans of America; Iraq and Afghanistan Veterans of 
America; and, the U.S. Department of Veterans Affairs. See 
Post-Traumatic Stress Disorder Treatment and Research: Moving 
Ahead Toward Recovery, Serial No. 110-78.

Subcommittee Field Hearing--Women, Rural and Special Needs Veterans, 
        Sanford, Maine

    On April 21, 2008, the Subcommittee held a hearing to 
examine how well VA is serving women, rural, and other special 
veteran populations and look at ways in which the VA can 
improve access to treatment for these populations. The hearing 
had specific emphasis on mental health care.
    The Subcommittee heard testimony from a veteran from Maine; 
the Bureau of Veterans' Services for the State of Maine; Maine 
Veterans Coordinating Committee; Maine Veterans' Homes; Maine 
Rural Health Research Center; local veterans service 
organizations; and, the Director of the Togus Veterans Affairs 
Medical Center. See Women, Rural, and Special Needs Veterans, 
Field Hearing in Sandford, ME, Serial No. 110-84.

Staff Visit to Charleston, South Carolina

    On April 28, 2008, minority staff accompanied the Honorable 
James B. Peake, M.D., Secretary of the U.S. Department of 
Veterans Affairs (VA), Ranking Member Steve Buyer and 
Congressman Henry Brown, Jr. on a tour of the new Medical 
University of South Carolina (MUSC) hospital and met with the 
President of MUSC and local VA medical center personnel to 
discuss the implementation of section 804 of Public Law 109-461 
which authorized VA to enter into an agreement with MUSC for 
the planning and design of a co-located, joint-use medical 
facility to replace the existing Ralph H. Johnson Department of 
Veterans Affairs Medical Center in Charleston, South Carolina.

Site Visit to Hawaii

    From May 11-16, 2008, majority and minority staff traveled 
to Hawaii to visit Department of Veterans Affairs (VA) and U.S. 
Department of Defense (DoD) medical facilities on the islands. 
The purpose of the trip was to gain a better understanding of 
the public health situation in Hawaii as well as the current 
state of VA operations, and to assess the feasibility and 
advisability of future VA and DoD partnerships.

Subcommittee Hearing--Human Resources Challenges within the Veterans 
        Health Administration

    On May 22, 2008, the Subcommittee held an oversight hearing 
to examine the challenges the Veterans Health Administration 
currently faces in hiring practices, including issues related 
to recruitment, retention and labor management.
    The Subcommittee heard testimony from the American 
Federation of Government Employees; American Psychological 
Association; University of Minnesota Nurse Anesthesia Area of 
Study at the Minneapolis Veterans Affairs Medical Center; 
Vertical Alliance Group, Inc.; Paralyzed Veterans of America; 
Nurses Organization of Veterans Affairs; Disabled American 
Veterans; and, the U.S. Department of Veterans Affairs. See 
Human Resources Challenges within the Veterans Health 
Administration, Serial No. 110-88.

Site Visit to San Antonio, Texas

    On May 28, 2008, majority staff traveled to San Antonio, 
Texas, to visit the Brooke Army Medical Center and the Center 
for the Intrepid. The purpose of the visit was to gain a better 
understanding of the services, operations and technologies 
supported by the centers.
    The center provides traumatic amputee patients, burn 
patients requiring advanced rehabilitation and those requiring 
limb salvage efforts with techniques and training to help them 
regain their ability to live and work productively. Staff 
toured the center's military performance laboratories, 
occupational therapy department, physical therapy department, 
prosthetics laboratory, case management and behavioral medicine 
departments. Staff also witnessed the Gait Lab which is fitted 
with 24 cameras on an automated truss which use infrared light 
to analyze human motion. Staff saw the CAREN--a computer 
assisted environment, which has a 21-foot simulated dome with a 
300-degree screen that immerses patients using sensors and 
high-speed infrared cameras and a moving platform that reacts 
to the patients' movements.

Site Visit to Lewiston, Maine

    On July 21, 2008, majority and minority staff accompanied 
Subcommittee on Health Chairman Michael H. Michaud to travel to 
Lewiston, Maine, to meet with members of the Auburn, Maine, 
Company of the 399th Combat Support Hospital. This unit 
recently returned from a mission in Iraq. The purpose of the 
meeting was for the unit to share personal experiences, discuss 
challenges they faced, and make recommendations for changes to 
the system.

Subcommittee CODEL to Kuwait, Iraq, and Germany

    Michael H. Michaud, Chairman of the Subcommittee on Health, 
led a Congressional delegation to visit medical facilities in 
the chain of care (from Level 1 through Level 5) for OIF and 
OEF service members to see first-hand the level and quality of 
health care being provided to active duty service members in 
Iraq; from August 3-7, 2008. Accompanying Chairman Michaud were 
Subcommittee on Health Ranking Member, Jeff Miller; Congressman 
Ciro D. Rodriguez; Congressman Bill Sali; Congressman Phil 
Hare; Congressman John T. Salazar; majority and minority staff 
of the Committee; and, the Secretary of the U.S. Department of 
Veterans Affairs, The Honorable James B. Peake, M.D.
    The Congressional delegation provided Committee members and 
staff with a first-hand look at evacuation routes, facilities, 
and health care delivery tools and capabilities available to 
service members serving in Operation Iraqi Freedom (OIF). 
Special attention was paid to U.S. Department of Defense (DoD) 
electronic medical records. The ability of DoD and the 
Department of Veterans Affairs (VA) to electronically 
communicate smoothly with each other is the foundation of a 
fluid transition from the DoD health care system to its VA 
counterpart. Complaints about missing or incomplete DoD medical 
records threaten to undermine the ability of separated service 
members to receive full and quality health care from VA.
    Medical records were generally adequate. Each level of 
facility has different medical capabilities and therefore 
differing records. However, all records are ultimately stored 
in and accessible from the Clinical Data Repository (CDR). On-
the-ground personnel appeared confident in the various systems. 
Although the Battlefield Information System Tactical-Joint 
(AHLTA Mobile), a computerized medical record entry system used 
at the point of injury, was not observed in operation, staff 
were assured that it is in use by far forward medics and 
corpsmen.
    The CODEL also examined the extent and quality of mental 
health services available in theatre. Facilities offered a 
number of outpatient services, including individual therapy, 
medication management, and anger and stress management. Short-
term inpatient care was available as well. The Level II site 
offered a psychologist and psychiatrist who traveled to command 
outposts to monitor the mental health status of forward 
deployed service members.

Site Visit to Billings, Montana, and Denver, Colorado

    From August 19-20, 2008, majority and minority staff 
traveled to Billings, Montana, to visit the Community Based 
Outpatient Clinic (CBOC) and to Denver, Colorado, to visit the 
site of a proposed VA Medical Center. The purpose of the visit 
was to better understand VA's new proposal for the Denver 
Medical Center, which would center around VA leasing beds at a 
new University of Colorado Hospital and expanding CBOC services 
in the surrounding areas rather than building a stand-alone 
hospital.

Site Visit to South Bend, Indiana, and Tucson, Arizona

    From September 5-6, 2008, majority staff traveled to South 
Bend, Indiana, and Tucson, Arizona. The South Bend visit was 
intended to introduce Subcommittee staff to health care access 
issues facing veterans in the South Bend area. After visiting 
the South Bend Community Based Outpatient Clinic (CBOC) and the 
St. Joseph Regional Medical Center, staff attended a roundtable 
event hosted by Congressman Joe Donnelly in which local 
veterans, veterans service organizations, the U.S. Department 
of Veterans Affairs, and other interested parties discussed 
health care access issues in the region. Veterans noted issues 
accessing specialty care and also noted that the South Bend 
CBOC was already operating at capacity.
    The Tucson leg of the trip began with a roundtable event 
hosted by Congresswoman Gabrielle Giffords. Veterans and 
policymakers discussed the state of mental health care 
available to veterans, both in Tucson and nationally. Veterans 
were concerned with issues as varied as the stigma of maladies 
such as Post-traumatic Stress Disorder (PTSD) and Traumatic 
Brain Injury and constant access to emergency mental health 
care services for suicidal veterans.
    Staff then visited the Tucson VA Medical Center which 
serves as the VISN 18 polytrauma network site and boasts an 
interdisciplinary team equipped to attack polytrauma injuries 
from a variety of angles. This center includes such specialists 
as neurologists and physical therapists, as well as a broad 
array of state-of-the-art equipment. The Tucson VAMC is also 
home to a new outpatient mental health clinic which has 
services that range from substance abuse treatment to intensive 
outpatient PTSD treatment.

Subcommittee Hearing--U.S. Department of Veterans Affairs Suicide 
        Hotline

    On September 16, 2008, the Subcommittee held an oversight 
hearing to examine the hotline's responsiveness to the needs of 
veterans, how suicidal veterans are helped, best practices for 
suicide prevention, and hotline staffing at the U.S. Department 
of Veterans Affairs.
    The Subcommittee heard testimony from the U.S. Department 
of Health and Human Services; Vietnam Veterans of America; 
American Psychological Association; National Veterans 
Foundation; National Hopeline Network; MHN; and, the U.S. 
Department of Veterans Affairs. See U.S. Department of Veterans 
Affairs Suicide Hotline, Serial No. 110-104.

Staff Visit to Honolulu, Hawaii, and Site Visit to Palo Alto, 
        California

    From September 28-30, 2008, majority and minority staff 
attended a conference hosted by the Honorable Dirk Kempthone, 
Secretary of the U.S. Department of Interior and co-chaired 
with the Honorable James B. Peake, M.D., Secretary of the U.S. 
Department of Veterans Affairs; Honorable David Chu, Under 
Secretary of Defense for Personnel and Readiness, U.S. 
Department of Veterans Affairs; and, Honorable Joxel Garcia, 
Assistant Secretary for Health, U.S. Department of Health and 
Human Services. The purpose of the summit was to create an 
Interagency Coordinated Assets for Insular Health Response 
(ICAIHR) with the four departments. The charge of the ICAIHR 
is: (1) to assess the health care needs of each of the seven 
insular areas including Guam, American Samoa, the Commonwealth 
of the Northern Mariana Islands, U.S. Virgin Islands, Palau, 
Federated States of Micronesia, and the Republic of the 
Marshall Islands, in consultation with appropriate leaders from 
these areas; (2) develop a priority list of actions specific to 
each insular area that addresses the most critical health care 
needs; and, (3) prepare an action report for each insular area 
by June 2009.

Site Visit to Minneapolis, Minnesota

    On November 14, 2008, majority and minority staff traveled 
to Minneapolis, Minnesota, to tour the Geriatric Research 
Education and Clinical Center (GRECC) at the Minneapolis U.S. 
Department of Veterans Affairs Medical Center. Additionally, 
staff was briefed on Project HERO (Healthcare Effectiveness 
through Resource Optimization).
    The briefing on the GRECC's mission highlighted the 
importance of focusing on elderly-specific issues; the 
proportion of 65-year olds within the veteran population far 
outstrips its counterpart in the general population. GRECCs 
provide cutting-edge research into the effects of aging on the 
brain and other issues relevant to elderly veterans.
    Project HERO, a demonstration project implemented in four 
Veterans Integrated Service Networks, explores the practice of 
filling health care access gaps in rural areas through the use 
of fee-based care. Staff noted the challenges the Minneapolis 
VAMC has met in recruiting providers to their network and 
examined the efforts made to evaluate Project HERO's 
effectiveness.

              SUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS


                          OVERSIGHT ACTIVITIES

First Session

Subcommittee Hearing--Oversight Efforts of the U.S. Department of 
        Veterans Affairs (VA) Inspector General: Issues, Problems and 
        Best Practices at the VA

    On February 15, 2007, the Subcommittee conducted a hearing 
on the best practices of the VA's Inspector General (IG). The 
purpose of this hearing was to gain the perspective of the IG 
and hear its take on the FY2008 budget.
    The Subcommittee heard testimony from the Inspector General 
for the U.S. Department of Veterans Affairs. See Oversight 
Efforts of the U.S. Department of Veterans Affairs (VA) 
Inspector General: Issues, Problems and Best Practices at the 
VA, Serial No. 110-4.

Site Visit to Martinsburg, West Virginia

    From February 22-25, 2007, majority staff conducted an 
unannounced site visit to the U.S. Department of Veterans 
Affairs Medical Center in Martinsburg, West Virginia.
    The purpose of the trip was to train new staff members on 
how to conduct unannounced inspections, and to familiarize 
staff with a tertiary level VA medical center. Staff visited 
the nursing home, domiciliary, pharmacy, cardiac ward, and 
psychiatric ward unescorted before meeting with the Director 
and the Chief of Staff for the facility. Following the meeting, 
staff were given a guided tour of the Fourth Mission 
facilities.

Subcommittee Hearing--Information Security Management at the Department 
        of Veterans Affairs--Current Effectiveness and the Need for 
        Cultural Change

    On February 28, 2007, the Subcommittee held a hearing to 
follow up on VA's commitment to improving its data security and 
information technology programs. Prior to the 110th Congress, 
the Committee held numerous hearings regarding data theft and 
security problems at the VA resulting in Public Law 109-461, 
The Veterans Benefits, Healthcare and Information Technology 
Act of 2006.
    The Subcommittee heard testimony from the U.S. Department 
of Veterans Affairs; Government Accountability Office; and the 
Inspector General for the U.S. Department of Veterans Affairs. 
See Information and Security Management at the U.S. Department 
of Veterans Affairs--Current Effectiveness and the Need for 
Cultural Chang, Serial No. 110-5.

Subcommittee Hearing--Servicemembers Seamless Transition Into Civilian 
        Live--The Heroes Return

    On March 8, 2007, the Subcommittee held a hearing on the 
transition of service members from active duty to civilian 
life. Following the scandal at the Walter Reed Army Medical 
Center, the Subcommittee began holding investigations into how 
service members are welcomed into the U.S. Department of 
Veterans Affairs (VA) and what steps are taken to ensure a 
seamless transition.
    The Subcommittee heard testimony from the U.S. Department 
of Veterans Affairs; the Government Accountability Office; 
Veterans for Common Sense; a recently transitioned veteran from 
the Walter Reed Army Medical Center; VA Polytrauma Center in 
Richmond, Virginia; VAPolytrauma Center in Tampa, Florida; VA 
social worker liaisons for seamless transition at Walter Reed Army 
Medical Center and the National Naval Medical Center in Bethesda, 
Maryland; and, the mother of a transitioning veteran from Mesa, 
Arizona. See Servicemembers Seamless Transition Into Civilian Life--The 
Heroes Return, Serial No. 110-7.

Subcommittee Hearing--Surgical Services at the W.G. (Bill) Hefner VA 
        Medical Center in Salisbury, North Carolina

    On April 19, 2007, the Subcommittee conducted a hearing on 
the quality of care at U.S. Department of Veterans Affairs 
Medical Centers using the W.G. (Bill) Hefner VA Medical Center 
in Salisbury, North Carolina, as a case study. The Subcommittee 
had been troubled by reports of numerous wrongful deaths at the 
Salisbury VA Medical Center, specifically in the surgical 
service, and requested VA's response to correct the problems.
    The Subcommittee heard testimony from the U.S. Department 
of Veterans Affairs Inspector General; Chief of Staff for the 
Salisbury VA Medical Center; and the U.S. Department of 
Veterans Affairs. See Surgical Services at the W.G. (Bill) 
Hefner VA Medical Center in Salisbury, North Carolina, Serial 
No. 110-14.

Subcommittee Hearing--Sharing of Electronic Medical Records Between the 
        U.S. Department of Defense and the U.S. Department of Veterans 
        Affairs

    On May 8, 2007, the Subcommittee held a hearing on sharing 
electronic medical information between the U.S. Department of 
Veterans Affairs (VA) and the U.S. Department of Defense (DoD). 
In an attempt to improve the sharing of health information, VA 
and DoD have been working since 1998 to gain the ability to 
exchange electronic health records for use by veterans, 
military personnel, and health care providers. VA and DoD are 
continuing with activities to support the sharing of health 
data; nonetheless, achieving the two-way electronic exchange of 
patient health information remains far from realized.
    The Subcommittee heard testimony from the U.S. Government 
Accountability Office; the U.S. Department of Veterans Affairs; 
and, the U.S. Department of Defense; Interagency Communications 
for the TRICARE Management Activity; Western Regional Command 
Informatics and the Madigan Army Medical Center; and, a Joint 
Patient Tracking Application specialist. See Sharing of 
Electronic Medical Records Between the U.S. Department of 
Defense and the U.S. Department of Veterans Affairs, Serial No. 
110-20.

Site Visit to Asheville, North Carolina

    From May 14-15, 2007, majority staff conducted a site visit 
of the Asheville VA Medical Center in Asheville, North 
Carolina.
    The purpose of travel was to inspect and assess: a) third 
party collection delivery; b) staff vacancies; and, c) cyber 
security. The Office of the Medical Inspector (OMI) issued a 
report on December 20, 2005, based on allegations of inadequate 
nurse staffing, patient safety and quality of care. In 
addition, three particular patient safety concerns were brought 
to OMI's attention, all occurring on the inpatient surgical 
ward on June 2, 2005. The value of the trip to the Committee 
was to review and follow up on the OMI report dated December 
20, 2005, to assess whether the problems stated in the report 
were corrected. The inspection comprised of group interviews 
and a guided tour of the facility, to include the nursing home, 
domiciliary, medical facility, and third party collection pilot 
center. The following department heads and staffs were also 
interviewed: VA Medical Center Director, nursing, IT, pharmacy, 
social workers, patient advocates, and procurement and 
acquisition. Majority staff also reviewed the Consolidated 
Patient Accounting Center demonstration.

Subcommittee Hearing--Senior Executive Service (SES) Bonuses: Ensuring 
        VA's Process Works

    On June 12, 2007, the Subcommittee held a hearing in 
response to troubling reports of the U.S. Department of 
Veterans Affairs (VA) handing out large bonuses to officials 
who had not deserved them. During the hearing, the process VA 
uses to award bonuses to members of its staff who qualify for 
the SES as directed by the Office of Personnel Management (OPM) 
was discussed. During the hearing and investigation it was 
determined that VA's system complies with OPM guidelines.
    The Subcommittee heard testimony from the U.S. Government 
Accountability Office; the U.S. Department of Veterans Affairs; 
and, the Senior Executives Association. See Senior Executive 
Service (SES) Bonuses: Ensuring VA's Process Works, Serial No. 
110-26.

Subcommittee Hearing--The U.S. Department of Veterans Affairs Internal 
        Contracting Oversight Deficiencies

    On June 27, 2007, the Subcommittee held a hearing on VA's 
deficiencies in contracting finding that, without oversight 
authority, it is impossible to keep track of contracts and how 
money is being spent. This hearing was held following a 
troubling Inspector General's report concerning contracting 
fraud at the Boston VA Medical Center, and briefings on the 
general acquisition and procurement functions at the VA.
    The Subcommittee heard testimony from the U.S. Department 
of Veterans Affairs Inspector General and the Office of 
Acquisition and Material Management for the U.S. Department of 
Veterans Affairs. See The U.S. Department of Veterans Affairs 
Internal Contracting Oversight Deficiencies, Serial No. 110-31.

Subcommittee Hearing--U.S. Department of Veterans Affairs Information 
        Technology Inventory Management

    On July 24, 2007, the Subcommittee conducted a hearing on 
IT Inventory Management at the VA. The hearing served as the 
public release of the U.S. Government Accountability Office's 
(GAO) report entitled Inadequate Controls over IT Equipment at 
Selected VA Locations Pose Continuing Risk of Theft, Loss, and 
Misappropriation (GAO-07-505). The Subcommittee was troubled 
over the report's initial findings of continued negligence at 
various VA facilities so soon after major data loss problems 
and new directives.
    The Subcommittee heard testimony from the U.S. Government 
Accountability Office; Assistant Secretary for Information & 
Technology, U.S. Department of Veterans Affairs; and, Assistant 
Secretary for Management, U.S. Department of Veterans Affairs. 
See the U.S. Department of Veterans Affairs Information 
Technology Inventory Management, Serial No. 110-36.

Site Visit to Washington, District of Columbia

    On July 30, 2007, majority and minority staff conducted a 
site visit to Walter Reed Army Medical Center in Washington, 
DC.
    This visit was in preparation for a number of site visits 
the Subcommittee had organized to review the seamless 
transition of wounded service members from active duty into the 
U.S. Department of Veterans Affairs. Attention was paid to 
electronic medical information transfers and case management. 
When dealing with staff at Walter Reed, Subcommittee staff made 
a point of noting patients who would be moving to the VA 
Polytrauma Rehabilitation Centers in Palo Alto, California, and 
Minneapolis, Minnesota, in preparation for seeing those 
patients. Additionally, staff toured Building 18 to view 
changes that have been made in outpatient living quarters since 
the exposure given to the hospital in February 2007.

Site Visit to Bethesda, Maryland

    On July 31, 2007, majority staff conducted a site visit to 
the National Naval Medical Center in Bethesda, Maryland.
    This visit was in preparation for a number of site visits 
the Subcommittee organized to review the seamless transition of 
wounded service members from active duty into the U.S. 
Department of Veterans Affairs. Attention was paid to 
electronic medical information transfers and case management. 
When dealing with staff at the medical center, Subcommittee 
staff made a point of noting patients who would be moving to 
the VA Polytrauma Rehabilitation Centers in Palo Alto, 
California and Minneapolis, Minnesota in preparation for seeing 
those patients.

Site Visit to Chicago, Illinois

    From August 1-2, 2007, majority staff conducted a site 
visit to view the North Chicago VA Medical Center and Naval 
Health Clinic Great Lakes which are being merged into a federal 
hospital, and VA's National Acquisition Center (NAC) in 
Chicago, Illinois.
    Two of the Subcommittee's main oversight topics are the 
centralization of procurement and acquisition functions at the 
VA, and the exchange of electronic medical records between the 
VA and DoD. The project being undertaken at the Great Lakes 
Naval Hospital and North Chicago VA Medical Center are of a 
joint facility working towards completely interoperable 
electronic records which is an important step towards the 
complete seamless transition of service members between DoD and 
VA.
    VA currently runs the NAC as a central procurement 
facility, but many VHA facilities do not go through the NAC as 
it was historically a poorly run facility. In addition, the NAC 
has the Strategic National Stockpile Program for Centers for 
Disease Control and a Consolidated Mail Outpatient Pharmacy 
program. VA recently hired a new chief executive officer for 
the NAC (as of February/March 2007), and the Subcommittee staff 
wanted to view firsthand the changes he has made to the 
process.

Site Visit to Palo Alto, California

    From August 6-7, 2007, Subcommittee majority and minority 
staff accompanied by the minority staff of the Subcommittee on 
Health conducted a site visit of the U.S. Department of 
Veterans Affairs Palo Alto Health Care System in Palo Alto, 
California.
    This visit was made for the purposes of (1) reviewing the 
Polytrauma Rehabilitation Center (PRC) following a highly 
negative report from the Office of the Medical Inspector; (2) 
meeting with patients and families at the PRC and the 
polytrauma transitional unit; and, (3) reviewing the processes 
in place for transitioning patients from Walter Reed and 
Bethesda to the PRC and from the PRC to the subsequent 
placement designated for patients following completion of 
treatment at the PRC.

Site Visit to Seattle, Washington

    From August 27-28, 2007, majority staff conducted a site 
visit of the U.S. Department of Veterans Affairs Puget Sound 
Health Care System (VAPSHCS) and Madigan Army Medical Center 
(MAMC) in Seattle, Washington.
    Subcommittee staff used this trip as the first step in a 
larger series of site visits to view systems of sharing 
electronic medical information between the U.S. Department of 
Veterans Affairs (VA) and the U.S. Department of Defense (DoD). 
MAMC and the VAPSHCS have been the leaders for a number of 
years in sharing medical information between VA and DoD. 
Currently, they are using Bidirectional Health Information 
Exchange extensively, and the VAPSHCS has a program awaiting 
central office approval that will allow bidirectional exchange 
of discharge summaries.
    The VAPSHCS has instituted a new Deployment Health Clinic 
at MAMC. When a recently separated service member presents at 
the hospital for any reason (emergency room, mental health 
issues, cold or flu), he/she is routed through the Deployment 
Health Clinic rather than the regular department in the 
hospital. At the clinic, veterans have access to doctors and 
nurses trained to deal with their recently separated status. 
All new veterans coming through the clinic are screened for 
PTSD and mild TBI, and the nursing staff of the clinic has 
received training in helping veterans with the veterans 
benefits process.
    MAMC is one of the largest deployment and redeployment 
centers in the Army and is continually perfecting the screening 
process and they work closely with the VA in Benefits Delivered 
on Discharge program. Staff happened to meet with a soon-to-be 
separated soldier who was at Madigan for a joint physical to 
get his VA benefits.

Site Visit to Minneapolis, Minnesota

    From August 28-29, 2007, Congressman Michael H. Michaud and 
majority staff of the Subcommittee on Oversight and 
Investigations traveled with majority staff from the 
Subcommittee on Health to the Minneapolis VA Medical Center to 
review one of VA's level one polytrauma centers (PRC). The 
purpose of the visit was to gain a better understanding of the 
level of care provided at PRCs and how that care is delivered 
within the VA health care system.

Site Visit to Anchorage, Alaska

    From August 27-30, 2007, majority staff conducted a site 
visit of the Anchorage VA Health Care System and Elmendorf Air 
Force Medical Center (AFMC) in Anchorage, Alaska.
    Subcommittee staff used this trip as part of a larger 
series of site visits to view systems of sharing electronic 
medical information between the Department of Veterans Affairs 
(VA) and the Department of Defense (DoD). Elmendorf is one of 
the newer pilot programs currently adopting Bidirectional 
Health Information Exchange and Federal Health Information 
Exchange (two systems used for recently separated active duty 
service members as they transition into the VA without going 
through a polytrauma center). Staff found that while BHIE had 
been installed at Elmendorf, it was not being used yet.
    By contrast, the Joint Patient Tracking Application was 
being used extensively by the Elmendorf administration to 
identify wounded service members with home ties in Alaska, and 
bring them directly from Landstuhl to Elmendorf rather than 
through Walter Reed or Bethesda in order to reunite the wounded 
with family members. Additionally, the new commander at 
Elmendorf had begun accepting more VA surgical patients rather 
than having them sent out into the community. The partnership 
between the Anchorage VA Health Care System and the Elmendorf 
AFMC was unique in that leadership worked very closely together 
in order to make sure care was provided to all veterans and 
service members within their geographic scope.

Site Visit to Richmond, Virginia

    On September 17, 2007, majority staff conducted a site 
visit of the Hunter Holmes McGuire U.S. Department of Veterans 
Affairs Medical Center in Richmond, Virginia, which houses one 
of the four level-one polytrauma centers in the Department of 
Veterans Affairs.
    The Director of the facility, Dr. Shane McNamee, was part 
of an inspection team that reviewed Palo Alto's polytrauma 
center's practices for accepting patient transfers and has a 
different management style to that which is practiced in Palo 
Alto. His opinions were extremely helpful to staff as they 
planned for the upcoming hearing on VA polytrauma center 
management.

Subcommittee Hearing--U.S. Department of Veterans Affairs Polytrauma 
        Rehabilitation Centers: Management Issues

    On September 25, 2007, the Subcommittee conducted a hearing 
on the VA's Polytrauma Rehabilitation Centers: Management 
Issues. Following a staff visit to the polytrauma center in 
Palo Alto, California, numerous management deficiencies were 
brought to light at the particular facility. The purpose of the 
hearing was to ensure that similar problems are not occurring 
at the VA's other three Polytrauma Rehabilitation Centers.
    The Subcommittee heard testimony from officials of the U.S. 
Department of Veterans Affairs. See U.S. Department of Veterans 
Affairs Polytrauma Rehabilitation Centers: Management Issues, 
Serial No. 110-45.

Subcommittee Hearing--Disability Claims Ratings and Benefits 
        Disparities within the Veterans Benefits Administration

    On October 16, 2007, the Subcommittee conducted a hearing 
to examine the disparity in state average compensation paid to 
veterans by the U.S. Department of Veterans Affairs. The 
disparity ranges from an average of more than $12,000 per 
veteran in New Mexico to less than $8,000 in Ohio (the 
nationwide average in 2005 was $8,890).
    The Subcommittee heard testimony from a Veteran Service 
Officer for Citrus County, Florida; a research staff member for 
IDA and the author of the July 2007 report; Office of the 
Inspector General of the U.S. Department of Veterans Affairs; 
veterans service organizations; and the Veterans Benefits 
Administration, U.S. Department of Veterans Affairs. See 
Disability Claims Ratings and Benefits Disparities within the 
Veterans' Benefits Administration, Serial No. 110-53.

Site Visit to Biloxi, Mississippi

    From October 18-19, 2007, Subcommittee majority staff 
accompanied by the staff from the Subcommittee on Health 
conducted a site visit to the Keesler Air Force Base (AFB) and 
the U.S. Department of Veterans Affairs Gulf Coast Veterans 
Health Care System in Biloxi, Mississippi.
    This visit was made for the purpose of reviewing the 
various sharing initiatives in place between the Air Force and 
medical systems at Keesler AFB, including the recently awarded 
Joint Incentive Fund projects in cardiac care and magnetic 
resonance imaging. An area of particular interest was how the 
Air Force and VA share electronic medical information. The 
Naval Hospital Pensacola Commander was also present, because 
the Air Force, Navy, and VA are all sharing resources in the 
Gulf Coast region.

Subcommittee Hearing--Sharing of Electronic Medical Records between the 
        U.S. Department of Defense and the U.S. Department of Veterans 
        Affairs

    On October 24, 2007, the Subcommittee conducted a hearing 
on sharing medical data between the U.S. Department of Defense 
and the U.S. Department of Veterans Affairs. This hearing was a 
direct continuation of the previous hearings held on this issue 
by the Subcommittee.
    Among others, the Subcommittee heard testimony from the 
81st Medical Wing of the U.S. Air Force and the former Surgeon-
General of CENTCOM; U.S. Government Accountability Office; 
Western Regional Medical Command for the U.S. Army and Madigan 
Army Medical Center; Regional Info System Officer for Military 
Sealift Command for the U.S. Navy; Office of Information and 
Technology at VA; Under Secretary for Health for VA; and 
Assistant Secretary of Defense for Health Affairs for DoD. See 
Sharing of Electronic Medical Records between the Department of 
Defense and Department of Veterans Affairs, Serial No. 110-57.

Subcommittee on Oversight and Investigation and Subcommittee on Health 
        Hearing--Outpatient Waiting Times

    On December 12, 2007, the Subcommittees conducted to assess 
whether issues identified as detrimental to the U.S. Department 
of Veterans Affairs Veterans Health Administration's outpatient 
waiting times have been corrected by VA.
    The Subcommittees heard testimony from Licking County 
Veterans' Service Commission, Newark, Ohio; Unum US; Office of 
Inspector General at the U.S. Department of Veterans Affairs; 
and the Deputy Under Secretary for Health of the U.S. 
Department of Veterans Affairs. See Outpatient Waiting Times, 
Serial No. 110-62.

Site Visit to San Antonio, Texas

    From December 19-20, 2007, majority staff visited 
University of Texas Health Science Center in San Antonio, 
Texas, and the U.S. Department of Veterans Affairs South Texas 
Health Care System for the purpose of discussing VA's 
agreements with medical school affiliates regarding research 
and information technology security.

Site Visit to Tampa, Florida

    On December 28, 2007, minority staff joined Ranking Member 
Ginny Brown-Waite and the Honorable Gus Bilirakis to visit the 
James A. Haley U.S. Department of Veterans Affairs Medical 
Center (VAMC) in Tampa, Florida. The purpose was to discuss the 
credentialing and licensing of clinical psychologists at the 
VAMC in Tampa, and the supervision of the unlicensed 
psychologists working at that facility. Ranking Member Brown-
Waite and minority staff also toured the Fisher House, and the 
VAMC Polytrauma unit, as well as visiting several veterans in 
the inpatient wards at the VAMC.

Second Session

Subcommittee CODEL to Kuwait, Iraq, Pakistan, Afghanistan and Germany

    From January 6-15, 2008, Harry E. Mitchell, the Chairman of 
the Subcommittee on Oversight and Investigations, led a 
Congressional delegation to Kuwait, Iraq, Pakistan, 
Afghanistan, and Germany. Accompanying Chairman Mitchell on the 
trip were the HonorableTimothy Walz of the Committee on 
Veterans' Affairs, and the Honorable Charles Dent of the Committee on 
Homeland Security. The primary purpose of the CODEL was to examine the 
transfer of medical information from the point of injury in theatre 
through the military medical system to the U.S. Department of Veterans 
Affairs. The delegation visited a number of U.S. military medical 
facilities, including Balad Field Hospital in Iraq, the Combat Support 
Hospital in Baghdad, Bagram Field Hospital in Afghanistan, and 
Landstuhl Regional Medical Center in Germany. In addition, the 
delegation was briefed on the current situation in Iraq by General 
David Petraeus, Commanding General, MNF-I, and Ambassador Ryan Crocker.
    In Islamabad, the delegation met with the Deputy Chief of 
Mission, Economics Officer, Political Officer, Military Liaison 
Officer, and AID representatives at the U.S. Embassy, to 
discuss the current political situation in Pakistan, military 
cooperation between the U.S. and Pakistan, AID education 
assistance programs, and Pakistan's energy needs. Other 
meetings in Pakistan included the Director General of 
Pakistan's Strategic Plans Division (responsible for security 
of Pakistan's nuclear weapons) and the Minister of Religious 
Affairs.
    At Bagram Airfield in Afghanistan, the delegation was 
briefed on a number of issues, including the military, 
political, and economic situations in the area, medical care 
and medevac systems, and Provincial Reconstruction Teams. The 
delegation also met with U.S. Embassy staff.
    In Iraq, the delegation travelled by helicopter to Balad 
Airfield, the staging point for all medical evacuations from 
theatre. The delegation toured the Air Force field hospital 
located at the airfield, met with hospital staff and patients, 
and received extensive briefings on operations there. At Camp 
Victory near Baghdad, the delegation visited the detainee 
medical facility and met with staff. In Baghdad, the Multi-
National Force/Corps-Iraq Surgeon and staff briefed the 
delegation, followed by the briefing with General Petraeus and 
Ambassador Crocker. In both Balad and Baghdad, members of the 
delegation met with service members from their home districts.
    Concluding the trip, the delegation travelled to Germany, 
where the members were briefed by the Commander and staff of 
Landstuhl Regional Medical Center. The visit concluded with a 
tour of the Warrior Transition Unit and the Medical Transient 
Unit.

Site Visit to Philadelphia, Pennsylvania

    On January 25, 2008, majority staff visited the U.S. 
Department of Veterans Affairs Veterans Benefits Administration 
Regional Office in Philadelphia, Pennsylvania, to observe the 
claims adjudication process and note areas that could be 
streamlined and/or made electronic.

Subcommittee Hearing--U.S. Department of Veterans Affairs Credentialing 
        and Privileging: A Patient Safety Issue

    On January 29, 2008, the Subcommittee conducted a hearing 
on VA's credentialing and privileging systems. This hearing was 
a direct result of Office of Medical Inspector and Office of 
the Inspector General reports on patient deaths at the VA 
medical center in Marion, Illinois.
    The Subcommittee heard testimony from a spouse whose 
husband's death at Marion was investigated and determined to be 
the result of unauthorized physician care; Office of Inspector 
General, U.S. Department of Veterans Affairs; and, the Veterans 
Health Administration, U.S. Department of Veterans Affairs. See 
U.S. Department of Veterans Affairs Credentialing and 
Privileging: A Patient Safety Issue, Serial No. 110-65.

Subcommittee Hearing--U.S. Department of Veterans Affairs FY 2009 
        Budget--Office of Inspector General and Office of Information & 
        Technology

    On February 13, 2008, the Subcommittee conducted a hearing 
to assess and evaluate the U.S. Department of Veterans Affairs 
Fiscal Year 2009 budgets for the Office of the Inspector 
General (OIG) and Office of Information and Technology. The 
VA's OIG, an independent entity, evaluates VA's programs and 
operations. OIG provides independent oversight that addresses 
mission-critical activities and programs in health care 
delivery, benefits processing, financial management, 
procurement practices and information management.
    The Subcommittee heard testimony from the Deputy Inspector 
General for the Office of the Inspector General; U.S. 
Government Accountability Office; and, Assistant Secretary of 
Information Technology for the U.S. Department of Veterans 
Affairs. See U.S. Department of Veterans Affairs FY 2009 
Budget--Office of Inspector General and Office of Information 
and Technology, Serial No. 110-69.

Site Visit to Philadelphia, Pennsylvania

    On February 14, 2008, majority staff visited the University 
of Pennsylvania Medical School for the purpose of discussing 
the impact of U.S. Department of Veterans Affairs (VA) 
information technology centralization and new security 
requirements on joint VA--medical school research and clinical 
trials with the Dean of Research and the Chief Information 
Officer.

Site Visit to Salisbury, North Carolina

    From February 19-20, 2008, majority staff visited the W.G. 
(Bill) Hefner VA Medical Center in Salisbury, North Carolina.
    The purpose of travel was to inspect and assess: (a) third 
party collection delivery; (b) women's health program moved 
into new facility where special services are now provided; (c) 
the new construction project in Surgery; (d) investigative and 
educational center for the Mental Illness Research, Education, 
and Clinical Center, which focuses on post-deployment mental 
health; (e) contract nursing home program; (f) Quality 
Management Program; and, (g) surgical credentialing and 
privileging programs.

Site Visit to San Antonio, Texas

    From February 20-21, 2008, minority Staff visited the Army 
Dental Command in San Antonio, Texas, to investigate issues 
relating to the transfer of dental cost of demobilizing Reserve 
Components to the U.S. Department of Veterans Affairs. There 
was further discussion of Dental Command's flawed cost 
estimates of accomplishing their dental mission in-house.

Subcommittee Hearing--Care of Seriously Wounded After Inpatient Care

    On March 13, 2008, the Subcommittee conducted a hearing to 
assess how the Department of Veterans Affairs is caring for, 
and the manner in which care is administered, to our nation's 
most seriously wounded veterans after inpatient care and the 
transition home occurs.
    The Subcommittee heard testimony from a U.S. Marine Corps 
combat veteran; a U.S. Army combat veteran; the wife of a U.S. 
Army combat veteran and veterans advocate; National Policy 
Director for the Wounded Warrior Project; Iraq and Afghanistan 
Veterans of America; and Chief Patient Care Services Officer 
for the Veterans Health Administration, U.S. Department of 
Veterans Affairs. See Care of Seriously Wounded After In-
Patient Car, Serial No. 110-76.

Site Visit to Palo Alto, California

    On March 18-20, 2008, majority staff visited the Palo Alto 
VA Healthcare System and Polytrauma Unit in Palo Alto, 
California.
    The Subcommittee held a hearing in September 2007, after 
disclosure of substantial turmoil at the Palo Alto Polytrauma 
Rehabilitation Center (PRC). While Palo Alto has made several 
management changes, the Palo Alto PRC continued to be the 
subject of complaints about quality of care from patients and 
families.

Site Visit to Newark, New Jersey

    On March 27, 2008, majority staff visited the Veterans 
Benefits Administration Regional Office to observe the claims 
adjudication process and investigate claims that the office was 
not being run efficiently.

Subcommittee Hearing--Traumatic Brain Injury Related Vision Issues

    On April 2, 2008, the Subcommittee conducted a hearing on 
vision issues related to traumatic brain injury (TBI). It had 
become clear that TBI is often associated with subsequent 
vision issues even in the absence of direct injury to the eye. 
Data from the only VA Polytrauma Rehabilitation Center (PRC) to 
keep track of this data shows that 75 percent of Level 1 
polytrauma patients with TBI and 78 percent of Level II 
polytrauma patients with TBI reported vision complaints.
    The Subcommittee heard testimony from a U.S. Army combat 
veteran; the wife of a U.S. Army combat veteran; a U.S. Navy 
combat veteran; Blinded Veterans Association; Professor of 
Clinical Neurology at Columbia University Medical Center; 
Associate Professor of Occupational Therapy at the University 
of Alabama at Birmingham; Neuro Vision Technology Pty. Ltd.; 
representatives of the U.S. Department of Veterans Affairs; and 
U.S. Department of Defense Center for Excellence for 
Psychological Health and Traumatic Brain Injury. See Traumatic 
Brain Injury (TBI) Related Vision Issues, Serial No. 110-79.

Site Visit to Chicago, Illinois

    On May 1, 2008, majority staff visited the U.S. Department 
of Veterans Affairs (VA) National Acquisition Center (NAC) in 
Chicago, Illinois. At the time, staff was investigating 
resellers on VA's Federal Supply Schedules (FSS) following the 
IG report finding significant problems with some resellers 
resulting in millions of dollars in excess costs.
    The NAC administers the FSS contracts and the contract 
files are at the NAC. Staff was briefed on the FSS contracts, 
how they are entered into and administered, and how they are 
modified. In addition, staff reviewed the contract files of the 
resellers examined in the IG report.

Site Visit to Washington, District of Columbia

    On May 14, 2008, majority and minority staff visited the 
Washington Hospital Center in Washington, D.C. The purpose of 
this visit was to observe Microsoft's new multi-hospital shared 
electronic medical information system.

Site Visit to San Antonio, Texas

    From May 28-29, 2008, majority staff visited the Brooke 
Army Medical Center for the Intrepid (BAMC); University of 
Texas (UT) Health Science Center, San Antonio, Texas, and the 
U.S. Department of Veterans Affairs South Texas Health Care 
System. The purpose of this visitwas to tour and be briefed on 
the Center for the Intrepid and the BAMC in San Antonio and be briefed 
on UT-VA joint research and clinical trials. Subcommittee staff gained 
a better understanding of the services, operations and technologies at 
BAMC and the Center for the Intrepid, and will learn at VA and UT 
whether correspondence with VA about IT and research is having an 
effect on the local level.

Site Visit to Chicago, Illinois

    From June 16-17, 2008, majority staff visited the Naval 
Health Clinic Great Lakes and the North Chicago U.S. Department 
of Veterans Affairs (VA) Medical Center to observe the pilot 
electronic medical records sharing program and joint facility 
being undertaken and operated by the Navy and the VA in the 
North Chicago/Great Lakes area. The project being undertaken at 
the Great Lakes Naval Hospital and North Chicago VA Medical 
Center of a joint facility working towards completely 
interoperable electronic records is an important step towards 
the complete seamless transition of service members between the 
U.S. Department of Defense and the U.S. Department of Veterans 
Affairs.

Site Visit to Ft. McCoy, Wisconsin

    From June 18-19, 2008, majority staff visited Ft. McCoy, 
Wisconsin, to visit with soldiers from the 325th Combat Support 
Hospital during their demobilization brief that coincides with 
the VA mandatory briefing session and ask questions regarding 
seamless transition back into the civilian life. Staff gained a 
better understanding of both the U.S. Department of Defense and 
the U.S. Department of Veterans Affairs interaction with 
service members, specifically in post-deployment. Staff will 
also gain more insight into the interaction between the two 
agencies, as it pertains to post-deployment seamless 
transition.

Subcommittee Hearing--U.S. Department of Veterans Affairs/U.S. 
        Department of Defense Cooperation in Reintegration of National 
        Guard and Reserves

    On July 24, 2008, the Subcommittee held a hearing to 
evaluate the progress of the U.S. Department of Veterans 
Affairs and the U.S. Department of Defense in cooperating to 
improve the reintegration of members of the National Guard and 
Reserves to civilian life.
    The Subcommittee heard testimony from veterans service 
organizations; U.S. Army Reserve; Office of Joint Manpower and 
Personnel, National Guard Bureau; National Guard and Reserve 
Coordinator; and, the U.S. Department of Veterans Affairs. See 
U.S. Department of Veterans Affairs/U.S. Department of Defense 
Cooperation in Reintegration of National Guard and Reserves, 
Serial No. 110-94.

Subcommittee Hearing--Media Outreach to Veterans

    On July 15, 2008, the Subcommittee held a hearing to 
explore the potential benefits veterans would receive if VA 
incorporates the power of advertising and marketing in their 
strategic outreach plan.
    The Subcommittee heard testimony from a Veteran of 
Operation Iraqi Freedom; Iraq and Afghanistan Veterans of 
America; Robert Emmett McDonough School of Business, Georgetown 
University; Communication and Social Marketing Expert from 
Washington, DC; U.S. Department of Veterans Affairs. See Media 
Outreach to Veterans, Serial No. 110-98.

Subcommittee Hearing--Billions Spent on ``Miscellaneous'' Expenditures: 
        Inadequate Controls at the VA

    On July 31, 2008, the Subcommittee held a hearing to 
evaluate the findings of the GAO's audit of VA's use of 
``miscellaneous obligations'' as a means of procuring goods and 
services. Miscellaneous obligations are used to obligate funds 
in circumstances where the amount to be spent is uncertain.
    The Subcommittee heard testimony from the U.S. Government 
Accountability Office and U.S. Department of Veterans Affairs. 
See Billions Spent on ``Miscellaneous'' Expenditures: 
Inadequate Controls at the VA--Serial No. 110-100.

Site Visit to Austin, Texas

    On September 4-5, 2008, majority staff traveled to the 
Austin Information Technology Center; Office of Business 
Oversight; and, the Office of Information and Technology 
contracting center. The purpose of the visit was to provide 
oversight and follow up on electronic interchange of 
information between the U.S. Department of Defense (DoD) and 
the U.S. Department of Veterans Affairs (VA); contracting by 
Office of Information and Technology; and, activities of the 
Office of Business Oversight. The staff also reviewed the 
current VA--DoD information exchange efforts, including 
electronic DD214s, VADIR, LC database, VA--DoD memorandum of 
understanding; Office of Information and Technology contracting 
activities; and, Office of Business Oversight compliance 
activities.

Subcommittee Hearing--Media Outreach to Veterans: An Update

    On September 23, 2008, the Subcommittee conducted a hearing 
to assess the U.S. Department of Veterans Affairs (VA) efforts 
after the July 15, 2008, hearing on media outreach. The purpose 
of this hearing was to evaluate the progress VA has made since 
the last hearing held on this issue on July 15, 2008, entitled 
VA Media Outreach. The purpose of the previous hearing was to 
explore the benefits veterans would receive if VA incorporated 
the power of advertising and marketing in its strategic 
outreach plan. In addition, the Subcommittee investigated how 
much money the VA intended to budget for this initiative, how 
many personnel the VA was prepared to allocate, and evaluated 
the VA's strategic outreach plan, specifically the 
advertisement and marketing aspect of the plan. This new 
hearing evaluated VA's progress.
    The Subcommittee heard testimony from Operation Iraqi 
Freedom veterans; veterans service organizations; MDB 
Communications, Inc.; and, the U.S. Department of Veterans 
Affairs. See Media Outreach to Veterans: An Update--Serial No. 
110-106.

Site Visit to Edinburgh, Indiana

    On November 12, 2008, minority staff accompanied Ranking 
Republican Member Steve Buyer to review Dental Command's 
efforts to address Reserve Component dental reset plan for the 
76th Brigade Combat Team and attend briefing on the Army 
Reserve Component Demo Dental Reset. This trip was a follow-up 
to the site visit to San Antonio, Texas, in February 2008.

                                                      SUMMARY OF VETERANS' AFFAIRS COMMITTEE ACTION
                                       BILLS AND RESOLUTIONS REFERRED, HEARINGS, AND EXECUTIVE SESSIONS CONDUCTED
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                   98th    99th    100th   101st   102d    103d    104th   105th   106th   107th   108th   109th   110th
--------------------------------------------------------------------------------------------------------------------------------------------------------
Bills and Resolutions Referred..................     229     198     147     194     215     174     128     134     146     194     253     239     345
Hearings Sessions...............................      71      76      44      72      67      71      39      56      66      58      66      71     108
Meetings and Markup Sessions....................      16      20      16      26      20      23      19      18      13      14      16      18      25
Bills Reported..................................      15      17      14      33      21      25      15      15      10      14      22      10      26
Bills in House..................................       3       3       1       4       3      11       0       0       1       0       0       0       0
Pending in Senate Committees....................       6       8       9      23       7      11      10       1       1      10       7      11      38
Bills on Senate Calendar or in Senate...........       0       1       3       1       3       3       0       0       1       0       5       0       0
Laws Enacted....................................       8       6       4       8      24      15       6       6      11      13       9      10      18
--------------------------------------------------------------------------------------------------------------------------------------------------------

                    HEARINGS AND EXECUTIVE SESSIONS

    (All hearings and executive sessions of the Committee are 
held in the Committee hearing room, Room 334, Cannon House 
Office Building unless otherwise designated.)

    January 30, 2007. OPEN. 2:00 p.m. Full Committee. Meeting. 
Organizational and Oversight Plan.

    February 8, 2007. OPEN. 9:30 a.m. Full Committee. Hearing. 
U.S. Department of Veterans Affairs Budget Request for Fiscal 
Year 2008. (Serial No. 110-1)

    February 12, 2007. OPEN. 1:00 p.m. Full Committee. Meeting. 
Stakeholders Roundtable Meeting.

    February 14, 2007. OPEN. 2:00 p.m. Subcommittee on Health. 
Hearing. U.S. Department of Veterans Affairs Fiscal Year 2008 
Health Budget. (Serial No. 110-2)

    February 15, 2007. OPEN. 10:00 a.m. Full Committee. 
Hearing. Equity for Filipino Veterans. (Serial No. 110-3)

    February 15, 2007. OPEN. 3:00 p.m. Subcommittee on 
Oversight and Investigations. Hearing. Oversight Efforts of the 
VA Inspector General: Issues, Problems and Best Practices at 
the Department of Veterans Affairs. (Serial No. 110-4)

    February 27, 2007. OPEN. 2:00 p.m. House and Senate 
Veterans' Affairs Committees. Joint Hearing. Room 345 Cannon. 
The Legislative Priorities of the Disabled American Veterans.

    February 28, 2007. OPEN. 2:00 p.m. Subcommittee on 
Oversight and Investigations. Hearing. Information and Security 
Management at the Department of Veterans Affairs--Current 
Effectiveness and the Need for Cultural Change. (Serial No. 
110-5)

    March 6, 2007. OPEN. 9:30 a.m. House and Senate Veterans' 
Affairs Committee. Joint Hearing. Room 345 Cannon. The 
Legislative Priorities of the Veterans of Foreign Wars.

    March 7, 2007. OPEN. 2:00 p.m. Subcommittee on Economic 
Opportunity. Hearing. Room 340 Cannon. Performance Review of 
Education, Loan Guaranty, Vocational Rehabilitation and 
Employment, and Veterans' Employment and Training Service 
Programs. (Serial No. 110-6)

    March 8, 2007. OPEN. 9:30 a.m. House and Senate Veterans' 
Affairs Committee. Joint Hearing. Room 106 Senate Dirkson. The 
Legislative Priorities of the Paralyzed Veterans of America, 
Jewish War Veterans, Blinded Veterans Association, and Vietnam 
Veterans of America.

    March 8, 2007. OPEN. 3:30 p.m. Subcommittee on Oversight 
and Investigations. Hearing. Servicemembers Seamless Transition 
Into Civilian Life--The Heroes Return. (Serial No. 110-7)

    March 13, 2007. OPEN. 10:00 a.m. Subcommittee on Disability 
Assistance and Memorial Affairs. Markup of H.R. 797 and H.R. 
1284.

    March 13, 2007. OPEN. 10:15 a.m. Subcommittee on Disability 
Assistance and Memorial Affairs. Hearing. Room 340 Cannon. The 
Impact of OIF/OEF on the VA Claims Process. (Serial No. 110-8)

    March 13, 2007. OPEN. 1:30 p.m. Subcommittee on Health. 
Markup of H.R. 327 and H.R. 612.

    March 15, 2007. OPEN. 10:00 a.m. Full Committee. Markup of 
H.R. 327, H.R. 797, and H.R. 1284.

    March 15, 2007. OPEN. 2:00 p.m. Subcommittee on Health. 
Hearing. Polytrauma Center Care and the TBI Patient: How 
Seamless is the Transition Between VA and DoD and Are Needs 
Being Met? (Serial No. 110-9)

    March 22, 2007. OPEN. 2:00 p.m. Subcommittee on Economic 
Opportunity. Hearing. Room 340 Cannon. Education Benefits for 
the National Guard & Reserve Members of the U.S. Armed Forces. 
(Serial No. 110-10)

    March 29, 2007. OPEN. 9:30 a.m. House and Senate Veterans' 
Affairs Committees. Joint Hearing. Room 226 Senate Dirksen. The 
Legislative Priorities of AMVETS, American Ex-Prisoners of War, 
Military Order of the Purple Heart, Fleet Reserve Association, 
The Retired Enlisted Association, Gold Star Wives, Military 
Officers Association of America, and National Association of 
State Directors of Veterans Affairs.

    April 17, 2007. OPEN. 2:00 p.m. Subcommittee on Disability 
Assistance and Memorial Affairs. Hearing. Legislative Hearing 
on H.R. 67, H.R. 1435, H.R. 1444, H.R. 1490. (Serial No. 110-
11)

    April 18, 2007. OPEN. 10:00 a.m. Full Committee. Markup of 
H.R. 1642.

    April 18, 2007. OPEN. 10:15 a.m. Full Committee. Hearing. 
H.R. 23 ``Belated Thank You to the Merchant Mariners of World 
War II Act of 2007.'' (Serial No. 110-12)

    April 18, 2007. OPEN. 2:00 p.m. Subcommittee on Health. 
Hearing. Access to VA Health Care: How Easy is it for Veterans' 
Addressing the Gaps. (Serial No. 110-13)

    April 19, 2007. OPEN. 10:00 a.m. Subcommittee on Oversight 
and Investigations. Hearing. Surgical Services at the W.G. 
(Bill) Hefner VA Medical Center in Salisbury, North Carolina. 
(Serial No. 110-14)

    April. 19, 2007. OPEN. 2:00 p.m. Subcommittee on Economic 
Opportunity. Hearing. State Approving Agencies. (Serial No. 
110-15)

    April 24, 2007. OPEN. 10:00 a.m. Subcommittee on Disability 
Assistance and Memorial Affairs. Markup of H.R. 1660.

    April 24, 2007. OPEN. 10:15 a.m. Subcommittee on Disability 
Assistance and Memorial Affairs. Hearing. ``Helping Those Left 
Behind: Are We Doing Enough for the Parents, Spouses and 
Children of Veterans?'' (Serial No. 110-16)

    April 26, 2007. OPEN. 10:00 a.m. Subcommittee on Health. 
Hearing. Legislative Hearing on H.R. 92, H.R. 315, H.R. 339, 
H.R. 463, H.R. 538, H.R. 542, H.R. 1426, H.R. 1470, H.R. 1471, 
H.R. 1527, H.R. 1944, and Discussion Draft of the ``Rural 
Veterans Health Care Act of 2007.'' (Serial No. 110-17)

    May 3, 2007. OPEN. 2:00 p.m. Subcommittee on Economic 
Opportunity. Hearing. Accelerated Education Benefits for 
Veterans. (Serial No. 110-18)

    May 8, 2007. OPEN. 10:00 a.m. Subcommittee on Oversight and 
Investigations. Hearing. Sharing of Electronic Medical Records 
Between Department of Defense and Department of Veterans 
Affairs. (Serial No. 110-20)

    May 8, 2007. OPEN. 2:00 p.m. Subcommittee on Disability 
Assistance and Memorial Affairs. Markup of H.R. 67.

    May 8, 2007. OPEN. 2:15 p.m. Subcommittee on Disability 
Assistance and Memorial Affairs. Hearing. Veterans Cemeteries: 
Honoring Those Who Served. (Serial No. 110-19)

    May 9, 2007. OPEN. 10:00 a.m. Subcommittee on Health. 
Hearing. State of VA's Long-Term Care Programs. (Serial No. 
110-21)

    May 9, 2007. OPEN. 2:00 p.m. Full Committee. Hearing. The 
Results of the President's Task Force on Returning Global War 
on Terror Heroes. (Serial No. 110-22)

    May 10, 2007. OPEN. 9:30 a.m. Subcommittee on Health. Room 
340 Cannon. Markup of H.R. 1470 and H.R. 2199.

    May 15, 2007. OPEN. 2:00 p.m. Full Committee. Markup of 
H.R. 612, H.R. 67, H.R. 1660, H.R. 1470, H.R. 2199, H.R. 2219, 
and H.R. 2239.

    May 16, 2007. OPEN. 10:00 a.m. Full Committee. Meeting. 
PTSD Mental Health Care Symposium.

    May 17, 2007. OPEN. 2:00 p.m. Subcommittee on Economic 
Opportunity. Hearing. Veterans' Entrepreneurship and Self 
Employment. (Serial No. 110-23)

    May 22, 2007. OPEN. 10:00 a.m. Subcommittee on Disability 
Assistance and Memorial Affairs. Hearing. The Challenges Facing 
the U.S. Court of Appeals for Veterans Claims. (Serial No. 110-
24)

    May 23, 2007. OPEN. 10:00 a.m. Full Committee. Meeting. VA 
Disability Claims Roundtable: Looking for a Solution.

    May 29, 2007. OPEN. 10:00 a.m. Full Committee. Joint House 
and Senate Meeting. Dover, Ohio. Issues Facing Veterans in the 
Rural Areas of Appalachia. (Senate Hearing Print 110-146)

    June 7, 2007. OPEN. 2:00 p.m. Subcommittee on Economic 
Opportunity. Hearing. Specially Adaptive Housing. (Serial No. 
110-25)

    June 12, 2007. OPEN. 2:00 p.m. Subcommittee on Oversight 
and Investigations. Hearing. SES Bonuses: Ensuring VA's Process 
Works. (Serial No. 110-26)

    June 14, 2007. OPEN. Subcommittee on Health. Hearing. Room 
340 Cannon. Legislative Hearing on H.R. 1448, H.R. 1853, H.R. 
1925, H.R. 2005, H.R. 2172, H.R. 2173, H.R. 2378, H.R. 2219, 
H.R. 2192, and H.R. 2623. (Serial No. 110-27)

    June 19, 2007. OPEN. 2:00 p.m. Subcommittee on Disability 
Assistance and Memorial Affairs. Hearing. Legislative Hearing 
on H.R. 156, H.R. 585, and H.R. 704. (Serial No. 110-28)

    June 20, 2007. OPEN. 10:00 a.m. Full Committee. Hearing. 
Priority Group 8 Veterans. (Serial No. 110-29)

    June 21, 2007. OPEN. 2:00 p.m. Subcommittee on Economic 
Opportunity. Hearing. Legislative Hearing on H.R. 1750, H.R. 
1824, H.R. 1598, H.R. 1315, H.R. 1240, H.R. 675, H.R. 513, H.R. 
2259, H.R. 2475, H.R. 1632, H.R. 112, H.R. 2579, and H.R. 1370. 
(Serial No. 110-30)

    June 27, 2007. OPEN. 10:00 a.m. Subcommittee on Oversight 
and Investigations. Hearing. Room 340 Cannon. VA Internal 
Contracting Oversight Deficiencies. (Serial No. 110-31)

    June 28, 2007. OPEN. 10:00 a.m. Subcommittee on Health. 
Markup of H.R. 2623 and H.R. 2874.

    June 29, 2007. OPEN. 9:30 a.m. Subcommittee on Economic 
Opportunity. Markup of H.R. 1315, H.R. 1750, H.R. 1240, and 
H.R. 1632.

    July 9, 2007. OPEN. 9:30 a.m. Full Committee. Field 
Hearing. New Orleans, Louisiana. The Future of VA Health Care 
in South Louisiana. (Serial No. 110-32)

    July 11, 2007. OPEN. 10:00 a.m. Subcommittee on Health. 
Markup of H.R. 2874.

    July 12, 2007. OPEN. 10:00 a.m. Joint Subcommittee on 
Health and Subcommittee on Disability Assistance and Memorial 
Affairs. Hearing. Issues Facing Women and Minority Veterans. 
(Serial No. 110-33)

    July 12, 2007. OPEN. 2:00 p.m. Subcommittee on Economic 
Opportunity. Hearing. Federal Procurement and the Three Percent 
Set Aside. (Serial No. 110-34)

    July 17, 2007. OPEN. 2:00 p.m. Full Committee. Markup of 
H.R. 2623, H.R. 2874, H.R. 1315, H.R. 760, and H.R. 23.

    July 18, 2007. OPEN. 10:00 a.m. Full Committee. Meeting. 
Traumatic Brain Injury Symposium

    July 19, 2007. OPEN. 2:00 p.m. Subcommittee on Health. 
Hearing Vet Centers. (Serial No. 110-35)

    July 24, 2007. OPEN. 2:00 p.m. Subcommittee on Oversight 
and Investigations. Hearing. VA IT Inventory Management. 
(Serial No. 110-36)

    July 25, 2007. OPEN. 10:00 a.m. Full Committee. Hearing. 
PTSD and Personality Disorders: Challenges for the VA. (Serial 
No. 110-37)

    July 26, 2007. OPEN. 10:00 a.m. Subcommittee on Health. 
Hearing. Gulf War Exposures. (Serial No. 110-38)

    July 26, 2007. OPEN. 2:00 p.m. Subcommittee on Economic 
Opportunity. Contract Bundling Oversight. (Serial No. 110-39)

    July 31, 2007. OPEN. 2:00 p.m. Subcommittee on Disability 
Assistance and Memorial Affairs. Hearing. Legislative Hearing 
on H.R. 674, H.R. 1273, H.R. 1900, H.R. 1901, H.R. 2346, H.R. 
2696, and H.R. 2697. (Serial No. 110-40)

    September 6, 2007. OPEN. 2:00 p.m. Subcommittee on Economic 
Opportunity. Hearing. Veterans' Preference. (Serial No. 110-41)

    September 18, 2007. OPEN. 10:00 a.m. Full Committee. 
Hearing. State of the U.S. Department of Veterans Affairs. 
(Serial No. 110-42)

    September 19, 2007. OPEN. 10:00 a.m. Full Committee. 
Hearing. Findings of the President's Commission on Care for 
America's Returning Wounded Warriors. (Serial No. 110-43)

    September 20, 2007. OPEN. 9:30 a.m. House and Senate 
Veterans' Affairs Committees. Joint Hearing. Room 345 Cannon. 
The Legislative Priorities of The American Legion.

    September 20, 2007. OPEN. 2:00 p.m. Subcommittee on 
Economic Opportunity. Hearing. Licensure and Certification of 
Transitioning Veterans. (Serial No. 110-44)

    September 25, 2007. OPEN. 10:00 a.m. Subcommittee on 
Oversight and Investigations. Hearing. U.S. Department of 
Veterans Affairs Polytrauma Rehabilitation Centers: Management 
Issues. (Serial No. 110-45)

    September 25, 2007. OPEN. 2:00 p.m. Subcommittee on 
Disability Assistance and Memorial Affairs. Hearing. Board of 
Veterans' Appeals Adjudication Process and the Appeals 
Management Center. (Serial No. 110-46)

    September 26, 2007. OPEN. 10:00 a.m. Full Committee. 
Hearing. The U.S. Department of Veterans Affairs Information 
Technology Reorganization: How Far Has VA Come? (Serial No. 
110-47)

    September 27, 2007. OPEN. 10:00 a.m. Subcommittee on 
Health. Hearing. The U.S. Department of Veterans Affairs Grant 
and Per Diem Program. (Serial No. 110-48)

    October 3, 2007. OPEN. 10:00 a.m. Full Committee. Hearing. 
Funding the U.S. Department of Veterans Affairs of the Future. 
(Serial No. 110-49)

    October 4, 2007. OPEN. 10:00 a.m. Subcommittee on Health. 
Hearing. The U.S. Department of Veterans Affairs Research 
Programs. (Serial No. 110-50)

    October 9, 2007. OPEN. 9:30 a.m. Subcommittee on Disability 
Assistance and Memorial Affairs. Field Hearing. New Windsor, 
New York. Personal Costs of the U.S. Department of Veterans 
Affairs Claims Backlog. (Serial No. 110-51)

    October 10, 2007. OPEN. 10:00 a.m. Full Committee. Hearing. 
Findings of the Veterans Disability Benefits Commission. 
(Serial No. 110-52)

    October 16, 2007. OPEN. 2:00 p.m. Subcommittee on Oversight 
and Investigations. Hearing. Disability Claims Ratings and 
Benefits Disparities within the Veterans Benefits 
Administration. (Serial No. 110-53)

    October 17, 2007. OPEN. 10:00 a.m. Full Committee. Hearing. 
Long-Term Costs of Current Conflicts. (Serial No. 110-54)

    October 18, 2007. OPEN. 10:00 a.m. Subcommittee on Health. 
Hearing. Healthcare Professionals--Recruitment and Retention. 
(Serial No. 110-55)

    October 18, 2007. OPEN. 2:00 p.m. Subcommittee on Economic 
Opportunity. Hearing. Updating the Montgomery G.I. Bill. 
(Serial No. 110-56)

    October 24, 2007. OPEN. 10:00 a.m. Subcommittee on 
Oversight and Investigations. Hearing. Sharing of Electronic 
Medical Records between the Department of Defense and 
Department of Veterans Affairs. (Serial No. 110-57)

    October 25, 2007. OPEN. 2:00 p.m. Subcommittee on Economic 
Opportunity. Markup of H.R. 513 and H.R. 3882.

    October 25, 2007. OPEN. 2:15 p.m. Subcommittee on Economic 
Opportunity. Hearing. Oversight of the U.S. Department of 
Labor's Veterans Employment Training Service (VETS), Disabled 
Veteran Outreach Program (DVOP) and Local Veterans Employment 
Representative Program (LVOP). (Serial No. 110-58)

    November 1, 2007. OPEN. 10:00 a.m. Subcommittee on Health. 
Hearing. The U.S. Department of Veterans Affairs Construction 
Process. (Serial No. 110-59)

    November 7, 2007. OPEN. 10:00 a.m. Full Committee. Markup 
of H.R. 3882.

    November 8, 2007. OPEN. 2:00 p.m. Subcommittee on 
Disability Assistance and Memorial Affairs. Hearing. 
Legislative Hearing on H.R. 3047, H.R. 3249, H.R. 3286, H.R. 
3415, H.R. 1137, H.R. 3954, and H.R. 4084. (Serial No. 110-60)

    December 12, 2007. OPEN. 10:00 a.m. Full Committee. 
Hearing. Room 345 Cannon. Stopping Suicides: Mental Health 
Challenges Within the U.S. Department of Veterans Affairs. 
(Serial No. 110-61)

    December 12, 2007. OPEN. 2:00 p.m. Joint Subcommittee on 
Health and Subcommittee on Oversight and Investigations. 
Hearing. Room 345 Cannon. Outpatient Waiting Times. (Serial No. 
110-62)

    January 17, 2008. OPEN. 10:00 a.m. Subcommittee on Health. 
Hearing. Room 340 Cannon. Legislative hearing on H.R. 2790, 
H.R. 3458, H.R. 3819, H.R. 4053, H.R. 4107, H.R. 4146, H.R. 
4204, and H.R. 4231. (Serial No. 110-63)

    January 17, 2008. OPEN. 1:00 p.m. Subcommittee on Economic 
Opportunity. Hearing. Room 340 Cannon. Legislative hearing on 
Review of Pending Montgomery G.I. Bill Legislation: H.R. 1102, 
H.R. 1211, H.R. 1214, H.R. 2247, H.R. 2385, H.R. 2702, and H.R. 
2910. (Serial No. 110-64)

    January 29, 2008. OPEN. 10:00 a.m. Subcommittee on 
Oversight and Investigations. Hearing. Room 340 Cannon. VA 
Credentialing and Privileging: A Patient Safety Issue. (Serial 
No. 110-65)

    January 29, 2008. OPEN. 2:00 p.m. Subcommittee on 
Disability Assistance and Memorial Affairs. Hearing. Room 340 
Cannon. The Use of Artificial Intelligence to Improve the VA's 
Claims Processing System. (Serial No. 110-66)

    February 7, 2008. OPEN. 1:00 p.m. Full Committee. Hearing. 
The Department of Veterans Affairs Budget Request for Fiscal 
Year 2009. (Serial No. 110-67)

    February 13, 2008. OPEN. 2:00 p.m. Subcommittee on Economic 
Opportunity. Hearing. Room 340 Cannon. Review of Expiring 
Programs. (Serial No. 110-68)

    February 13, 2008. OPEN. 2:30 p.m. Subcommittee on 
Oversight and Investigations. Hearing. Room 210 Cannon. VA FY 
2009 Budget--Office of the Inspector General and Office of 
Information and Technology. (Serial No. 110-69)

    February 14, 2008. OPEN. 2:00 p.m. Subcommittee on 
Disability Assistance and Memorial Affairs. Hearing. Room 340 
Cannon. Examining the U.S. Department of Veterans Affairs 
Claims Processing System. (Serial No. 110-70)

    February 26, 2008. OPEN. 2:00 p.m. Subcommittee on 
Disability Assistance and Memorial Affairs. Hearing. The U.S. 
Department of Veterans Affairs Schedule for Rating 
Disabilities. (Serial No. 110-71)

    February 27, 2008. OPEN. 10:00 a.m. Subcommittee on Health. 
Hearing. VA Construction Authorization. (Serial No. 110-72)

    February 28, 2008. OPEN. 10:00 a.m. Subcommittee on Health. 
Hearing. Mental Health Treatment for Families: Supporting Those 
Who Support Our Veterans. (Serial No. 110-73)

    February 28, 2008. OPEN. 2:00 p.m. Subcommittee on Economic 
Opportunity. Hearing. Subprime Mortgage Crisis and America's 
Veterans. (Serial No. 110-74)

    March 4, 2008. OPEN. 9:30 a.m. House and Senate Veterans' 
Affairs Committee. Joint Hearing. Room 216 Senate Hart. The 
Legislative Priorities of the Veterans of Foreign Wars.

    March 4, 2008. OPEN. 2:00 p.m. House and Senate Veterans' 
Affairs Committee. Joint Hearing. Room 345 Cannon. The 
Legislative Priorities of the Disabled American Veterans.

    March 6, 2008. OPEN. 9:30 a.m. House and Senate Veterans' 
Affairs Committee. Joint Hearing. Room 345 Cannon. The 
Legislative Priorities of the Paralyzed Veterans of America, 
Jewish War Veterans, Blinded Veterans Association, Vietnam 
Veterans of America, Non Commissioned Officers Association, Air 
Force Sergeants Association, and American Ex-Prisoners of War.

    March 11, 2008. OPEN. 10:00 a.m. Subcommittee on Health. 
Hearing. Substance Abuse/Comorbid Disorders: Comprehensive 
Solutions to a Complex Problem. (Serial No. 110-75)

    March 13, 2008. OPEN. 10:00 a.m. Subcommittee on Oversight 
and Investigations. Hearing. Room 340 Cannon. Care of Seriously 
Wounded After Inpatient Care. (Serial No. 110-76)

    March 13, 2008. OPEN. 1:00 p.m. Subcommittee on Economic 
Opportunity. Hearing. U.S. Paralympic Military Program. (Serial 
No. 110-77)

    April 1, 2008. OPEN. 10:00 a.m. Subcommittee on Health. 
Hearing. PTSD Treatment and Research: Moving Ahead Toward 
Recovery. (Serial No. 110-78)

    April 2, 2008. OPEN. 10:00 a.m. Subcommittee on Oversight 
and Investigations. Hearing. Traumatic Brain Injury (TBI) 
Related Vision Issues (Serial No. 110-79)

    April 3, 2008. OPEN. 9:30 a.m. House and Senate Veterans' 
Affairs Committee. Joint Hearing. Room 216 Senate Hart. The 
Legislative Priorities of the AMVETS, Military Order of the 
Purple Heart, Gold Star Wives, Fleet Reserve Association, The 
Retired Enlisted Association, Military Officers Association of 
America, National Association of State Directors of Veterans 
Affairs.

    April 9, 2008. OPEN. 10:00 a.m. Full Committee. Hearing. 
Ending Homelessness for Our Nation's Veterans. (Serial No. 110-
80)

    April 10, 2008. OPEN. 2:00 p.m. Subcommittee on Disability 
Assistance and Memorial Affairs. Hearing. Legislative hearing 
on Veterans Disability Benefits Claims Modernization Act of 
2008 (H.R. 5892). (Serial No. 110-81)

    April 15, 2008. OPEN. 10:00 a.m. Subcommittee on Health. 
Hearing. Legislative hearing on H.R. 2818, H.R. 5554, H.R. 
5595, H.R. 5622, H.R. 5729, H.R. 5730. (Serial No. 110-82)

    April 16, 2008. OPEN. 1:00 p.m. Subcommittee on Economic 
Opportunity. Hearing. Legislative hearing on H.R. 4883, H.R. 
4884, H.R. 4889, H.R. 4539, H.R. 3646, H.R. 5664, H.R. 3798, 
H.R. 3393, H.R. 3298, H.R. 3467, H.R. 3889, H.R. 3681, and H.R. 
5684. (Serial No. 110-83)

    April 21, 2008. OPEN. 10:00 a.m. Subcommittee on Health. 
Field Hearing. Sanford, Maine. Women, Rural and Special Needs 
Veterans. (Serial No. 110-84)

    April 23, 2008. OPEN. 1:00 p.m. Subcommittee on Economic 
Opportunity. Room 340 Cannon. Markup of H.R. 5684, H.R. 4884, 
H.R. 4883, H.R. 4889, H.R. 3681, H.R. 3889, and H.R. 5664.

    April 23, 2008. OPEN. 2:30 p.m. Subcommittee on Health. 
Markup of H.R. 2790, H.R. 3819, H.R. 5729, H.R. 5554, and H.R. 
5856.

    April 24, 2008. OPEN. 11:00 a.m. Subcommittee on Disability 
Assistance and Memorial Affairs. Room 340 Cannon. Markup of 
H.R. 5892.

    April 30, 2008. OPEN. 10:00 a.m. Full Committee. Markup of 
H.R. 2790, H.R. 3819, H.R. 5729, H.R. 5554, H.R. 5856, H.R. 
3681, H.R. 3889, H.R. 4883, H.R. 4884, H.R. 4889, H.R. 5664, 
H.R. 5684, H.R. 5826, and H.R. 5892.

    May 2, 2008. OPEN. 12:00 p.m. Subcommittee on Disability 
Assistance and Memorial Affairs. Field Hearing. Colorado 
Springs, Colorado. Is the VA Cemetery Construction Policy 
Meeting the Needs of Today's Veterans and Their Families? 
(Serial No. 110-85)

    May 6, 2008. OPEN. 10:00 a.m. Full Committee. Hearing. The 
Truth about Veterans' Suicides. (Serial No. 110-86)

    May 16, 2008. OPEN. 1:00 p.m. Subcommittee on Economic 
Opportunity. Field Hearing. South Bend, Indiana. Transition 
Assistance Program for Guard and Reserve Forces. (Serial No. 
110-87)

    May 22, 2008. OPEN. 10:00 a.m. Subcommittee on Health. 
Hearing. Human Resources Challenges within the Veterans Health 
Administration. (Serial No. 110-88)

    May 22, 2008. OPEN. 1:00 p.m. Subcommittee on Disability 
Assistance and Memorial Affairs. Hearing. Room 340 Cannon. 
Examining the Effectiveness of VBA Outreach Efforts. (Serial 
No. 110-89)

    June 5, 2008. OPEN. 10:00 a.m. Subcommittee on Health. 
Markup of H.R. 2818 and H.R. 2192.

    June 5, 2008. OPEN. 10:00 a.m. Subcommittee on Health. 
Hearing. Legislative Hearing on H.R. 4089, H.R. 4463, H.R. 
5888, H.R. 6114, and H.R. 6112. (Serial No. 110-90)

    June 11, 2008. OPEN. 10:00 a.m. Full Committee. Meeting. 
Approve Subcommittee Membership and Markup of H.R. 2818.

    June 11, 2008. OPEN. 10:15 a.m. Full Committee. Hearing. 
Implementing the Wounded Warrior Provisions of the National 
Defense Authorization Act for Fiscal Year 2008. (Serial No. 
110-91)

    June 12, 2008. OPEN. 2:00 p.m. Subcommittee on Disability 
Assistance and Memorial Affairs. Hearing. Room 340 Cannon. 
Legislative Hearing on H.R. 1197, H.R. 3008, H.R. 3795, H.R. 
4274, H.R. 5155, H.R. 5448, H.R. 5454, H.R. 5709, H.R. 5954, 
H.R. 5985, and H.R. 6032. (Serial No. 11-092)

    June 19, 2008. OPEN. 1:00 p.m. Subcommittee on Economic 
Opportunity. Hearing. Legislative Hearing on H.R. 2721, H.R. 
3786, H.R. 6070, H.R. 4255, H.R. 6221, H.R. 6224, H.R. 6225, 
and H.R. 6272. (Serial No. 110-93)

    June 24, 2008. OPEN. 2:00 p.m. Subcommittee on Oversight 
and Investigations. Hearing. VA/DoD Cooperation in 
Reintegration of National Guard and Reserves. (Serial No. 110-
94)

    June 26, 2008. OPEN. 10:00 a.m. Subcommittee on Health. 
Hearing. Legislative Hearing on Draft Legislation. (Serial No. 
110-95)

    June 26, 2008. OPEN. 1:00 p.m. Subcommittee on Economic 
Opportunity. Markup of H.R. 6225, H.R. 6224, H.R. 6221, H.R. 
6272, H.R. 4255, H.R. 6070, H.R. 2910, H.R. 3298, and H.R. 
2721.

    July 9, 2008. OPEN. 10:00 a.m. Full Committee. Hearing. Why 
Does the VA Continue to Give a Suicide-Inducing Drug to 
Veterans with PTSD? (Serial No. 110-96)

    July 10, 2008. OPEN. 10:00 a.m. Subcommittee on Health. 
Markup of H.R. 1527, H.R. 6114, H.R. 6122, H.R. 6366, H.R. 
6439, and H.R. 6445.

    July 10, 2008. OPEN. 1:00 p.m. Subcommittee on Economic 
Opportunity. Hearing. Independent Living. (Serial No. 110-97)

    July 15, 2008. OPEN. 2:00 p.m. Subcommittee on Oversight 
and Investigations. Hearing. Media Outreach to Veterans. 
(Serial No. 110-98)

    July 16, 2008. OPEN. 10:00 a.m. Full Committee. Markup of 
H.R. 6445, H.R. 1527, H.R. 2192, H.R. 4255, H.R. 6225, H.R. 
6221, and H.R. 674.

    July 28, 2008. OPEN. 10:00 a.m. Subcommittee on Economic 
Opportunity. Field Hearing. Rapid City, South Dakota. 
Transitional Assistance Program. (Serial No. 110-99)

    July 30, 2008. CLOSED. 10:00 a.m. Full Committee. Meeting. 
Commission on the Future for America's Veterans.

    August 18, 2008. OPEN. 9:00 a.m. Subcommittee on Economic 
Opportunity. Field Hearing. Bentonville, Arkansas. Uniformed 
Services Employment and Reemployment Rights Act (USERRA) and 
Servicemembers Civil Relief Act (SCRA) Issues. (Serial No. 110-
101)

    September 9, 2008. OPEN. 10:00 a.m. Subcommittee on Health. 
Hearing. Room 340 Cannon. Legislative Hearing on H.R. 3051, 
H.R. 6153, and H.R. 6629. (Serial No. 110-102)

    September 11, 2008. OPEN. 9:30 a.m. House and Senate 
Veterans' Affairs Committees. Joint Hearing. Room 345 Cannon. 
The Legislative Priorities of  The American Legion.

    September 11, 2008. OPEN. 1:00 p.m. Subcommittee on 
Economic Opportunity. Hearing. Room 340 Cannon. Oversight of 
G.I. Bill Implementation. (Serial No. 110-103)

    September 16, 2008. OPEN. 10:00 a.m. Subcommittee on 
Health. Hearing. Room 340 Cannon. VA Suicide Hotline. (Serial 
No. 110-104)

    September 17, 2008. OPEN. 10:00 a.m. Full Committee. Room 
210 Cannon. Markup of H.R. 6897.

    September 18, 2008. OPEN. 10:00 a.m. Subcommittee on 
Disability Assistance and Memorial Affairs. Hearing. Room 340 
Cannon. Examining the Effectiveness of the Veterans Benefits 
Administration's Training, Performance Management and 
Accountability. (Serial No. 110-105)

    September 23, 2008. OPEN. 10:00 a.m. Subcommittee on 
Oversight and Investigations. Hearing. Room 340 Cannon. Media 
Outreach to Veterans: An Update. (Serial No. 110-106)

    September 24, 2008. OPEN. 1:00 p.m. Subcommittee on 
Economic Opportunity. Hearing. Room 340 Cannon. Follow-up 
Oversight Hearing on G.I. Bill Implementation. (Serial No. 110-
107)

    November 18, 2008. OPEN. 10:30 a.m. Subcommittee on 
Economic Opportunity. Hearing. VA Short and Long-Term 
Strategies for Implementing New G.I. Bill Requirements. (Serial 
No. 110-108)

    November 19, 2008. OPEN. 10:00 a.m. OPEN. Full Committee. 
Meeting. CRISIS: The VA Shreds Veterans' Confidence.

                          COMMITTEE WEB SITES


                         www.veterans.house.gov


                   www.republicans.veterans.house.gov

    The Committee on Veterans' Affairs operates, maintains, and 
updates a website (veterans.house.gov), as well as a minority 
website (republicans.veterans.house.gov) containing 
comprehensive and timely information on Committee activities, 
Federal actions, and other news of interest to veterans. The 
websites contain thousands of pages of information: Committee 
Information; Committee Resources; Chairman's Welcome Message; 
Committee Schedule; Publications; Committee Hearings; Committee 
Spotlight; Legislation; Recent News; Multimedia Links; Veterans 
Benefits; Veterans Healthcare; Subcommittees; and Live 
Webcasting. The websites continue to be a resource for the 
veteran community for news and information relating to benefits 
and programs.
                     U.S. HOUSE OF REPRESENTATIVES


                     COMMITTEE ON VETERANS' AFFAIRS


                   OVERSIGHT PLAN FOR 110th CONGRESS

    In accordance with clause 2(d)(1) of Rule X of the House of 
Representatives, the Committee on Veterans' Affairs on January 
30, 2007, adopted its oversight plan for the 110th Congress.
    This oversight plan is directed at those matters most in 
need of oversight during the duration of this Congress. The 
Committee is cognizant that its oversight plans for the 110th 
Congress ``have a view toward assuring effective, fact-based 
management.'' The Committee will consult, as necessary, with 
other House Committees having jurisdiction over the same or 
related laws affecting veterans.
    Oversight will be accomplished through committee and 
subcommittee hearings, field and site visits by Members and 
staff, review of documentation, and meetings and correspondence 
with interested parties. Methods of oversight will include 
existing and requested reports, studies, estimates, 
investigations and audits by the Congressional Research 
Service, the Congressional Budget Office, the Government 
Accountability Office, and the Offices of the Inspectors 
General of the Departments of Veterans Affairs and Labor.
    The Committee will seek the views of veterans' service 
organizations, military associations, other interest groups and 
private citizens. The Committee also welcomes communications 
from any individuals and organizations desiring to bring 
matters to its attention.
    While this oversight plan describes the foreseeable areas 
in which the Committee expects to conduct oversight during the 
110th Congress, the Committee and its subcommittees will 
undertake additional oversight activities as the need arises.
    The full Committee may, at the discretion of the Chairman, 
after consultation with the Ranking Republican Member, conduct 
any of the oversight activities planned by the subcommittees.

Subcommittee on Disability Assistance and Memorial Affairs

    1. Review of the Department of Veterans Affairs (VA) 
disability claim process. The Subcommittee plans to take a 
wholesale look at the VA disability claim process from the 
initial filing through the judiciary stage. This includes, but 
is not limited to, inter-governmental cooperation, training of 
claims adjudicators, uniformity of ratings, operation of the 
Board of Veterans Appeals and decisions handed down by the 
Court of Appeals for Veterans Claims. The Subcommittee will 
give special consideration to disability claims for post-
traumatic stress disorder (PTSD) and traumatic brain injury 
(TBI).
    2. Examination of the Nonservice-Connected Pension Program. 
The Subcommittee plans to examine whether this pension program 
is benefiting those who need it most. In addition, this 
Subcommittee will look to see if it is appropriate to expand 
the pension program to include veterans who may have been 
previously omitted and the pay-go costs associated with any 
expansion.
    3. Outreach. The Subcommittee plans to take a close look at 
the outreach efforts conducted by the VA to ensure that every 
eligible veteran, surviving spouse or other candidate for 
assistance is aware of the benefits available to him or her. 
Furthermore, the Subcommittee will examine whether the rules 
and pay-go costs regarding veteran eligibility need to be 
expanded.
    4. Maintenance, Appearance, and Upkeep of National 
Cemeteries. The Subcommittee will examine the immediate and 
long-term needs of the national cemetery system including the 
need for additional VA national cemeteries or national cemetery 
annexes. The Subcommittee will also review the condition of VA 
national cemeteries, both open and closed, to determine if 
their condition befits their status as national shrines to 
veterans.
    5. Insurance. The Subcommittee will examine all of the 
insurance programs under the jurisdiction of the VA to ensure 
that they are providing the proper level of indemnification. In 
addition, the Subcommittee will examine the overall operation 
of these insurance programs.
    6. Burial Benefits. The Subcommittee will look at the 
burial benefits provided by the VA to see if they are properly 
functioning and/or need to be expanded.
    7. Information Technology. The Subcommittee will review 
current information technology programs related to the business 
lines under the Subcommittee's jurisdiction with a focus on 
VETSNET. The Subcommittee will also explore the applicability 
of rules-based applications to further automate adjudication of 
disability claims.
    8. Veterans' Disability Benefits Commission. Public Law 
108-136 established the Veterans' Disability Benefits 
Commission. The commission will examine and make 
recommendations concerning, among other things, the 
appropriateness of the level of benefits and the 
appropriateness of the level of benefits and the appropriate 
standard of standards for determining whether a disability or 
death of a veteran should be compensated. The Committee will 
review the recommendations of the Commission through briefings 
and hearings.

Subcommittee on Economic Opportunities

    1. Employment and self-employment opportunities for 
veterans--The Subcommittee plans to conduct hearings to 
highlight servicemembers and veterans as a desirable business 
asset, with a focus on recently separated servicemembers 
returning from Iraq and Afghanistan, including demobilizing 
Reserve and National Guard personnel.
    2. Department of Labor workforce and transition services--
Public Law 107-288, the Jobs for Veterans Act, improved and 
modernized the Department of Labor's veterans' employment and 
training services, including providing veterans ``first-in-
line'' priority in all DOL funded employment and training 
programs. Public Law 108-183 requires DOL to furnish pre-
separation job placement services to servicemembers serving 
overseas. Public Law 109-461 modified and reorganized the 
Veterans Employment, Training and Employer Outreach Advisory 
Committee within the Department of Labor and the Subcommittee 
will examine the progress and effectiveness related to the 
Advisory Committee as well.
    3. State Approving Agencies--Veterans may only receive GI 
Bill benefits while attending a VA-approved course of 
instruction. VA contracts with state education agencies to 
approve and monitor education and training programs to ensure 
they meet the needs of veterans. The state agencies also 
provide local resources to investigate alleged violations of VA 
education regulations as well as a wide range of oversight 
functions on behalf of VA. Funding for the SAAs is scheduled to 
be decreased at the end of fiscal year 2008. The Subcommittee 
will explore the affects of any potential decrease in SAA 
funding and possible alternative to current funding schemes.
    4. Vocational Rehabilitation and Employment--VA's 
Vocational Rehabilitation and Employment (VR&E) program 
provides services and assistance to enable veterans with 
service-connected disabilities to obtain and maintain suitable 
employment, and to enable certain other disabled veterans to 
achieve independence in daily living. The Subcommittee will 
examine VR&E's recent efforts to implement its 5-track program 
throughout the 57 regional offices. In addition the 
Subcommittee will likely focus on areas such as suitable 
employment including self employment assistance to the most 
seriously disabled veterans, contracted services, claims 
processing, employer outreach and quality assurance.
    5. Uniformed Services Employment and Reemployment Rights 
Act--Uniformed Services Employment and Reemployment Rights Act 
(USERRA) provides a broad range of employment rights and 
responsibilities for veterans and employers. The law was 
recently amended to establish a demonstration project for 
improved enforcement by the Federal government. The 
Subcommittee will assess the effectiveness of USERRA with 
special emphasis on employers' willingness to hire National 
Guard and Reserve members and employment-related issues related 
to returning to the workforce following activation.
    6. Transition Assistance to Demobilizing Reserve and 
National Guard Personnel--Due to the increased utilization of 
the Selected Reserve since September 11, 2001, many more 
citizen soldiers are being activated and serving on active 
duty. Consequently, as the Reserve and National Guard forces 
demobilize after their activation period, they like active duty 
troops require period of readjustment and transition services. 
The Subcommittee will continue to examine and focus its efforts 
to ensure that Selected Reserve personnel receive the 
assistance and benefits they may need to successfully 
transition into civilian workforce and lifestyle.
    7. VA Office of Small and Disadvantaged Business/Center for 
Veterans Enterprise--Public Law 109-461 required the VA to set 
and meet certain procurement goals with respect to veteran and 
service-disabled veteran owned small businesses. The 
Subcommittee will examine VA's efforts to effectively implement 
this law and improve its contracting efforts with such 
concerns.
    8. GI Bill--Congress, other than providing benefit 
increases, has not comprehensively modified, modernized or 
updated the Montgomery G.I. Bill since 1985. Due to advances in 
technology, dynamic workforce changes, and ever increasing 
demands on servicemembers, as well as military recruiting 
efforts the time is right to seriously review the MGIB. 
TheSubcommittee may hold a series of hearings to provide a 
comprehensive review of the program and to ascertain whether the 
current veterans' education system is adequate and reflects the way 
current society learns, studies and trains for success. The 
Subcommittee will also explore the effectiveness of various possible 
improvements as a means to increase the use of education benefits, as 
well as improving recruiting and retention in the armed forces.
    9. Information Technology--VBA currently uses several 
information technology applications to assist administration of 
its education and vocational rehabilitation and employment 
programs. Despite this basic level of automation, significant 
backlogs persist. The Subcommittee will assess opportunities to 
increase the ability of rules-based systems to improve 
administration and decrease the backlogs.

Subcommittee on Health

    1. Provision of VA Health Care--The Subcommittee will 
examine the manner in which VA provides care to veterans, and 
ways in which the VA's health care delivery can be improved. 
The Subcommittee plans to examine how technology can improve 
the delivery of health care, especially to rural and under-
served veterans. The Subcommittee plans to explore the current 
efforts of the VA in meeting the health care needs of veterans' 
including quality of care and access issues, as well as how the 
VA can improve in the future. The Subcommittee also plans on 
conducting oversight over the VA's Project HERO (``Healthcare 
Effectiveness through Resource Optimization'') initiative, as 
well as VA's current contract care practices.
    2. Health Care Personnel--The Subcommittee plans on 
evaluating VA's current efforts to recruit and retain nurses, 
physicians, dentists, and other health care professionals. The 
Subcommittee plans on examining how best to ensure that VA 
personnel meet the health care needs of our veterans. The 
Subcommittee will explore innovative measures VA medical 
centers may use to attract and retain nursing personnel and 
support quality patient care, including the Magnet Recognition 
Program.
    3. VA Medical and Prosthetic Research--The Subcommittee 
plans on examining the effectiveness of the VA's current 
research endeavors, how they match up with Congressional intent 
in regards to addressing injuries and illnesses in the 
veterans' population, and the importance of VA's clinical 
research efforts. The Subcommittee also plans on looking at 
such issues as the role of intellectual property in the 
research effort and the function and effectiveness of VA's 
research corporations.
    4. Prosthetics and Specialized Services--The Subcommittee 
plans to examine VA's specialized services, such as blind 
rehabilitation, spinal cord injury, and prosthetics, including 
ways to improve these services and ways the VA can meet 
Congressional intent in these areas.
    5. Women Veterans' Programs--With increasing numbers of 
women veterans, the Subcommittee will examine VA's provision of 
health care services to women, and whether there are 
improvements that must be made.
    6. Long-term Care--The Subcommittee plans to examine the 
current state of VA's long-term care programs, and explore ways 
to improve and augment the VA's efforts in this area, including 
issues relating to state veterans homes and contract community 
homes.
    7. CARES, VA Construction, and Facilities Management--The 
Subcommittee plans on reviewing the current state of the VA's 
construction programs, including major and minor construction, 
facilities management efforts, and capital asset plans. Also of 
interest to the Subcommittee is the VA's historic preservation, 
and enhanced use lease endeavors. The Subcommittee also plans 
to continue monitoring the VA's collaborative efforts with 
other governmental and non-profit health care entities.
    8. VA Funding--The Subcommittee plans to examine the 
adequacy of VA funding, and ways to improve the current funding 
system. The Subcommittee is interested in examining the 
efficacy of, and improvements to, the VA's financial controls 
and systems, in order to better stretch scarce health care 
resources. The Subcommittee plans on examining the Medical Care 
Collections Fund (MCCF). The Subcommittee plans to examine the 
VA's use of ``management efficiencies,'' and other budget items 
that may serve to depress the Administration's annual budget 
requests, as well as looking at the VA's ability to budget for 
returning servicemembers and account for the long-term costs of 
these new veterans.
    9. PTSD and Mental Health Issues--The Subcommittee plans to 
examine the VA's current efforts in the area of mental health 
and post-traumatic-stress-syndrome (PTSD) as they relate to 
returning servicemembers and veterans of previous conflicts.
    10. Traumatic Brain Injury and VA Polytrauma Centers--The 
Subcommittee plans on examining the efforts of the VA in 
diagnosing and treating Traumatic Brain Injury (TBI) as well as 
the operation of the VA's Polytrauma Centers. Veterans 
returning from Iraq and Afghanistan have shown a marked 
increase in TBI. The Subcommittee wants to ensure that the VA 
is doing all it can in this area.
    11. Homelessness--The Subcommittee plans to review the VA's 
current efforts to combat homelessness amongst veterans, and 
examine ways to improve services to homeless veterans.
    12. VA/DOD Cooperation--The Subcommittee plans to examine 
how the VA and DOD health care systems can best work together 
to provide health care services to veterans. The Subcommittee 
plans to look into progress the agencies have made in ensuring 
that health information is shared, including electronic medical 
records, and other ways in which both agencies can improve 
services to returning servicemembers and veterans.
    13. VA's Fourth Mission--The VA has an important role to 
play outside of the direct provision of health care to 
veterans. The Subcommittee plans to examine the VA's readiness 
to accomplish its fourth mission--to serve as backup to the 
Department of Defense health care system in times of war or 
other emergencies and to support communities following domestic 
terrorist incidents and natural disasters. The Subcommittee 
seeks to be assured that the VA has devoted adequate resources 
for its fourth mission contingencies and that the VA's fourth 
mission duties do not detract from its first mission of caring 
for veterans.

Subcommittee on Oversight and Investigations

    1. Competitive Sourcing and Alternative Management 
Systems--The VA is implementing the President's Management 
Agenda and Office of Management and Budget Directives through 
competitive sourcing and alternative management systems. The 
Subcommittee is interested in the factual basis for conduct of 
this program and the organizational benefits yielded.
    2. VA's Procurement and Acquisition System--the 
Subcommittee will continue to monitor the performance of this 
system to determine its efficiency and effectiveness. VA spends 
over $6 billion annually for medical and surgical supplies, 
prosthetics, information technology, construction and other 
materials and services.
    3. VA Information Technology Programs--VA has had problems 
fielding integrated information technology systems. The 
Subcommittee continues oversight of VA's progress.
    4. VA Information Security Management Program--the loss of 
computer hardware containing the personal information of 
millions of veterans enhanced awareness of ongoing problems 
with VA's information security program. The Subcommittee has 
ongoing interest in the effectiveness of the program.
    5. VA's Fourth Mission--Are they ready?--VA has a role in 
this nation's response to certain types of large scale 
incidents, whether natural or man-made. VA must maintain the 
capacity to meet its responsibilities under the National 
Response Plan and provide for its continuity of operations.
    6. Force Protection and Seamless Transition--the 
Subcommittee will oversee DoD and VA efforts to assure that the 
transition between the two departments is seamless and 
responsive to the needs of veterans. The Subcommittee review 
will include DoD's referral of discharged Guard and Reeserve 
personnel to VA's dental program for their follow-up dental 
care.
    7. Enhanced Land Leases and Divestment of Federal 
Property--VA has used expanded authorizations to engage in 
enhanced-use leases of its property and on occasion divests 
federally-owned property. The Subcommittee will assure that the 
decision process for these actions is sound and that revenues 
received and other benefits are appropriate. Also of interest 
to the Subcommittee is the VA's preservation of historic 
landmarks and buildings and the appropriate disposition of 
unused, unkempt, or hazardous facilities and properties.
    8. Evaluating Management Efficiency-based Budget Offsets--
This Committee and the Government Accountability Office have 
been critical of the VA's practice of offsetting budget 
requirements with claimed management efficiencies. Subcommittee 
interest in this issue is ongoing.
    9. Chemical, Radiological, Biological and other Test 
Veterans issues--Since WWII, servicemembers have participated 
in tests with potentially harmful agents, to determine 
warfighting capability and the utility of protective equipment. 
The committee will assure that veterans who participated in 
these tests receive appropriate care for medical problems 
caused by the testing.
    10. Medical Recruitment, Retention and Staffing--to include 
nursing and certain medical specialties, pay and bonus issues, 
title 5/38 issues, and employment conditions--Are the human 
resource needs of VA being met effectively?
    11. Human Subjects Protection--Previous problems in the 
area of human testing led the committee to strengthen human 
subject protections. The Subcommittee will review this matter 
to assure the protections in place are working.
    12. Laboratory and Clinical select agent security--VA Level 
3 Laboratories and all VA Medical Centers are host to various 
chemical, biological and radiological agents. Are these agents 
secure?
    13. VA Inspector General--Budget and Performance--The 
Subcommittee will examine the budget of the VA Inspector 
General (IG) and review how VA uses the recommendations of the 
IG to increase efficiency and effectiveness in providing 
services to veterans.
    14. Veterans Preference in Federal Hiring--Categorical 
Ranking Systems--Veterans have complained that Federal Veterans 
Preference is not working. The Office of Personnel Management 
has implemented an alternative personnel system to enlarge 
selection pools of applicants. Is Veterans Preference lost in 
this process?
    15. Small Business Contracting Goals for Service Connected 
Disabled Business Owners--The federal government has a poor 
result in assuring that small business contracting goals with 
service-connected disabled veteran small business owners are 
being met. The Subcommittee will explore the root cause for 
this underachievement.
    16. Electronic Medical Records--Electronic medical record 
keeping offers a number of potential benefits. Implementing and 
integrating bi-directional electronic medical records should 
result in savings, added security, and safety. The Subcommittee 
will review the results of VA's efforts in this area.
    17. Medical Care Collections Fund--The Subcommittee will 
conduct oversight on VA collection efforts.
    18. VA/DOD Benefits Delivery at Discharge Program--This 
would implement a type of one-stop-shopping for servicemembers 
separating from the service. The Subcommittee will review and 
assess progress.
    19. EEO Complaint Resolution System--Problems in the 1990's 
led to significant changes. New changes are being crafted by 
VA. The Subcommittee will conduct oversight to determine if 
these changes have the impact Congress intended.
    20. Worker's Compensation Program--VA is evaluating the 
performance of this program. The Subcommittee will also review 
the program and recent program changes for effectiveness and 
adverse impact.
    21. Credentialing and Screening of VA Employees--The 
Subcommittee will review the portfolio of background checks and 
reviews that involve current and potential VA employees with 
the goal of assuring that veterans and coworkers are safe.
    22. VA Reporting Requirements--VA reports to Congress and 
to the Committees to meet a variety of requirements. The 
Subcommittee will determine if it is possible to streamline or 
consolidate any of these requirements?
 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 FY 2008, MARCH 1, 2007

                              ----------                              

                          House of Representatives,
                            Committee on Veterans' Affairs,
                                      Washington, DC, March 1, 2007
Hon. John M. Spratt, Jr.,
Chairman, House Committee on the Budget
U.S. 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, along 
with Additional 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 2008. The Minority will be submitting Additional and 
Dissenting Views under separate cover.
    Caring for our veterans is an ongoing cost of war, and a 
continuing cost of our national defense. As a Congress, and a 
nation, we must fulfill our obligations to the men and women 
who have served. We hope that you will carefully consider these 
Committee views and estimates. We have a lot of work ahead of 
us if we are to keep our promises to veterans. Working 
together, we can make sure that our veterans are not forgotten, 
and that we meet our obligations to them as a nation.

            Sincerely,

                    Bob Filner, Chairman; Corrine Brown, Vic Snyder, 
                            Michael H. Michaud, Stephanie Herseth, 
                            Harry E. Mitchell, John J. Hall, Phil Hare, 
                            Michael F. Doyle, Shelley Berkley, John T. 
                            Salazar, Ciro Rodriguez, Joe Donnelly, 
                            Jerry McNerney, Zachary T. Space, Timothy 
                            J. Walz.

                     DEMOCRATIC VIEWS AND ESTIMATES


                             MARCH 1, 2007


                   SECTION 1--DISCRETIONARY ACCOUNTS


                     DEPARTMENT OF VETERANS AFFAIRS

    The Committee 1 is recommending a total of 
$41.028 billion for discretionary accounts for the Department 
of Veterans Affairs (VA). This recommendation is $4.562 
billion, or 12.5 percent, above FY 2007 levels, and $1.611 
billion above the Administration's FY 2008 request. This 
recommendation includes an increase in appropriated dollars for 
VA medical care of $3.254 billion over FY 2007, and $1.310 
billion above the Administration's request. The Committee 
believes these additional resources are necessary if we are to 
provide adequate funding for veterans' health care.
---------------------------------------------------------------------------
    \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.
---------------------------------------------------------------------------

                            VA Medical Care

    We are recommending a total of $35.512 billion in 
appropriated dollars for the three accounts comprising VA 
medical care (Medical Services, Medical Administration, and 
Medical Facilities). This amount is $1.310 billion above the 
Administration's FY 2008 budget request of $34.202 billion, and 
is a 10.1 percent increase over the FY 2007 2 
levels, compared to the Administration's increase of 6 percent 
over FY 2007 levels. This recommended level is less than the 
$36.348 billion (which represents a 12.7 percent increase over 
FY 2007 levels) recommended by the Independent Budget, co-
authored by AMVETS, Disabled American Veterans, Paralyzed 
Veterans of America, and the Veterans of Foreign Wars. The 
Committee is recommending a total for the Veterans Health 
Administration (VHA) (which includes Medical Care accounts and 
Medical and Prosthetic Research) of $35.992 billion, $3.320 
billion over FY 2007 levels and $1.379 billion above the 
Administration's FY 2008 request.
---------------------------------------------------------------------------
    \2\ Amounts for FY 2007 are from P.L. 110-5, H.J. Res. 20, a joint 
resolution making further continuing appropriations for the fiscal year 
2007, and for other purposes. This measure was signed into law on 
February 15, 2007.
---------------------------------------------------------------------------
    This recommended increase would better enable the VA to 
meet high-priority needs in the coming fiscal year. These 
increases would provide additional dollars for increased 
patient workload, including estimated increases due to 
servicemembers returning from Iraq and Afghanistan, mental 
health, long-term care, homeless programs, prosthetics, and 
Traumatic Brain Injury (TBI) and Polytrauma Centers, which care 
for our most grievously wounded veterans. The Committee's 
medical care recommendation also includes additional funding 
for the VA to begin to address urgent non-recurring maintenance 
needs at VA facilities.

Medical Services

FY 2007 enacted.........................................  25,512,000,000
FY 2008 request.........................................  27,167,671,000
Independent budget......................................  28,979,000,000
FY 2008 recommendation..................................  28,407,975,000
Recommendation vs. request..............................  +1,240,304,000

    The Medical Services appropriation 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.
    The Medical Services account comprises the majority of 
funding for VA health care--nearly 80 percent of the total of 
the three accounts that make up ``VA medical care.'' The 
Committee is recommending a total increase in appropriated 
dollars, above the Administration's request, of $1.240 billion.

                           Workload Increases

    The Committee is concerned that the Administration may have 
once again underestimated the total number of unique patients 
it expects to see in FY 2008. Over the five-year period from FY 
2002 through FY 2007, the VA saw an average annual increase in 
unique patients of 4 percent, or approximately 203,000 
additional patients per year.
    The VA's FY 2008 budget request estimates a total of 
5,819,176 total unique patients, a 134,030 increase above FY 
2007 estimates of 5,685,146. This estimate is 2.4 percent above 
the FY 2007 level. Out of the 134,030 increase in patients, the 
VA estimates that 54,037 are attributable to an increase in 
Operation Enduring Freedom and Operation Iraqi Freedom (OEF/
OIF) veterans.
    The Committee is recommending increased funding to care for 
an additional 25,000 OEF/OIF veterans. In the FY 2007 VA budget 
submission, the VA estimated that it would see 110,566 OEF/OIF 
veterans in FY 2006 and 109,191 in FY 2007. In the current 
submission, the VA now estimates 155,272 for FY 2006 and 
209,308 for FY 2007. The Committee believes it is prudent to 
provide additional resources to account for increased OEF/OIF 
demand in case the Administration's estimates prove as 
divergent in the coming year as these estimates have been in 
the past.
    The Committee has also requested additional funds to fully 
fund the level of the average annual increase the VA has 
experienced over the last five years (FY 2002-FY 2007). We note 
that we have estimated costs separately for our estimate of an 
additional 25,000 OEF/OIF veterans (which are a component of 
the overall increase of 70,000 additional patients). The 
committee has also included resources for an additional 30,000 
patients (for a total overall increase including OEF/OIF 
veterans of 100,000), recognizing the inherent volatility of 
these estimates and the cost of health care, for a total 
recommended increase for additional workload of $534 million.
    The Committee notes that a possible reason for the VA 
estimating a lower increase in workload may be attributable to 
the Administration's proposal to increase the pharmacy 
copayment from $8 to $15 for priority 7 and 8 veterans. The 
Administration's proposal to institute an annual enrollment fee 
would, if enacted, begin in FY 2009.
    The Committee recommends an additional $534 million to 
account for increased workload and to bring the VA's estimates 
up to the average increase over the past five years.
           Increase attributable to additional demand 
        from OEF/OIF veterans--$71 million
           Increase attributable to overall health care 
        demand--$463 million

                           Priority Programs


Mental Health

    VA Secretary R. James Nicholson testified before the 
Committee regarding the VA's FY 2008 budget request on February 
8, 2007, and stated:

          The President's request includes nearly $3 billion to 
        continue our effort to improve access to mental health 
        services across the country. These funds will help 
        ensure VA provides standardized and equitable access 
        throughout the Nation to a full continuum of care for 
        veterans with mental health disorders. The resources 
        will support both inpatient and outpatient psychiatric 
        treatment programs as well as psychiatric residential 
        rehabilitation treatment services. We estimate that 
        about 80 percent of the funding for mental health will 
        be for the treatment of seriously mentally ill 
        veterans, including those suffering from post-traumatic 
        stress disorder (PTSD).

    Colonel Charles W. Hoge, M.D., stated in testimony before 
the Subcommittee on Health on September 28, 2006 ``[t]here are 
now robust data from different sources that indicate that 
approximately 10-15% of Soldiers develop PTSD after deployment 
to Iraq and another 10% have significant symptoms of PTSD, 
depression, or anxiety and may benefit from care. Alcohol 
misuse and relationship problems add to these rates. Conditions 
often overlap.''
    An article in the Miami Herald, Combat Stress Takes its 
Toll, But VA's Response Falls Short, from February 11, 2007, 
calls into question VA's response to the mental health crisis 
it faces, finding that mental health care is ``wildly 
inconsistent from state to state'' and that the ``lack of 
adequate psychiatric care strikes hard in the western and rural 
states that have supplied a disproportionate share of the 
soldiers in the wars of Iraq and Afghanistan[.]''
    Not only is the VA facing a surge in mental health needs 
due to servicemembers returning from Iraq and Afghanistan, but 
soldiers from previous conflicts are seeking more mental health 
treatment.
    The Committee believes that the VA needs additional 
resources in this area, and believes that the VA should fully 
allocate resources dedicated to mental health. The Committee is 
recommending a $125 million increase to address increasing 
demand, as well as an additional $13 million for VA's Vet 
Centers. The VA currently operates 207 Vet Centers, community-
based counseling centers that provide readjustment counseling 
and outreach services to all veterans who served in any combat 
zone. Vet Center services are also available for family members 
for military related issues. The Committee's recommendation for 
Vet Centers would provide for $125 million for Vet Centers, and 
enable the hiring of 100 veterans to provide outreach services, 
as mandated by P.L. 109-461.
    VA's ability to treat veterans with substance abuse 
problems has continued to diminish. It has been reported that 
many veterans who suffer from mental illness also suffer from 
substance abuse. Also, early reports suggest that alcohol 
misuse will have a profound impact on the reintegration efforts 
of returning OEF/OIF veterans. The VA needs to be able to 
handle not only the increase, but the veterans of past wars who 
are on VA waiting lists to get into a substance abuse program.
    The Committee recommends an additional $148 million for 
mental health, to enhance capacity to meet the needs of new 
veterans and veterans from previous conflicts who bear the 
psychological wounds of war.
           Increase to address the increasing demand on 
        VA's mental health services--$125 million
           Increase funding for Vet Centers--$13 
        million
           Increase VA's capacity to provide substance 
        abuse treatment--$10 million

Long-Term Care

    The Administration is in violation of its statutory 
responsibility to maintain FY 1998 levels for the Average Daily 
Census (ADC) for VA nursing home care, as mandated by P.L. 106-
117,the Veterans Millennium Health Care and Benefits Act. The 
VA's FY 2008 budget submission requests resources to support an 
estimated 11,000 ADC, an amount 2,391 below the 1998 figure.
    The non-institutional programs are indeed a necessary part 
of VA's care continuum, but we should hold to the 1998 
recommendations of the Federal Advisory Committee on the Future 
of VA Long-Term Care that VA should maintain its bed capacity, 
increase capacity in the state homes and double or triple 
capacity in its non-institutional long-term care settings. 
While telemedicine and home care are important components of 
long-term care, telemedicine cannot help a veteran to get out 
of bed or take a shower. Home care may not be suitable for many 
severely disabled veterans who need 24-hour care for complex 
medical and psychiatric conditions.
    The Committee estimates that it would cost $567 million to 
bring the VA up to compliance with P.L. 106-117. We recommend 
increasing the VA's capacity to provide additional ADC in 
nursing home care over the next three years. We believe that 
this will enable veterans who need nursing home care to receive 
it and enable this Committee to better analyze the VA's 
argument that these nursing home beds are unnecessary. We 
therefore recommend an increase of $189 million to enable the 
VA to add an additional 800 ADC to its budget request of 11,000 
and to begin to meet its statutory obligations.
    While increasing the funding for VA to meet the statutory 
requirements of VA operated nursing home care, we also 
recommend that VA develop a long-term plan to meet the extended 
care needs of its patient population. VA projects that in FY 
2008, the demand for VA-sponsored institutional care will be 
nearly 87,000 ADC. Neither VA, nor Congress, can ignore the 
urgent and increasing needs consequent to the exponential 
growth in the population of veterans who are frail and aging.
           Increase for VA long-term care--$189 million

Prosthetics

    We recommend providing an additional five percent increase 
above the Administration's request for prosthetics. We remain 
very concerned that we are not providing the necessary 
resources to fund this area, especially in light of the 
increased needs of our servicemembers returning from Iraq and 
Afghanistan.
           Increase for prosthetics--$62 million

Homeless Veterans

    VA is the largest single provider of direct service to 
homeless veterans, reaching 100,000 or 25 percent of the 
homeless veterans a year through their various programs. Like 
their non-veteran counterparts, veterans are at high risk of 
homelessness due to extremely low or no livable income, extreme 
shortage of affordable housing, and lack of access to health 
care. But these factors combined with their military service 
put them at even greater risk of homelessness. Last Congress, 
P.L. 109-461, the Veterans Benefits, Health Care, and 
Information Technology Act of 2006, increased the authorization 
level for the VA's homeless grant and per diem program to $130 
million. The VA estimates that it will spend $107 million in FY 
2008. The Committee recommends that an additional $23 million 
be made available to fund this program.
           Increase in VA's grant and per diem 
        program--$23 million

TBI/Polytrauma

    VHA Directive 2005-024, Polytrauma Rehabilitation Centers, 
dated June 8, 2005, states that:

          While serving in Operations Iraqi and Enduring 
        Freedom, military service members are sustaining 
        multiple severe injuries as a result of explosions and 
        blasts. Improvised explosive devices, blasts, landmines 
        and fragments account for 65 percent of combat 
        injuries. Congress recognized this newly emerging 
        pattern of military injuries with the passage of Public 
        Law 108-422, Section 302, and Public Law 108-447.
          Of these injured military personnel, 60-62 percent 
        have some degree of traumatic brain injury (TBI). 
        Operating under a national Memorandum of Agreement with 
        the Department of Defense (DOD), the four current 
        Department of Veterans Affairs (VA) TBI Lead 
        Rehabilitation Centers have provided rehabilitation 
        care to the majority of the severely combat injured 
        personnel requiring inpatient rehabilitation. 
        Consequently, they have developed the necessary 
        expertise to provide the coordinated interdisciplinary 
        care required. This experience has demonstrated that 
        treatment of brain injury sequelae needs to occur 
        before or in conjunction with rehabilitation of other 
        disabling conditions.
          Recognizing the specialized clinical care needs of 
        Polytrauma patients, VA has established four Polytrauma 
        Rehabilitation Centers (PRCs). The mission of the PRCs 
        is to provide comprehensive inpatient rehabilitation 
        services for individuals with complex cognitive, 
        physical and mental health sequelae of severe and 
        disabling trauma and provide support to their families. 
        Intensive clinical and social work case management 
        services are essential to coordinate the complex 
        components of care for polytrauma patients and their 
        families. Coordination of rehabilitation services must 
        occur seamlessly as the patient moves from acute 
        hospitalization through acute rehabilitation and 
        ultimately back to his or her home community.

    The Committee notes that TBI is considered by many to be 
the signature injury of this war. We must ensure that the VA 
has the resources it needs to begin tackling the issues 
surrounding TBI, as well as the resources it needs for VA 
Polytrauma centers to treat our most grievously wounded 
veterans.
           Increase funding for TBI/Polytrauma--$285 
        million

                         Other Areas of Concern


Priority 8 Veterans

    The Committee believes that all veterans should have access 
to VA health care. In January, 2003, the Administration banned 
the enrollment of new Priority 8 veterans. The VA currently 
estimates that lifting this ban would result in approximately 
1.6 million veterans seeking health care at a cost of $1.7 
billion. The Independent Budget estimates a total expenditure 
of $366 million, but the Independent Budget's calculation uses 
a utilization rate and subtracts out estimated collections. 
Last year, in the Democratic Views and Estimates, the estimate 
was $341 million, which included subtracting estimated 
collections. The Committee will explore ways to re-open access 
to all veterans.
    We note that the authority of the Administration to deny 
enrollment to an entire class of veterans was never meant to 
extend ad infinitum, but was provided to the VA as a management 
tool in order for it to address unexpected shortfalls that 
might arise during the course of the year. Finally, we note 
that these veterans are not necessarily ``high income'' 
veterans, as they are often described by some. These veterans, 
who may be combat-decorated, can make as little as $27,000 per 
year and be categorized as Priority 8 veterans and be shut out 
of the system.

Recruitment and Retention of Health Care Professionals

    Over the past few years, VA has received accolades for the 
quality of health care it provides as an institution. To 
maintain that quality, it is essential that VA develop and 
execute an effective recruitment and retention program for 
highly qualified medical personnel.
    Through the VA's affiliations with 107 medical schools and 
over 1,200 educational institutions, VA trains over 76,000 
medical and associated health students, residents and fellows.
    The Committee believes that it is essential that the VA 
address recruitment and retention issues in order to ensure 
that veterans receive quality health care not only today, but 
in the coming years.

Efficiencies

    The VA, in its FY 2008 budget submission, claims it will 
achieve ``clinical and pharmacy cost avoidance.'' The VA does 
not provide any estimates as to the totals of these ``cost 
avoidances.''
    The VA's FY 2007 budget submission, estimated a base level 
of ``efficiencies'' of $884 million for FY 2006, and estimated 
additional ``efficiencies'' of $197 million ($107 million in 
clinical efficiencies and $90 million in pharmaceutical 
efficiencies) for a total level of ``efficiencies'' of $1.1 
billion. The GAO last year found that the VA was unable to 
document previous claims of ``efficiencies.'' The VA's clinical 
and pharmacy ``efficiencies'' language from the FY 2007 budget 
submission is remarkably similar to the language on ``cost 
avoidance'' in the FY 2008 budget submission.
    The Committee is concerned that the VA is still relying on 
``efficiencies'' without providing cost estimates for the level 
of ``efficiencies'' it is relying upon, nor justifications 
demonstrating that it is achieving ``efficiencies'' it has 
claimed to achieve.

Medical Administration

FY 2007 enacted.........................................   3,177,000,000
FY 2008 request.........................................   3,442,000,000
Independent budget......................................   3,378,067,000
FY 2008 recommendation..................................   3,442,000,000
Recommendation vs. request..............................               0

    The Medical Administration appropriation provides funds for 
the expenses of management and administration of the VA health 
care system. Included under this heading are provisions for 
costs associated with operation of VA medical centers, other 
facilities, and VHA headquarters, plus the costs of VISN 
offices and facility director offices, chief of staff 
operations, quality of care oversight, all information 
technology hardware and software, legal services, billing and 
coding activities, and procurement.
    The Committee is proposing the same level of funding for 
Medical Administration as requested by the VA.

Medical Facilities

FY 2007 enacted.........................................   3,569,000,000
FY 2008 request.........................................   3,592,000,000
Independent budget......................................   3,991,152,000
FY 2008 recommendation..................................   3,661,974,000
Recommendation vs. request..............................     +69,974,000

    The Medical Facilities appropriation provides funds for the 
operation and maintenance of the VA health care system's vast 
capital infrastructure. Included under this heading are 
provisions for costs associated with utilities, engineering, 
capital planning, leases, laundry and food services, 
groundskeeping, garbage, housekeeping, facility repair, and 
property disposition and acquisition.
    The Committee is recommending an additional $70 million in 
order to provide for a 25 percent increase for non-recurring 
maintenance.
           Provide additional resources to equal a 25 
        percent increase for Non-Recurring Maintenance 
        obligations over FY 2007 level--$70 million
    The Committee notes that the VA's FY 2008 request transfers 
$400 million and 5,689 FTE for Food Services from this account 
to the Medical Services account. The Committee hopes that this 
transfer does not obfuscate the resource requirements of either 
the Medical Facilities or Medical Services accounts, and will 
be monitoring these accounts to ensure that adequate resources 
are in place to meet the needs of veterans.

Medical and Prosthetic Research

FY 2007 enacted.........................................     413,700,000
FY 2008 request.........................................     411,000,000
Independent budget......................................     480,000,000
FY 2008 recommendation..................................     480,000,000
Recommendation vs. request..............................     +69,000,000

    This account includes medical, rehabilitative and health 
services research. Medical research is an important aspect of 
the Department'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 
service 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; and 
grants from the National Institutes of Health, private 
proprietary sources, and voluntary agencies provide support for 
the Department's researchers.
    The Committee recommends $480 million, an increase of $69 
million above the Administration's FY 2008 request of $411 
million. The Administration is seeking a $2.7 million cut below 
the FY 2007 level.
    The Committee recommends $2.7 million to restore the 
Administration's proposed cut in its FY 2008 request. The 
Committee also recommends $15.3 million to account for the 
effects of biomedical inflation on VA research. The Biomedical 
Research and Development Price Index, which was developed by 
the Department of Commerce's Bureau of Economic Analysis for 
use by the National Institutes for Health (NIH) estimates a 3.7 
percent increase to account for inflation. By restoring funds 
cut from the FY 2007 level and by more accurately projecting 
the impact of inflation on VA's research dollars we signal a 
strong commitment to VA's research program and achieve 
stability for ongoing projects.
    The Committee also recommends $3.5 million to restore 
proposed cuts to VA's Centers of Excellence. The Administration 
proposes $45.8 million in obligations for these Centers, down 
from a level of $49.3 million for FY 2007.
    The Committee also recommends an additional $47.5 million 
in order for VA research to advance its efforts in areas such 
as deployment health, genetic medicine, and chronic disease 
management.
    Deployment health includes prospective research to get 
baseline information on the health status of military personnel 
being deployed in combat zones. Research funding is needed to 
collect pre-deployment health information to assist researchers 
and clinicians in better assessing the health needs of 
returning personnel. Deployment health is also responsive to 
conflict-related conditions faced by returning military from 
Iraq and Afghanistan. Such health needs currently include TBI, 
PTSD, and injuries related to multiple-blast wounds.
    Research into genetic medicine recognizes the need to 
unlock the potential of applying genetics to improving 
individual patient care and systems of care for veterans. 
Funding is needed to understand the genetic composition of 
individual veterans and how unique genetic profiles need to 
change the way health care is provided. For example, genetic 
information could help prevent adverse drug reactions known to 
happen with individuals with unique genetic profiles. 
Additionally, veterans with known genetic predisposition to 
certain diseases could be monitored before diseases develop, 
placed on preventative therapy where it exists, be closely 
monitored and provided earlier intervention when appropriate. 
Not only does genetic medicine have the ability to improve 
individual patient care, it has the potential to improve 
systems of care for our veterans.
    Veterans of all ages and theaters of conflict suffer from 
long-term chronic diseases. These diseases include mental 
health disorders, lung diseases, diabetes, and heart 
conditions. Research is needed to both improve clinical tools 
to treat and cure these chronic diseases, but also to research 
how systems of care can improve both individual patient care 
and care of the veterans' population.
    The Committee notes that the VA's expectation of receiving 
additional federal dollars outside of monies appropriated in 
this account may not be realized with the Administration's 
proposed flat FY 2008 budget request for the National 
Institutes of Health (NIH). This makes increased appropriated 
dollars in the Medical and Prosthetic Research account even 
more vital to this important program. There was a concerted 
effort to double the research budget of the NIH. The Committee 
would like to see a similar effort undertaken for VA research.
    The Committee recommendation of $480 million, an increase 
of $69 million above the Administration's request, is comprised 
of the following increases:
           Restore the proposed cuts from the FY 2007 
        level--$2.7 million
           Provide a 3.7 percent increase to account 
        for estimates of biomedical research inflation--$15.3 
        million
           Restore proposed cuts to VA's Centers of 
        Excellence--$3.5 million
           Provide additional resources for VA research 
        to address high priority projects--$47.5 million

General Operating Expenses

FY 2007 enacted.........................................   1,480,764,000
FY 2008 request.........................................   1,471,837,000
Independent budget......................................   2,233,841,000
FY 2008 recommendation..................................   1,668,925,000
Recommendation vs. request..............................        +197,088

    The General Operating Expenses appropriation provides for 
the administration of all VA non-medical benefits and support 
functions for the entire VA. The account is subdivided into two 
activities; the Veterans Benefits Administration (VBA) and 
General Administration.

                    Veterans Benefits Administration

    VBA consists of five programs: Disability Compensation, 
Pensions and Burial; Education; Housing; Vocational 
Rehabilitation and Employment; and Insurance.

Compensation 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.

Education Service

    VA provides education assistance to servicemembers, 
veterans, and certain eligible survivors and dependents in 
exchange for military service. VA education assistance, 
popularly known as 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.

Housing (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.

Vocational 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.

Insurance

    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.
    The Administration's request would provide resources for 
13,065 FTE (9,559 in Disability Compensation, Pensions and 
Burial; 894 in Education; 893 in Housing; 1,260 in Vocational 
Rehabilitation and Employment, and 459 in Insurance).

                         General Administration

    General Administration funds the Office of the Secretary, 
six Assistant Secretaries, the Board of Veterans' appeals, and 
the Office of the General Counsel.

                             Recommendation

    The Administration's request for the GOE account is 
comprised of $1,198,294,000 for VBA, an increase of $30.4 
million over the FY 2007 level, and $273,543,000 for General 
Administration, a decrease of $39.4 million from the FY 2007 
level.
    The Committee is recommending $1.628 billion for this 
account, an increase of $156 million over the Administration's 
FY 2008 request. This increase would restore the proposed cuts 
to the General Administration component of GOE, while adding an 
additional 1,370 FTE, in line with the recommendation of the 
Independent Budget for FTE, in order for the VA to begin to 
address its enormous claims backlog. The Committee notes that 
funding for the Board of Contract Appeals, effective January 7, 
2007, was transferred to the General Services Administration 
(GSA) as part of a government-wide plan to consolidate contract 
appeals within GSA. The Committee has restored proposed cuts in 
general Administration, but believes that any resources not 
fully needed by the VA for this activity should be made 
available to VBA in order to address the claims backlog.
    As of February 17, 2007, the total number of compensation 
and pension claims pending at the VA was 626,429, an increase 
of 5,107 from the previous week (Source: VA Monday Morning 
Workload Report, February 17, 2007). The number of pending 
claims last year at this same time was 573,597 (Source: VA 
Monday Morning Workload Report, February 18, 2006). The 
Administration's request provides for 8,320 ``direct labor 
FTE'' and an ``output per FTE'' of 101. The VA also estimates 
that it will receive the same number of claims in FY 2008 as it 
projects it will receive in FY 2007. Based on the VA's 
estimates, an additional 1,000 FTE should decrease the claims 
backlog in FY 2008 by 100,000 claims. The Committee recommends 
that an adequate number of FTE be added to the VBA Education 
Services Program to ensure that timely and accurate service 
claims processing is provided at the educational services 
Regional Processing Centers.
           Provide for an additional 1,370 FTE to begin 
        to address claims backlog--$153 million
           Restore proposed cuts in General 
        Administration from FY 2007 level--$44 million

Information Technology Systems

FY 2007 enacted.........................................   1,213,820,000
FY 2008 request.........................................   1,859,217,000
Independent budget......................................   1,340,098,000
FY 2008 recommendation..................................   1,832,517,000
Recommendation vs. request..............................     -26,700,000

    The Information Technology Systems account was first 
instituted in the FY 2006 VA appropriations bill (P.L. 109-
114). The VA is undergoing a significant change in its 
information technology (IT) activities, consolidating all IT 
staffing and budgetary resources under a Chief Information 
Officer. The VA's FY 2008 request reflects staff transfers for 
maintenance and operations, but does not include costs for 
development employees, who are expected to be transferred at a 
later date. Of the request, $1.3 billion is non-pay, and $555 
million is pay.
    The VA's base request represents an increase of $90 million 
over the FY 2007 level--the additional monies are attributable 
to the transfer of $555 million and 5,529 FTE into the IT 
account.
    The Committee is recommending $26.7 million less than the 
Administration's request. We are recommending decreases in 
funding for the Financial and Logistics Integrated Technology 
Enterprise (FLITE) program, and Compensation and Pension 
Maintenance and Operations program.
    The VA requested $35 million for FLITE. The Committee 
believes that $20 million is sufficient for this program for FY 
2008. The FLITE program is the successor to the VA's Core FLS 
program. In an article last year, a spokesman for 
Pricewaterhouse Coopers, which was hired by the VA after the VA 
had spent $342 million on Core FLS, stated that ``business 
standardization is the first step. IT comes later.'' ``VA plans 
CoreFLS Successor,'' Government Computer News, March 2, 2006. 
The Committee believes that there is much the VA must 
accomplish first before it should be spending $35 million on 
this program.
    The Committee is also recommending a decrease of $11.7 
million for the VA's Compensation and Pension Maintenance and 
Operations activities. The VA is seeking an increase from $6 
million, the FY 2007 level; to $31.7 million, a total increase 
of $25.7 million. The Committee believes that this increase is 
sought without sufficient supporting documentation and is 
therefore recommending a FY 2008 level of $20 million, an 
increase of $14 million above FY 2007 levels and a decrease of 
$11.7 million below the FY 2008 requested level.
         Decrease in funding for FLITE and Maintenance 
        and Operations funding--$26.7 million

National Cemetery Administration

FY 2007 enacted.........................................     160,733,000
FY 2008 request.........................................     166,809,000
Independent budget......................................     217,910,000
FY 2008 recommendation..................................     166,809,000
Recommendation vs. request..............................               0

    The National Cemetery Administration was established in 
accordance with the National Cemeteries Act of 1973. It has a 
fourfold mission: to provide for the interment in any national 
cemetery with available grave space the remains of eligible 
deceased servicepersons and discharged veterans, together with 
their spouses and certain dependents, and to permanently 
maintain their graves; to mark graves of eligible persons in 
national 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 
provides for the operation and maintenance of 125 national 
cemeteries and 33 other cemeterial installations in 39 states, 
the District of Columbia, and Puerto Rico.
    The Administration's requested level for FY 2008 of $167 
million represents a 3.8 percent increase over the FY 2007 
level of $161 million.
    The Committee concurs with the Administration's request.

Office of Inspector General

FY 2007 enacted.........................................      69,500,000
FY 2008 request.........................................      72,599,000
Independent budget......................................      73,233,000
FY 2008 recommendation..................................      84,445,000
Recommendation vs. request..............................     +11,846,000

    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 Department of Veterans 
Affairs 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 Department programs to operate economically 
in accomplishing program goals, and prevent and deter recurring 
and potential fraud, waste and inefficiencies.
    In testimony before the Subcommittee on Oversight and 
Investigations on February 15, 2007, the VA Inspector General 
George J. Opfer stated that from FY 2001-2006:
    OIG delivered a return on investment of $31 for every 
dollar invested in OIG operations. We produced $11.6 billion in 
monetary benefits from recommended better use of funds, 
savings, costs avoidances, recoveries, questioned costs, 
restitutions, and civil judgments. We issued 1,169 audit and 
inspection reports with 6,601 recommendations to improve 
services to veterans and to improve the economy and efficiency 
of VA programs, operations, and facilities. Almost 90 percent 
of these recommendations have been implemented by VA to date.
    The Administration has requested $72.6 million for FY 2008, 
an increase of $3.1 million above FY 2007 levels. The VA's 
request assumes a total FTE level of 470, 13 fewer than FY 
2007. The Committee recommends $84.4 million for FY 2008, an 
increase of $11.8 million, or 21.5 percent over FY 2007 levels 
and $11.8 million, or 16.3 percent, above the VA's FY 2008 
request.
    The Committee believes that as the OIG is being expected to 
do more, and the economic benefit of investment in the OIG has 
been clearly demonstrated, that an increase in FTE is 
necessary. The Committee recommends restoring the proposed cut 
in FTE and adding an additional 87 FTE, to provide for a total 
FTE of 570.
           Increase to restore proposed FTE cut of 13--
        $1.5 million
           Provide for an additional 87 FTE--$10.3 
        million

Construction, Major Projects

FY 2007 enacted.........................................     399,000,000
FY 2008 request.........................................     727,400,000
Independent budget......................................   1,602,000,000
FY 2008 recommendation..................................     727,400,000
Recommendation vs. request..............................               0

    The Construction, Major Projects, appropriation provides 
for constructing, altering, extending, and improving any VA 
facility, including planning, architectural and engineering 
services, assessments, and site acquisition, where the 
estimated cost of a project is $10 million, or where funds for 
a project were made available in a previous appropriation under 
Construction, Major Projects.
    For FY 2008, the Administration is requesting $727.4 
million, an increase of $328.4 million, or 82.3 percent, over 
FY 2007 levels. This recommendation includes $560 million for 
VHA-related construction and $167.4 million for National 
Cemetery Administration (NCA).
    The NCA portion of the request seeks funds for Phase 1 
Development for cemeteries in the Columbia/Greenville-area; 
Sarasota-area; Jacksonville-area; Southeastern Pennsylvania-
area; Birmingham-area; and Bakersfield-area. The request also 
seeks funding for Gravesite Development for the Ft. Sam Houston 
National Cemetery and the Advance Planning Fund.
    The VHA-related construction request, totaling $560 
million, seeks funding for the following projects:
          Pittsburgh, PA--Consolidation of Campuses
                   Total Estimated Cost--$248 million; 
                Funded through FY 2006--$102.5 million; FY 2008 
                Request--$40 million
          Denver, CO--New Medical Center Facility
                   Total Estimated Cost--$646 million; 
                Funded through FY 2006--$55 million; FY 2008 
                Request--$61.3 million
          Orlando, FL--New Medical Facility, Land Acquisition
                   Total Estimated Cost--$553.9 
                million; Funded through FY 2006--$25 million; 
                FY 2008 Request--$35 million
          Las Vegas, NV--New Medical Center Facility
                   Total Estimated Cost--$600.4 
                million; Funded through FY 2006--$259 million; 
                FY 2008 Request--$341.4 million
          Syracuse, NY--Spinal Cord Injury (SCI) Center
                   Total Estimated Cost--$77.7 million; 
                Funded through FY 2006--$53.9 million; FY 2008 
                Request--$23.8 million
          Lee County, FL--Outpatient Clinic
                   Total Estimated Cost--$109.4 
                million; Funded through FY 2006--$10.5 million; 
                FY 2008 Request--$9.9 million
    The Additional $48.6 million is for various components of 
the Major Construction account, such as the Advanced Planning 
Fund, Claims Analysis, Asbestos, Hazardous Waste Abatement, and 
other activities.

Construction, Minor Projects

FY 2007 enacted.........................................     198,937,000
FY 2008 request.........................................     233,396,000
Independent budget......................................     541,000,000
FY 2008 recommendation..................................     248,396,000
Recommendation vs. request..............................     +15,000,000

    The Construction, Minor Projects, appropriation provides 
for constructing, altering, extending, and improving any VA 
facilities, including planning, assessment of needs, 
architectural and engineering services, site acquisition and 
disposition, where the estimated cost of a project is less than 
$10 million, with a minor improvement component costing 
$500,000 or more.
    The Administration has requested $233.4 million, an 
increase of $34.5 million, or 17.3 percent, over FY 2007 
levels.
    The Committee notes that the VA's 5-Year Capital Plan 2007-
2012, submitted as part of the Administration's FY 2008 budget 
request, lists over 1,200 ``FY 2008-2012 Potential Department-
wide Minor Construction Projects.'' The Committee hopes that 
the VA is prioritizing these projects and is seeking sufficient 
funding to meet these needs and other needs that arise and can 
be best addressed through the Minor Construction account.
    The Committee is recommending an additional $15 million 
above the VA's FY 2008 request to provide funding to upgrade 
and modernize research facilities. The Subcommittee on Health, 
in a hearing on the VHA's FY 2008 budget request held on 
February 14, 2007, receivedtestimony from the Friends of VA 
Medical Care and Health Research (FOVA). FOVA recommended ``an annual 
appropriation of $45 million in the minor construction budget dedicated 
to renovating existing research facilities[.]'' The Committee notes 
that the FY 2007 VA appropriations bill as passed by the House of 
Representatives included $12 million in the minor construction account 
``to be used solely for a program of upgrade and modernization of 
research facilities to ensure they maintain or attain state-of-the-art 
status.'' H.Rept. 109-464, to accompany H.R. 5385, the Military Quality 
of Life and Veterans Affairs and Related Agencies Appropriations Bill, 
at 64. The Committee on Appropriations directed the VA to conduct a 
comprehensive review of its research facilities and to report to 
Congress by March 1, 2007. The VA has indicated that this review may 
take three years to complete.
           Increase to upgrade and modernize research 
        facilities--$15 million

Grants for Construction of State Extended Care Facilities

FY 2007 enacted.........................................      85,000,000
FY 2008 request.........................................      85,000,000
Independent budget......................................     150,000,000
FY 2008 recommendation..................................     120,000,000
Recommendation vs. request..............................     +35,000,000

    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.
    State homes play an important role in VA's long-term care 
strategy by filling the gap of available beds for elderly and 
sick veterans who need them. In FY 2006, there were 80 priority 
group 1 projects for a total of $420 million. Priority group 1 
projects are those projects that already have the State funding 
to start construction. In FY 2007, VA's priority group 1 
projects totaled $491 million with 22 of the top 23 needing 
life safety corrections.
           Increase for Construction of State Extended 
        Care Facilities--$35 million

Grants for Construction of State Veterans Cemeteries

FY 2007 enacted.........................................      32,000,000
FY 2008 request.........................................      32,000,000
Independent budget......................................      37,000,000
FY 2008 recommendation..................................      32,000,000
Recommendation vs. request..............................               0

    This program provides grants to states for 100 percent of 
the cost for the establishment, expansion or improvement of 
state cemeteries. The states are responsible for on-going 
maintenance. State cemeteries provide a last resting place for 
veterans who live in areas not reasonably served by a national 
cemetery.

                          DEPARTMENT OF LABOR


                    Veterans Employment and Training


  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 
$228.1 million in FY 2008 to support the staffing and grant-
making ability of VETS. This is a $5.1 million, or 2.3 percent, 
increase over FY 2007. For FY 2008, the Committee recommends an 
increase of $5 million for VETS, for a total of $233.1 million. 
This recommended level would provide an additional $3 million 
for HVRP, bringing that program up to $26.6 million; $1 million 
for NVTI; and $1 million for additional FTE, including one 
additional FTE in each of the six regional offices to address 
complaints and investigations arising under USERRA.

                             OTHER AGENCIES


American Battle Monuments Commission

FY 2007 enacted.........................................      41,988,000
FY 2008 request.........................................      53,300,000
Independent budget......................................             N/A
FY 2008 recommendation..................................      53,300,000
Recommendation vs. request..............................               0

Includes appropriation for salaries and expenses, and foreign currency 
fluctuations.

    The American Battle Monuments Commission (ABMC) 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 and the World War II and Korean 
War Veterans Memorials in Washington, D.C.
    The ABMC is seeking a total of $53.3 million for FY 2008, 
consisting of $42.1 million for salaries and expenses, and 
$11.2 million for costs associated with foreign currency 
fluctuations.

U.S. Court of Appeals for Veterans Claims

FY 2007 enacted.........................................      20,100,000
FY 2008 request.........................................      21,217,000
Independent budget......................................             N/A
FY 2008 recommendation..................................      21,217,000
Recommendation vs. request..............................               0

    The Veterans' Judicial Review Act, P.L. 100-687, 
established the U.S. Court of Appeals for Veterans Claims. The 
Court has exclusive jurisdiction to review decisions of the 
Board of Veterans' Appeals. The court, one of four Article I 
courts in the federal judicial system, may affirm, vacate, 
reverse, or remand decisions of the Board of Veterans' Appeals. 
Out of the total denials from the Board in FY 2006 of 18,107, 
the Court received 3,729 filings, or 21 percent of the number 
of total denials from the Board.
    The Court's request for FY 2008 includes $1,120,000 for the 
Pro Bono Representation Program. This program is administered 
by the Legal Services Corporation. The Court includes the 
Program's FY 2008 request as an appendix to its submission, and 
applauds the ``Program's high success in providing, along with 
others, counsel to reduce the percentage of unrepresented 
appellants before the Court. Since 1997, the percentage 
unrepresented appellants at the decision point of their appeals 
has dropped from 48-percent in FY 1997 to 24-percent or less in 
FY 2006.''

                     SECTION 2--MANDATORY ACCOUNTS


 Full Equity for World War II Filipino Veterans who Served in the U.S. 
                                  Army

    Many World War II Filipino veterans, who served and fought 
alongside American servicemembers during World War II, do not 
receive veterans' benefits. Shortly after the war, Congress 
passed the Rescission Acts which stripped away many veterans' 
benefits for Filipino service members who served in the U.S. 
Army. For the past 60 years, Congress has taken a piece-meal 
approach to restoring these benefits.
    We recommend an additional $900 million be included to 
complete the last step of the process of restoring these 
veterans' benefits.
           Increase for Filipino World War II veterans 
        who served in the U.S. Army--$900 million

                 Belated Thank You to Merchant Mariners

    World War II Merchant Mariners suffered the highest 
casualty rate of any of the branches of service while they 
delivered troops, tanks, food, airplanes, fuel and other needed 
supplies to every theater of the war. Despite their efforts 
during the war, Merchant Mariners were not covered by the 
original G.I. Bill of Rights. No legislation to benefit 
merchant seamen was passed by Congress until 1988 when the 
Seaman Acts of 1988 finally granted them a ``watered down'' 
G.I. Bill of Rights. To make up for lost benefits and 
opportunities, we recommend an additional $400 million be 
included in the budget resolution to permit Merchant Mariners, 
and their surviving spouses, to receive a monthly benefit of 
$1,000.
           Increase for Merchant Mariners--$400 million

                         Other Areas of Concern

    There are several mandatory veterans' programs where there 
is room for improvement. These are programs that provide 
monetary assistance to disabled veterans and their families.

Compensation and Pension Benefits

Dependency and Indemnity Compensation (DIC) for survivors with 
        dependent children under 18.

    DIC is a monthly benefit paid to eligible survivors of a 
military service member who died while on active duty, a 
veteran whose death resulted from a service-related injury or 
disease, or a veteran whose death resulted from a nonservice-
related injury or disease, and who was receiving, or was 
entitled to receive, VA Compensation for service-connected 
disability that was rated as totally disabling for at least 10 
years immediately before death, or since the veteran's release 
from active duty and for at least five years immediately 
preceding death, or for at least one year before death if the 
veteran was a former prisoner of war who died after September 
30, 1999.
    In May of 2001, the Program Evaluation of Benefits for 
Survivors of Veterans with Service-connected Disabilities 
recommended that surviving spouses with dependent children 
receive an additional amount per month for the first five years 
after the veterans' death. Public Law 108-422 provided an 
increase, but only for the first two years of eligibility.

Pension and death pension benefits for veterans and surviving spouses 
        and children

    Veterans who have honorably served the Nation during a 
period of war and who have reached age 65 or who are under age 
65 and are totally and permanently disabled as the result of 
nonservice-connected disabilities are eligible to receive a 
pension benefit if they meet certain income criteria. Surviving 
spouses and children of such wartime veterans, including adult 
disabled children, are eligible for a death pension. According 
to a 2004 evaluation of VA's pension program, the pension 
program is not meeting Congressional intent because it is not 
allowing veterans and their survivors to live in dignity.

Insurance

Base premiums for Service-Disabled Veterans Life Insurance (SDVI) on 
        current actuarial tables

    The SDVI program provides life insurance to veterans with 
service-connected disabilities who apply within two years of 
being service-connected and who would be insurable but for 
their service-connected disabilities. At the time the SDVI 
program began, premium rates were based on the then current 
(1941) actuarial tables used by commercial life insurance 
companies. Although commercial life insurance tables have been 
updated several times since 1941 (most recently in 2001), 
service-connected disabled veterans, including those injured in 
Afghanistan and Iraq, are subjected to premiums approximately 
three times higher than the original program intended because 
the actuarial tables are more than 60 years out of date.
    In May of 2001, the Program Evaluation of Benefits for 
Survivors of Veterans with Service-connected Disabilities 
recommended that veterans' premiums should be based on current 
mortality rates.
            SDVI maximum insurance
    In May of 2001, the Program Evaluation of Benefits for 
Survivors of Veterans with Service-connected Disabilities 
recommended that SDVI coverage limits should be increased. The 
basic amount of SDVI available has not been increased from 
$10,000 since 1951.
            Veterans Mortgage Life Insurance (VMLI)
    VMLI is a type of mortgage life insurance available only to 
those veterans disabled enough by a service-connected 
disability to qualify for a specially adapted housing grant. 
Today, VMLI covers only about 55 percent of the mortgages of 
these veterans. The mortgage coverage has been the same since 
1992.

Readjustment Benefits

            Total Force GI Bill
    The Montgomery GI Bill (MGIB), implemented over 20 years 
ago, was a landmark piece of legislation that provided 
education and training benefits to many veterans. The time has 
come to update, modernize, and provide greater flexibility 
within the VA's educational assistance programs. For GI Bill 
education benefits to remain a relevant recruitment, retention, 
as well as readjustment benefit, we must ensure that VA's 
education and training programs reflect the manner in which 
individuals earn and learn in the 21st Century.
    Congress, other than providing benefit increases, has not 
significantly modified administrative or process provisions of 
the GI Bill since 1985. Due to advances in technology, 
recognition of the lifetime learning concept, dynamic workforce 
changes, and ever-increasing demands on military recruiting 
efforts, Congress should review the current veterans' education 
system and make necessary changes to provide servicemembers, 
veterans and their families relevant education and training 
benefits that meet their educational and vocational goals for 
success.
    The Committee plans, on a bipartisan basis, to explore a 
number of options to improve and modernize the GI Bill. The 
VA's Advisory Committee on Education and the Partnership for 
Veterans Education--a group made up of traditional veterans and 
military service organizations, as well as higher education 
advocates all have endorsed a proposal termed the ``Total Force 
GI Bill.'' The proposal has three features: one, a clearer 
alignment of education benefit rates according to service 
rendered; two, establishment of a readjustment element to 
reservists' MGIB benefits earned during activation for a 
contingency operation (presently, activated reservists eligible 
for the new `Chapter 1607' MGIB can only retain unused 
entitlement by remaining in the Selected Reserve--there is no 
portability of benefits after completion of a Selected-Reserve 
service contract; three, to achieve the first and second 
objectives and to ensure future correlation of active duty, 
veterans, and National Guard and Reserve benefits in an 
equitable and proportional manner, Chapters 1606 and 1607 in 
Title 10 and Chapter 30 in Title 38 need to be reorganized 
together under Title 38.
            State Approving Agencies/Montgomery GI Bill
    State Approving Agencies (SAA) have partnered with the VA 
in the administration of veterans educational and training 
programs for nearly 60 years. Through the program approval and 
supervision process, they ensure that money spent on the 
Montgomery GI Bill is money well spent. Moreover, SAA provide 
critical assistance in reducing the opportunities for fraud, 
waste and abuse throughout the system. For FY 2006 and 2007 the 
VA's Education Service was allocated $19 million from the 
Readjustment Benefits Account to enter into contracts with SAA 
for purposes of approving courses of education under the 
Montgomery GI Bill and other related activities. Per section 
301 of P.L. 107-330 at the end of fiscal year 2007, the SAA 
funding will decrease to $13 million. The Committee believes 
that Congress must find a way to restore this proposed cut to 
this activity.

                            Section 3--Chart


                                                                  DEPARTMENT OF VETERANS AFFAIRS DISCRETIONARY ACCOUNTS FY 2008
                                                                                         (In thousands)
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                     FY 2008                               FY 2008                                             FY 2008 Committee
                          Account                                 FY 2007          President's      FY 2008 Request      Independent     FY 2008 Committee  FY 2008 Committee     vs. FY 2008
                                                                                     Request          vs. FY 2007           Budget         Recommendation      vs. FY 2007          Request
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Medical Services...........................................         25,512,000         27,167,671          1,655,671         28,979,220         28,407,975          2,895,975          1,240,304
Medical Administration.....................................          3,177,000          3,442,000            265,000          3,378,067          3,442,000            265,000                  0
Medical Facilities.........................................          3,569,000          3,592,000             23,000          3,991,152          3,661,794             92,794             69,794
                                                            ------------------------------------------------------------------------------------------------------------------------------------
      Total, Medical Care..................................         32,258,000         34,201,671          1,943,671         36,348,439         35,511,769          3,253,769          1,310,098
Medical and Prosthetic Research............................            413,700            411,000             -2,700            480,000            480,000             66,300             69,000
                                                            ------------------------------------------------------------------------------------------------------------------------------------
      Total, Veterans Health Administration................         32,671,700         34,612,671          1,940,971         36,828,439         35,991,769          3,320,069          1,379,098
                                                            ====================================================================================================================================

General Operating Expenses.................................          1,480,764          1,471,837             -8,927          2,233,841          1,668,925            188,161            197,088
Information Technology Systems.............................          1,213,820          1,859,217            645,397          1,340,098          1,832,517            618,697            -26,700
National Cemetery Administration...........................            160,733            166,809              6,076            218,335            166,809              6,076                  0
Office of Inspector General................................             69,500             72,599              3,099             73,233             84,445             14,945             11,846
Construction, Major Projects...............................            399,000            727,400            328,400          1,602,000            727,400            328,400                  0
Construction, Minor Projects...............................            198,937            233,396             34,459            541,000            248,396             49,459             15,000
Grants for Construction of State Extended Care Facilities..             85,000             85,000                  0            150,000            120,000             35,000             35,000
Grants for Construction of State Veterans Cemeteries.......             32,000             32,000                  0             37,000             32,000                  0                  0
                                                            ------------------------------------------------------------------------------------------------------------------------------------
      Total Departmental Administration....................          3,639,754          4,648,258          1,008,504          6,195,507          4,880,492          1,240,738            232,234
Other Discretionary........................................            154,548            155,572              1,024            158,629            155,572              1,024                  0
                                                            ====================================================================================================================================
      Total Discretionary..................................         36,466,002         39,416,501          2,950,499         43,182,575         41,027,833          4,561,831          1,611,332
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

                    REPUBLICAN LETTER OF TRANSMITTAL

                          House of Representatives,
                            Committee on Veterans' Affairs,
                                      Washington, DC, March 1, 2007
Hon. John Spratt,
Chairman, Committee on the Budget
U.S. House of Representatives, Washington, DC.
    Dear Mr. Chairman: Pursuant to the Congressional Budget Act 
of 1974 and House Rule X, clause 4(f), 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 FY 2008 budget request for 
veterans' programs.
    In recommending record discretionary funding for veterans' 
health care and benefits, the Republican Budget Views and 
Estimates reflects our enduring priorities: to care for 
veterans who have service-connected disabilities, those with 
special needs, and the indigent; to ensure a seamless 
transition from military service to the care of the Department 
of Veterans Affairs (VA); and to provide veterans every 
opportunity to live full, healthy lives.
    Reflecting the cost of war, Republican Members recommend 
funding that honors our returning servicemembers with truly 
seamless transition from the military to quality VA health care 
and benefits. Our recommendations further increase access to VA 
health care and preserve the high quality of care for which VA 
has justly become the envy of the medical community. Funding 
recommended by Republican Members will resource VA to slash the 
backlog in disability claims with a progressive blend of 
personnel increases, leveraged technology, and an energized 
network of intergovernmental collaboration.
    The Republican views and estimates take into consideration 
information provided to the Committee in February 2007 during 
hearings on the budget at which written and oral testimony was 
provided by the Secretary of Veterans Affairs, the national 
leadership of some veterans' service organizations (VSOs), and 
other authorities.
    These views and estimates consider insights gathered in the 
109th Congress, during which the Committee enhanced input from 
VSOs and military service organizations (MSOs) by holding 
hearings during development of the views and estimates and 
boosting the number of these groups which testified. In 
February 2006, 19 of these organizations testified on the 
budget, and in September 2006, 20 testified in a fiscal-year 
review. Many of these views retain their validity. Contending 
with the Majority's decision to restrict the hearing process 
and curtail the opportunity for veterans' groups to testify 
early in the budget cycle, the Republican views and estimates 
continue to implement insights of last year.
    In developing these views and estimates, we commend the 
President and the Secretary of Veterans Affairs for sending to 
the Congress a strong request. The Administration's FY 2008 
budget submission reflects the priorities of a nation at war 
and the commitment of Americans to care for their veterans. The 
President has proposed substantial increases in the budgets of 
agencies focused on fighting the war on terror, the Department 
of Defense and the Department of Homeland Security. Consistent 
with his focus, the Department of Veterans Affairs, with its 
mission of caring for those who have borne the battle, again 
this year received a substantial increase. Much of the rest of 
government received very modest, if any, augmentation.
    Medical services funding recommended within this Budget 
Views and Estimates strengthens our ability to respond directly 
to the needs of servicemembers returning from the global war on 
terror. Many of these warriors have suffered traumatic brain 
injury and other grievous and complex injuries requiring the 
most advanced treatments and rehabilitation. Veterans and the 
families at their side will see dramatic increases in medical 
care accounts, mental health care, and funding for polytrauma 
care. Republicans recommend increases in research, prosthetics, 
sensory aids, and blind rehabilitation. As we expand current 
access to quality health care and long-term care, our 
recommendations will dramatically improve VA's future ability 
to care for veterans with aggressive construction spending on 
the kind of medical facilities that veterans need, where they 
need them.
    Sports at all levels of skill provide the opportunity for 
service-disabled veterans to accelerate their rehabilitation 
and improve their overall lives. In 2005, VA joined with the 
U.S. Olympic Committee to provide increased opportunities for 
service-disabled veterans to participate in sports and we 
recommend funding to defray the program's modest expenses.
    The backlog of disability compensation and pension claims 
continues to climb. It is now well past 600,000, with another 
137,000 appeals awaiting decision. Just since the beginning of 
February 2007, nearly 10,000 claims have been added to the 
backlog. Each claim is a veteran waiting for the government to 
act, and possibly dying before that happens. We recommend 
funding 1,000 additional full-time employee equivalents over 
the Administration's request, 600 for compensation and pension 
adjudication, and 400 for education and veterans' 
rehabilitation and employment programs. We would also increase 
hiring for the Board of Veterans' Appeals above the 
Administration's request.
    Additional hiring is only part of the solution to improving 
quality, accuracy, and timeliness in claims processing. 
Republican Members recommend funds for mobile claims offices, 
training and performance support systems, and skills 
certification and improved processes. Innovations such as 
rules-based technology could help speed accurate decision 
making, as will closer partnerships with municipal, county and 
state veterans offices and veterans groups; our recommendations 
include funding for pilot projects in these areas.
    Our young men and women returning from military service are 
a national treasure. During the 109th Congress, the Committee 
determined the need to modernize the Montgomery GI Bill for 
both active duty and reserve component servicemembers. 
Consequently, we propose additional mandatory spending to 
improve these education and training benefits, which have 
proven since 1944 to be one of our nation's greatest 
investments.
    The nation lost some 688,000 veterans in 2006, with similar 
numbers projected for the near future, most from our ``Greatest 
Generation.'' More than 1,600 veterans pass from us each day, 
most of whom served during World War II and the Korean War. To 
assure our veterans a final resting place in a national shrine, 
the Republican Membership recommends additional funds for 
operations, maintenance and minor construction of National 
Cemeteries, and for an accelerated expansion of some existing 
cemeteries which are near or at capacity.
    The cause of America's veterans has long been a bipartisan 
cause calling forth the best efforts within the community of 
legislators. The Republican Membership looks forward to working 
with the Committee's Majority Members and the Budget Committee 
on this salutary basis as we develop a FY 2008 veterans' budget 
that continues to honor this nation's commitment to those who 
have borne the battle and to their families.

            Sincerely,

                    Steve Buyer, Ranking Republican Member; Cliff 
                            Stearns, Committee Member; Dan Burton, 
                            Committee Member; Jerry Moran, Committee 
                            Member; Richard H. Baker, Committee Member; 
                            Henry E. Brown, Jr., Committee Member; Jeff 
                            Miller, Ranking Republican Member, 
                            Subcommittee on Health; John Boozman, 
                            Ranking Republican Member, Subcommittee on 
                            Economic Opportunity; Ginny Brown-Waite, 
                            Ranking Republican Member, Subcommittee on 
                            Oversight & Investigations; Michael R. 
                            Turner, Committee Member; Brian P. Bilbray, 
                            Committee; Doug Lamborn, Subcommittee on 
                            Disability Assistance and Memorial Affairs; 
                            Gus M. Bilirakis, Committee Member.

               REPUBLICAN VIEWS AND ESTIMATES FOR FY 2008


                             March 1, 2007


                                OVERVIEW

    For veterans healthcare and program costs in FY 2008, the 
Republican Members of the Committee on Veterans' Affairs 
recommend $1.411 billion above the Administration's request for 
discretionary spending in FY 2008. In addition, we recommend 
$1.5 billion for a legislative initiative to modernize GI Bill 
education and training benefits for servicemembers of the 
Reserves and National Guard.

                    Veterans Benefits Administration


                           Mandatory Funding

    The Veterans Benefits Administration (VBA) administers a 
broad range of non-medical benefits to veterans, their 
dependents, and survivors through 57 regional offices. These 
programs include disability compensation, non service-connected 
pension, education, vocational rehabilitation, burial, 
insurance, and home loan guaranty.
    The Republican Members support the Administration's FY 2008 
budget request of $45 billion in mandatory funding for 
veterans' programs, a 6.6 percent increase over the enacted 
level for FY 2007.

                         Discretionary Funding

    With the exception of the recommendations noted below, the 
Republican Members support the Administration's FY 2008 request 
of $1.2 billion in discretionary funding for the management of 
the benefits programs--disability compensation, pension, 
education, vocational rehabilitation and employment, housing, 
burial, and life insurance.
    Disability Compensation--The Administration requests $941 
million in budget authority to fund the discretionary portion 
of the Disability Compensation, Pension, and Burial programs, 
including administrative expenses of 9,559 Full Time Equivalent 
Employees (FTEE), an overallincrease of 114 FTEE over FY 2007. 
This accounts for a transfer of 334 FTEE to VA Office of Information 
and Technology (OI&T), a loss of 9 FTEE in Management Direction and 
Support, and a gain of 457 FTEE for Compensation and Pension (claims 
adjudicators).
    For FY 2008, VBA projects the same number of claims it 
received in FY 2007: 800,000. The backlog of compensation and 
disability claims has grown since February 2006 by more than 
52,000 to a total of 626,429 on February 17, 2007. This backlog 
has grown by some 9,742 claims just since the beginning of 
February 2007.
    The Administration estimates the backlog of pending rating 
related compensation and pension claims will decrease to 
330,000 from the current 401,700 and the average days to 
complete such a claim from 177 to 145 by the end of FY 2008. 
The evidence from early 2007, however, does not support that 
estimate. We recommend 1,000 additional FTEE over the 
Administration's request, for a cost of $109,375,000. Of this 
1,000 FTEE, we recommend 600 FTEE for direct compensation for 
Compensation and Pension over the Administration's request of 
457 FTEE, at a cost of approximately $65,400,000. The remainder 
of this additional 1,000 FTEE would serve in Education and 
Vocational Rehabilitation.
    The Republican Members recognize that additional direct 
compensation FTEE will not improve quality, accuracy, and 
timeliness in claims processing without corresponding increases 
in training resources. Therefore, we recommend an additional 
$400,000 for Training and Performance Support Systems and an 
additional $400,000 for Skills Certification.
    The Department has spent more than $600 million over the 
past decade in an attempt to automate the compensation and 
pension claims processing system. This complicated paper-driven 
process is more than 25 years old. With the growing demands on 
the system, VBA needs to reexamine its Business Process 
Reengineering (BPR) focus to implement changes necessary in the 
field. The Republican Members recommend $25 million for BPR to 
reengineer and streamline the claims process and implement 
major business process changes.
    Pilot Program for Rules Based Adjudication System--The 
Republican Members recommend $5 million for a pilot program to 
develop a rules-based adjudication system for compensation and 
pension programs. This could reduce the backlog by allowing a 
computer to accurately adjudicate simple claims, allowing human 
adjudicators to work on more complex cases at a faster rate.
    Intergovernmental Partnerships--The Republican Members also 
recommend $6 million for a pilot program to explore the 
feasibility of intergovernmental partnerships in the 
development of compensation and pension claims between VA and 
municipal, county and state veterans departments and service 
officers, as well as veterans' and military service 
organizations. We recommend the pilot occur in three states: 
New York, Missouri, and Wyoming, or other states with varied 
veteran demographics. This expanded pilot would build on 
findings from the 2002 intergovernmental pilot conducted 
between VA's Buffalo, NY, regional office and the New York 
State Division of Veterans Affairs.
    Education Service--VBA estimates a workload increase of 
over 16,000 education claims, but the Administration requests 
only 14 additional direct support FTEE. As of February 17, 
2007, the backlog of education claims was 76,000, and average 
processing times for original and supplemental claims were 40 
and 17 days respectively, with targets of 35 and 15 days. While 
this is an improvement over the previous year, it is 
insufficient to meet the needs of veterans.
    The loss of experienced staff from retirements, increased 
workloads, and the pending backlog of claims convince us that 
an additional 100 FTE are needed for the Education Service with 
a projected discretionary cost of $7.8 million.
    Vocational Rehabilitation and Employment--The 
Administration requests an additional 39 direct service FTEE 
for the Vocational Rehabilitation & Education program. We 
applaud the Department's efforts to realign functions and 
duties to allow counseling and employment staff to concentrate 
on increasing rehabilitation rates. However, we believe current 
average caseload, which now exceeds 130 per counselor 
nationally, should be about 100 per counselor to provide 
appropriate levels of service. Therefore, we recommend $28.5 
million to fund an additional 300 professional level FTEE.
    VA-USOC Military Paralympic Program--Competition at elite 
levels of athletic events requires significant dedication to 
training, especially for service-disabled athletes. Therefore, 
we believe it is appropriate for VA to defray expenses for 
service-disabled athletes participating at elite levels in the 
program. We estimate the cost at $1 million per year. The 
Department recently announced an expanded agreement with the 
U.S. Olympic Committee (USOC) to promote participation in 
athletics by service-connected disabled veterans. This includes 
competition at elite levels culminating in the USOC Paralympic 
Program. The Republican Members recommend an additional $2 
million to offset administrative and other costs for this 
program.
    Mobile Claims Offices--The Republican Members are aware 
that access to Regional Offices can be difficult for many 
veterans. We recommend $2 million for a pilot program on Mobile 
Claims Offices. VBA staff members in mobile offices helping 
veterans with their claims could speed up the claims process by 
improving communication and access for veterans.

                       Board of Veterans' Appeals

    The Administration requests $58.5 million to support 468 
FTEE for the Board of Veterans' Appeals (BVA), an increase of 
$2.5 million and 31 FTEE over FY 2007. The Republican Members 
recommend an additional $4,055,000 to this request to support 
an additional 32 FTEE for a total BVA staffing of 500 FTEE. The 
BVA provides independent reviews of VA regional office 
decisions and makes the final administrative decision on behalf 
of the Secretary of Veterans Affairs. While BVA has made 
improvements, it continues to experience difficulties meeting 
the production levels needed to reduce the backlog of over 
137,000 appeals. The average time to decide an appeal is now 
over 400 days. We believe that additional staff is necessary if 
BVA is to provide timely and accurate decisions to veterans and 
their families.

                    National Cemetery Administration

    National Shrine Commitment--The Administration requests 
$362.3 million in discretionary funding for the National 
Cemetery Administration (NCA). This includes $166.8 million for 
operations and maintenance of VA's national cemeteries and 
1,582 FTEE, an increase of $7 million and decrease of 7 FTEE 
over the FY 2007 Administration request. Additionally, the 
Administration requests $24.4 million in minor construction to 
address cemetery infrastructure improvements.
    Cemetery Operations and Maintenance--The Republican Members 
recommend an additional $9 million to the Administration's 
request of $166.8 million NCA operations and maintenance, and 
an additional $5 million for minor construction.
    Gravesite Expansion--Additionally, the Republican Members 
recommend an additional $60 million to accelerate VA's five-
year strategic plan to fund National Cemetery gravesite 
expansion. The nation lost some 688,000 veterans in 2006, with 
similar projections for the near future, most from our 
``Greatest Generation.'' The Republican Membership believes 
accelerated expansions are an appropriate response to assure 
veterans a final resting place in a national shrine. Expansions 
funded in FY 2008 would include National Cemeteries in 
Calverton, NY, Houston, TX, Dayton, OH, and Phoenix, AZ.
    Alternative for Headstones--The Republican Members 
recommend $100,000 for VA to offer a bronze V as an alternative 
to a headstone to mark the graves of veterans whose graves are 
marked by a non-VA marker.

                     Veterans Health Administration

    For FY 2008, the Administration requests $34.2 billion in 
appropriations for discretionary spending on veterans' medical 
care, an increase of $1.943 billion or 6 percent over the FY 
2007 appropriated level.
    Medical Services--The Administration requests $27.2 billion 
for medical services. We recommend an $850.2 million increase 
above the Administration's request as follows:
          Medical Patient Workload--We recommend a $100 million 
        increase to provide timely and accessible high-quality 
        health care to core constituency veterans--the service-
        connected disabled, injured and indigent;
          Operation Iraqi Freedom and Operation Enduring 
        Freedom (OIF/OEF)--We recommend a $100 million increase 
        to provide medical care to military personnel who 
        served in OIF/OEF;
          Prosthetic and Sensory Aids--We recommend a $65 
        million increase to cover the increased costs of 
        providing, repairing and replacing prosthetics and 
        sensory aids;
          Polytrauma System of Care--We recommend a $50 million 
        increase to enhance specialized treatment in VA's 
        polytrauma rehabilitation centers for servicemembers 
        and veterans with traumatic brain injuries;
          Mental Health--We recommend a $200 million increase 
        to continue implementation of mental health initiatives 
        begun in 2005 to address deficiencies and gaps in 
        services. While this amount is substantial, last 
        September the Government Accountability Office (GAO) 
        reported that VA had not used all of the mental health 
        funds Congress allocated. We expect better performance 
        in VA's use of these resources to meet the emerging 
        demand for mental health services, especially post 
        traumatic stress disorder (PTSD). VA must plan for and 
        fund those programs that have been identified as 
        particularly relevant to the needs and requirements of 
        our servicemembers;
          Case Management--We recommend $10 million to hire 100 
        new social workers to provide case management at 
        military treatment facilities.
          Blind Rehabilitation Services--We recommend a $25 
        million increase to increase the number of Blind 
        Rehabilitation Outpatient Specialists at VA facilities 
        as required by Public Law 109-461 and enhance access 
        and quality of services for blinded veterans.
          Dental Care--We recommend a $100 million increase to 
        provide dental care for the increasing number of 
        returning veterans from OIF/OEF. Many OIF/OEF active 
        duty, Guard, and Reserve servicemembers are returning 
        with serious dental problems, and are not receiving 
        corrective dental care prior to separation from active 
        duty. VA is then obligated to treat these separated 
        servicemembers, often through costly contract care.
          Medical Care Collections Fund (MCCF)--We recommend a 
        $60 million increase in medical services as we remain 
        concerned that VA cannot meet its estimated collections 
        goal.
          Emergency Preparedness--We recommend a $60 million 
        increase to fulfill VA's fourth mission 
        responsibilities. We remain committed to achieve the 
        readiness necessary by supporting emergency 
        preparedness activities.
          Long-term Care--We recommend an $80.2 million 
        increase to support increased demand for long-term care 
        services.
    Medical Administration--The Administration requests $3.4 
billion for medical administration, and we concur with this 
request.
    Medical Facilities--We recommend an $80 million increase 
above the Administration's request for necessary costs 
associated with operating and maintaining VA's health care 
system infrastructure.
    Medical and Prosthetic Research--The Administration 
requests $411 million in appropriations for medical and 
prosthetic research, a decrease of $2.7 million below the FY 
2007 appropriated level. We place a high premium on conducting 
research into injuries and illnesses related to military 
service that benefit the clinical treatment needs of veterans. 
While the Department intends to place additional reliance on 
outside federal grants to realize a net gain in research 
funding, we recommend a $51 million increase above the 
Administration's request. This increase includes an additional 
$20 million for research to promote the successful 
rehabilitation, psychological adjustment and reintegration of 
veterans who suffer with traumatic brain injuries.
    Legislative Proposals--The Administration includes 
proposals for three legislative initiatives. These proposals 
would: (1) allow VA to establish a tiered annual enrollment fee 
for priority groups 7 and 8 veterans based on family income; 
(2) increase pharmacy co-payments for priority groups 7 and 8 
veterans from $8 to $15; and (3) eliminate the practice of 
offsetting or reducing VA first-party co-payment debts with 
collection recoveries from third-party health plans. These 
legislative requests differ from those proposed in the past, in 
that they do not reduce the Administration's request for 
discretionary medical care appropriations. The additional 
revenue would be classified as mandatory receipts to the 
Treasury and would not be retained in VA for veterans' health 
care programs. The Republican Members reject these legislative 
proposals.
    VHA Major Construction Projects--The Administration 
requests $560 million for VHA major construction projects. We 
recommend a $231.12 million increase above the Administration's 
request. Of this amount, we recommend $164 million to continue 
projects that were partially funded and that VA did not request 
additional funding for in FY 2008; $30.32 million for the 
advanced planning fund for advancing several of the FY 2008 
prioritized major construction projects; and $36.8 million to 
carry out section 804 of Public Law 109-461 for the design of a 
co-located joint-use medical facility in Charleston, South 
Carolina.
    Grants for Construction of State Extended Care Facilities--
The Administration requests $85 million in appropriations for 
grants for the construction of state extended care facilities, 
the same amount as the FY 2007 appropriated level. The 
partnership between the federal government and States is a 
longstanding and honored tradition of cost sharing. We 
recommend a $35 million increase above the Administration's 
request.

                  Office of Information and Technology

    The Republican Members concur with the administration's 
request for $1.86 billion for the Office of Information and 
Technology (OI&T). However, we recommend reallocation of 
funding amounts to individual accounts or programs within the 
budget for OI&T due to poor performance or failures, as 
follows:
          Reduced funding: We recommend reducing funding in the 
        amount of $20 million to the Financial and Logistics 
        Integrated Technology Enterprise (FLITE), due to poor 
        performance.
          Reduced funding: In the amount of $20 million to the 
        Compensation & Pension Maintenance and Operations fund 
        that was to be allocated to VETSNET.
          Additional funding: In the amount of $20 million to 
        the Office of the Inspector General for Information 
        Security Risk Assessment for Forensic Analysis.
          Additional funding: In the amount of $10 million for 
        Cyber Security.
          Additional funding: In the amount of $10 million for 
        the Office of Information and Technology Oversight and 
        Compliance Office.
          Additional funding: In the amount of $1 million to 
        accelerated development of The Expert Education System.
    We note that as part of the VA centralization of its IT 
accounts and personnel under the auspices of the Chief 
Information Officer, an additional $555 million for FY 2007 has 
been reallocated in pay transfers from other accounts to 
support 5,529 FTE for operations and maintenance activities 
that were previously included in other accounts throughout the 
Department.

                    Office of the Inspector General

    The VA Office of Inspector General (OIG) is responsible for 
the audit, investigation, and inspection of all VA programs and 
operations. For FY 2008, the Administration requests $72.6 
million and 445 Full Time Equivalent Employees (FTEE) to 
support the activities of the OIG. This compares with the FY 
2007 request of $69.5 million for administrative expenses and 
458 FTEE. However, this FY 2008 funding level would result in a 
reduction of 40 FTEE from current staffing levels. Major 
audits, reviews and investigations would have to be cancelled 
should this reduction in staffing occur. During FY 2006, OIG 
identified over $900 million in monetary benefits, for a return 
of $12 for every dollar expended on OIG oversight. The 
Republican Members of the Committee recommend adding $4.153 
million to the FY 2008 funding request, in order to provide for 
a total of 558 FTEE.

  U.S. Department of Labor--Veterans' Employment and Training Service

    The Administration has increased the request for all 
programs administered by the Veterans Employment and Training 
Service with the exception of the Veterans Workforce 
Integration Program. We support the increased funding levels 
and recommend three additional increases, as follows:
    National Veterans Training Institute--In Public Law 109-
461, Congress mandated several changes in the state grant 
program that will require greater training capacity at the 
National Veterans Training Institute in Denver, CO. We 
recommend an additional $1 million to fund NVTI operations.
    USERRA Training and Enforcement--The Veterans Employment 
and Training Service has primary responsibility for enforcing 
veterans' employment and reemployment rights under USERRA. VETS 
federal staff located in each of the six regions are 
responsible for administration and training VETS staff located 
in each state. With the high operational tempo of members of 
the Selected Reserve, case loads are climbing and additional 
resources are required to ensure timely resolution of USERRA-
related cases. Therefore, we recommend an additional $1 million 
to fund six additional professional investigators.
    Homeless Veterans Reintegration Program--This program has 
been cited by GAO and others as an effective model employment 
program for homeless veterans. The Administration has requested 
an additional $2 million for the program. Because we are 
concerned about the apparent increase in homeless veterans from 
the first Gulf War and current conflicts in the global War on 
Terror, we recommend an additional $3 million above the 
President's request to enable VETS to expand the number of 
grantees serving homeless veterans while maintaining quality 
standards for grantee performance.

                          Proposed Legislation

    GI Bill--During the 109th Congress, the Economic 
Opportunity Subcommittee conducted a series of hearing and site 
visits to determine the need to modernize the Montgomery GI 
Bill for both active duty and members of the Selected Reserve. 
MGIB benefit levels for active duty members have not nearly 
kept pace with the increasing cost of higher education, and 
extensive utilization of the Reserve Components in the Global 
War on Terror justifies increases in the basic levels of their 
benefits. Therefore, we propose an additional $1.5 billion in 
mandatory spending to improve education benefits. This includes 
indexing the basic payment at 100% of the Department of 
Education average four year public school cost.

                     ADDITIONAL VIEWS AND ESTIMATES

                         HONORABLE STEVE BUYER

    The Administration's requested FY 2008 budget for veterans' 
programs includes legislative proposals to change the 
Department of Veterans Affairs (VA) fee structure for health 
care. The proposals for certain fees and co-payments are more 
fully described in the Republican Views and Estimates for FY 
2008. According to the legislative proposals, the revenue 
generated by these fees and co-payments would be mandatory 
receipts to be deposited in the U.S. Treasury, rather than 
retained by the VA for the benefit of veterans. I strongly 
believe that any revenue generated from enrollment fees and co-
payments should be retained by the VA for its veterans 
programs.
    The Administration's proposal includes fees, copayments 
related to enrollment of category 7 and 8 veterans in medical 
care. The Administration proposed a tiered enrollment fee based 
on income. The fees would range from $250 per year for a 
veteran with an income of $50,000 to $750 per year for a 
veteran with an income of $100,000 or greater. Copayments for 
pharmaceuticals would rise from the current $8 to a new level 
of $15 per 30-day supply. VA would also be authorized to 
discontinue the current practice of offsetting or reducing a 
patient's first party co-payment debt from funds received from 
third-party insurance for non service-connected treatment. I 
support these initiatives that would generate $355.2 million in 
the first year and $4.866 billion over 10 years, if the 
revenues generated were retained by the VA.
    The first priority should be to improve the GI Bill 
education and training benefits for members of the National 
Guard and Reserves. These dedicated men and women are bulwarks 
in the Global War on Terror who are serving shoulder to 
shoulder with their active duty counterparts in Iraq, 
Afghanistan and wherever they are needed. However, their GI 
Bill education and training benefits are significantly less. 
They should have greater parity with the active duty forces in 
these benefits. The application of the revenues from the 
Administration's proposed fees and copayments to GI Bill 
increases for the Reserve Components would be a fitting way to 
recognize their service to our Nation.
 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 FY 2009, FEBRUARY 28, 2008

                          House of Representatives,
                            Committee on Veterans' Affairs,
                                  Washington, DC, February 28, 2008
Hon. John M. Spratt, Jr.,
Chairman, House Committee on the Budget
U.S. House of Representatives, Washington, DC.
    Dear Mr. Chairman: Pursuant to Sec. 301(d) of the 
Congressional Budget Act of 1974, and House Rule X, clause 
4(f), and Rule 7 of the Rules of the Committee on Veterans' 
Affairs, the Committee on Veterans' Affairs hereby submits its 
Views and Estimates with regard to programs and matters within 
the jurisdiction of the Committee to be set forth in the 
concurrent resolution on the budget for fiscal year 2009. The 
Minority will be submitting Additional and Dissenting Views 
under separate cover.
    Caring for our veterans is an ongoing cost of war, and a 
continuing cost of our national defense. As a Congress, and a 
nation, we must fulfill our obligations to the men and women 
who have served. We hope that you will carefully consider these 
Committee views and estimates. We have a lot of work ahead of 
us if we are to keep our promises to veterans. Working 
together, we can make sure that our veterans are not forgotten, 
and that we meet our obligations to them as a nation.

            Sincerely,

                    Bob Filner, Chairman; Corrine Brown; Vic Snyder; 
                            Michael H. Michaud; Stephanie Herseth 
                            Sandlin; Harry E. Mitchell; John J. Hall; 
                            Phil Hare; Michael F. Doyle; Shelley 
                            Berkley; John T. Salazar; Ciro Rodriguez; 
                            Joe Donnelly; Jerry McNerney; Zachary T. 
                            Space; Timothy J. Walz.

                     DEMOCRATIC VIEWS AND ESTIMATES


                           FEBRUARY 28, 2008


                   SECTION 1--DISCRETIONARY ACCOUNTS


                     DEPARTMENT OF VETERANS AFFAIRS

    The Committee \1\ is recommending an overall level of $48.6 
billion for the discretionary accounts of the Department of 
Veterans Affairs (VA) for FY 2009. This recommendation is $5.5 
billion, or 12.7 percent, above the FY 2008 level of $43.1 
billion, and $3.8 billion, or 8.6 percent, above the 
Administration's FY 2009 request of $44.8 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 recommended discretionary level includes an increase 
for VA medical care of $4.5 billion, or 12.3 percent, above FY 
2008, and $2.5 billion, or 6.5 percent, above the 
Administration's request. The Committee believes these 
additional resources are necessary if we are to provide 
sufficient funding for veterans' health care, restore many of 
the cuts proposed by the Administration, and keep our promises 
to our veterans.

                            VA Medical Care

    For VA medical care (the Medical Services, Medical 
Administration, and Medical Facilities accounts) the Committee 
is recommending $41.2 billion in appropriated dollars, $2.5 
billion above the Administration's FY 2009 budget request of 
$38.7 billion, and is a $4.5 billion, or 12.3 percent, increase 
over the FY 2008 levels. The Administration requests a 5.5 
percent increase over FY 2008 levels.
    Including total available resources (including medical 
collections), the Committee recommendation would provide $43.7 
billion for VA Medical Care. This recommended level in total 
medical care resources is $882 million above the amount 
recommended by the Independent Budget, co-authored by AMVETS, 
Disabled American Veterans, Paralyzed Veterans of America, and 
the Veterans of Foreign Wars.\2\ Including funding for the VA's 
Medical and Prosthetics Research account, the Committee is 
recommending a total for the Veterans Health Administration 
(VHA) of $41.8 billion ($44.3 billion including collections), 
$4.6 billion above the FY 2008 level and $2.6 billion above the 
Administration's FY 2009 request.
---------------------------------------------------------------------------
    \2\ In prior years, the Independent Budget recommendation did not 
include amounts attributable to medical collections. This year, the 
Independent Budget changed its methodology and included amounts 
attributable to medical collections in its FY 2008 Medical Services 
baseline and is recommending that these amounts be fully provided for 
in the Medical Services appropriation, in accordance with its long-
standing position that these amounts should be ``a supplement to, not a 
substitute for'' appropriated levels. In FY 2008, medical collections 
amounted to 6.2 percent of the amount available for VA medical care; in 
FY 2009, these collections are 6 percent of the VA's request. If the 
collection amounts estimated for FY 2009 are subtracted from the 
Independent Budget recommendation, the Independent Budget is requesting 
$40.3 billion for VA Medical Care, which compares to the Administration 
request of $38.7 billion ($1.6 billion above the Administration's 
request) and the Committee recommendation of $41.2 billion ($900 
million below the Committee's recommendation).
---------------------------------------------------------------------------
    The Committee recommendation would better enable the VA to 
provide quality health care in a timely fashion and to meet 
high-priority needs in the coming fiscal year. The recommended 
funding level would provide additional dollars to account for a 
higher level of inflation than estimated by the Administration 
to ensure the health care received by veterans tomorrow is not 
less than the care received today. The Committee recommends 
additional resources to account for a greater workload level 
and health care demand than estimated by the VA, including a 
greater-than-estimated number of veterans returning from Iraq 
and Afghanistan. The Committee provides additional resources 
for mental health care and services, long-term care, homeless 
programs, prosthetics, and Traumatic Brain Injury (TBI) care 
and treatment. The Committee recommendation restores proposed 
cuts to Non-Recurring Maintenance funding, funding that is 
essential if the VA is not to experience deteriorating medical 
facilities that impede the delivery of quality health care. The 
Committee also recommends providing funding to end the 
Administration's ban on enrollment of Priority 8 veterans 
(veterans with incomes above the geographically adjusted 
Housing and Urban Development threshold for low-income 
housing--$28,430in some communities--and who do not have 
compensable service-connected conditions) first instituted by the 
Administration in January 2003.
    As Congress contemplates further spending on the war in 
Iraq through the supplemental funding process, the Committee 
plans to seek opportunities to add additional resources for 
veterans' programs--for we should not forget the warrior as we 
fund the war.

Medical Care--Total Resources 

                         [Including collections]

FY 2008 Enacted.........................................  39,135,220,000
FY 2009 Request.........................................  41,203,363,000
Independent Budget......................................  42,821,903,000
FY 2009 Recommendation..................................  43,703,870,000
Recommendation vs. Request..............................   2,500,507,000

    The Committee, as it has every year they have been 
proposed, emphatically rejects the Administration's proposal to 
institute enrollment fees and increase co-payments for certain 
veterans. The Administration estimates that instituting an 
enrollment fee and increasing pharmaceutical co-payments would 
result in $2.3 billion (over 5 years) and $5.2 billion (over 10 
years) in mandatory receipts. The Administration proposes that 
these dollars be considered ``mandatory'' as compared to 
``discretionary dollars'' and would direct that they be 
deposited in the Treasury instead of being retained by the VA. 
According to the VA, as many as 444,000 veterans next fiscal 
year would choose not to be enrolled in the VA and 146,000 
individual veterans would not seek VA health care if the 
Administration's fee and co-payment proposals were accepted by 
Congress. The Committee remains puzzled as to why the 
Administration requests these proposals annually in the face of 
consistent Congressional opposition, and is concerned about the 
effect these proposals have, especially in terms of workload 
and resource estimates, on VA budget estimates and planning for 
future years.

                                                              MEDICAL CARE--TOTAL RESOURCES
                                                                      [By account]
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                    Independent        FY 2009 HVAC      Recommendation
                                                            FY 2008 enacted    FY 2009 request         budget         recommendation      vs. request
--------------------------------------------------------------------------------------------------------------------------------------------------------
Medical Services.........................................     29,104,220,000     29,465,503,000     32,153,138,000     31,656,100,000     +2,190,597,000
Medical Administration...................................      3,517,000,000      4,610,000,000      3,625,762,000      4,610,000,000                  0
Medical Facilities.......................................      4,100,000,000      4,661,000,000      4,576,143,000      4,971,000,000       +310,000,000
Total, Medical Care......................................     36,721,220,000     38,736,503,000     40,355,043,000     41,237,100,000     +2,500,597,000
MCCF Collections.........................................      2,414,000,000      2,466,860,000      2,466,860,000      2,466,860,000                  0
Total, Medical Care (with Collections)...................     39,135,220,000     41,203,363,000     42,821,903,000     43,703,960,000     +2,500,597,000
--------------------------------------------------------------------------------------------------------------------------------------------------------

* Important Notes:

           For comparison purposes, and unless 
        otherwise noted, amounts attributable to medical 
        collections have been subtracted from the Independent 
        Budget's Medical Services recommendation (and, when 
        appropriate, are displayed on the MCCF Collections 
        line). Medical collections are not included in the 
        discretionary estimates relied upon by the Committee on 
        the Budget. In a departure from previous 
        recommendations, the Independent Budget has included 
        collections in its baseline for Medical Services for FY 
        2008 and is advocating that these amounts be fully 
        appropriated in the Medical Services account for FY 
        2009. Therefore, the Independent Budget is recommending 
        $34.6 billion in Medical Services to account for this. 
        The Independent Budget has not provided clear 
        recommendations regarding how Congress and the 
        Administration are to treat the $2.5 billion, or 6 
        percent of the VA health care budget, received in 
        collections. The Administration's request, and the 
        Committee recommendation, does not include 
        appropriating medical collections in the Medical 
        Services account.
            The Administration's FY 2009 budget 
        submission proposed abolishing the Medical 
        Administration account and including these activities 
        in the Medical Services account. Under this structure, 
        the VA is requesting $34.1 billion for the Medical 
        Services account. The Views and Estimates displays the 
        VA's request in the traditional three-account structure 
        and amounts attributable to the Medical Administration 
        account have been subtracted from the Medical Services 
        account and restored to the Medical Administration 
        account.

Medical Services

FY 2008 enacted.........................................  29,104,220,000
FY 2009 request.........................................  29,465,503,000
Independent budget......................................  32,153,138,000
FY 2009 recommendation..................................  31,656,100,000
Recommendation vs. request..............................  +2,190,597,000

Description \3\
---------------------------------------------------------------------------

    \3\ Unless otherwise noted, account descriptions are from H. Rept. 
110-186.
---------------------------------------------------------------------------
    This appropriation provides for medical services of 
eligible veterans and beneficiaries in Department 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 Department of Veterans 
Affairs.

Recommendation

    For FY 2009, the Administration has requested $29.5 billion 
for the Medical Services account, an increase of $400 million 
above the FY 2008 level of $29.1 billion. The Committee 
recommends $31.7 billion, $2.6 billion above FY 2008 levels and 
$2.2 billion above the Administration's request.
    The Committee recommendation would:
           Provide additional resources for medical 
        inflation--$166 million;
           Provide for additional workload, including 
        increased number of OEF/OIF veterans--$613 million;
           Provide additional funding for mental 
        health--$223 million;
           Provide additional funding for long-term 
        care--$332 million;
           Provide additional amounts for homeless 
        veterans by matching the authorization level for the 
        Grant and Per Diem program--$8 million;
           Provide for an additional 5 percent increase 
        for the VA's Prosthetics program--$66 million;
           Provide additional resources for TBI care 
        and treatment--$32 million;
           Provide funding to end the Administration's 
        ban on enrollment of Priority 8 veterans--$750 million.
    Inflation: The VA is estimating an overall medical 
inflation rate of 4.63 percent. According to the Bureau of 
Labor Statistics, ``[f]or the 12 months ended in December, the 
medical careindex rose 5.2 percent, its largest annual advance 
since a 5.4 percent increase in 1993.'' (Bureau of Labor Statistics, 
Consumer Price Index: December 2007, released January 16, 2008). 
Although as with any forward-looking estimate the future remains 
uncertain, the Committee believes that it is more likely than not that 
medical inflation will be closer to the level experienced in 2007 than 
the amount estimated by the VA. The Committee, therefore, recommends 
that an additional $166 million be provided to match the estimated rate 
of medical inflation in FY 2009.
    Workload: The Committee is concerned that the 
Administration may have, once again, underestimated the total 
number of unique patients it expects to see in FY 2009. From FY 
2003 through FY 2008, the VA saw an average annual increase in 
unique patients of 2.7 percent and from FY 2002 through FY 2008 
the VA saw a 3.3 percent average annual increase. For FY 2009, 
the VA estimates a 1.6 percent increase, including an increase 
of only 2,621 Priority 7 and 8 veterans. As part of this 1.6 
percent increase, the VA expects it will see 333,275 OEF/OIF 
veterans, an increase of 39,930 from the FY 2008 current 
estimate. The VA is now estimating it will see 293,345 OEF/OIF 
veterans in 2008, an increase of 87,717 over FY 2007 while 
initially estimating last year that this increase would only 
amount to 57,717. The Committee recommends $613 million in 
additional funding to provide for an increased number of OEF/
OIF veterans that more closely matches the VA's recent 
experiences and ongoing combat activities in Iraq and 
Afghanistan, as well as to provide a modest increase in overall 
unique patients that more closely tracks the VA's average 
annual workload increases.
    Mental Health: For FY 2009, the VA has requested a 9 
percent increase in mental health care spending. With the VA 
facing an ever-growing demand for mental health services, 
especially from veterans returning from Iraq and Afghanistan, 
the Committee is recommending a 15 percent increase for FY 
2009, or $212 million in additional resources. The Committee 
recommendation also provides funding for an additional 15 Vet 
Centers, bringing the total for FY 2009 up to 247. The VA 
estimates 232 for FY 2009, which matches the current estimate 
for FY 2008 and is 23 more than the number in FY 2007.
    Long-Term Care: The Committee recommends an additional $332 
million for VA's Long-Term Care program. The Administration is 
in violation of its statutory responsibility to maintain FY 
1998 levels for the Average Daily Census (ADC) for VA nursing 
home care, as mandated by P.L. 106-117, the Veterans Millennium 
Health Care and Benefits Act. The VA's FY 2009 budget 
submission requests resources to support an estimated 11,000 
ADC, an amount 2,391 below the 1998 figure, and equal to its FY 
2008 budget request. The Committee recommends additional long-
term care funding for the VA to begin to meet its statutory 
obligations. In addition, the Committee recommends additional 
funding for non-institutional and community-based services, 
especially those programs targeting the unique needs of 
younger, wounded veterans returning from Iraq and Afghanistan 
who need long-term care services.
    Homeless Veterans: The Committee recommends an additional 
$8 million to bring the VA's Grant and Per Diem program up to 
the levels authorized in the 109th Congress. Although Congress 
has authorized this program at a level of $130 million, the VA 
is requesting $122 million. The Committee plans to explore 
changes to the Grant and Per Diem program where appropriate in 
order to begin to effectively address the tragedy of homeless 
veterans.
    Prosthetics: The Committee recommends providing an 
additional 5 percent increase for the VA's Prosthetics program. 
This will assist the VA in meeting the needs of a new 
generation of wounded veterans needing technologically advanced 
prosthetics, while not forgetting the needs of our older 
veterans.
    TBI Care and Treatment: VA's budget estimate regarding 
spending for TBI states that data used to make these estimates 
are preliminary and ``based on stable growth patterns with 
small increases thru 2009 and beyond.'' (FY 2009 VA Budget 
Submission, Volume 2, 1H-18). The Committee understands that 
insufficient data may not provide an accurate or realistic 
picture of the needs of veterans with TBI, from mild to more 
severe cases. TBI is often called the signature wound of the 
current conflict, and the Committee believes the VA must be in 
the forefront of providing health care to our veterans with 
TBI. The Committee recommends an additional $32 million for TBI 
care and treatment, a 15 percent increase above FY 2009 
estimated levels. Additionally, the Committee believes that VA 
should look at innovative programs, such as increasing the 
number of patient or bedside advocates to help insure that our 
seriously wounded veterans receive the health care and services 
they need, as well as rapidly meeting its responsibilities 
under title XVII of the FY 2008 National Defense Authorization 
Act (P.L. 110-181).
    Women Veterans: Although the Committee is pleased that the 
VA has requested an additional $14 million over FY 2008 levels 
for the Women Veterans Outreach Program, the Committee believes 
that the VA must ensure that women veterans get the care and 
treatment they have earned. Additional resources may well be 
necessary in order to meet the needs of an ever-increasing 
cohort of women veterans.
    VA/DoD Health Care Sharing Incentive Fund: The VA has 
transferred $15 million to this cooperative effort in FY 2008, 
but plans to provide no funding in FY 2009. In FY 2007, $35 
million was transferred. The Committee believes it is essential 
that the VA find the needed resources to continue this 
important endeavor.
    The Committee urges the VA to work closely with the DoD to 
institute and operate an innovative program to address the 
needs of returning servicemembers, especially regarding mental 
health care, and their families. We believe that an approach 
involving servicemembers and their families receiving 
information on benefits, necessary training and support, as 
well as specific services in a joint and comprehensive manner 
at the point of discharge or immediately prior to discharge 
offers a unique manner in which the VA and DoD can address the 
needs of veterans returning from Iraq and Afghanistan who are 
beginning the process of integrating back into civilian life.
    Ending Enrollment Ban on Priority 8 Veterans: The Committee 
recommendation includes $750 million to meet the costs 
associated with ending the Administration's enrollment ban on 
Priority 8 veterans. The Committee requested a detailed report 
from the VA regarding the costs the VA believes it would incur 
if the enrollment ban was lifted. This report was promised to 
the Committee by January 1, 2008. The Committee finally 
received a copy on February 26, 2008.
    The Committee is disappointed at the level of detail 
provided by the VA. The report provides no specific information 
regarding how the VA ended up estimating that it would 
``require $3.1 billion dollars to provide health care services 
to the additional 1.4 million enrollees and approximately 
750,000 patients during the first year of implementation,'' nor 
does it include detailed information regarding facility 
requirements and staffing levels. The VA believes that 2013 
would be the first year it would be able to allow enrollment of 
new Priority 8 veterans by putting into place ``needed 
infrastructure to accommodate increases in demand'' and 
questions its ability to meet staffing requirements by this 
time.
    The VA argues that ``[a]ccounting for the increased growth 
expected under the current enrollment policy and reopening 
enrollment in 2013 to new Priority 8 veterans will result in a 
total growth in enrollees of 22 percent and a total growth in 
users of 21 percent.'' According tothe VA, growth under the 
current policy of banning enrollment of new Priority 8 veterans would 
result in an increase of 4 percent (enrollees) and 6 percent 
(patients).
    The Independent Budget bases its estimate as to net cost 
($600 million) to lift the enrollment ban on a projection of 
1.9 million new users and a utilization rate of 20 percent. The 
VA's estimate is based on 1.4 million enrollees and a 
utilization rate of 54 percent. The Committee is concerned that 
the VA's estimates are filled with apparent contradictions. The 
VA argues that lifting the enrollment ban is not necessary 
since ``almost 91 percent of Priority 8 enrollees report having 
some form of health insurance coverage other than VA.'' At a 
hearing on Priority 8 veterans held last year, a witness 
testified that as many as 2 million veterans may be without 
health insurance and not have access to VA care. The VA also 
argues that new enrollees would mainly utilize ``ambulatory, 
diagnostic and pharmacy services.'' The VA states that 
``[a]pproximately 75 percent of current enrollees report that 
they do not intend to use VA as their primary source of health 
care in the future.'' The VA then bases its cost estimate 
assuming a utilization rate of 54 percent for new enrollees, a 
figure that seems unduly high considering VA's statements 
regarding reliance and utilization.
    The Committee would like to see more specific details 
regarding its estimates as to costs over the first year ($3.1 
billion), 5-year period ($16.9 billion), and ten-year period 
($39.3 billion). The Committee does not put great faith in 
these estimates. For example, the 5-year cost of $16.9 billion 
seems to provide for slightly more than an annual increase 
based upon its first year estimate, even though the VA states 
elsewhere in its report that ``once enrollment in Priority 8 is 
reopened, VA expects a significant surge in the first year'' 
which would seem to necessitate a higher first-year cost and 
lower costs for future years.
    The Committee wants to ensure that the VA has the resources 
it needs to lift the ban and ensure that veterans currently in 
the system do not see a diminution of service or access. The 
Committee believes that $750 million in additional funding is 
sufficient to meet the increased demand for services that would 
occur once the enrollment ban is lifted, but retains its 
flexibility to recommend additional resources if it is 
convinced that additional resources are needed. The Committee 
agrees with VA that the it would face an increased demand for 
additional infrastructure when the enrollment ban is lifted, 
not only to care for new Priority 8 veterans, but all veterans 
seeking access, and has recommended substantial increases in 
both Major and Minor construction accounts in part to address 
these concerns. With a faltering economy, it is even more 
essential that we re-open access to VA health care to all 
veterans.

Medical Administration

FY 2008 enacted.........................................   3,517,000,000
FY 2009 request.........................................   4,610,000,000
Independent budget......................................   3,625,762,000
FY 2009 recommendation..................................   4,610,000,000
Recommendation vs. request..............................               0

Description

    The Medical Administration appropriation provides funds for 
the expenses of management and administration of the 
Department's health care system. Included under this heading 
are provisions for costs associated with operation of 
department medical centers, other facilities, and VHA 
headquarters, plus the costs of VISN offices and facility 
director offices, chief of staff operations, quality of care 
oversight, legal services, billing and coding activities, 
procurement, financial management, and human resources 
management.

Recommendation

    For FY 2009, the Administration has requested $4.6 billion 
for the Medical Administration account, an increase of $1.1 
billion, or 31 percent, above the amount provided in FY 2008.
    The Committee recommends that the Administration's 
requested funding level be provided. The Committee notes the 
large requested increase for Medical Administration, and hopes 
that by providing this level of funding it will assist the VA 
in maintaining the quality of its health care system and 
responding to problems when they arise.

Medical Facilities

FY 2008 enacted.........................................   4,100,000,000
FY 2009 request.........................................   4,661,000,000
Independent budget......................................   4,576,143,000
FY 2009 recommendation..................................   4,971,000,000
Recommendation vs. request
                                                             310,000,000

Description

    The Medical Facilities appropriation provides funds for the 
operation and maintenance of the Department's 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 2009, the Administration has requested $4.7 billion 
for the Medical Facilities account, an increase of $561 million 
above the FY 2008 level. The Committee recommends $5 billion 
for this account, an increase of $310 million above the 
Administration's request and $871 million above the FY 2008 
level.
    The Administration has proposed cutting funding for Non-
Recurring Maintenance by $300 million below the FY 2008 current 
estimate and $15 million below the level provided in FY 2007. 
The Committee recommendation restores this proposed cut. It is 
vital that resources be made available to meet the maintenance 
needs of VA medical facilities. The Committee recommendation 
also proposes increases for Community-Based Outpatient Clinics 
(CBOCs) and for facility activations in order for the VA to 
provide greater access to medical services for veterans, 
especially those residing in rural and under-served areas.
    The Administration's FY 2009 budget request states that the 
VA plans to open 51 CBOCs in FY 2009, and is estimating that it 
will open 64 new CBOCs in FY 2008. The Committee desires the VA 
to move forcefully to open needed CBOCs in Maine (Dover-
Foxcroft), Wisconsin (Green Bay), Illinois (Moline and Madison 
County), and Florida (Gainesville).
    The Committee recommendation would:
           Restore proposed cuts to Non-Recurring 
        Maintenance--$300 million;
           Increase resources for CBOCs by 50 percent--
        $5 million;
           Increase funding for facility activations by 
        50 percent--$5 million.

Medical and Prosthetic Research

FY 2008 enacted.........................................     480,000,000
FY 2009 request.........................................     442,000,000
Independent budget......................................     555,000,000
FY 2009 recommendation..................................     555,000,000
Recommendation vs. request..............................    +113,000,000

Description

    This account includes medical, rehabilitative and health 
services research. Medical research is an important aspect of 
the Department'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 
service 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; and 
grants from the National Institutes of Health, private 
proprietary sources, and voluntary agencies provide support for 
the Department's researchers.

Recommendation

    For FY 2009, the Administration has requested $442 million 
for the VA Medical and Prosthetic Research account, $38 million 
below the FY 2008 level. The Committee recommendation of $555 
million for Medical and Prosthetic Research is $75 million 
above the FY 2008 level and $113 million above the 
Administration's request.
    The Committee recommends $38 million to restore the 
Administration's proposed cut in this account. Especially 
troubling to the Committee are proposed cuts in eight of the 21 
Designated Research Areas, including cuts in research on mental 
illness, acute and traumatic injury, central nervous system and 
associated disorders, diabetes, special populations, and 
military occupation and environmental exposures.
    The Committee recommends $17 million to account for the 
effects of biomedical inflation on VA research. The Biomedical 
Research and Development Price Index, developed by the 
Department of Commerce's Bureau of Economic Analysis for use by 
the National Institutes of Health (NIH) and updated on February 
4, 2008, estimates that a 3.5 percent increase is needed to 
compensate for increases due to inflation and to maintain 
research purchasing power.
    The Committee is concerned that VA estimates are unduly 
optimistic regarding expected revenues from other Federal 
sources, especially in light of the Administration's proposed 
flat-lined budget for the NIH. The VA estimates it received 
$668 million in Federal resources in 2007. Last year, in its FY 
2008 budget submission, the VA estimated it would receive $769 
million in FY 2008; it now estimates it will receive $708 
million. For FY 2009, the VA estimates that it will receive 
$751 million, an increase of $43 million. The Committee doubts 
that the VA will meet its estimate of $751 million in Federal 
resources and believes that an increased appropriation is 
essential if the VA research program is to meet the challenges 
it faces.
    The Committee recommendation provides $58 million for 
additional research projects, especially those concentrating on 
the unique needs of veterans returning from Iraq and 
Afghanistan. This increase would also ameliorate any possible 
effects of a shortfall in other Federal resources. In addition, 
the Committee believes that caps on investigator-initiated 
awards should be increased from the current $125,000 annually 
to the previous level of $150,000, in accordance with 
recommendations made by the Friends of VA Medical Care and 
Health Research (FOVA) and the Independent Budget.
    The Committee recommendation would:
           Restore proposed FY 2009 cuts--$38 million;
           Provide for a 3.5 percent increase for 
        estimated biomedical inflation--$17 million;
           Increase overall funding for research 
        projects, particularly those addressing needs of 
        servicemembers returning from Iraq and Afghanistan--$58 
        million.

General Operating Expenses

FY 2008 enacted.........................................   1,605,000,000
FY 2009 request.........................................   1,699,867,000
Independent budget......................................   1,985,602,000
FY 2009 recommendation..................................   1,896,126,000
Recommendation vs. request..............................    +196,259,000

Description

    The General Operating Expenses appropriation provides for 
the administration of non-medical veterans' benefits through 
the Veterans Benefits Administration and departmental 
management and support.
    The General Operating Expenses account funds activities of 
the Veterans Benefits Administration and General 
Administration.

                    Veterans Benefits Administration

    VBA consists of five programs: Disability Compensation, 
Pensions and Burial; Education; Housing; Vocational 
Rehabilitation and Employment; and, Insurance.

Compensation 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.

Education Service

    VA provides education assistance to servicemembers, 
veterans, and certain eligible survivors and dependents in 
exchange for military service. VA education assistance, 
popularly known as 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.

Housing (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.

Vocational 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.

Insurance

    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.

                         GENERAL ADMINISTRATION

    General Administration funds the Office of the Secretary, 
six Assistant Secretaries, the Board of Veterans' Appeals, the 
Office of the General Counsel, and the Office of Construction 
and Facilities Management.

Recommendation

    For FY 2009, the Administration is requesting $1.7 billion 
for the General Operating Expenses (GOE) account, an increase 
of $95 million, or 5.9 percent, above the $1.6 billion provided 
in FY 2008. This request includes $1.4 billion for VBA, an 
increase of $44.8 million over the FY 2008 level, and $328 
million for General Administration, an increase of $50.1 
million over FY 2008.
    The Committee is recommending $1.9 billion, an increase of 
$291 million above FY 2008 and $196 million above the 
Administration's request.
    The Committee recommendation would:
           Provide an additional 1,500 FTE for the 
        Compensation, Burial, and Pension program to better 
        address the claims backlog and other deficiencies--$117 
        million
           Provide an additional 130 FTE for the 
        Education program--$10 million
           Provide an additional 150 FTE for the 
        Vocational Rehabilitation and Counseling Program--$14 
        million
           Double the amount provided for the 
        Compensation, Burial and Pension training program--$6 
        million
           Provide resources to explore innovative 
        pilot programs and other solutions to address the 
        claims backlog--$50 million
    Claims Backlog: As of February 16, 2008, the inventory of 
compensation and pension claims pending at the VA was 663,319, 
an increase of 5,351 from the previous week and 36,890 above 
the 626,429 pending this time last year. (VA Monday Morning 
Workload Report, February 16, 2008).
    The Committee is concerned that VA is not moving swiftly 
enough to hire the additional 3,100 FTE provided so far by the 
110th Congress. On July 31, 2007, VA submitted a ``White Paper 
on the VA Disability Claims Processing Workforce'' to the 
Committees on Appropriation. The report listed a total of 3,100 
new hires funded through the FY 2007 appropriation (400), the 
FY 2007 supplemental (800), and the FY 2008 House 
Appropriations recommended level (1,900). The VA projected an 
end-of-year staffing level for Compensation and Pension of 
9,068 FTE (direct) and 10,998 FTE (direct) for FY 2008.
    The VA's FY 2009 budget submission provides a 2007 level of 
8,353 FTE (direct) and estimates an FY 2008 level of 10,304 FTE 
(direct). The VA's estimate for 2009 is 10,998 FTE (direct), 
the same level it projected in July for the end of 2008. The 
VA's budget request for FY 2009 estimates an additional 694 
direct FTE (for a total of 10,998) over the FY 2008 current 
level (10,304). Therefore, the VA is estimating the same FTE 
levels for FY 2009 as projected for the end of FY 2008 in its 
July 2007 White Paper.
    Although the Committee's recommendation includes a 
substantial increase in FTE above the Administration's request, 
the Committee believes that merely adding FTE is not the sole 
answer to addressing the claims backlog issue. We believe the 
VA must vigorously explore alternative methods of addressing 
once and for all this intolerable backlog.
    The Veterans' Disability Benefits Commission noted that in 
2006, two-thirds of compensation claims were from veterans 
previously determined to have a service-connected disability 
and that most of these veterans were from previous conflicts. 
The average age of veterans filing claims is 55. As the number 
of claims increases, the ability of the VBA to process these 
claims in a timely fashion under the current system is 
increasingly called into question. The Committee is concerned 
that since 2002, and the inception of the Claims Improvement 
Processing Model, the VBA has failed to meet its major 
strategic goals in the Compensation and Pension program. In 
addition to more rigorous training, addressed by the Committee 
in its recommendation, there simply must be greater 
accountability for failure to meet strategic goals.
    In fact, according to the VA's FY 2007 Performance and 
Accountability Report, released on November 15, 2007, the VBA 
missed the vast majority of its compensation and pension 
rating-related and non-rating-related performance targets. The 
Committee believes there must be a closer coordination between 
performance goals and the VA's actual experience; for goals 
that are never met are useless in measuring any real progress 
or increasing accountability.
    The Systematic Technical Accuracy Review (STAR) is the 
VBA's system-wide program for measuring compensation and 
pension claims processing accuracy. The Committee believes VBA 
should significantly increase the level of FTE devoted to STAR 
in order to increase accountability, reduce avoidable errors, 
and ensure more uniform decisions between Regional Office 
ratings.
    The Committee recommends an additional $5.5 million for 
training expenses, doubling the amount proposed by the 
Administration. Training is essential for all employees, 
especially new hires, in order to make sure claims are 
processed speedily and correctly. The Committee also believes 
that VBA should reinstitute administration of the skills 
certification test with sustained input on development from all 
interested parties.
    The Committee is also concerned that tools already provided 
to the VA are not being utilized fully. The VA has testified 
before the Subcommittee on Disability Assistance and Memorial 
Affairs that it is not fully utilizing the pre-stabilization 
rate mechanism as outlined in regulations. We believe the VA 
must fully utilize this tool in addressing the claims of 
returning servicemembers.
    The Committee believes there must be a greater attempt by 
the VA to embrace possible technological improvements to its 
current practices, including innovative information technology 
and artificial intelligence applications that offer the hope of 
reducing the average time for a claims decision to be made. The 
Committee also strongly recommends that the VA take the 
necessary steps to reduce the amount of paper involved in the 
process as it moves toward thegoal of a ``paperless'' claims 
process. The Committee awaits the final report from IBM, which VA 
contracted with, to evaluate its business lines and provide long-range 
strategies.
    Although more properly under the Information Technology 
Systems account, the Committee wishes to note that the 
Administration's IT request includes funding for the Virtual VA 
program, but this is only to scan in VBA's paper records. While 
this is an essential task, it does little to create a true 
electronic claims processing system that would benefit veterans 
by applying technological solutions to the impediments faced by 
processes that are rooted in the previous century. The 
Committee recommends that VA reassess its plan and maximize 
available information technologies and artificial intelligence 
applications to modernize its claims processing system.
    The Committee believes VA must embrace radical ideas to 
solve the claims backlog issue and is recommending that $50 
million be provided to explore various pilot programs and 
initiatives that could revolutionize the process by which 
veterans receive the benefits they have earned. The Committee 
believes that one such initiative could include the creation of 
a Veterans Advocates Training Institute to provide consistent 
and improved training of State service officers and others who 
assist veterans in filing claims.
    Burial Claims: The Committee notes that the 
Administration's FY 2009 request assumes a decrease in FTE for 
burial claims of 17 below the FY 2008 current estimate, and 50 
below the FY 2008 budget estimate. The FY 2009 estimate is also 
25 FTE below the FY 2007 level. As the number of interments is 
expected to increase, and VA has missed many of its performance 
and accountability targets, the Committee believes that 
additional FTE should be detailed to this activity.
    Vocational Rehabilitation and Employment: The Committee is 
concerned that VR&E counselors are overloaded and are managing 
an excessively large caseload. Currently, each counselor has a 
caseload of 130 cases where minimal contact is made with the 
veteran. While the VA maintains that this is a proper level of 
cases for providing services, the Committee is not convinced 
that such a caseload leads to the optimum level of service to 
veterans and is recommending an additional 150 FTE to properly 
staff the division and provide adequate services to veterans.
    Education: The Committee is recommending an additional 130 
FTE to handle education claims. With the enactment of the 
National Defense Authorization Act for FY 2008 (P.L. 110-181), 
which included the addition of portability of Chapter 1607 
benefits, the Committee anticipates an increase in workload and 
recommends an additional 80 FTE to meet this expected increase. 
The Education program also recently started a call center in 
Muskogee, Oklahoma, and has pulled 50 FTE from other areas to 
staff this call center. These 50 FTE have not been replaced and 
the Education program would benefit from maintaining a stable 
level of personnel. The Committee believes the VA should also 
explore ways to increase outreach to improve participation of 
returning servicemembers and veterans in pursuing opportunities 
to achieve college educations with their respective benefits.

Information Technology Systems

FY 2008 enacted.........................................   1,966,465,000
FY 2009 request.........................................   2,442,066,000
Independent budget......................................   2,164,938,000
FY 2009 recommendation..................................   2,442,066,000
Recommendation vs. request..............................               0

Description

    The Information Technology Systems account was established 
in the FY 2006 VA Appropriations bill, P.L. 109-114. The 
account previously encompassed the entire non-pay information 
technology portfolio for the Department of Veterans Affairs, 
including all automation efforts in all administrations. 
Starting in fiscal year 2007, and reflected for the first time 
in the budget request for fiscal year 2008, this account also 
includes pay and associated costs for information technology 
maintenance and operations staff.
    In describing the new structure of the VA's IT budget 
submission, the VA states that:

          The proposed FY 2009 budget has been realigned from 
        previous submissions to delineate veteran strategic 
        issues into two major classifications--veteran facing 
        IT systems and internal facing IT systems. Veteran 
        facing IT systems include IT programs that directly 
        impact current and future veterans' services and 
        account for $1.295 billion or 75.6 percent of 
        resources. Internal facing IT systems indirectly affect 
        veterans' services through IT administrative and 
        infrastructure support at $418 million or 24.4 percent 
        of resources.
          Within each of the two classifications, IT programs 
        and initiatives were further classified to reflect the 
        two core processes of development and operations and 
        maintenance. These changes complement the Department's 
        Performance and Accountability Report structure, 
        thereby enabling better communication of performance 
        results and outcomes. As a result, all veteran facing 
        IT systems fall under one of the following eight 
        Performance Accountability Report categories: medical 
        care, compensation, pension, education, vocational 
        rehabilitation, housing, insurance, and burial. 
        Internal facing IT systems are mapped to eight programs 
        for corporate management, financial resources 
        management, asset management, human capital management, 
        IT infrastructure, cyber security, privacy, and E-
        Government (E-Gov). Additionally, infrastructure 
        activities are aligned as a sub-cost for each 
        Performance Accountability Report category. (Emphasis 
        in original). (FY 2009 VA Budget Submission, Volume 2, 
        4A-3).

Recommendation

    For FY 2009, the Administration has requested $2.442 
billion for the Information Technology Systems account, an 
increase of $476 million, or 24 percent, over the amount 
provided in FY 2008.
    The Committee recommends that the Administration's 
requested funding level be provided.
    The Committee understands that as the VA moves to a 
centralized IT system that the IT budget is, by necessity, a 
``work in progress.'' The Committee believes that the VA should 
be nearing the point where it has a clear and consistent view 
of its IT funding requirements. The Government Accountability 
Office, in testimony before the Subcommittee on Oversight and 
Investigations regarding the VA's FY 2009 IT budget request, 
noted that the VA is ``in the initial stages of implementing 
new management process that are critical to centralizing its 
control over the IT resources and budget''. The GAO also 
testified that ``it remains too early to assess [the new 
management processes] their overall impact because most of the 
actions taken have only recently become operational or have not 
yet been fully implemented. Thus, their effectiveness in 
ensuring accountability for the resources and budget has not 
yet been clearly established.''(Testimony before the 
Subcommittee on Oversight and Investigations, House Committee on 
Veterans' Affairs, February 13, 2008 (GAO-08-449T)).
    As the Committee noted under the General Operating Expenses 
account, the VA must act vigorously to realize a true 
electronic benefits system. Although Virtual VA is a step 
forward, merely scanning in paper documents does not begin to 
realize the advantages that a true electronic benefits system 
can yield to veterans seeking benefits.
    The Committee notes with approval the VA's assurance that 
Medical Center Innovations will be funded in FY 2009, contrary 
to the Administration's FY 2009 budget submission. The 
Committee also looks to the VA to provide assurances that it 
has sufficient resources to provide the ``gold standard'' in 
data security.

National Cemetery Administration

FY 2008 enacted.........................................     195,000,000
FY 2009 request.........................................     180,959,000
Independent budget......................................     251,975,000
FY 2009 recommendation..................................     210,250,000
Recommendation vs. request..............................     +29,291,000

Description

    The National Cemetery Administration was established in 
accordance with the National Cemeteries Act of 1973. It has a 
fourfold mission: to provide for the interment in any national 
cemetery with available grave space the remains of eligible 
deceased servicepersons and discharged veterans, together with 
their spouses and certain dependents, and to permanently 
maintain their graves; to mark graves of eligible persons in 
national 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 
provides for the operation and maintenance of 158 cemeterial 
installations in 39 states, the District of Columbia, and 
Puerto Rico.

Recommendation

    For FY 2009, the Administration has requested $181 million 
for the National Cemetery Administration, $14 million, or 7 
percent, below FY 2008 levels. The Committee recommends $210 
million for FY 2009, $15 million above the FY 2008 level and 
$29 million above the Administration's request.
    The Administration request proposes to cut funding for 
recurring maintenance and repair projects by $27 million below 
FY 2008 levels, and $5 million below the amount provided in FY 
2007. The Committee recommendation restores this cut.
    The Committee applauds the Administration's proposal to 
``establish a non-recurring maintenance (NRM) program focusing 
on the correction of deficiencies cited in the Facility 
Condition Assessments and Five Year Plan.'' The Administration 
proposes $2 million for this activity. The Committee recommends 
doubling this amount to $4 million.
    The Committee recommendation would:
           Restore proposed cuts to the Maintenance and 
        Repair (Recurring) budget--$27 million;
           Double the amount provided for Non-Recurring 
        Maintenance--$2 million.

Office of Inspector General

FY 2008 enacted.........................................      80,500,000
FY 2009 request.........................................      76,500,000
Independent budget......................................      83,158,000
FY 2009 Recommendation..................................      89,645,000
Recommendation vs. request..............................     +13,145,000

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 Department of Veterans 
Affairs 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 Department programs to operate economically 
in accomplishing program goals, and prevent and deter recurring 
and potential fraud, waste and inefficiencies.

Recommendation

    The Administration has requested $76.5 million for the 
Office of Inspector General for FY 2009, a decrease of $4 
million below the FY 2008 level of $80.5 million. The VA's 
request assumes a total FTE level of 465, 56 fewer than the 
total currently estimated for FY 2008 and five fewer FTE than 
in 2007.
    The Committee recommends $89.6 million for FY 2009, an 
increase of $9.1 million, or 11 percent over FY 2008 levels and 
$13.1 million, or 17 percent, above the VA's FY 2009 request.
    The Committee recommendation restores the proposed FTE cuts 
and adds additional FTE to match last year's Committee-
recommended FTE level.
    In testimony before the Subcommittee on Oversight and 
Investigations on February 13, 2008, Jon A. Wooditch, Deputy 
Inspector General, Office of Inspector General, U.S. Department 
of Veterans Affairs stated that ``[t]he OIG seeks to help VA 
become the best-managed service delivery organization in 
Government. OIG audits, health care inspections, 
investigations, and Combined Assessment Program (CAP) reviews 
recommend improvements in VA programs and operations, and act 
to deter waste, fraud, abuse, and mismanagement. For 2007, OIG 
funding supported 443 FTE from appropriations. An additional 25 
FTE was funded under a reimbursable agreement with VA to 
perform pre-award and post-award contract reviews. During 2007, 
the OIG exceeded its overall performance goals. For example, 
monetary benefits for the year were $820 million, for a return 
on investment of $12 for every dollar expended. Collectively, 
the OIG issued a total of 217 audit, health care inspection, 
and contract review reports, with over 500 recommendations for 
corrective action. We also completed 1,181 criminal 
investigations, which led to 2,061 arrests, indictments, 
convictions, and administrative sanctions. We also responded to 
over 19,000 contacts received by the OIG Hotline.''
    The Committee believes that vigorous oversight of the VA is 
essential to ensure that the Department provides quality health 
care and benefits to veterans in an efficient, fair and cost-
effective manner. Since the beginning of this Congress, the 
Committee has embarked on an ambitious oversight agenda, and 
the OIG is an important partner in this ongoing initiative. The 
economic benefit realized to taxpayers by investment in the 
OIG, as well as programmatic improvements resulting from the 
Inspector General's activities, have been clearly demonstrated. 
As the OIG is being expected to do more, it is vital that 
proposed cuts to FTE be restored and the overall FTE level be 
increased to meet expected workload increases.
    The Committee recommendation would:
           Restore proposed cuts of 56 FTE--$7 million;
           Provide for an additional 49 FTE, for a 
        total FTE level of 570--$6 million.

Construction, Major Projects

FY 2008 enacted.........................................   1,069,100,000
FY 2009 request.........................................     581,582,000
Independent budget......................................   1,275,000,000
FY 2009 Recommendation..................................   1,092,094,000
Recommendation vs. request..............................    +510,512,000

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 
Department of Veterans Affairs, 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 2009, the Administration is requesting $582 million, 
a decrease of $488 million, or 46 percent, from the FY 2008 
level of $1.1 billion. The Administration's request includes 
$472 million for VHA-related construction and $105 million for 
NCA-related construction.
    The NCA portion of the request seeks funds for gravesite 
expansion and cemetery improvements at the Puerto Rico National 
Cemetery, Massachusetts National cemetery, and the Calverton 
National Cemetery. The request also seeks funding for the 
Advance Planning Fund, NCA Land Acquisition Fund, and 
Sustainability and Energy Fund.
    The VHA-related construction request, totaling $472 
million, seeks funding for the following projects:
    Denver, CO--New Medical Facility
           Total Estimated Cost--$769.2 million; 
        Funding through FY 2008--$168.3 million; FY 2009 
        Request--$20 million
    Orlando, FL--New Medical Facility
           Total Estimated Cost--$656.8 million; 
        Funding through FY 2008--$74.1 million; FY 2009 
        Request--$120 million
    San Juan, PR--Seismic Corrections Bldg. 1
           Total Estimated Cost--$225.9 million; 
        Funding through FY 2008--$69.9 million; FY 2009 
        Request--$64.4 million
    Lee County, FL--Outpatient Clinic
           Total Estimated Cost--$131.8 million; 
        Funding through FY 2008--$20.4 million; FY 2009 
        Request--$111.4 million
    St. Louis (JB), MO--Medical Facility Improvements and 
Cemetery Expansion
           Total Estimated Cost--$134.5 million; 
        Funding through FY 2008--$7 million; FY 2009 Request--
        $5 million
    Bay Pines, FL--Inpatient/Outpatient Improvements
           Total Estimated Cost--$174.3 million; 
        Funding through FY 2008--$0 million; FY 2009 Request--
        $17.4 million
    Tampa, FL--Polytrauma Expansion and Bed Tower Upgrades
           Total Estimated Cost--$223.8 million; 
        Funding through FY 2008--$0 million; FY 2009 Request--
        $21.1 million
    Palo Alto, CA--Centers for Ambulatory Care and Polytrauma 
Rehabilitation Center
           Total Estimated Cost--$450.3 million; 
        Funding through FY 2008--$0 million; FY 2009 Request--
        $38.3 million
    The Committee recommends a funding level of $1.1 billion, 
$511 million above the Administration's request and $23 million 
above the level provided in FY 2008. The Administration has 
requested funding for the CARES priority projects 1-3 (Bay 
Pines, FL; Tampa, FL; and Palo Alto, CA). The Committee 
recommendation includes planning funding for CARES priority 
projects 4-20:
           Seattle, WA--Seismic NHCU Bldg. 100 (#4)
           Seattle, WA--Mental Health Building 101 
        Seismic (#5)
           Dallas, TX--Spinal cord Injury Center (#6)
           Louisville, KY--New Medical facility (#7)
           Roseburg, OR--Mental Health Bldg. 2 Seismic 
        (#8)
           Los Angeles, CA--Seismic Corrections of 13 
        Buildings (#9)
           Bronx, NY--Spinal cord Injury Center (#10)
           Butler, PA--Outpatient Clinic (#11)
           American Lake, WA--Seismic corrections Bldg. 
        81 (#12)
           Dallas, TX--Clinical Expansion for Mental 
        Health (#13)
           Walla Walla, WA--Multi-specialty Clinic 
        (#14)
           San Francisco, CA--Seismic Corrections 
        Buildings 1, 6, 8, and 12 (#15)
           Wichita, KS--Med/Surg Bed Modernization/
        Ambulatory Expansion (#16)
           Fayetteville, NC--Outpatient Addition (#17)
           Salisbury, NC--Clinical Addition (#18)
           Columbia, SC--Diagnostics and Specialty Care 
        Clinics Renovation (#19)
           Birmingham, AL--Huntsville Outpatient Clinic 
        (#20)
    Although not on the CARES list, the Committee believes the 
needs of veterans in South Texas have gone unmet for far too 
long, and believes that the VA should undertake a major project 
that will meet the inpatient and outpatient needs of these 
veterans in a centrally located facility.
    In addition, the Committee believes that the VA should 
enter into a sharing agreement with the Department of Defense 
to make inpatient care available to veterans at Eglin Air Force 
Base in Florida, as well as begin constructing a joint VA/DoD 
outpatient medical facility.
    It is essential that the VA invest the resources needed to 
address its aging infrastructure and provide state-of-the-art 
modern medical facilities. This will require a sustained 
commitment to providing adequate funding levels for the VA's 
Major Construction program. This will also require a commitment 
from the VA to substantially increase its in-house ability to 
manage large and complex construction projects. Assisting the 
VA in improving its abilities and expertise in this area was a 
driving force behind the creation of the office of Director of 
Construction and Facilities Management last Congress.
    The Committee also desires to see the VA begin to take 
action to begin planning and development of new national 
cemeteries in Southern Colorado, Nevada (which does not have a 
national cemetery), and Eastern Nebraska (Sarpy County).
    The recommended increase would also provide the remaining 
funding needed for the Pittsburgh, PA Campus Consolidation 
project, and additional resources, above the Administration's 
request, for the Orlando, Florida, Medical Facility project. 
Therecommendation would provide additional funding for the VA's 
Advanced Planning Fund and the Sustainability and Energy Fund.
    The Committee trusts that as major facilities come on-line 
in the years ahead, that sufficient funding for equipment, 
staffing, and activation are provided for fully and included 
early in the VA's budget process in order not to require 
shifting funds from other areas of the VA budget.
    The Committee recommendation would:
           Provides planning funding for top-20 
        priority CARES projects not previously funded (or 
        funded in FY 2009 request) and other projects--$187 
        million;
           Provides an additional $231 million for the 
        Orlando, Florida project;
           Provides remaining $62 million needed for 
        Pittsburgh, Pennsylvania campus consolidation project;
           Provides an additional $25 million for the 
        Advance Planning Fund;
           Doubles the amount provided for the 
        Sustainability and Energy fund for VHA--$5 million.

Construction, Minor Projects

FY 2008 enacted.........................................     630,535,000
FY 2009 request.........................................     329,418,000
Independent budget......................................     621,000,000
FY 2009 recommendation..................................     673,718,000
Recommendation vs. request..............................    +344,300,000

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 
Department, 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 2009, the Administration has requested $329 million, 
a decrease of $301 million, or 48 percent below the level 
provided in FY 2008. The Committee recommends $674 million, $43 
million above FY 2008 and $344 million above the 
Administration's request.
    Based upon the Administration's 5-year Capital Plan list of 
``FY 2008 Prioritized VHA Minor Construction Projects,'' \4\ 
the average total estimated cost for the top 50 listed projects 
is $5.7 million. The Committee recommendation includes $287 
million to provide for an additional 50 projects for FY 2009. 
The Committee notes that this amount funds the complete average 
cost of these projects: the VA may be able to undertake 
additional projects above the 50 provided for since total costs 
of each project are not required to be provided all at once. 
The Committee desires the VA to be more aggressive in tackling 
its backlog of minor construction projects.
---------------------------------------------------------------------------
    \4\ FY 2009 VA Budget Submission, Volume 4, 7-90 et seq.
---------------------------------------------------------------------------
    The Committee recommendation also provides a 50 percent 
increase for minor construction for the National Cemetery 
Administration (NCA). The Administration proposes $25 million 
for this construction for FY 2009, an amount equal to the FY 
2007 funding level and $50 million below the FY 2008 current 
estimate. The Committee recommendation would add an additional 
$12.5 million for NCA minor construction projects.
    The Committee is recommending $45 million to provide 
funding to upgrade and modernize VA research facilities. The 
Subcommittee on Health, in a hearing on the VHA's FY 2008 
budget request held on February 14, 2007, received testimony 
from the Friends of VA Medical Care and Health Research (FOVA). 
FOVA recommended ``an annual appropriation of $45 million in 
the minor construction budget dedicated to renovating existing 
research facilities[.]'' The Committee notes that the FY 2007 
VA appropriations bill, as passed by the House of 
Representatives, included $12 million in the minor construction 
account ``to be used solely for a program of upgrade and 
modernization of research facilities to ensure they maintain or 
attain state-of-the-art status.'' (H. Rept. 109-464, to 
accompany H.R. 5385, the Military Quality of Life and Veterans 
Affairs and Related Agencies Appropriations Bill, at 64). The 
Committee on Appropriations directed the VA to conduct a 
comprehensive review of its research facilities and to report 
to Congress by March 1, 2007. The VA has indicated that this 
review may take three years to complete. Funding for VA 
research facilities was not provided in FY 2008. The 
Committee's recommended level of $45 million mirrors the 
recommendation made by FOVA.
    The Committee would also like the VA to take action in 
repairing and remodeling existing facilities in Livermore, 
California, to provide for a PTSD Rehabilitation clinic.
    The Committee recommendation would:
           Provide full funding for an additional 50 
        Minor Construction projects--$287 million;
           Provide a 50 percent increase above the FY 
        2009 request for NCA minor construction projects--$13 
        million;
           Provide funding to begin to upgrade and 
        modernize VA research facilities--$45 million.

Grants for Construction of State Extended Care Facilities

FY 2008 enacted.........................................     165,000,000
FY 2009 request.........................................      85,000,000
Independent budget......................................     200,000,000
FY 2009 Recommendation..................................     200,000,000
Recommendation vs. request..............................    +115,000,000

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 2009, the Administration requests $85 million for 
the Grants for Construction of State Extended Care Facilities 
account, $80 million below the level provided in FY 2008. The 
Committee is recommending $200 million, an increase of $35 
million above FY 2008 and $115 million above the 
Administration's request.
    The VA's ``Priority List of Pending State Home Construction 
Grant Applications for FY 2008'' lists a total of $553 million 
in Priority 1 applications. In FY 2007, these projects totaled 
$491 million. In FY 2006, there were 80 priority group 1 
projects for a total of $420 million. Priority 1 projects are 
those projects that have State funding in place to start 
construction and are awaiting VA funding. State homes play an 
important role in VA's long-term care strategy by filling the 
gap of available beds for elderly and sick veterans who need 
them. As the VA isfacing an aging veteran population, the 
Committee believes it is essential to provide the resources needed to 
begin to tackle the project backlog.
    The Committee recommendation would:
           Provide additional resources to enable the 
        VA to begin to reduce the State Home project backlog--
        $115 million.

Grants for Construction of State Veterans Cemeteries

FY 2008 enacted.........................................      39,500,000
FY 2009 request.........................................      32,000,000
Independent budget......................................      42,000,000
FY 2009 recommendation..................................      39,500,000
Recommendation vs. request..............................      +7,500,000

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

    The Administration, for FY 2009, requests $32 million for 
the Grants for Construction of State Veterans Cemeteries 
program, a level $7.5 million, or 19 percent, below the FY 2008 
level. The Committee recommends a funding level equal to the 
amount provided in FY 2008.
    The Committee recommendation would:
           Restore proposed Administration cut--$7.5 
        million.

                          DEPARTMENT OF LABOR


                    Veterans Employment and Training


  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 
$238.4 million in FY 2009 to support the staffing and grant-
making ability of VETS. This is a $10 million, or 4 percent, 
increase over FY 2008. For FY 2009, the Committee recommends an 
increase of $60 million for VETS, for a total of $298 million. 
This recommended level would provide an additional $31 million 
for State Grants to bring up the level of DVOPs/LVERs from the 
current 2,100 to the original 2,500. This will help VETS better 
manage the One Stop Centers and provide better priority 
services to veterans. The recommended funding will also provide 
an additional $10 million to HVRP. Although accurate numbers 
are impossible to come by--no one keeps national records on 
homeless veterans--the VA estimates that nearly 200,000 
veterans are homeless on any given night and nearly 400,000 
experience homelessness over the course of a 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. This 
program currently operates only in 11 states and should be 
expanded to more areas, especially those with a heavy veteran 
population. The funding for NVTI should be increased by $1 
million to assist NVTI in providing the training necessary to 
be a successful DVOP/LVER. This training is required to be 
provided within three years of the appointment of the DVOP/
LVER. Finally, the Committee urges the Department of Labor to 
explore innovative job training efforts for returning 
servicemembers to assist them in integrating into civilian 
life.

                             OTHER AGENCIES


American Battle Monuments Commission

FY 2008 enacted.........................................      44,600,000
FY 2009 request.........................................      47,470,000
Independent budget......................................             N/A
FY 2009 recommendation..................................      47,470,000
Recommendation vs. request..............................               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 and the World War II and Korean 
War Veterans Memorials in Washington, D.C.

Recommendation

    The American Battle Monument Commission is seeking a total 
of $64.6 million for FY 2009, consisting of $47.5 million for 
salaries and expenses, and $17.1 million for costs associated 
with foreign currency fluctuations.
    The Committee recommends the requested level of $47.5 
million be provided in FY 2009.

U.S. Court of Appeals for Veterans Claims

FY 2008 enacted.........................................      22,717,000
FY 2009 request.........................................      23,975,000
Independent budget......................................             N/A
FY 2009 recommendation..................................      23,975,000
Recommendation vs. request..............................               0

Description

    The Veterans' Judicial Review Act [P.L. 100-687] 
established the U.S. Court of Appeals for Veterans Claims. The 
Court reviews appeals from Department of Veterans Affairs' 
claimants seeking review of a benefit denial. The Court has the 
authority to overturn findings of fact, regulations, and 
interpretations of law.

Recommendation

    The Court's request for FY 2009 of $24 million includes 
$1.7 million for the Pro Bono Representation Program. This 
program is administered by the Legal Services Corporation. The 
Court includes the Program's FY 2009 request as an appendix to 
its submission; although having ``no comment on that request'' 
applauds the ``Program's continuing success in reducing the 
percentage of unrepresented appellants before the Court. Since 
1997, the percentage of appellants who are unrepresented at the 
decision point of their appeals has dropped from 48% in FY 1997 
to 19% or less in FY 2007.''
    The Committee recommends the requested level of $24 million 
be provided in FY 2009.

                           MERCHANT MARINERS

    World War II Merchant Mariners suffered the highest 
casualty rate of any of the branches of service while they 
delivered troops, tanks, food, airplanes, fuel and other needed 
supplies to every theater of the war. Despite their efforts 
during the war, Merchant Mariners were not covered by the 
original G.I. Bill of Rights. No legislation to benefit 
merchant seamen was passed by Congress until 1988 when the 
Seaman Acts of 1988 finally granted them a ``watered down'' 
G.I. Bill of Rights. To make up for lost benefits and 
opportunities, the House of Representatives passed H.R. 23, the 
Belated Thank You to the Merchant Mariners of World War II Act 
of 2007. This measure provides authorization for $120 million 
in FY 2008 and $108 million in FY 2009. The Committee 
recommends that this funding be made available to recognize the 
service and sacrifice of our Merchant Mariners.

                     SECTION 2--MANDATORY ACCOUNTS


 Full Equity for World War II Filipino Veterans Who Served in the U.S. 
                                  Army

    Many World War II Filipino veterans, who served and fought 
alongside American servicemembers during World War II, do not 
receive veterans' benefits. Shortly after the war, Congress 
passed the Rescission Acts which stripped away many veterans' 
benefits for Filipino servicemembers who served in the U.S. 
Army. For the past 60 years, Congress has taken a piecemeal 
approach to restoring these benefits.
           The Committee plans to work with the 
        leadership of the House of Representatives and our 
        counterparts in the Senate to end this inequity once 
        and for all and provide VA benefits and services to 
        these deserving veterans.

                          Total Force GI Bill

    The Montgomery GI Bill (MGIB), implemented over 20 years 
ago, was a landmark piece of legislation that provided 
education and training benefits to many veterans. The time has 
come to update, modernize, and provide greater flexibility to 
meet the needs of today's veterans. For GI Bill education 
benefits to remain a relevant recruitment, and readjustment 
benefit, we must ensure that VA's education and training 
programs reflect the manner in which individuals earn and learn 
in the 21st Century.
    Due to advances in technology, recognition of the lifetime 
learning concept, dynamic workforce changes, and ever-
increasing demands on military recruiting efforts, Congress 
should continue to review current MGIB entitlements and make 
necessary changes to provide servicemembers, veterans and their 
families relevant education and training benefits that meet 
their educational and vocational goals for success.
    The Committee plans, on a bipartisan basis, to explore a 
number of options to improve and modernize the GI Bill. The 
VA's Advisory Committee on Education and the Partnership for 
Veterans Education--a group made up of traditional veterans and 
military service organizations, as well as higher education 
advocates all have endorsed a proposal termed the ``Total Force 
GI Bill.'' The proposal has two unmet features which include: 
providing parity of education benefit rates according to 
service rendered; and ensuring future correlation of active 
duty, veterans, and National Guard and Reserve benefits in an 
equitable and proportional manner, Chapters 1606 and 1607 in 
Title 10 and Chapter 30 in Title 38 need to be reorganized 
together under Title 38.
    Congress recently expanded MGIB entitlements for our 
nation's Guard and Reserve Forces. The National Defense 
Authorization Act for Fiscal Year 2008 (P.L. 110-181) includes 
language that would allow certain members of the Reserve Forces 
to use their REAP (Chapter 1607 of Title 10) education benefits 
during the 10-year period beginning on the date which they 
separated.
    President Bush proposed, in his State of the Union Address, 
that Congress expand on MGIB entitlements to allow 
servicemembers and veterans to transfer their unused benefits 
to their spouses and children. While the President did not 
request funding for this proposal in his FY 2009 budget 
request, Congress will explore the idea of transferring 
education benefits to dependents along with other proposals.
    Major legislative proposals that have been highlighted by 
veteran service organizations include: eliminating MGIB 
benefits from being considered as income for eligibility 
requirements for Federal grants or loans; expand accelerated 
benefits to all areas; increase the monthly benefit amount; 
eliminate the $1,200 enrollment fee for MGIB; allow 
servicemembers to use the GI Bill to repay loans once they are 
eligible for the GI Bill, they can pay $6,000 up to the amount 
they are qualified; protect servicemembers with education 
interruptions due to military service; and expand the period of 
use for educational entitlements.

                  Mandatory Funding for VA Health Care

    Facing years of insufficient VA health care budgets 
provided consistently after the start of the fiscal year, a 
coalition of veterans service organizations formed the 
Partnership for Veterans Health Care Budget Reform, to advocate 
for providing mandatory, or ``assured'' funding for VA health 
care. The Committee held a hearing in October 2007 on funding 
the VA of the future at which the Partnership, budget experts, 
and the VA testified. At this hearing, there was much 
discussion regarding how the VA would fare in direct 
competition with other mandatory programs, as well as the 
sufficiency and flexibility of a mandatory funding formula.
    Veterans have fared better at the hands of Congress than 
they have with this Administration. From FY 2002-FY 2008, the 
Administration's health care budget requests represent slightly 
less than half of the amount finally provided to the VA. The 
110th Congress has provided unprecedented increases for 
veterans' programs, although we note that funding for the VA 
was not finally put in place until nearly three months after 
the start of the current fiscal year.
    Many on the Committee believe that funding VA health care 
with mandatory dollars as compared to discretionary dollars, as 
advocated by the Partnership, would provide the VA with stable 
and adequate funding to meet the needs of veterans.
    The Committee urges Congress to seriously consider the best 
manner in which to fund VA health care, and provide sufficient 
and timely funding for veterans. Providing a mandatory funding 
mechanism for VA health care will require cooperation in 
Congress, and cooperation between Congress, the Administration, 
and the VA, in order to insure that the funding mechanism 
decided upon meets the needs of the Department, and the 
veterans who rely on the VA for the health care they need.

                           Section 3--Charts


                                                                       DEPARTMENT OF VETERANS AFFAIRS FY 2009--FEBRUARY 2008
                                                                                         [In thousands]
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                     FY 2009                               FY 2009            FY 2009            FY 2009            FY 2009
                          Account                                 FY 2008          President's      FY 2009  Request     Independent         Committee      Committee vs.  FY  Committee vs.  FY
                                                                                     Request          vs.  FY 2008          Budget         Recommendation          2008           2009 Request
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Medical Services...........................................         29,104,220         29,465,503            361,283         32,153,138         31,656,100          2,551,880          2,190,597
Medical Administration.....................................          3,517,000          4,610,000          1,093,000          3,625,762          4,610,000          1,093,000                  0
Medical Facilities.........................................          4,100,000          4,661,000            561,000          4,576,143          4,971,000            871,000            310,000
                                                            ------------------------------------------------------------------------------------------------------------------------------------
      Total, Medical Care..................................         36,721,220         38,736,503          2,015,283         40,355,043         41,237,100          4,515,880          2,500,597
MCCF Collections...........................................          2,414,000          2,466,860             52,860          2,466,860          2,466,860             52,860                  0
                                                            ------------------------------------------------------------------------------------------------------------------------------------
      Total, Medical Care (with Collections)...............         39,135,220         41,203,363          2,068,143         42,821,903         43,703,960          4,568,740          2,500,597
Medical and Prosthetic Research............................            480,000            442,000            -38,000            555,000            555,000             75,000            113,000
                                                            ====================================================================================================================================

      Total, Veterans Health Administration (excluding              37,201,220         39,178,503          1,977,283         40,910,043         41,792,100          4,590,880          2,613,597
       collections)........................................
General Operating Expenses.................................          1,605,000          1,699,867             94,867          1,985,602          1,896,126            291,126            196,259
Information Technology Systems.............................          1,966,465          2,442,066            475,601          2,164,938          2,442,066            475,601                  0
National Cemetery Administration...........................            195,000            180,959            -14,041            251,975            210,250             15,250             29,291
Office of Inspector General................................             80,500             76,500             -4,000             83,158             89,645              9,145             13,145
Construction, Major Projects...............................          1,069,100            581,582           -487,518          1,275,000          1,092,094             22,994            510,512
Construction, Minor Projects...............................            630,535            329,418           -301,117            621,000            673,718             43,183            344,300
Grants for Construction of State Extended Care Facilities..            165,000             85,000            -80,000            200,000            200,000             35,000            115,000
Grants for Construction of State Veterans Cemeteries.......             39,500             32,000             -7,500             42,000             39,500                  0              7,500
                                                            ------------------------------------------------------------------------------------------------------------------------------------
      Total Departmental Administration....................          5,751,100          5,427,392           -323,708          6,623,673          6,643,399            892,299          1,216,007
Other Discretionary........................................            155,572            158,237              2,665            160,084            158,237              2,665                  0
                                                            ====================================================================================================================================
      Total Discretionary (Excludes Collections)...........         43,107,892         44,764,132          1,656,240         47,693,800         48,593,736          5,485,844         3,829,604
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
* Amounts attributable to medical collections have been subtracted from the Independent Budget recommendation for Medical Services and added to the MCCF Collections line.


                                                          DEPARTMENT OF VETERANS AFFAIRS ACCOUNT COMPARISONS FY2009--FEBRUARY 28, 2008
                                                                                         [In thousands]
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                 Administration's                                                                HVAC vs.
                          Account                                 FY 2008            Request               IB                HVAC            HVAC v. IB       Administration    HVAC v. FY 2008
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Medical Services...........................................         29,104,220         29,465,503         32,153,138         31,656,100           -497,038          2,190,597          2,551,880
Medical Administration.....................................          3,517,000          4,610,000          3,625,762          4,610,000            984,238                  0          1,093,000
Medical Facilities.........................................          4,100,000          4,661,000          4,576,143          4,971,000            394,857            310,000            871,000
                                                            ------------------------------------------------------------------------------------------------------------------------------------
      Total, Medical Care..................................         36,721,220         38,736,503         40,355,043         41,237,100            882,057          2,500,597          4,515,880
MCCF Collections...........................................          2,414,000          2,466,860          2,466,860          2,466,860                  0                  0             52,860
                                                            ------------------------------------------------------------------------------------------------------------------------------------
      Total, Medical Care (with Collections)...............         39,135,220         41,203,363         42,821,903         43,703,960            882,057          2,500,597          4,568,740
Medical and Prosthetic Research............................            480,000            442,000            555,000            555,000                  0            113,000             75,000
                                                            ====================================================================================================================================
      Total VHA (Medical Care and Research excluding                37,201,220         39,178,503         40,910,043         41,792,100          1,764,114          5,114,194          9,212,480
       Collections)........................................
General Operating Expenses.................................          1,605,000          1,699,867          1,985,602          1,896,126            -89,476            196,259            291,126
Information Technology Systems.............................          1,966,465          2,442,066          2,164,938          2,442,066            277,128                  0            475,601
National Cemetery Administration...........................            195,000            180,959            251,975            210,250            -41,725             29,291             15,250
Office of Inspector General................................             80,500             76,500             83,158             89,645              6,487             13,145              9,145
Construction, Major Projects...............................          1,069,100            581,582          1,275,000          1,092,094           -182,906            510,512             22,994
Construction, Minor Projects...............................            630,535            329,418            621,000            673,718             52,718            344,300             43,183
Grants for Construction of State Extended Care Facilities..            165,000             85,000            200,000            200,000                  0            115,000             35,000
Grants for Construction of State Veterans Cemeteries.......             39,500             32,000             42,000             39,500             -2,500              7,500                  0
                                                            ------------------------------------------------------------------------------------------------------------------------------------
      Total, Departmental Administration...................          5,751,100          5,427,392          6,623,673          6,643,399             19,726          1,216,007            892,299
Other Discretionary........................................            155,572            158,237            160,084            158,237             -1,847                  0              2,665
                                                            ====================================================================================================================================
      Total, VA Discretionary..............................         43,107,892         44,764,132         47,693,800         48,593,736            899,936          6,330,201        10,107,444
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
*Amounts attributable to medical collections have been subtracted from the Independent Budget recommendation Medical Services and added to the MCCF Collections line.

                    REPUBLICAN LETTER OF TRANSMITTAL

                          House of Representatives,
                            Committee on Veterans' Affairs,
                                  Washington, DC, February 28, 2008
Hon. John Spratt,
Chairman, Committee on the Budget
U.S. House of Representatives, Washington, DC.
    Dear Mr. Chairman: Pursuant to House Rule X, clause 
4(f)(1), 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 FY 2009 
budget request with regard to programs and matters within the 
jurisdiction of the Committee, along with Supplemental Views 
and Estimates.
    In recommending record discretionary funding for veterans' 
health care and benefits, the Republican Budget Views and 
Estimates reflects our enduring priorities: to care for 
veterans who have service-connected disabilities, those with 
special needs, and the indigent; to ensure a seamless 
transition from military service to the care of the Department 
of Veterans Affairs (VA); and to provide veterans every 
opportunity to live full, healthy lives.
    We look forward to working with the 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., Committee Member; Jeff Miller, 
                            Ranking Republican Member, Subcommittee on 
                            Health; John Boozman, Ranking Republican 
                            Member, Subcommittee on Economic 
                            Opportunity; Ginny Brown-Waite, Ranking 
                            Republican Member, Subcommittee on 
                            Oversight & Investigations; Michael R. 
                            Turner, Committee Member; 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.

          REPUBLICAN VIEWS AND ESTIMATES FOR FISCAL YEAR 2009


                           February 28, 2008


                                OVERVIEW

    For veteran's healthcare and program costs in FY 2009, the 
Republican Members of the Committee on Veterans' Affairs 
recommend $3.831 billion above the Administration's request for 
discretionary spending in FY 2009. In addition, we recommend $2 
billion for a legislative initiative to modernize GI Bill 
education and training benefits for servicemembers of the 
Reserves and National Guard.

              UNITED STATES DEPARTMENT OF VETERANS AFFAIRS


                    Veterans Benefits Administration


                           Mandatory Funding

    The Veterans Benefits Administration (VBA) administers a 
broad range of non-medical benefits to veterans, their 
dependents, and survivors through 57 regional offices. These 
programs include disability compensation, non service-connected 
pension, education, vocational rehabilitation, burial, 
insurance, and home loan guaranty.
    The Republican Members support the Administration's FY 2009 
budget request of $46.4 billion in mandatory funding for 
veterans' programs, a 3.5 percent increase over the enacted 
level for FY 2008, except for the additional $2 billion we 
recommend to modernize the GI Bill.

                         Discretionary Funding

    With the exception of the recommendations noted below, the 
Republican Members support the Administration's FY 2009 request 
of $1.371 billion in discretionary funding for the management 
of the benefits programs--disability compensation, pension, 
education, vocational rehabilitation and employment, housing, 
burial, and life insurance.
    Disability Compensation and Pension Service--The 
Administration requests $1.113 billion in budget authority to 
fund the discretionary portion of the disability compensation, 
pension, and burial programs. This includes administrative 
expenses for 12,120 Full Time Equivalent Employees (FTEE), an 
overall increase of 703 FTEE over the FY 2008 level. This 
increase includes an additional 694 Direct FTEE over the FY 
2008 level.
    For FY 2009, VBA projects receipt of 872,002 claims, an 
increase of 17,098 claims over FY 2008 levels. Though the 
accumulation of the claims backlog has slowed, the Republican 
Members remain concerned that VBA still has an inventory of 
over 400,000 claims. Of this inventory, 103,410 claims (or 25.8 
percent), have been pending over 180 days.
    VBA intends to address this large workload in three ways:
    First, VBA plans to enhance its use of information 
technology to help with claims processing. VBA plans to 
increase collaboration with the Department of Defense to obtain 
medical and discharge information electronically. VBA will also 
begin funding a paperless claims processing initiative (known 
as Virtual VA), which will reduce reliance on burdensome paper 
claims files. Additionally, VBA will utilize rules-based 
technology to help claims adjudicators make rating decisions in 
a more accurate and timely manner. VA has spent more than $600 
million over the past decade in an attempt to automate the 
compensation and pension (C&P) claims processing system. This 
complicated, paper-driven process is more than twenty-five 
years old.
    The Republican Members applaud this initiative, which 
reflects our long-held position favoring increased use of 
information technology, and recommend an additional $10 million 
to fund this initiative. This increase is reflected in our 
recommended increase in the Virtual VA account of the Office of 
Information and Technology.
    Second, VBA expects to reduce the backlog of claims by 
continuing to consolidate all original pension claims 
processing to three pension maintenance centers. This will take 
the burden of adjudicating pension claims off regional offices.
    Third, VBA expects to reduce the backlog by continuing to 
train and prepare the 2,900 direct FTEE that VBA plans to hire 
for C&P service by the end of FY 2009. This includes funding 
for 1,830 direct FTEE for C&P service that was appropriated 
with the contingent emergency funding in the Consolidated 
Omnibus Appropriations Act of 2008.
    All three of these are part of VBA's overall strategy to 
reduce the average processing time for C&P claims to 145 days. 
This would represent a thirty eight day (or 26 percent) 
improvement in processing timeliness from FY 2007, and a twenty 
seven day (or 18 percent) reduction in the amount of time 
required to process claims in FY 2008. The Republican Members 
believe that in order to realistically reach this strategic 
goal the C&P service will need additional FTEE and recommend an 
additional $31.2 million to fund an additional 300 FTEE for the 
C&P service.
    Since it takes new raters an average of up to two years 
before most C&P employees become fully productive, increased 
training of new hires is vital to reducing the backlog. 
Therefore, the Republican Members recommend an additional $8 
million for Training and Performance Support Systems, and an 
additional $2 million for skills certification. The Republican 
Members also recommend an additional $1.88 million to fund 20 
additional FTEE for VBA's National Training Academy in 
Baltimore, MD.
    The Republican Members recognize that additional direct 
compensation FTEE will not improve quality, accuracy, and 
timeliness in claims processing without corresponding increases 
in training resources.
    Intergovernmental Partnerships--The Republican Members 
recommend $15 million for a pilot program to explore the 
feasibility of intergovernmental partnerships in the 
development of compensation and pension claims between VA and 
municipal, county and state veterans departments and service 
officers, as well as veterans' and military service 
organizations. This pilot program would also use information 
technology to assist in the development and transmittal of 
veterans claims to VA regional offices. We recommend the pilot 
occur in three states: New York, Missouri, and Wyoming, or 
other states with varied veteran demographics. This expanded 
pilot would build on findings from the 2002 intergovernmental 
pilot conducted between the VA regional office in Buffalo and 
the New York State Division of Veterans Affairs.
    Veterans Choice in Filing Pilot Program--The Republican 
Members also recommend $5 million for a two-year pilot program 
where veterans who live in the jurisdiction of VA regional 
offices in New York, NY; Newark, NJ; Atlanta, GA; and Detroit, 
MI would be able to submit their disability claims to any VA 
regional office for adjudication. This pilot program would give 
veterans a choice about where they would like to have their 
claim adjudicated.
    Systematic Technical Accuracy Review (STAR) Reviews--STAR 
reviews are one of many ways that VBA reviews the quality of 
their ratings decisions. Despite the recent increase in the 
number of STAR reviews, the Republican Members believe that too 
much emphasis is placed on the number of claims decided by VBA 
instead of the quality of decisions made. The Republican 
Members would rather the adjudication of a disability claim 
take longer and be right than not take as long and be wrong. 
The Republican Members recommend $4 million to increase the 
number of claims reviewed by STAR reviewers and increase the 
amount of STAR staff training at regional offices.
    Education Service--The Republican Members were pleased with 
the results of the pilot call center project during FY 2007 and 
understand VA intends to implement a permanent education call 
center in Muscogee, OK during FY 2008. They believe this 
project is vital to continuing the progress made in reducing 
the processing times for education claims. VBA estimates a 
workload increase of about 13,000 education claims, but the 
Administration requests only 23 additional direct support FTEE. 
As of February 11, 2008, the backlog of education claims was 
nearly 66,000, and average processing times for original and 
supplemental claims were 24 and 11 days respectively, with 
targets of 19 and 10 days. While this is an improvement over 
the previous year, it is insufficient to meet the needs of 
veterans. Passage of the FY 2008 National Defense Authorization 
Act included several provisions such as post-discharge use of 
chapter 1607 education benefits for members of the Guard and 
Reserves that will increase the workload of the Education 
Service.
    It is difficult to determine the exact magnitude of the 
increased workload due to those provisions and expanding 
participation in nearly all other education programs 
administered by VA. However, the continuing loss of experienced 
staff from retirements, increased workloads, staffing the call 
center and the pending backlog of claims convince the 
Republican Members that an additional 160 FTEE are needed for 
the Education Service with a projected discretionary cost of 
$12.32 million.
    Vocational Rehabilitation and Employment Service--With the 
continuing Global War on Terror producing large numbers of 
severely wounded service Members and the challenges entailed in 
rehabilitating those with multiple trauma including significant 
numbers of traumatic brain injury, the Republican Members are 
disappointed that the Administration did not request additional 
staff for the VR&E program. We applaud the Department's 
continuing efforts to realign functions and duties to allow 
counseling and employment staff to concentrate on increasing 
rehabilitation rates. However, we believe current average 
caseload, which now exceeds 130 per counselor nationally, 
should be not more than 100 per counselor to provide 
appropriate levels of service including oversight of cares 
served through contract counselors. Therefore, we recommend 
$13.5 million to fund an additional 150 professional level 
FTEE. The Republican Members also recommend an additional 
$18.02 million to contract for continued rehabilitation 
services for veterans.
    Loan Guaranty Service--The Republican Members recommend an 
additional 40 FTEE at a cost of $3.656 million to improve the 
percentage of loans transmitted through VA's Foreclosure 
Avoidance through Closing (FAC) system within the Loan Guaranty 
Service.
    VA-USOC Military Paralympic Program--This coming summer, 
America's Olympic and Paralympic teams will compete in the 
Beijing Olympics. In 2005, at the urging of then Chairman 
Buyer, VA signed a Memorandum of Understanding (MOU) with the 
US Olympic Committee (USOC) to begin a cooperative effort to 
increase disabled veteran participation in sports at all 
levels, including elite events such as the Paralympics.
    Over the three years since the MOU, the USOC has held a 
series of military sports summits for recently-injured veterans 
of the War on Terror, and VA has assisted by providing medical 
and recreational therapy staff and disabled veterans undergoing 
rehabilitation. As a result of this collaboration, as well as 
interest by the disabled veteran's community in general, it is 
possible that as many as eight disabled veterans will compete 
in Beijing.
    Competition at elite levels of athletic events requires 
significant dedication to training, especially for service-
disabled athletes. Therefore, we believe it is appropriate for 
VA to defray expenses for service-disabled athletes 
participating at elite levels in the program. We estimate the 
cost at $2 million per year. The Republican Members also 
recommend an additional $5 million to improve opportunities for 
these veterans to participate in sporting or other special 
events. To facilitate these opportunities the Republican 
Members recommend an additional $1.05 million to fund and 
additional 10 FTEE for the National Programs and Special 
Events.

                       Board of Veterans' Appeals

    The Administration requests $64.744 million to support 487 
FTEE for the Board of Veterans' Appeals (BVA), an increase of 
$2.475 million and 21 FTEE over FY 2008 level. The Republican 
Members recommend an additional $14.865 million to support an 
additional 113 FTEE for a total BVA staffing of 600 FTEE. The 
BVA provides independent reviews of VA regional office 
decisions and makes the final administrative decision on behalf 
of the Secretary of Veterans Affairs. While BVA has made 
improvements, it continues to experience difficulties meeting 
the production levels. We believe that additional staff is 
necessary if BVA is to provide timely and accurate decisions to 
veterans and their families. The Republican Members recommend 
$79.609 million for the BVA program account.

                    National Cemetery Administration

    The Administration requests $425 million in discretionary 
funding for the National Cemetery Administration (NCA). This 
includes $181 million for operations and maintenance of VA's 
national cemeteries and 1,603 FTEE, a decrease of $14 million 
and increase of 51 FTEE over the FY 2008 level. This also 
includes $25 million in minor construction to address cemetery 
infrastructure improvements. The administration also requested 
$6 million to create an advance planning account that will give 
NCA flexibility in purchasing land for future cemeteries.
    Cemetery Operations and Maintenance--The Republican Members 
recommend an additional $19 million to the Administration's 
request of $181 million for a total of $200 million for NCA 
operations and maintenance, and an additional $144 million for 
minor construction.
    NCA Major Construction and Gravesite Expansion--The 
Republican Members recommend an additional $100 million to 
accelerate VA's five-year strategic plan to fund National 
Cemetery gravesite expansion. VA will inter an estimated 
111,000 veterans in 2009, with similar projections for the near 
future, most from our ``Greatest Generation.'' The Republican 
Members believe accelerated expansions are an appropriate 
response to assure veterans a final resting place in a national 
shrine. Expansions funded in FY 2009 would include National 
Cemeteries in Annville, PA, Fort Mitchell, AL, Dayton, OH, 
Kent, WA, Triangle, VA, Houston, TX, Elwood, IL, St. Louis, MO, 
Phoenix, AZ, and Riverside, CA. The Republican Members also 
recommend an additional $100 million to fund the construction 
of additional columbarium space for veteran internments in 
populated areas.
    National Shrine Commitment--The Republican Members also 
recommend an additional $300 million to complete the NCA's 
National Shrine Commitment. The funding from the commitment 
would be used on infrastructure projects such as irrigation 
improvements, renovation of historic structures, and road 
resurfacing. This additional funding would be part of the NCA's 
major construction account. The total funding for the NCA major 
construction account recommended by the Republican Members is 
$610 million which is $500 million above the administration's 
request.
    Grants for the Construction of State Cemeteries--The 
Republican Members also recommend an additional $10 million for 
grants for the construction of state cemeteries for a total of 
$42 million. This program gives funding to states to build 
national cemeteries and requires that the state then pay all 
operation and maintenance costs once the cemetery is built. 
This program continues to have a waiting list and additional 
funding would provide better access to veterans cemeteries for 
veterans and their families.

                     Veterans Health Administration

    For FY 2009, the Administration requests $41.2 billion in 
appropriations for discretionary spending on veterans' medical 
care, an increase of $2 billion or 5.4 percent over the FY 2008 
appropriated level.
    Medical Services--The Administration requests $34.1 billion 
for medical services. In the FY 2009 request, VA merged the 
medical services and medical administration appropriation 
accounts. VA argues that merging these two accounts will 
improve the budget execution and allow VA to respond rapidly to 
unanticipated changes in the health care environment throughout 
the year.
    The Republican Members recommend $35.2 billion for medical 
services which is $1.137 billion above the Administration's 
request. This increase is recommended as follows:
    Operation Iraqi Freedom and Operation Enduring Freedom 
(OIF/OEF)--We recommend a $50 million increase to account for 
the enactment of Public Law 110-181 that extends the period 
during which combat veterans can receive care in priority 
category 6 from two to five years from their date of discharge, 
and provides for multiple requirements for wounded warrior 
assistance programs. The Administration requests $1.267 billion 
to meet the needs of veterans from OIF/OEF, an increase of $216 
million, or 21 percent from expected costs for FY 2008. The 
Republican recommendation would bring funding to $1.317 billion 
for OIF/OEF veterans;
    Traumatic Brain Injury (TBI)--We recommend a $50 million 
increase to support the care of our wounded warriors with TBI 
and the needs of their family caregivers. VA should establish a 
centralized policy and procedures to ensure that best practices 
for both short and long-term TBI rehabilitation are rapidly 
disseminated and adopted throughout the VA system.
    Rural Health Care--We recommend a $200 million increase to 
improve the access and quality of care for enrolled veterans 
residing in rural areas. This includes additional funding for 
the Office of Rural Health and improving access to care by 
utilizing existing non-VA rural health infrastructure;
    Dental Care--We recommend a $100 million increase to 
provide dental care for the increasing number of returning OIF/
OEF servicemembers accessing VA for dental care. Many OIF/OEF 
active duty, Guard, and Reserve servicemembers are returning 
with serious dental problems and are not receiving corrective 
dental care prior to separation from active duty. VA is then 
obligated to treat these separated servicemembers, often 
through costly contract care. Although we include this 
additional funding, we also anticipate enacting legislation 
that would require VA to seek reimbursement from DoD for the 
post-deployment dental care VA is providing;
    Health Professional Educational Assistance Program--We 
recommend a $50 million increase to provide scholarships to 
employees pursing degrees or training in health care 
disciplines for which recruitment and retention of qualified 
personnel is difficult. We expect this additional funding to 
include support for the recruitment and retention of staff to 
provide mental health care in rural settings;
    Mental Health Care--We recommend a $213 million increase 
for VA to continue to implement the Mental Health Strategic 
Plan and to enhance efforts to identify and respond to mental 
health problems of returning OIF/OEF service members, including 
members of the National Guard and Reserve;
    Emergency Care--We recommend a $50 million increase to 
reimburse certain veterans enrolled in VA health care without a 
service-connected disability for the cost of emergency 
treatment received in a non-VA facility until such time as such 
veterans are transferred to a VA facility;
    Medical Patient Workload--We recommend a $100 million 
increase to provide timely and accessible high-quality health 
care to core constituency veterans--the service-connected 
disabled, injured and indigent;
    Prosthetic and Sensory Aids--We recommend a $50 million 
increase to cover the increased costs of providing, repairing 
and replacing prosthetics and sensory aids;
    Long-term care--We recommend a $200 million increase to 
support long-term care services;
    Medical Care Collections Fund--We recommend a $74 million 
increase in medical services, as we remain concerned that VA 
cannot meet its estimated collections goal.
    Medical Facilities--We recommend a $400 million increase 
above the Administration's request of $4.661 billion for 
necessary costs associated with operating and maintaining VA's 
health care system infrastructure.
    Medical and Prosthetic Research--The Administration 
requests $442 million in appropriations for medical and 
prosthetic research, a decrease of $38 million below the FY 
2008 appropriated level. We place a high premium on conducting 
research into injuries and illnesses related to military 
service that benefit the clinical treatment needs of veterans. 
While the Department intends to place additional reliance on 
outside federal grants to realize a net gain inresearch 
funding, we recommend an $83 million increase above the 
Administration's request for a total of $525 million for this program 
account.
    Legislative Proposals--The Administration includes seven 
new legislative proposals as well as legislative policy 
proposals from last year. The Republican Members support the 
seven new health legislative proposals that would: exempt co-
payments from all hospice care provided through VA from co-
payments; allow VA to pay for specialized residential care and 
rehabilitation for OEF/OIF veterans in medical foster homes; 
update HIV testing policy; provide permanent authority for IRS 
income data matching for VA eligibility determinations; 
authorize VA to release certain health information to secure 
third-party reimbursement for care provided by VA; allow ``in-
lieu-of'' reimbursement for certain continuing medical 
education; and extend the application time for post discharge 
dental benefits from 90 to 180 days. (The extension of dental 
benefits has already been enacted in Public Law 110-181.)
    The Republican Members continue to reject the three policy 
proposals that would: allow VA to establish a tiered annual 
enrollment fee for priority groups 7 and 8 veterans based on 
family income; increase pharmacy co-payments for priority 
groups 7 and 8 veterans from $8 to $15 dollars; and eliminate 
the practice of offsetting or reducing VA first-party co-
payment debts with collection recoveries from third-party 
health plans. These proposals do not reduce the 
Administration's request for discretionary medical care 
appropriations. The additional revenue would be classified as 
mandatory receipts to the Treasury and would not be retained in 
VA for veterans' health care programs.
    VHA Major Construction Projects--The Administration 
requests $471.5 million for VHA major construction projects. We 
recommend a $752 million increase above the Administration's 
request. This increase includes funding to cover increased 
costs of construction and increased funding for the advanced 
planning fund for developing the design of major construction 
projects including public-private ventures to support the 
future demand for health care services. This would bring the 
total to $1.224 billion for this program account or $752 
million above the Administration's request.
    VHA Minor Construction Projects--The Administration 
requests $273.418 million for VHA minor construction projects 
and the Republican Members recommend a $200 million increase 
over the Administration's request, for a total of $473.418 for 
this account.
    Grants for Construction of State Extended Care Facilities--
The Administration requests $85 million in appropriations for 
grants for the construction of State extended care facilities, 
the same amount as the FY 2008 appropriated level. The 
partnership between the Federal government and the States is a 
long-standing and honored tradition of cost sharing. We 
recommend a $90 million increase above the Administration's 
request for a total of $175 million for this account.

                  Office of Information and Technology

    The Republican Members concur with the Administration's 
request for $2.442 billion for the Office of Information and 
Technology (OI&T). This should be the last year for 
appropriations for VETSNET application development. Any further 
funding should be for code-conversion and operations and 
maintenance.
    Additionally, the Committee recognizes the value of 
programs designed to reduce the backlog of claims, and provide 
improved services to veterans. Therefore, we recommend an 
additional funding amount of $10 million for Virtual VA.
    The Republican Members also recommend an additional $100 
million for 915 FTEE to provide for information technology 
services at all VA locations nationwide, and an additional $200 
million to be used to consolidate the multiple infrastructures 
presently in existence at the VA. Without a significant 
injection of funds to consolidate, the VA will spend at least 
10 years to slowly combine these multiple infrastructures into 
one. The Republican Members also believe in encouraging IT 
innovation at the outlying VA facilities, and therefore 
recommend an additional $16 million for field innovation in 
order to continue a program started in FY 2008 by the Office of 
Information and Technology.
    The Republican Members recommend reducing funding to The 
Education Expert System (TEES) in the amount of $5.259 million 
until the VA can articulate a measurable performance outcome 
for the program for FY 2009.
    The total recommended amount for the Office of Information 
and Technology is $2.762 billion, which is $320 million above 
the Administration's request.

                    Office of the Inspector General

    The VA Office of Inspector General (OIG) is responsible for 
the audit, investigation, and inspection of all VA programs and 
operations. For FY 2009, the Administration requests $76.5 
million and 440 FTEE to support the activities of the OIG. This 
compares with the FY 2008 request of $72.6 million for 
administrative expenses and 445 FTEE. However, this FY 2009 
funding level would result in a reduction of 48 FTEE from 
current staffing levels. In order to maintain the current level 
of audits, inspections, and investigations completed, as well 
as the monetary benefits identified, Congress would need to 
provide funding of $84.9 million (an $8.4 million increase over 
the Administration request). Major audits, reviews and 
investigations would have to be cancelled should this reduction 
in staffing occur. During FY 2007, OIG identified over $670.2 
million in monetary benefits, for a return of $11 for every 
dollar expended on OIG oversight. The Republican Members 
recommend adding $8.9 million in FY 2009, in order to provide 
for a total of 540 FTEE at a cost of $93.8 million.
    Additionally, the Republican Members recognize the 
importance of forward looking initiatives and investigations 
provided by the OIG. Therefore, the Republican Members also 
recommend an additional increase in funding to the OIG by $17.3 
million for the following initiatives: $10.3 million and 60 
FTEE for DoD/VA Transitional Health Care; $3.5 million and 20 
FTEE for information technology security; and $3.5 million and 
20 FTEE for acquisition reform. The total funding for the OIG 
account recommended by the Republican Members is $111.1 million 
which is $34.6 million above the Administration's request.

                       General Operating Expenses

    The Republican Members recommend an additional $1.03 
million be made available to fund an additional 10 FTEE to 
improve timeliness and customer service at the VA Office of 
Congressional and Legislative Affairs. The Republican Members 
also recommend an additional 19 FTEE at a cost of $2.09 million 
for the Center on Veterans Employment to improve implementation 
of the service disabled veteran-owned small business provisions 
in P.L. 109-461. The Republican Members further recommend an 
additional 10 FTEE for the Office of Small and Disadvantaged 
Business Utilization to improve small business procurement 
opportunities within VA at a cost of $1.1 million. These 
increases combined with other general operating expensesfrom 
VBA bring the Republican Member recommendation for general operating 
expenses to $1.841 billion, which is $142 million above the 
Administration's request.

 UNITED STATES DEPARTMENT OF LABOR--VETERANS' EMPLOYMENT AND TRAINING 
                                SERVICE

    Homeless Veterans Reintegration Program (HVRP)--The 
Republican Members are pleased with the increase in HVRP 
funding that will allow VETS to contract with an additional 7 
grantees. The program has been cited by GAO as the most cost-
effective employment program for the homeless, placing 65 
percent of homeless veterans with an average cost per placement 
of about $2,400. We recommend an additional $1 million to bring 
the total number of potential new grantees to 10.
    National Veterans Training Institute--In Public Law 109-
461, Congress mandated several changes in the state grant 
program that will require greater training capacity at the 
National Veterans Training Institute in Denver, CO. The 
Committee recommends an additional $2 million to fund increased 
NVTI operations.
    USERRA Training and Enforcement--The Veterans Employment 
and Training Service has primary responsibility for enforcing 
veterans' employment and reemployment rights under USERRA. Case 
loads are climbing and additional resources are required to 
ensure timely resolution of USERRA-related cases. Therefore, we 
recommend an additional $1 million to fund six additional 
professional investigators.
    State Grants for DVOPS and LVERs & the Transitional 
Assistance Program--The Republican Members are concerned that 
the small increases over the past few years have resulted in a 
gradual reduction in state veterans' employment staff while 
demands related to the Transition Assistance Program (TAP) 
continue to increase. The economic downturn will also result in 
more veterans seeking employment. Therefore, we recommend an 
additional $1.5 million.

                          PROPOSED LEGISLATION

    GI Bill--During the 109th Congress, the Economic 
Opportunity Subcommittee conducted a series of hearings and 
site visits to determine the need to modernize the Montgomery 
GI Bill (MGIB) for both active duty and members of the Selected 
Reserve. MGIB benefit levels for active duty members have not 
nearly kept pace with the increasing cost of higher education, 
and extensive utilization of the Reserve Components in the 
Global War on Terror justifies increases in the basic levels of 
their benefits. Therefore, we propose an additional $2 billion 
in mandatory spending to improve education benefits. This 
includes indexing the basic payment at 100 percent of the 
Department of Education average four year public school cost.
    Disability Benefits Reform Bill--The Republican Members 
propose legislation that will implement disability compensation 
reform for VA and the Department of Defense. The bill is based 
on some of the recommendations of the President's Commission on 
Care of America's Returning Wounded Warriors, also known as the 
Dole-Shalala Commission and the Veterans Disability Benefits 
Commission. Our proposal would end dual disability systems run 
by the Department of Defense (DOD) and Department of Veterans 
Affairs (VA). Currently, servicemembers who are medically 
separated receive a physical evaluation and disability rating 
from their respective branch of service and then typically go 
to the VA for another physical and disability rating based on 
service-related conditions. Our proposal would use a single 
examination and rating, and take DOD out of the disability 
rating business altogether. Those deemed unfit for service due 
to injury would receive an annuity from DOD based on rank and 
years of service. VA would conduct a study to determine 
appropriate amounts of compensation under a new, modern 
disability compensation rating schedule. The new schedule would 
reflect average loss of earning capacity and loss of quality of 
life due to disability.
    Comprehensive Heath and Benefit Improvements--The 
Republican Members recognize that improvements need to be made 
in a variety of VA programs so that they meet the emerging 
needs of both newly returning veterans from recent conflicts 
and our aging veterans from previous wars. Therefore, the 
Republican Members plan to introduce comprehensive legislation 
that will address a variety of issues facing the VA, including 
a proposal to provide dental insurance to eligible veterans and 
expanding contract care for rural veterans. Other proposals 
will include increased funding for adaptive housing and auto 
grants, and make adjustments to the Home Loan Guarantee program 
to bring it in line with current market conditions. In 
addition, the legislation will address the current claims 
backlog by increasing training for veteran's service officers, 
establishing a paperless and rules based adjudication system, 
and establishing a pilot program to give veterans a choice of 
where they file their claims. Finally, the proposed legislation 
will increase the burial plot allowance for veterans.

            SUPPLEMENTAL VIEWS OF THE HONORABLE STEVE BUYER


                    VIEWS AND ESTIMATES FOR FY 2009


                           February 28, 2008

    The Administration's requested FY 2009 budget for veterans' 
programs includes legislative proposals to change the 
Department of Veterans Affairs (VA) fee structure for health 
care. These proposals for certain fees and co-payments are more 
fully described in the Republican Views and Estimates for FY 
2009. According to the legislative proposals, the revenue 
generated by these fees and co-payments would be mandatory 
receipts to be deposited in the U.S. Treasury, rather than 
retained by the VA for the benefit of veterans.
    The Administration proposal includes fees and co-payments 
related to enrollment of category 7 and 8 veterans in VA 
medical care. Tiered enrollment fees would range from $250 per 
year for a veteran with an income of $50,000 to $750 per year 
for a veteran with an income of $100,000 or greater. Copayments 
for pharmaceuticals would rise from the current $8 to a new 
level of $15 per 30-day supply. VA would also be authorized to 
discontinue the current practice of offsetting or reducing a 
patient's first party co-payment debt from funds received from 
third-party insurance for non service-connected treatment. I 
would only support these initiatives to generate $378.7 million 
in the first year and $5.204 billion over 10 years, if the 
revenues generated were retained by the VA for its veterans' 
health care programs.
        MESSAGES FROM THE PRESIDENT AND EXECUTIVE COMMUNICATIONS

                                ------                                


                         Presidential Messages

Mar. 4, 2008:
    Communication from the President of the United States, 
transmitting the Administration's 2008 National Drug Control 
Strategy, pursuant to 21 U.S.C. 1504.
                                ------                                


                        Executive Communications

Jan. 5, 2007:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Extension of the Presumptive Period for 
Compensation for Gulf War Veterans (RIN: 2900-AM47) Received 
December 20, 2006, pursuant to 5 U.S.C. 801(a)(1)(A).

Jan. 5, 2007:
    Letter from the Assistant to the Secretary for Regulations 
Policy and Management, Department of Veterans Affairs, 
transmitting the Department's final rule--Filipino Veterans' 
Benefits Improvements (RIN: 2900-AK65) Received December 29, 
2006, pursuant to 5 U.S.C. 801(a)(1)(A).

Jan. 5, 2007:
    Letter from the Director of Regulations Management, Office 
of Regulation Policy and Management, Department of Veterans 
Affairs, transmitting the Department's final rule--Transfer of 
Montgomery GI Bill-Active Duty Entitlement to Dependents (RIN: 
2900-AM12) Received December 20, 2006, pursuant to 5 U.S.C. 
801(a)(1)(A).

Feb. 6, 2007:
    Letter from The American Legion, transmitting the financial 
statement and independent audit of The American Legion 
proceedings of the 88th annual National Convention of The 
American Legion, held in Salt Lake City, Utah from August 25-
31, 2006, and a report on the Organizations' activities for the 
year preceding the Convention, pursuant to 36 U.S.C. 49.

Feb. 12, 2007:
    Letter from the Chief, Office of Regulation Policy and 
Management, Department of Veterans' Affairs, transmitting the 
Department's final rule--Accrued Benefits (RIN: 2900-AM28) 
Received December 29, 2006, pursuant to 5 U.S.C. 801(a)(1)(A).

Mar. 14, 2007:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Traumatic Injury Protection Rider to 
Servicemembers' Group Life Insurance (RIN 2900-AM36) Received 
March 7, 2007, pursuant to 5 U.S.C. 801(a)(1)(A).

Mar. 22, 2007:
    Letter from the General Counsel, Department of Defense, 
transmitting the Department's requested legislative proposals 
as part of the National Defense Authorization Bill for Fiscal 
Year 2008.

Mar. 28, 2007:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Home Schooling and Educational Institution (RIN: 
2900-AM37) Received February 27, 2007, pursuant to 5 U.S.C. 
801(a)(1)(A).

Mar. 28, 2007:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Priority for Partial Grants to States for 
Construction or Acquisition of State Home Facilities (RIN: 
2900-AM42) Received February 27, 2007, pursuant to 5 U.S.C. 
801(a)(1)(A).

Mar. 29, 2007:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Cost Estimate 06-26 Schedule for Rating 
Disabilities; Appendices A, B, C (RIN: 2900-AM60) Received 
March 18, 2007, pursuant to 5 U.S.C. 801(a)(1)(A).

Apr. 16, 2007:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Vocation Rehabilitation and Employment Program--
Initial Evaluations (RIN: 2900-AM25) Received March 26, 2007, 
pursuant to 5 U.S.C. 801(a)(1)(A).

Apr. 23, 2007:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Veterans and Dependent's Education: Topping-Up 
Tuition Assistance; Licensing and Certification Tests; Duty to 
Assist Education Claimants (RIN 2900-AK80) Received April 10, 
2007, pursuant to 5 U.S.C. 801(a)(1)(A).

Apr. 23, 2007:
    Letter from the Deputy Secretary of Veterans Affairs, 
Department of Veterans Affairs and Department of Defense Joint 
Executive Committee, transmitting a copy of the report for 
Fiscal Year 2006 regarding the activities and accomplishments 
of the Department of Veterans Affairs and Department of Defense 
Joint Executive Committee, pursuant to 38 U.S.C. 320.

May 23, 2007:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Administration of VA Educational Benefits--
Centralized Certification (RIN: 2900-AL43) Received April 25, 
2007, pursuant to 5 U.S.C. 801(a)(1)(A).

May 23, 2007:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Medical: Informed Consent--Designate Health Care 
Professionals to Obtain Informed Consent (RIN: 2900-AM21) 
Received April 1, 2007, pursuant to 5 U.S.C. 801(a)(1)(A).

Jun. 7, 2007:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Delegations of Authority-National Cemetery 
Administration (RIN: 2900-AM18) Received March 18, 2007, 
pursuant to 5 U.S.C. 801(a)(1)(A).

Jun. 7, 2007:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Department of Veterans Affairs Implementation of 
OMB Guidance on Non-procurement Debarment and Suspension (RIN: 
2900-AM44) Received June 4, 2007, pursuant to 5 U.S.C. 
801(a)(1)(A).

Jun. 19, 2007:
    Letter from the Adjutant General, the Veterans of Foreign 
Wars of the U.S., transmitting proceedings of the 107th 
National Convention of the Veterans of Foreign Wars of the 
United States, held in Reno, Nevada, August 26-August 31, 2006, 
pursuant to 36, U.S.C. 118 and 44 U.S.C. 1332.

Jul. 17, 2007:
    Letter from the Secretary, Department of Labor, 
transmitting the 2005 Annual Report of the Assistant Report of 
the Assistant Secretary for Veterans' Employment and Training 
of the Department of Labor, pursuant to 38, U.S.C. 4107(c).

Jul. 17, 2007:
    Letter from the Secretary, Department of Veterans Affairs, 
transmitting a copy of a draft bill entitled, ``To amend title 
38, United States Code, to improve veterans' health care 
benefits, and for other purposes.''

Jul. 23, 2007:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Data Breaches (RIN: 2900-AM63) Received June 25, 
2007, pursuant to 5 U.S.C. 801(a)(1)(A).

Jul. 25, 2007:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Increase in Rates Payable Under the Montgomery GI 
Bill-Selected Reserve and Other Miscellaneous Issues (RIN: 
2900-AM50) Received July 18, 2007, pursuant to 5 U.S.C. 
801(a)(1)(A).

Aug. 3, 2007:
    Letter from the Secretary, Department of Veterans Affairs, 
transmitting a copy of a draft bill to clarify the requirements 
for special monthly pension based on age and disability.

Aug. 3, 2007:
    Letter from the Secretary, Department of Veterans Affairs, 
transmitting a copy of a draft bill entitled, ``Agent Orange 
Equitable Compensation Act.''

Aug. 3, 2007:
    Letter from the Secretary, Department of Veterans Affairs, 
transmitting a copy of a draft bill entitled, ``Veterans' Pride 
Initiative Act.''

Sept. 25, 2007:
    Letter from the Secretary, Department of Veterans Affairs, 
transmitting a copy of a draft bill, ``to enhance the 
functioning and integration of formerly homeless veterans who 
reside in permanent housing, and for other purposes.''

Oct. 10, 2007:
    Letter from the Director, Regulations Management, Office of 
Regulation Policy and Management, Department of Veterans 
Affairs, transmitting the Department's final rule--Disclosure 
of Information to Organ Procurement Organizations (RIN: 2900 
AM65) Received September 4, 2007, pursuant to 5 U.S.C. 
801(a)(1)(A).

Oct. 24, 2007:
    Letter from the Assistant Secretary for Reserve Affairs, 
Department of Defense, transmitting the biennial report 
entitled, ``Report on the Montgomery G.I. Bill for Members of 
the Selected Reserve'' for Fiscal Year 2006, pursuant to 10 
U.S.C. 16137 Public Law 106-65, Sec. 546.

Oct. 29, 2007:
    Letter from the Director of Regulations Management Office 
of Regulation Policy and Management, VA Department of Veterans 
Affairs, transmitting the Department's final rule--Government-
Furnished Headstone and Marker Regulations (RIN: 2900-AM64) 
Received September 18, 2007, pursuant to 5 U.S.C. 801(a)(1)(A).

Oct. 29, 2007:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Accreditation of Service Organization 
Representatives and Agents (RIN: 2900-AM29) Received October 
10, 2007, pursuant to 5 U.S.C. 801(a)(1)(A).

Dec. 4, 2007:
    Letter from the National Adjutant, the Disabled American 
Veterans, transmitting the 2006 National Convention Proceedings 
of the Disabled American Veterans, pursuant to 36 U.S.C. 90i 
and 44 U.S.C. 1332.

Dec. 10, 2007:
    Letter from the Acting Secretary, Department of Veterans 
Affairs, transmitting a copy of a draft bill entitled, 
``America's Wounded Warriors Act.''

Dec. 11, 2007:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Reasonable Charges for Medical Care or Services 
(RIN: 2900-AM35) Received December 3, 2007, pursuant to 5 
U.S.C. 801(a)(1)(A).

Dec. 12, 2007:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Transfer of Duties of Former VA Board of Contract 
Appeals (RIN: 2900-AM73) Received November 19, 2007, pursuant 
to 5 U.S.C. 801(a)(1)(A).

Dec. 17, 2007:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Extension of the Presumptive Period for 
Compensation for Gulf War Veterans (RIN: 2900-AM47) Received 
December 4, 2007, pursuant to 5 U.S.C. 801(a)(1)(A).

Dec. 19, 2007:
    Letter from the Secretary, Department of Veterans Affairs, 
transmitting a copy of a draft bill entitled, ``Veterans' 
Authorities Expansion Act of 2007.''

Jan. 15, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Veterans Education: Incorporation of Miscellaneous 
Statutory Provisions (RIN: 2900-AL28) Received January 10, 
2007, pursuant to 5 U.S.C. 801(a)(1)(A).

Jan. 18, 2008:
    Letter from the Secretary, Department of Veterans Affairs, 
transmitting a copy of a draft bill, ``To amend title 38, 
United States Code, to establish within the Department of 
Veterans Affairs, the position of Assistant Secretary for 
Acquisition, Logistics, and Construction, and for other 
purposes.''

Jan. 18, 2008:
    Letter from the Director, Office Personnel Management, 
transmitting the Office's Fiscal Year 2006 annual report on 
Veteran's Employment in the Federal Government.

Jan. 29, 2008:
    Letter from the Director of Regulations Management, Office 
of Regulation Policy and Management, VA, Department of Veterans 
Affairs, transmitting the Department's final rule--Dependents' 
Educational Assistance (RIN: 2900-AM72) Received January 4, 
2008, pursuant to 5 U.S.C. 801(a)(1)(A).

Jan. 29, 2008:
    Letter from the Director of Regulations Management (00REG), 
Department of Veterans Affairs, transmitting the Department's 
final rule--Education: Approval of Accredited Courses for VA 
Education Benefits (RIN: 2900-AM80) Received January 4, 2008, 
pursuant to 5 U.S.C. 801(a)(1)(A).

Jan. 29, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--VA Acquisition Regulation: Plain Language Rewrite 
(RIN: 2900-AK78) Received January 4, 2008, pursuant to 5 U.S.C. 
801(a)(1)(A).

Feb. 7, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Loan Guaranty: Loan Servicing and Claims Procedures 
Modifications (RIN: 2900-AL65) Received January 28, 2008, 
pursuant to 5 U.S.C. 801(a)(1)(A).

Feb. 12, 2008:
    Letter from The American Legion, transmitting the financial 
statement and independent audit of The American Legion 
proceedings of the 89th annual National Convention of The 
American Legion, held in Reno, Nevada, from August 24-30, 2007, 
and a report on the Organization's activities for the year 
preceding the Convention, pursuant to 36 U.S.C. 49.

Feb. 27, 2008:
    Letter from the Secretary, Department of Veterans Affairs, 
transmitting a copy of a draft bill to authorize major medical 
facility projects for the Department of Veterans Affairs for 
fiscal year 2009.

Apr. 15, 2008:
    Letter from the Chairman, Board of Veterans' Appeals, 
Department of Veterans Affairs, transmitting a copy of the 
Report of the Chairman for fiscal year 2007.

Apr. 15, 2008:
    Letter from the Secretary, Department of Veterans Affairs, 
transmitting a copy of a draft bill entitled, ``To amend title 
38, United States Code, to improve veterans' health care 
benefits and for other purposes.''

Apr. 18, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Data Breaches (RIN: 2900-AM63) Received April 14, 
2008, pursuant to 5 U.S.C. 801(a)(1)(A).

May 19, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Notice and Assistance Requirements and Technical 
Correction (RIN: 2900-AM17) Received April 30, 2008, pursuant 
to 5 U.S.C. 801(a)(1)(A).

May 20, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Accreditation of Agents and Attorneys: Agent and 
Attorney Fees (RIN: 2900-AM62) Received May 13, 2008, pursuant 
to 5 U.S.C. 801(a)(1)(A).

May 20, 2008:
    Letter from the Director, Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Provision of Hospital Care and Medical Services 
During Certain Disasters or Emergencies (RIN: 2900-AM40) 
Received May 9, 2008, pursuant to 5 U.S.C. 801(a)(1)(A).

May 20, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--VA Veteran-Owned Small Business Verification 
Guidelines (RIN: 2900-AM78) Received May 9, 2008, pursuant to 5 
U.S.C. 801(a)(1)(A).

May 20, 2008:
    Letter from the Secretary, Department of Veterans Affairs, 
transmitting a copy of a draft bill entitled, ``The Veterans' 
Benefits Enhancement Act of 2008.''

May 20, 2008:
    Letter from the Acting General Counsel, Department of 
Defense, transmitting a copy of legislative proposals that 
would implement initiatives concerning military spousal 
benefits presented by the President of the United States in his 
State of the Union Address.

May 21, 2008:
    Letter from the Director, Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Graves Marked with a Private Headstone or Marker 
(RIN: 2900-AM93) Received May 14, 2008, pursuant to 5 U.S.C. 
801(a)(1)(A).

Jun. 3, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Survivors' and Dependents' Educational Assistance 
Program Period of Eligibility for Eligible Children and Other 
Miscellaneous Issues (RIN: 2900-AL44) Received May 27, 2008, 
pursuant to 5 U.S.C. 801(a)(1)(A).

Jun. 10, 2008:
    Letter from the General Counsel, Department of Defense, 
transmitting the Department's requested legislative proposals 
as part of the National Defense Authorization Bill for Fiscal 
Year 2009.

Jun. 25, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Prohibition of Interment or Memorialization in 
National Cemeteries and Certain State Cemeteries Due to 
Commission of Capital Crimes (RIN: 2900-AM86) Received June 19, 
2008, pursuant to 5 U.S.C. 801(a)(1)(A).

Jul. 9, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Beneficiary Travel Under 38 U.S.C. 111 Within the 
United States (RIN: 2900-AM02) Received July 1, 2008, pursuant 
to 5 U.S.C. 801(a)(1)(A).

Jul. 16, 2008:
    Letter from the Adjutant General, the Veterans of Foreign 
Wars of the U.S., transmitting proceedings of the 108th 
National Convention of the Veterans of Foreign Wars of the 
United States, held in Kansas City, Missouri, August 18-23, 
2007, pursuant to 36 U.S.C. 118 and 44 U.S.C. 1332.

Jul. 21, 2008:
    Letter from the Assistant Secretary for Veterans' 
Employment and Training, Department of Labor, transmitting the 
2006 and 2007 annual report on the Department's Veterans' 
Employment and Training Service, pursuant to 38 U.S.C. 4107(c).

Jul. 21, 2008:
    Letter from the Deputy Secretary, Department of Veterans 
Affairs and Department of Defense, transmitting a copy of the 
report for Fiscal Year 2007 regarding the activities and 
accomplishments of the Department of Veterans Affairs and 
Department of Defense Joint Executive Committee, pursuant to 38 
U.S.C. 320.

Jul. 31, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Supplemental Statement of the Case (RIN: 2900-AM49) 
Received July 18, 2008, pursuant to 5 U.S.C. 801(a)(1)(A).

Sept. 8, 2008:
    Letter from the Disabled American Veterans, transmitting 
the 2008 National Convention Proceedings of the Disabled 
American Veterans, pursuant to 36 U.S.C. 90i and 44 U.S.C. 
1332.

Sept. 25, 2008:
    Letter from the Director, Regulation Policy and Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Schedule of Rating Disabilities; Evaluation of 
Residuals of Traumatic Brain Injury (TBI) (RIN: 2900-AM75) 
Received September 23, 2008, pursuant to 5 U.S.C. 801(a)(1)(A).

Sept. 25, 2008:
    Letter from the Director, Regulation Policy and Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Presumption of Service Connection for Amyotrophic 
Lateral Sclerosis (RIN: 2900-AN05) Received September 19, 2008, 
pursuant to 5 U.S.C. 801(a)(1)(A).

Sept. 25, 2008:
    Letter from the Assistant Secretary of the Army, Department 
of Defense, transmitting a report entitled, ``Report on 
Alternative Measures to Address Cracks in the Monument at the 
Tomb of the Unknowns at Arlington National Cemetery, 
Virginia,'' pursuant to Public Law 110-181, Section 2873.

Sept. 26, 2008:
    Letter from the Director, Regulation Policy and Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Schedule for Rating Disabilities; Evaluation of 
Scars (RIN: 2900-AM55) Received September 19, 2008, pursuant to 
5 U.S.C. 801(a)(1)(A).

Sept. 29, 2008:
    Letter from the Director, Office of Agency Management and 
Budget, Department of Labor, transmitting the Department's 
final rule--Annual Report From Federal Contractors (RIN: 1293-
AA12) Received September 26, 2008, pursuant to 5 U.S.C. 
801(a)(1)(A).

Nov. 19, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Schedule for Rating Disabilities; Eye (RIN: 2900-
AH43) Received November 5, 2008, pursuant to 5 U.S.C. 
801(a)(1)(A).

Nov. 19, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Grants to States for Construction and Acquisition 
of State Home Facilities (RIN: 2900-AJ43) Received October 7, 
2008, pursuant to 5 U.S.C. 801(a)(1)(A).

Nov. 19, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Posttraumatic Stress Disorder (RIN: 2900-AN04) 
Received October 29, 2008, pursuant to 5 U.S.C. 801(a)(1)(A).

Nov. 19, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Board of Veterans' Appeals: Expedited Claims 
Adjudication Initiative--Pilot Program (RIN: 2900-AM77) 
Received November 5, 2008, pursuant to 5 U.S.C. 801(a)(1)(A).

Nov. 19, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Civilian Health and Medical Program of the 
Department of Veterans Affairs (RIN: 2900-AM22) Received 
November 5, 2008, pursuant to 5 U.S.C. 801(a)(1)(A).

Nov. 19, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Disclosure of Information to Organ, Tissue and Eye 
Procurement Organizations (RIN: 2900-AM65) Received November 7, 
2008, pursuant to 5 U.S.C. 801(a)(1)(A).

Nov. 19, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Dental Care-Provision of One-Time Outpatient Dental 
Care for Certain Veterans (RIN: 2900-AM95) Received October 7, 
2008, pursuant to 5 U.S.C. 801(a)(1)(A).

Nov. 20, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Increase in Rates Payable Under the Montgomery GI 
Bill Active Duty and Other Miscellaneous Issues (RIN: 2900-
AM45) Received November 5, 2008, pursuant to 5 U.S.C. 
801(a)(1)(A).

Nov. 20, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Elimination of Co-payment for Weight Management 
Counseling (RIN: 2900-AM59) Received November 5, 2008, pursuant 
to 5 U.S.C. 801(a)(1)(A).

Nov. 20, 2008:
    Letter from the Acting Director, Office of Personnel 
Management, transmitting a report entitled, ``Employment of 
Veterans in the Federal Government--Fiscal Year 2007.''

Dec. 9, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Servicemembers' Group Life Insurance Traumatic 
Injury Protection Program (RIN: 2900-AN00) Received November 
25, 2008, pursuant to 5 U.S.C. 801(a)(1)(A).

Dec. 9, 2008:
    Letter from the Director of Regulations Management, 
Department of Veterans Affairs, transmitting the Department's 
final rule--Assistance to States in hiring and Retaining Nurses 
at State Veterans Homes (RIN: 2900-AM26) Received December 2, 
2008, pursuant to 5 U.S.C. 801(a)(1)(A).
             STATISTICAL DATA--WAR VETERANS AND DEPENDENTS

    Current information on statistical data on War Veterans and 
Dependents can be found on the Web at http://www1.va.gov/opa/
fact/amwars.asp. Listed below is the current information as of 
November 2008.

                     American Revolution (1775-1783)

Total U.S. Servicemembers....................................\1\ 217,000
Battle Deaths......................................................4,435
Non-mortal Woundings...............................................6,188

                         War of 1812 (1812-1815)

Total U.S. Servicemembers........................................286,730
Battle Deaths......................................................2,260
Non-mortal Woundings...............................................4,505

                     Indian Wars (approx. 1817-1898)

Total U.S. Servicemembers (VA estimate)..........................106,000
Battle Deaths (VA estimate)........................................1,000

                         Mexican War (1846-1848)

Total U.S. Servicemembers.........................................78,718
Battle Deaths......................................................1,733
Other Deaths (In Theater).........................................11,550
Non-mortal Woundings...............................................4,152

                          Civil War (1861-1865)

Total U.S. Servicemembers (Union)..............................2,213,363
Battle Deaths (Union)............................................140,414
Other Deaths (In Theater) (Union)................................224,097
Non-mortal Woundings (Union).....................................281,881
 Total Servicemembers (Conf.)..............................2 
                                                               1,050,000
                                             Battle Deaths (Confederate)
                   ..................................3 74,524
                          Other Deaths (In Theater) (Confederate).......
                                      ............3, 4 59,297
Non-mortal Woundings (Confederate)...............................Unknown

                    Spanish-American War (1898-1902)

Total U.S. Servicemembers (Worldwide)............................306,760
Battle Deaths........................................................385
Other Deaths in Service (Non-Theater)..............................2,061
Non-mortal Woundings...............................................1,662

                         World War I (1917-1918)

Total U.S. Servicemembers (Worldwide)..........................4,734,991
Battle Deaths.....................................................53,402
Other Deaths in Service (Non-Theater).............................63,114
Non-mortal Woundings.............................................204,002
Living Veterans........................................................1

                        World War II (1941-1945)

Total U.S. Servicemembers (Worldwide).........................16,112,566
Battle Deaths....................................................291,557
Other Deaths in Service (Non-Theater)............................113,842
Non-mortal Woundings.............................................671,846
 Living Veterans...........................................5 
                                                               2,306,000

                         Korean War (1950-1953)

Total U.S. Servicemembers (Worldwide)..........................5,720,000
Battle Deaths.....................................................33,739
Other Deaths (In Theater)..........................................2,835
Other Deaths in Service (Non-Theater).............................17,672
Non-mortal Woundings.............................................103,284
Living Veterans................................................2,307,000

                         Vietnam War (1964-1975)

 Total U.S. Servicemembers (Worldwide).....................6 
                                                               8,744,000
 Deployed to Southeast Asia................................7 
                                                               3,403,000
                                                           Battle Deaths
           ................................................8 
                                                                  47,434
                                               Other Deaths (In Theater)
                 ....................................8 10,786
                                   Other Deaths in Service (Non-Theater)
                             ........................8 32,000
Non-mortal Woundings........................................9 
                                                                 153,303
 Living Veterans.......................................5, 10 
                                                               7,125,000

                 Desert Shield/Desert Storm (1990-1991)

Total U.S. Servicemembers (Worldwide)..........................2,322,000
Deployed to Gulf.................................................694,550
Battle Deaths........................................................147
Other Deaths (In Theater)............................................235
Other Deaths in Service (Non-Theater)..............................1,590
Non-mortal Woundings.................................................467
 Living Veterans.......................................5, 10 
                                                               2,269,000

                    America's Wars Total (1775-1991)

U.S. Military Service during Wartime..........................41,891,368
Battle Deaths....................................................651,030
Other Deaths (In Theater)........................................308,800
Other Deaths in Service (Non-Theater)............................230,279
Non-mortal Woundings...........................................1,431,290
Living War Veterans...........................................17,456,000
Living Veterans (Periods of War & Peace)......................23,442,000

                   Global War on Terror (Oct. 2001-  )

(Data as of June 30, 2008)
Total U.S. Servicemembers (Worldwide)..........................1,385,122
Deployed to Iraq & Afghanistan...................................214,800
(Data as of December 6, 2008)
Battle Deaths......................................................3,797
Other Deaths (In Theater)..........................................1,026
Non-mortal Woundings..............................................33,476

(The Global War on Terror (GWOT), including Operation Enduring 
    Freedom (OEF) and Operation Iraqi Freedom (OIF), are 
    ongoing conflicts.)

_____

NOTES:
\1\ Exact number is unknown. Posted figure is the median of estimated 
range from 184,000-250,000.
\2\ Exact number is unknown. Posted figure is median of estimated range 
from 600,000-1,500,000.
\3\ Death figures are based on incomplete returns.
\4\ Does not include 26,000 to 31,000 who died in Union prisons.
\5\ Estimate based upon new population projection methodology.
\6\ Covers the period 8/5/64-1/27/73 (date of cease fire).
\7\ Department of Defense estimate.
\8\ Covers period 11/1/55-/15/75.
\9\ Excludes 150,341 not requiring hospital care.
\10\ VA estimate, as of 5/08, does not include those still on active 
duty and may include veterans who served in Iraq and Afghanistan.

Source: Department of Defense (DOD), except living veterans, which are 
VA estimates as of September 2008.

                                 U.S. VETERANS AND DEPENDENTS ON BENEFITS ROLLS
                                             [As of September 2008]
----------------------------------------------------------------------------------------------------------------
                                                                                                      Surviving
                                                                Veterans     Children     Parents      spouses
----------------------------------------------------------------------------------------------------------------
Civil War...................................................  ...........            2  ...........  ...........
Indian Wars.................................................  ...........  ...........  ...........  ...........
Spanish-American War........................................  ...........           94  ...........           90
Mexican Border..............................................  ...........           15  ...........           60
World War I.................................................  ...........        3,169  ...........        4,873
World War II................................................      274,052       14,403          117      223,895
Korean Conflict.............................................      156,842        3,170          257       60,948
Vietnam Era.................................................    1,015,151        8,843        2,932      165,376
Gulf War \1\................................................      896,288       13,688          926       15,945
Non service-connected.......................................      315,763       18,103            2      182,236
Service-connected...........................................    2,951,587       28,016        5,385     320,979
----------------------------------------------------------------------------------------------------------------
\1\ For compensation and pension purposes, the Persian Gulf War period has not yet been terminated and includes
  veterans of Operations Iraqi and Enduring Freedom.

                                  
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