[House Report 114-497]
[From the U.S. Government Publishing Office]
114th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 114-497
======================================================================
MILITARY CONSTRUCTION, VETERANS AFFAIRS, AND RELATED AGENCIES
APPROPRIATIONS BILL, 2017
_______
April 15, 2016.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Dent, from the Committee on Appropriations, submitted the following
R E P O R T
together with
MINORITY AND ADDITIONAL VIEWS
[To accompany H.R. 4974]
The Committee on Appropriations submits the following
report in explanation of the accompanying bill making
appropriations for military construction, the Department of
Affairs, and related agencies for the fiscal year ending
September 30, 2017, and for other purposes.
CONTENTS
Page
Purpose of the Bill.............................................. 2
Summary of Committee Recommendation.............................. 2
Comparative Statement of New Budget Authority.................... 4
Management and Oversight Initiatives............................. 15
Department of Defense:
Military Construction........................................ 17
NATO Security Investment Program............................. 25
Family Housing Construction and Operation and Maintenance.... 27
Department of Defense Family Housing Improvement Fund........ 28
Department of Defense Base Closure Account................... 28
Administrative Provisions.................................... 28
Department of Veterans Affairs:
Veterans Benefits Administration............................. 31
Veterans Health Administration............................... 34
National Cemetery Administration............................. 53
Departmental Administration.................................. 54
Administrative Provisions.................................... 69
Related Agencies:
American Battle Monuments Commission......................... 73
U.S. Court of Appeals for Veterans Claims.................... 74
Cemeterial Expenses, Army.................................... 74
Armed Forces Retirement Home................................. 74
Administrative Provisions.................................... 75
Department of Defense:
Overseas Contingency Operations.............................. 76
General Provisions............................................... 77
House of Representatives Report Requirements..................... 78
Statement of General Performance Goals and Objectives........ 78
Rescissions.................................................. 78
Transfer of Funds............................................ 79
Disclosure of Earmarks and Congressionally Directed Spending
Items...................................................... 80
Changes in Application of Existing Law....................... 80
Appropriations Not Authorized by Law......................... 84
Program Duplication.......................................... 86
Directed Rule Making......................................... 86
Full Committee Votes......................................... 87
Ramseyer Rule................................................ 88
Comparison With the Budget Resolution........................ 88
Five-Year Projection of Outlays.............................. 88
Assistance to State and Local Governments.................... 89
State Project List........................................... 89
Minority and Additional Views
Purpose of the Bill
The purpose of the bill is to support our military and
their families and provide the benefits and medical care that
our veterans have earned for their service to our Nation. This
is accomplished through the programs funded in the bill, which
provide the facilities and infrastructure needed to house,
train, and equip our military personnel to defend this Nation,
both in the United States and abroad; provide the housing and
military community infrastructure that supports a good quality
of life for them and their families; and allow the military to
maintain an efficient and effective base structure. The bill
also funds programs to ensure that all veterans receive the
benefits and medical care that they have earned as a result of
the sacrifices they have made in their service to our country.
Finally, the bill funds four related agencies that provide
support to our Nation's heroes: the American Battle Monuments
Commission, Cemeterial Expenses, Army (including Arlington
National Cemetery), the United States Court of Appeals for
Veterans Claims, and the Armed Forces Retirement Home.
Summary of Committee Recommendation
The Committee recommends $184,175,481,000 in budget
authority for the fiscal year 2017 programs and activities
funded in the bill. The fiscal year 2017 recommendation is an
increase of $13,050,419,000 above the fiscal year 2016 enacted
level and $1,277,405,000 below the President's request. Of the
increase over the fiscal year 2016 enacted level,
$11,276,419,000 is in mandatory programs. Included in the total
budget authority is $102,532,481,000 in mandatory budget
authority and $81,643,000,000 in discretionary budget
authority.
The Committee recommendation highlights the continued
commitment to our servicemembers and their families and to our
veterans. In discretionary budget authority, the bill is 2.2
percent over the fiscal year 2016 enacted level. The bill
includes a slight decrease in military construction, which is
3.7 percent below the fiscal year 2016 level, and an increase
in the Department of Veterans Affairs budget, which is 3.0
percent over the fiscal year 2016 level. While the Committee
recommendation continues essential support for servicemembers
and veterans, it does not provide funds for projects or
activities that lacked sufficient justification or were less
mission-critical. Where it was prudent, the Committee
recommendation rescinds prior year funding that is no longer
needed for the purpose for which it was appropriated while
leaving sufficient resources to close out contracts.
The programs funded in the bill for the Department of
Defense address the priorities of the Department's Agencies and
the Services for numerous facility challenges that they face.
The funds provided support new construction, family housing,
continued cleanup of military bases closed during previous Base
Realignment and Closure rounds, resource Combatant Commanders
requirements where appropriate, and ensure that our military
personnel and their families' quality of life is preserved.
The total recommended funding level for military
construction and family housing, including base and Overseas
Contingency Operations funding is $7,866,000,000, which is
$305,000,000 below the fiscal year 2016 enacted level and
$249,495,000 above the budget request. The recommendation
includes full funding for Family Housing, funding for necessary
construction on our bases, including barracks, health
facilities and schools, and support for critical overseas
investments, including the European Reassurance Initiative.
The total funding level for fiscal year 2017 for the
Department of Veterans Affairs is $176,068,336,000, an increase
of $13,397,331,000 over the fiscal year 2016 enacted level. Of
the total, $102,532,481,000 is provided for mandatory benefit
programs and $73,535,855,000 is allocated to discretionary
programs such as medical care, claims processing, and
construction. In this bill, discretionary funding for the
Department of Veterans Affairs is recommended at 3.0 percent
over the fiscal year 2016 level. For fiscal year 2017,
$63,271,000,000 for medical care has been appropriated in
advance, and the recommendation includes an additional
$850,000,000 in newly identified needs for VA, focusing on
hepatitis C treatment, homelessness, long-term care, and
caregiver stipends. The recommendation fully funds the request
for the administrative costs of Veterans Benefits
Administration, including funding for paperless claims,
centralized mail, and additional staff. The bill also provides
the full request of $156,096,000 for the Board of Veterans
Appeals, a $46,212,000 increase, to target the growing caseload
of appeals of initial benefits decisions. In addition, the
Committee recommendation includes $66,385,032,000 in advance
appropriations for fiscal year 2018 for the four health care
accounts of the Department and $103,935,996,000 in advance
appropriations for mandatory benefits programs for fiscal year
2018.
The following table compares amounts recommended in the
bill to the President's request and amounts appropriated in
fiscal year 2016:
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Management and Oversight Initiatives
The Committee believes the effective stewardship of
taxpayer dollars is of the highest priority. In the interest of
eliminating waste, fraud, and abuse in Federal programs, the
Committee has and will continue to use public hearings,
briefings, and information requests, and reviews by the
Government Accountability Office and the Inspectors General to
promote strong financial and program management, oversight and
leadership at the Department of Defense, the Department of
Veterans Affairs, and other agencies under the jurisdiction of
this bill.
The fiscal year 2017 appropriations Act and the
accompanying report address management challenges of the
Federal agencies funded herein, including directives to
strengthen financial and program management, eliminate
redundancy, and improve implementation and oversight of
initiatives that support the mission of this bill. The
Committee will use every means at its disposal to reduce
mismanagement that results in waste, fraud, and abuse.
Department of Defense (DOD).--In addition to the
notification and reporting requirements for military
construction programs contained in Title 10, United States
Code, the Committee's recommendations include several
provisions requiring the Department of Defense to report on
various aspects of military construction programs, or to
provide notification to the Committee when certain actions are
taken. The Committee also retains prior approval authority for
any reprogramming of funds exceeding a specific threshold.
Department of Veterans Affairs (VA).--With the
$176,068,336,000 provided for VA in this bill and the increase
in the number of veterans seeking VA medical services, the
Committee believes it is important to strengthen its tools to
monitor spending as well the operating procedures of the VA
workforce. The following initiatives demonstrate the
Committee's oversight focus:
VA electronic health record.--The Committee continues to
feel it is critical to closely track VA's development of its
electronic health record. In the aftermath of the DOD and VA
decision not to pursue a single integrated health record, it
becomes doubly important to ensure that the two health records
are designed in a way that permits interoperability between the
two in order that computable data from one record can be viewed
and used by clinicians with a different electronic record
system. In addition, the Committee now understands that VA is
reconsidering whether it should modernize its existing health
record or instead purchase a commercial product. Especially
with the uncertainties VA has now introduced regarding the
development, timing and cost of its electronic health record,
the Committee continues its practice of including language
requiring VA to provide information on cost, timeline,
performance benchmarks, and interoperability capacity of
whichever electronic record system it ultimately chooses before
release of the funding provided.
Disability and appeals claims.--The Committee bill
continues the aggressive monthly reporting requirements from
each specific regional office on claims processing performance
and quarterly reports on remediation efforts at the poorest
performing regional offices. As the backlog of initial benefits
claims continues to drop, the workload for the Board of
Veterans Appeals is skyrocketing. The Committee provides the
full request for the Board, $156,096,000, which is a
$46,212,000 increase, to provide the staffing power it needs to
manage appeals.
Information technology (IT).--The Committee continues to
include bill language prohibiting obligation or expenditure of
funds for information technology systems development,
modernization and enhancement until VA submits to the
Committees a certification of the amounts. The bill limits the
amount of funds that can be transferred into IT to 10 percent
of the total of either the source or destination account. The
bill contains language which permits the reprogramming of funds
among development, modernization and enhancement projects upon
prior notification to, and approval by, the Committees.
Stricter control of construction funding.--In response to
the egregious management of the Denver hospital construction
project, the Committee includes bill language to fence funding
for major construction projects over $100,000,000 in cost until
VA certifies that it has contracted with a non-VA governmental
entity to design and manage the project. Several additional
bill language provisions are included to enhance the
Committee's capacity to conduct oversight on VA's facility
construction efforts: (1) no funding greater than $5,000,000
may be reprogrammed between construction projects unless
approved by the Committees on Appropriations of both House of
Congress; (2) any change to the scope of a construction project
is prohibited without the approval of the Committees; and (3)
VA must report any bid savings of $5,000,000 or more on
projects as soon as they are identified.
Item of Special Interest
Construction contracting outreach.--Department of Defense
(DOD) and Department of Veterans Affairs (VA) construction
projects funded in this Act are, in general, executed by the
U.S. Army Corps of Engineers, the Naval Facilities Command, and
the VA Office of Construction. Effective communication and
collaboration between Federal procurement officials and the
local construction industry is essential to improve
opportunities for local contractors and businesses to compete
for local DOD and VA construction projects. But despite the
efforts of the Office of Federal Procurement Policy to increase
communication between procurement officers and industry, local
business owners often do not know about nor have the
opportunity to compete for contracts for Federally funded
construction projects. Therefore, the Secretaries of the Army
and the Navy, and the Secretary of Veterans Affairs are
directed to ensure that their respective regional/district
offices responsible for construction projects inform and engage
local construction industry contractors, especially small
businesses, minority-owned businesses, and women-owned
businesses, about Federal procurement opportunities and the
bidding process.
TITLE I
DEPARTMENT OF DEFENSE
Military Construction Overview
Fiscal year 2016 enacted level (including rescissions) $8,171,000,000
Fiscal year 2017 budget request....................... 7,444,056,000
Committee recommendation in the bill (including 7,694,000,000
rescissions).........................................
Comparison with:
Fiscal year 2016 enacted level.................... (477,000,000)
Fiscal year 2017 budget request................... 249,944,000
Military construction accounts provide funds for new
construction, construction improvements, planning and design,
and host nation support. Projects funded by these accounts
include facilities for operations, training, maintenance,
research and development, supply, medical care, and force
protection, as well as unaccompanied housing, utilities
infrastructure, and land acquisition.
Reprogramming guidelines.--The following reprogramming
guidelines apply for all military construction and family
housing projects. A project or account (including the sub-
elements of an account) which has been specifically reduced by
the Congress in acting on the budget request is considered to
be a Congressional interest item and as such, prior approval is
required. Accordingly, no reprogramming to an item specifically
reduced below the threshold by the Congress is permitted,
except that the Department of Defense may seek reprogramming
for appropriated increments.
The reprogramming criteria that apply to military
construction projects (25 percent of the funded amount or
$2,000,000, whichever is less) continue to apply to new housing
construction projects and to improvements over $2,000,000. To
provide the services the flexibility to proceed with
construction contracts without disruption or delay, the costs
associated with environmental hazard remediation such as
asbestos removal, radon abatement, lead-based paint removal or
abatement, and any other legislated environmental hazard
remediation may be excluded, if such remediation requirements
could not be reasonably anticipated at the time of the budget
submission. This exclusion applies to projects authorized in
this budget year, as well as projects authorized in prior years
for which construction has not been completed. Planning and
design costs associated with military construction and family
housing projects may also be excluded from these guidelines. In
instances where prior approval to a reprogramming request for a
project or account has been received from the Committees on
Appropriations of both Houses of Congress, the adjusted amount
approved becomes the new base for any future increase or
decrease via below-threshold reprogramming (provided that the
project or account is not a Congressional interest item as
defined above).
In addition to these guidelines, the services are directed
to adhere to the guidance for military construction
reprogramming actions and notifications, including the
pertinent statutory authorities contained in Department of
Defense Financial Management Regulation 7000.14-R and relevant
updates and policy memoranda. The Committee further encourages
the Office of the Director of National Intelligence to use a
format similar to that used by the Office of the Secretary of
Defense to submit reprogramming requests.
Facilities Sustainment, Restoration and Modernization
(FSRM).--The Department of Defense is directed to continue
describing on form 1390 the backlog of FSRM requirements at
installations with future construction projects. For troop
housing requests, form 1391 should describe any FSRM conducted
in the past two years. Likewise, future requirements for
unaccompanied housing at the corresponding installation should
be included. Additionally, the forms should include English
equivalent measurements for projects presented in metric
measurement. Rules for funding repairs of facilities under the
Operation and Maintenance accounts are described below:
(1) components of the facility may be repaired by
replacement. Such replacement can be up to current
standards or codes;
(2) interior arrangements and restorations may be
included as repair;
(3) additions, new facilities, and functional
conversions must be performed as military construction
projects. Such projects may be done concurrently with
repair projects as long as the final conjunctively
funded project is a complete and usable facility; and
(4) the appropriate service secretary shall notify
the appropriate committees 21 days prior to carrying
out any repair project with an estimated cost in excess
of $7,500,000. The Committee strongly encourages the
services and defense agencies to indicate the plant
replacement value of the facility to be repaired on
each such notification.
Quarterly summary of notifications.--The Committee directs
the services and the Office of the Secretary of Defense (on
behalf of itself and defense agencies) to continue to submit a
quarterly report listing all notifications that have been
submitted to the Committees during the preceding three-month
period.
Work in Progress or Planned (WIP) curve.--The Committee
directs the services and the Office of the Secretary of Defense
(on behalf of itself and defense agencies) to submit a WIP
curve for each project requested in a budget submission over
$100,000,000 with the 1391 justification to the congressional
defense committees.
Transfer of funds to and from the Foreign Currency
Fluctuations, Construction, Defense Account.--The Committee
directs the Department of Defense to submit a quarterly report
to the Committees on Appropriations of both Houses of Congress
on the transfer of funds from military construction and family
housing accounts to the Foreign Currency Fluctuations,
Construction, Defense account. The report shall specify the
amount transferred to the Foreign Currency account from each
military construction and/or family housing account, and all
other accounts for which an appropriation is provided in this
Act, during the preceding fiscal quarter, and the amounts
transferred from the Foreign Currency account to the above
accounts during the same period. This report shall be submitted
no later than 30 days after the close of each fiscal quarter.
In addition, the Department of Defense shall notify the
Committees on Appropriations of both Houses of Congress within
7 days of transferring any amount in excess of $10,000,000 to
or from the Foreign Currency account.
Bid savings.--The Committee has ascertained from cost
variation notices required by 10 U.S.C. 2853 that the
Department of Defense continues to have bid savings on
previously appropriated military construction projects. The
Committee's recommendation therefore includes rescissions to
the Army, Navy and Marine Corps, and Defense-Wide construction
accounts. The Committee directs the Secretary of Defense to
continue to submit 1002 reports on military construction bid
savings at the end of each fiscal quarter to the Subcommittee
on Military Construction, Veterans Affairs, and Related
Agencies of both the House and Senate.
Defense Access Roads (DAR).--The Committee is concerned
about the surface transportation infrastructure around key
military installations, especially those that handle the
important protective functions required for the President and
diplomats. The Committee strongly supports the utilization of
the DAR program to address these congestion issues. The
Committee urges the Department to examine if adjustments in
Defense Access Roads eligibility thresholds are needed for
installations that provide protective functions. Therefore, the
Department should report back to the Committee not later than
60 days after enactment of this Act on whether the DAR program
adequately addresses the needs of installations that handle
protective functions.
High performance and sustainable building requirements.--
The Committee notes that in March 2013, the Department of
Defense released Unified Facilities Criteria (UFC) 1-200-02,
High Performance and Sustainable Building Requirements. UFC 1-
200-02 defines the minimum requirements for planning, design
and construction, renovation, repair, maintenance and
operations, and equipment installation in new and existing
facilities. In a policy memorandum issued in November 2013,
military components were authorized to pursue greater energy
and water efficiency if such initiatives are shown to reduce
total ownership cost of the facility, or preserve or increase
mission effectiveness in the face of projected resource
scarcity. The Committee regrets that the Department of Defense
has done little to increase the use of innovative building
materials following the inclusion of similar language in the
report accompanying the Howard P. Buck McKeon National Defense
Authorization Act for Fiscal Year 2015, H.R. 4435. The
Committee recognizes that innovative technologies have expanded
the availability of materials with lower embodied energy for
facilities that require tall walls and large open spaces with
minimal intermediate supports. In addition, design techniques
such as advanced framing contribute to lower material costs,
increased energy efficiency, and reduced waste in facilities.
Therefore, the Committee encourages the Department of Defense
to incorporate the use of innovative renewable building
materials, systems, and design techniques that support the
requirements of UFC 1-200-02 and the goals of achieving greater
efficiency and lower environmental impacts at a lower material
cost. Furthermore, the Committee encourages the Department of
Defense to collaborate with the United States Department of
Agriculture and the United States Forest Service to advance its
understanding of innovative renewable building materials and
systems and jointly develop a plan on expanding their use as
appropriate.
Alternative building materials.--The Committee believes
that the Department of Defense (DOD) should explore other
materials for the construction of its facilities. It has come
to the Committee's attention that the use of Cross Laminated
Timber (CLT) has been used as an alternative building method to
concrete and steel construction. CLT is an applicable material
for low-rise, as well as mid-rise to high-rise construction and
has a lighter environmental footprint than traditional concrete
and steel construction systems. The advantages to using CLT are
many, but the main benefits include: shorter construction
times, fewer skilled laborers, better tolerances and quality,
safer work environment, utilization of regional, sustainable
materials, and reduction of carbon footprint of buildings.
Therefore, the Committee directs the Secretary of Defense to
study the economic viability of utilizing CLT in future DOD
facilities and determine if any fiscal year 2017 or fiscal year
2018 project could be used as a demonstration project to
accelerate the testing of CLT and report back to the Committee
not later than 60 days after enactment of this Act on its
findings.
Military Construction, Army
Fiscal year 2016 enacted level........................ $663,245,000
Fiscal year 2017 budget request....................... 503,459,000
Committee recommendation in the bill.................. 503,459,000
Comparison with:
Fiscal year 2016 enacted level.................... (159,786,000)
Fiscal year 2017 budget request................... - - -
The Committee recommendation includes a rescission of
$25,000,000 from bid savings under Administrative Provisions.
The Committee recommendation includes additional funding
for the Army in section 128 under Administrative Provisions for
projects on the Services Unfunded Priority lists as approved by
the Secretary of Defense and submitted to Congress in priority
order.
Aging army hangars for Combat Aviation Units.--The
Committee recognizes that the Army's aging hangars housing
combat aviation units are structurally deficient and do not
meet the operational requirements of the Army's Combat Aviation
Brigades. A critical need exists for the Army to modernize
infrastructure associated with operational needs, inclement
weather, personnel changes, and other unforeseen circumstances.
The Committee directs the Secretary of the Army to submit a
report to the congressional defense committees not later than
90 days after the enactment of this Act detailing the age and
condition of the Army's Combat Aviation Brigade aircraft
maintenance hangars, a prioritization of the most deficient
infrastructure assets, the plan to modernize or replace those
hangars, and the required resources.
Air traffic control facilities.--The Committee is concerned
that many of the Army's air traffic control facilities are
unsafe, antiquated, and do not provide adequate control,
communications or observation abilities for the current air
traffic levels at certain locations. For example, the current
facility located at Fort Benning will become wholly inadequate
at the current pace of operations and a replacement facility is
necessary to ensure Air Traffic Services are available to
support mission readiness and deployment platforms and the
military flying community. The Committee is concerned that this
could be a problem throughout the Army enterprise with the
recent reductions to the Department of Defense's construction
accounts. Therefore, the Secretary of the Army is directed to
conduct a risk assessment on Army air traffic control
facilities throughout the Army enterprise and develop a plan to
update these facilities. This assessment shall be submitted to
the congressional defense committees not later than 60 days
after enactment of this Act.
Military Construction, Navy and Marine Corps
Fiscal year 2016 enacted level........................ $1,669,239,000
Fiscal year 2017 budget request....................... 1,027,763,000
Committee recommendation in the bill.................. 1,021,580,000
Comparison with:
Fiscal year 2016 enacted level.................... (647,659,000)
Fiscal year 2017 budget request................... (6,183,000)
The Committee recommendation includes a rescission of
$51,848,000 from bid savings under Administrative Provisions.
The Committee recommendation includes additional funding
for the Navy and Marine Corps in section 129 under
Administrative Provisions for projects on the Services Unfunded
Priority lists as approved by the Secretary of Defense and
submitted to Congress in priority order.
Townsend Bombing Range.--The Committee is closely
monitoring the impact that the range expansion would have on
the local timber economy. The Committee is concerned that the
Department of the Navy is still failing to consider the impact
this project will have on the local community and urges the
Navy to quickly find a resolution on this issue.
F-35C Basing at MCAS Miramar.--During budget briefings the
Committee was informed by the Marine Corps that a change in
mission by the Navy to support the Pacific Commander had
occurred. The new mission requirement involved the movement of
an aircraft carrier from the East Coast to the West Coast. The
Marine Corps requested in their fiscal year 2017 budget the
hangars for the F-35B assets to be stationed on the East Coast.
Therefore, the assets to support the West Coast-based carrier
were not requested in fiscal year 2017 but planned for fiscal
year 2019 when a carrier was to be on the West Coast. The
Marine Corps provided the Committee the unfunded priorities
list for fiscal year 2017 that was approved by the Secretary of
Defense which included the assets necessary to support the West
Coast-based carrier. Therefore, Committee has provided
$193,600,000 for the Marine Corps' number 1, 2 and 3 priorities
from the Services Unfunded Priority lists as approved by the
Secretary of Defense and submitted to Congress in priority
order to support the Department of the Navy operational
requirement in the Pacific Area of Responsibility.
Military Construction, Air Force
Fiscal year 2016 enacted level........................ $1,389,185,000
Fiscal year 2017 budget request....................... 1,481,058,000
Committee recommendation in the bill.................. 1,398,758,000
Comparison with:......................................
Fiscal year 2016 enacted level.................... 9,573,000
Fiscal year 2017 budget request................... (82,300,000)
The Committee recommendation includes additional funding
for the Air Force in section 132 under Administrative
Provisions for one project on the Services Unfunded Priority
lists as approved by the Secretary of Defense and submitted to
Congress in priority order.
Air traffic control towers.--The Committee is concerned
that the Department of the Air Force's air traffic control
towers have been neglected over the years and funding for
military construction has been deferred to the out years of
budget submissions. Many of the air towers are deteriorating
and antiquated, creating significant life, safety, and health
concerns. In some cases, towers have developed extensive mold
issues and contain health risks related to the use of asbestos
and lead-based paint. Additionally, obstructed views in some
cases prevent 100 percent positive visual control of aircraft
landing and taxiing on the airfield. The Committee urges the
Department of the Air Force to prioritize funding for these
towers in a much timelier manner. The Committee believes that
these towers are valuable national security assets that the
Department of the Air Force should maintain in a manner that
will ensure their vital role in protecting U.S. national
security interests.
Conditions at expeditionary facilities.--The Committee is
concerned about reports of black mold at Al Udeid Air Base in
Qatar and the effect it is having on the health of those
serving at the Air Base. Therefore, the Air Force shall provide
a report to the congressional defense committees on the status
and way ahead to alleviate the mold issue as well as a
comprehensive remediation plan not later than 60 days after
enactment of this Act.
F-35A Aircraft Weather Shelter (SQD 2).--The Committee is
concerned that the Air Force brought numerous new starts into
the fiscal year 2017 budget submission that may prove difficult
to execute in States with limited construction time periods.
Therefore, the recommendation does not include $82,300,000 for
F-35A aircraft weather shelters for squad 2.
Offutt Air Force Base runway repair.--The Committee
understands that the Air Force is providing operation and
maintenance funding for runway repair at Offutt Air Force Base.
The Committee directs the Air Force to follow the appropriate
notification process for using operation and maintenance
funding for large repair projects and to keep the Committee
informed as to how the repair is proceeding.
Military Construction, Defense-Wide
(INCLUDING TRANSFER OF FUNDS)
Fiscal year 2016 enacted level........................ $2,242,867,000
Fiscal year 2017 budget request....................... 2,056,091,000
Committee recommendation in the bill.................. 2,024,643,000
Comparison with:......................................
Fiscal year 2016 enacted level.................... (218,224,000)
Fiscal year 2017 budget request................... (31,448,000)
The Committee recommendation includes a rescission of
$37,377,000 from bid savings under Administrative Provisions.
Transfer of funds.--The accompanying bill provides transfer
authority to the Secretary of Defense to allow the transfer of
funds to such appropriations of the Department of Defense
available for military construction or family housing as the
Secretary may designate.
National Geospatial Intelligence Agency West Campus.--The
Committee is concerned that the site selection and land
acquisition for the new National Geospatial Intelligence Agency
(NGA) West Campus Headquarters does not satisfy all existing
Federal directives regarding federal construction projects.
This includes Federal partnership, grant and contract programs
requirements; maximizing return on Federal investment and
minimizing environmental impact; and Executive Order 12072,
which states that when a Federal agency's mission is to
relocate or build a new facility, preference should be given to
an urban site that provides the greatest socioeconomic
redevelopment opportunity for the considered region. The
Committee urges the Department to follow its current guidelines
regarding federal construction projects.
The Committee is also concerned that site selection and
land acquisition has yet to take place; therefore, the bill
does not include the fiscal year 2017 request of $801,000 for
land acquisition. The Committee was informed that the cost of
the land acquisition could be as much as $15,000,000 and that
one of the potential sites would be of no cost to the agency;
therefore, the Committee directs NGA to request the full
funding for the land after site selection has occurred.
Finally, the military construction funding profile has not been
determined and does not include a utility plant or a main
office building; therefore, the Committee reduces the planning
and design request and provides $36,000,000 instead of
$71,647,000.
Special Operations Command military construction
requirements.--The Committee remains concerned about the lack
of transparency and consistency in SOCOM's process of
evaluating and accounting for the military construction
requirements for facilities writ large, including the out-
years. The Committee notes that on many bases, there may be
excess capacity as missions have relocated. However, as part of
military construction planning, SOCOM does not as a matter of
course assess the suitability of existing, non-SOCOM structures
on installations that the Command may be able to modify and use
if the structure is excess to the base commander's
requirements. At a time of shrinking military construction
budgets, and the drawdown of forces overall, this should be a
planning requirement. The Committee is further concerned about
the costing of facilities. There have been instances in which a
facility cost has increased multiple times, and by a
significant percentage, prior to award of the contract.
Therefore, the Committee directs the SOCOM Commander to report
to the congressional defense committees not later than 90 days
after enactment of this Act on the construction requirements
with respect to all SOCOM military priorities in priority
order, to include unfunded requirements, the costs of each
project, and an explanation of how the costing for each
facility is determined by the command.
Guard and Reserve Items of Interest
Enforcement of border security.--Recognizing the need to
bolster resources for the enforcement of border security, the
Committee instructs the Army National Guard and the Air
National Guard to explore public-private partnerships with
state and local governments, to design, and construct
facilities adjacent to our southwestern border that will
support National Guard activities and house and support assets
used by Customs and Border Protection and other law enforcement
agencies for the terrestrial, maritime, and aerial surveillance
of those borders, to include aircraft hangars suitable for
unmanned aerial systems, and report back to the Committee not
later than 180 days after the enactment of this Act.
Security/Access points at Air Reserve facilities.--Military
construction budget constraints are negatively affecting the
ability of the Department of Defense to address urgent
transportation requirements at certain U.S. military
installations. This includes both Security Forces Facilities
and access that are necessary for the safety and well-being of
employees, both civilian and military. The Committee is
concerned that many Reserve facilities in the Department's
inventory do not meet anti-terrorism and force protection
requirements. Furthermore, these deficiencies contribute to
traffic congestion at Reserve facilities and are serious
problems both on base and on surrounding public roads. The
Committee is concerned that the Department does not have a
coherent strategy to address the growing problem of access and
traffic congestion on Reserve installations during a time of
severe budget constraints. As a result, traffic congestion and
safety concerns on both internal base roads and public
connecting roads at growth installations are likely to
increase. Therefore, the Secretary of Defense is directed to
submit to the Committee with the fiscal year 2018 military
construction budget request the following reports: an updated
list of certified unfunded Reserve access point requirements
and list of unfunded requirements for Security Installations at
Reserve facilities. Finally, each of the Reserve Components is
further directed to submit, with the fiscal year 2018 military
construction budget request, a list of how those requirements
will be incorporated into their construction requests for
fiscal years 2018 through 2022.
Military Construction, Army National Guard
Fiscal year 2016 enacted level........................ $197,237,000
Fiscal year 2017 budget request....................... 232,930,000
Committee recommendation in the bill.................. 232,930,000
Comparison with:
Fiscal year 2016 enacted level.................... 35,693,000
Fiscal year 2017 budget request................... - - -
The Committee recommendation includes additional funding
for the Army National Guard in section 130 under Administrative
Provisions for projects on the Services Unfunded Priority lists
as approved by the Secretary of Defense and submitted to
Congress in priority order.
Military Construction, Air National Guard
Fiscal year 2016 enacted level........................ $138,738,000
Fiscal year 2017 budget request....................... 143,957,000
Committee recommendation in the bill.................. 143,957,000
Comparison with:
Fiscal year 2016 enacted level.................... 5,219,000
Fiscal year 2017 budget request................... - - -
Military Construction, Army Reserve
Fiscal year 2016 enacted level........................ $113,595,000
Fiscal year 2017 budget request....................... 68,230,000
Committee recommendation in the bill.................. 68,230,000
Comparison with:
Fiscal year 2016 enacted level.................... (45,365,000)
Fiscal year 2017 budget request................... - - -
The Committee recommendation includes additional funding
for the Army Reserve in section 131 under Administrative
Provisions for projects on the Services Unfunded Priority lists
as approved by the Secretary of Defense and submitted to
Congress in priority order.
Military Construction, Navy Reserve
Fiscal year 2016 enacted level........................ $36,078,000
Fiscal year 2017 budget request....................... 38,597,000
Committee recommendation in the bill.................. 38,597,000
Comparison with:
Fiscal year 2016 enacted level.................... 2,519,000
Fiscal year 2017 budget request................... - - -
Military Construction, Air Force Reserve
Fiscal year 2016 enacted level........................ $65,021,000
Fiscal year 2017 budget request....................... 188,950,000
Committee recommendation in the bill.................. 188,950,000
Comparison with:
Fiscal year 2016 enacted level.................... 123,929,000
Fiscal year 2017 budget request................... - - -
North Atlantic Treaty Organization Security Investment Program
Fiscal year 2016 enacted level........................ $135,000,000
Fiscal year 2017 budget request....................... 177,932,000
Committee recommendation in the bill.................. 177,932,000
Comparison with:
Fiscal year 2016 enacted level.................... 42,932,000
Fiscal year 2017 budget request................... - - -
The Committee recommendation includes a rescission of
$30,000,000 from unobligated balances under Administrative
Provisions.
The North Atlantic Treaty Organization (NATO) Security
Investment Program (NSIP) consists of annual contributions by
NATO member countries. The program finances the costs of
construction needed to support the roles of the major NATO
commands. The investments cover facilities such as airfields,
fuel pipelines and storage, harbors, communications and
information systems, radar and navigational aids, and military
headquarters, both within NATO nations and for ``out of area''
operations such as Afghanistan.
The U.S. occasionally has been forced to temporarily delay
the authorization of projects due to shortfalls in U.S.
obligation authority. The Committee directs the Secretary of
Defense to notify the Committee within 14 days of the U.S.
taking action to temporarily delay the authorization of
projects, or to temporarily withhold funds from previously
authorized projects, due to shortfalls in U.S. obligation
authority.
Family Housing Overview
Fiscal year 2016 enacted level........................ $1,404,281,000
Fiscal year 2017 budget request....................... 1,319,852,000
Committee recommendation in the bill.................. 1,319,852,000
Comparison with:
Fiscal year 2016 enacted level.................... (84,429,000)
Fiscal year 2017 budget request................... - - -
Family housing construction accounts provide funds for new
construction, construction improvements, the Federal government
costs for family housing privatization projects, and planning
and design. The operation and maintenance accounts provide
funds to pay for maintenance and repair, furnishings,
management, services, utilities, leasing, interest, mortgage
insurance, and miscellaneous expenses.
Family housing privatization progress reports.--The
Committee directs the Department of Defense to continue
submitting semi-annual progress reports on the family housing
privatization program, including a breakout of military tenant
satisfaction rates by project.
Foreign currency savings and sub-account transfers.--The
Committee directs that savings in family housing operation and
maintenance accounts from foreign currency re-estimates be used
to maintain and repair existing family housing units. The
Comptroller is directed to report to the Committees on
Appropriations of both Houses of Congress on how these savings
are allocated not later than 90 days after enactment of this
Act. In addition, the Committee directs the services and
Defense agencies to notify the Committees on Appropriations of
both Houses of Congress not later than 30 days of a transfer of
funds between sub-accounts within the family housing
construction and family housing operation and maintenance
accounts, if such transfer is in excess of 10 percent of the
funds appropriated to the sub-account to which the funds are
being transferred. Notifications to the Committees shall
indicate the sub-accounts and amounts that are being used to
source the transfer.
Leasing reporting requirements.--The Secretary of Defense
is directed to report to the Committees on Appropriations of
both Houses of Congress quarterly on the details of all new or
renewed domestic leases entered into during the previous
quarter that exceed the cost threshold set by 10 U.S.C.
2828(b)(2), including certification that less expensive housing
was not available for lease. For foreign leases, the Department
is directed to: (1) perform an economic analysis on all new
leases or lease/contract agreements where more than 25 units
are involved; (2) report the details of new or renewed lease
agreements that exceed the cost threshold set by 10 U.S.C.
2828(e)(1) 21 days prior to entering into such an agreement;
and (3) base leasing decisions on the economic analysis.
Prioritizing base housing.--The Department of Defense
should take into consideration, when prioritizing base housing
projects: the commuting times for base personnel, length of
waitlist for base housing and land available for development on
the base.
Family Housing Construction, Army
Fiscal year 2016 enacted level........................ $108,695,000
Fiscal year 2017 budget request....................... 200,735,000
Committee recommendation in the bill.................. 200,735,000
Comparison with:
Fiscal year 2016 enacted level.................... 92,040,000
Fiscal year 2017 budget request................... - - -
Family Housing Operation and Maintenance, Army
Fiscal year 2016 enacted level........................ $375,611,000
Fiscal year 2017 budget request....................... 325,995,000
Committee recommendation in the bill.................. 325,995,000
Comparison with:
Fiscal year 2016 enacted level.................... (49,616,000)
Fiscal year 2017 budget request................... - - -
Family Housing Construction, Navy and Marine Corps
Fiscal year 2016 enacted level........................ $16,541,000
Fiscal year 2017 budget request....................... 94,011,000
Committee recommendation in the bill.................. 94,011,000
Comparison with:
Fiscal year 2016 enacted level.................... 77,470,000
Fiscal year 2017 budget request................... - - -
Family Housing Operation and Maintenance, Navy and Marine Corps
Fiscal year 2016 enacted level........................ $353,036,000
Fiscal year 2017 budget request....................... 300,915,000
Committee recommendation in the bill.................. 300,915,000
Comparison with:
Fiscal year 2016 enacted level.................... (52,121,000)
Fiscal year 2017 budget request................... - - -
Family Housing Construction, Air Force
Fiscal year 2016 enacted level........................ $160,498,000
Fiscal year 2017 budget request....................... 61,352,000
Committee recommendation in the bill.................. 61,352,000
Comparison with:
Fiscal year 2016 enacted level.................... (99,146,000)
Fiscal year 2017 budget request................... - - -
Family Housing Operation and Maintenance, Air Force
Fiscal year 2016 enacted level........................ $331,232,000
Fiscal year 2017 budget request....................... 274,429,000
Committee recommendation in the bill.................. 274,429,000
Comparison with:
Fiscal year 2016 enacted level.................... (56,803,000)
Fiscal year 2017 budget request................... - - -
Family Housing Operation and Maintenance, Defense-Wide
Fiscal year 2016 enacted level........................ $58,668,000
Fiscal year 2017 budget request....................... 59,157,000
Committee recommendation in the bill.................. 59,157,000
Comparison with:
Fiscal year 2016 enacted level.................... 489,000
Fiscal year 2017 budget request................... - - -
Department of Defense Family Housing Improvement Fund
Fiscal year 2016 enacted level........................ $ - - -
Fiscal year 2017 budget request....................... 3,258,000
Committee recommendation in the bill.................. 3,258,000
Comparison with:
Fiscal year 2016 enacted level.................... 3,258,000
Fiscal year 2017 budget request................... - - -
The Department of Defense Base Closure Account
Fiscal year 2016 enacted level........................ $266,334,000
Fiscal year 2017 budget request....................... 205,237,000
Committee recommendation in the bill.................. 230,237,000
Comparison with:
Fiscal year 2016 enacted level.................... (36,097,000)
Fiscal year 2017 budget request................... 25,000,000
Accelerated clean-up.--The Committee has included
additional funding for the Army and the Navy to accelerate
environmental remediation at installations closed during
previous Base Realignment and Closure (BRAC) rounds. The
Committee recognizes that many factors hinder the cleanup of
BRAC sites. However, the Committee believes that strategic
investments can lead to quicker clean-ups and faster turnover
of DOD property to the local community. Therefore, the
Secretary of Defense should submit to the congressional defense
committees a spend plan for the additional BRAC funds not later
than 30 days after enactment of this Act.
Administrative Provisions
The bill includes 36 provisions of which 25 were in effect
in fiscal year 2016 and 11 are new provisions. The
administrative provisions included in the bill are as follows:
The bill includes section 101 prohibiting the use of funds
for payments under a cost-plus-a-fixed-fee contract for
construction where cost estimates exceed $25,000. An exception
for Alaska is provided.
The bill includes section 102 permitting the use of
construction funds for the hire of passenger motor vehicles.
The bill includes section 103 permitting funds to be
expended on the construction of defense access roads under
certain circumstances.
The bill includes section 104 prohibiting construction of
new bases in the United States without a specific
appropriation.
The bill includes section 105 limiting the use of funds for
the purchase of land or land easements that exceed 100 percent
of value except under certain conditions.
The bill includes section 106 prohibiting the use of funds
to acquire land, prepare sites, or install utilities for family
housing except housing for which funds have been appropriated.
The bill includes section 107 limiting the use of minor
construction funds to relocate any activity from one
installation to another without prior notification.
The bill includes section 108 prohibiting the procurement
of steel unless American producers, fabricators, and
manufacturers have been allowed to compete.
The bill includes section 109 prohibiting the use of funds
to pay real property taxes in foreign nations.
The bill includes section 110 prohibiting the use of funds
to initiate a new installation overseas without prior
notification.
The bill includes section 111 establishing a preference for
United States architectural and engineering services where the
services are in Japan, NATO member countries, or countries
bordering the Arabian Sea.
The bill includes section 112 establishing a preference for
United States contractors for military construction in the
United States territories and possessions in the Pacific and on
Kwajalein Atoll, or countries within the Central Command area
of responsibility, except bids by Marshallese contractors for
military construction on Kwajalein Atoll.
The bill includes section 113 requiring the Secretary of
Defense to give prior notice to Congress of military exercises
where construction costs exceed $100,000.
The bill includes section 114 allowing funds appropriated
in prior years to be used for new projects authorized during
the current session of Congress.
The bill includes section 115 allowing the use of expired
or lapsed funds to pay the cost of supervision for any project
being completed with lapsed funds.
The bill includes section 116 providing that funds for
military construction projects are available until the end of
the fourth fiscal year following the fiscal year in which funds
are appropriated, subject to certain conditions.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 117 allowing for the transfer of
funds from Family Housing Construction accounts to the
Department of Defense Family Housing Improvement Fund and funds
from Military Construction accounts to the Department of
Defense Military Unaccompanied Housing Improvement Fund.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 118 providing transfer authority
to the Homeowners Assistance Program.
The bill includes section 119 requiring that funds in this
title be the sole source of all operation and maintenance for
flag and general officer quarter houses, and limits the repair
on these quarters to $35,000 per year without notification.
The bill includes section 120 making funds in the Ford
Island Improvement Fund available until expended.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 121 allowing the transfer of
expired funds to the ``Foreign Currency Fluctuations,
Construction, Defense'' account.
The bill includes section 122 prohibiting the use of funds
to relocate a unit of the Army that would impact more than 200
personnel.
The bill includes section 123 allowing the transfer of
funds among projects and activities in accordance with the
reprogramming guidelines.
The bill includes section 124 prohibiting the use of funds
for projects at Arlington National Cemetery.
(INCLUDING RESCISSION OF FUNDS)
The bill includes section 125 rescinding funds from prior
appropriations Acts.
(INCLUDING RESCISSION OF FUNDS)
The bill includes section 126 rescinding funds from prior
appropriations Acts.
(INCLUDING RESCISSION OF FUNDS)
The bill includes section 127 rescinding funds from prior
appropriations Acts.
The bill includes section 128 providing additional funding
for Military Construction, Army.
The bill includes section 129 providing additional funding
for Military Construction, Navy and Marine Corps.
The bill includes section 130 providing additional funding
for Military Construction, Army National Guard.
The bill includes section 131 providing additional funding
for Military Construction, Army Reserve.
The bill includes section 132 providing additional funding
for Military Construction, Air Force.
(INCLUDING RESCISSION OF FUNDS)
The bill includes section 133 rescinding unobligated
balances from the fund established by Sec. 103(d) of 42 U.S.C.
3374 for expenses associated with the Homeowners Assistance
Program.
The bill includes section 134 defining the congressional
defense committees.
(INCLUDING RESCISSION OF FUNDS)
The bill includes section 135 rescinding unobligated
balances from prior appropriations Acts.
The bill includes section 136 prohibiting the use of funds
to close or realign Naval Station Guantanamo Bay. The provision
is intended to prevent the closure or realignment of the
installation out of the possession of the United States, and
maintain the Naval Station's long-standing regional security
and migrant operations missions.
The bill does not include section 121 as requested to
provide authority under a continuing resolution when an
authorization bill has been enacted to obligate funds that have
not been appropriated.
TITLE II
DEPARTMENT OF VETERANS AFFAIRS
Fiscal year 2016 enacted level\1\................... $162,671,005,000
Fiscal year 2017 budget request\1\.................. 177,545,236,000
Committee recommendation in the bill\1\............. 176,068,336,000
Comparison with:
Fiscal year 2016 enacted level.................. 13,397,331,000
Fiscal year 2017 budget request................. (1,476,900,000)
Fiscal year 2018 advance budget request\1\.......... 170,321,028,000
Fiscal year 2018 Committee recommendation in the 170,321,028,000
bill\1\............................................
\1\All funding cited excludes amounts in the Medical Care Collections
Fund.
The Department of Veterans Affairs (VA) serves
approximately 48,300,000 people or 14.8 percent of the total
estimated resident population of the U.S. and Puerto Rico:
21,700,000 veterans and 26,600,000 family members of living
veterans or survivors of deceased veterans. To serve adequately
the nation's veterans, VA employs 350,000 people, making it one
of the largest Federal agencies in terms of employment.
Veterans Benefits Administration (VBA)
COMPENSATION AND PENSIONS
(INCLUDING TRANSFER OF FUNDS)
Fiscal year 2016 enacted level........................ $76,865,545,000
Fiscal year 2017 enacted level........................ 86,083,128,000
Fiscal year 2018 advance budget request............... 90,119,449,000
Fiscal year 2018 Committee recommendation in the bill. 90,119,449,000
Comparison with:
Fiscal year 2017 enacted level.................... 4,036,321,000
Fiscal year 2017 budget request................... - - -
This appropriation will provide funds for service-connected
compensation payments to an estimated 4,832,000 veterans,
survivors, and dependents in 2017. In addition, pension
payments will be funded for 507,000 veterans and their
survivors. The average cost per compensation case for veterans
in 2017 is estimated at $16,273 and pension payments are
projected at $13,369.
The appropriation includes authority to transfer funding
not to exceed $17,224,000 in 2018 to General Operating
Expenses, Veterans Benefits Administration and Information
Technology Systems. These funds are for the administrative
expenses of implementing cost-saving provisions required by the
Omnibus Budget Reconciliation Act of 1990, Public Law 101-508,
the Veterans' Benefits Act of 1992, Public Law 102-568, and the
Veterans' Benefits Improvements Act of 1994, Public Law 103-
446. These cost-saving provisions include verifying pension
income against Internal Revenue Service (IRS) and Social
Security Administration (SSA) data; establishing a match with
the SSA to obtain verification of Social Security numbers; and
applying the VA pension cap for Medicaid-eligible single
veterans and surviving spouses alone in Medicaid-covered
nursing homes. The bill also continues to include language
permitting this appropriation to reimburse such sums as may be
earned to the Medical Care Collections Fund to help defray the
operating expenses of individual medical facilities for nursing
home care provided to pensioners.
READJUSTMENT BENEFITS
Fiscal year 2016 enacted level........................ $14,313,357,000
Fiscal year 2017 enacted level........................ 16,340,828,000
Fiscal year 2018 advance budget request............... 13,708,648,000
Fiscal year 2018 Committee recommendation in the bill. 13,708,648,000
Comparison with:
Fiscal year 2017 enacted level.................... (2,632,180,000)
Fiscal year 2018 budget request................... - - -
This appropriation finances the education and training of
veterans and servicemembers through the Post-9/11 GI Bill and
the All-Volunteer Force Educational Assistance Program.
Supplemental education benefits are also provided to certain
veteran members of the Selected Reserve and are funded through
transfers from the Department of Defense (DOD). In addition,
certain disabled veterans are provided with vocational
rehabilitation, specially adapted housing grants, and grants
for automobiles with approved adaptive equipment. This account
also finances educational assistance allowances for eligible
dependents of veterans who died from service-connected causes
or have a total and permanent service-connected disability, as
well as dependents of servicemembers who were captured or are
missing in action. More than 82 percent of the funds in the
account support the Post-9/11 GI Bill. The reduction in the
fiscal year 2018 budget request is due to the availability of
carried-over unobligated balances.
VETERANS INSURANCE AND INDEMNITIES
Fiscal year 2016 enacted level........................ $77,160,000
Fiscal year 2017 enacted level........................ 91,920,000
Fiscal year 2017 current year request................. 16,605,000
Fiscal year 2017 Committee recommendation in the bill. 16,605,000
Fiscal year 2018 advance budget request............... 107,899,000
Fiscal year 2018 Committee recommendation in the bill. 107,899,000
Comparison with:
Fiscal year 2017 enacted level.................... 15,979,000
Fiscal year 2018 budget request................... - - -
The Veterans Insurance and Indemnities appropriation is
made up of the former appropriations for military and naval
insurance, applicable to World War I veterans; national service
life insurance (NSLI), applicable to certain World War II
veterans; servicemen's indemnities, applicable to Korean
conflict veterans; and veterans mortgage life insurance,
applicable to individuals who have received a grant for
specially adapted housing.
The amount provided will enable the Department to transfer
funding to the service-disabled veterans insurance fund and
transfer additional amounts for payments for policies under the
veterans mortgage life insurance program. These policies are
identified under the Veterans Insurance and Indemnity
appropriation since they provide insurance to service-disabled
veterans unable to qualify under basic NSLI.
VETERANS HOUSING BENEFIT PROGRAM FUND
----------------------------------------------------------------------------------------------------------------
Limitation on
direct loans
Program account for specially Administrative
(indefinite) adapted housing expenses
loans
----------------------------------------------------------------------------------------------------------------
Fiscal year 2016 enacted level............................. - - - ($500,000) $164,558,000
Fiscal year 2017 budget request est........................ - - - (500,000) 198,856,000
Committee recommendation est. in the bill.................. - - - (500,000) 167,612,000
Comparison with:
Fiscal year 2016 enacted level......................... - - - - - - 3,054,000
Fiscal year 2017 budget request........................ - - - - - - (31,244,000)
----------------------------------------------------------------------------------------------------------------
The purpose of the home loan guaranty program is to
facilitate the extension of mortgage credit on favorable terms
by private lenders to eligible veterans. This appropriation
provides for all costs, with the exception of the Native
American veterans housing loan program, of the Department's
direct and guaranteed loans programs. The Federal Credit Reform
Act of 1990 requires budgetary resources to be available prior
to incurring a direct loan obligation or a loan guaranty
commitment. In addition, the bill requires all administrative
expenses of a direct or guaranteed loan program to be funded
through a program account. Loan guaranties are made to
servicemembers, veterans, reservists, and single surviving
spouses for the purchase of homes, condominiums, and
manufactured homes and for refinancing loans. The Department
guarantees part of the total loan, permitting the purchaser to
obtain a mortgage with a competitive interest rate, even
without a down payment if the lender agrees. The Department
requires that a down payment be made for a manufactured home.
With a Department guaranty, the lender is protected against
loss, up to the amount of the guaranty, if the borrower fails
to repay the loan.
The increase above fiscal year 2016 funding for
administrative expenses is directed to personal services
(staffing) cost increases. At this time, the Committee has not
approved the remainder of the requested administrative expenses
increase for fiscal year 2017 because of a lack of any
justification in the budget materials.
VA Loan Mortgage Service.--The Committee remains encouraged
that the VA Loan Mortgage Service continues to perform
favorably when compared to its commercial counterparts.
However, the Committee recognizes the ongoing need to
continually upgrade software tools that incorporate the latest
analytic, forecasting and workflow methods. Such upgrades will
further reduce the number of troubled loans still experienced
by a segment of the veteran population. Further improved
software will strengthen program accountability while
simultaneously enhancing the veteran's Loan Guaranty
experience. The Committee encourages the VA Loan Mortgage
Service to consider using a common software with embedded
analytic and forecasting tools in its upgrade.
VOCATIONAL REHABILITATION LOANS PROGRAM ACCOUNT
----------------------------------------------------------------------------------------------------------------
Limitation on Administrative
Program account direct loans expenses
----------------------------------------------------------------------------------------------------------------
Fiscal year 2016 enacted level............................. $31,000 ($2,952,000) $367,000
Fiscal year 2017 budget request............................ 36,000 (2,517,000) 389,000
Committee recommendation in the bill....................... 36,000 (2,517,000) 389,000
Comparison with:
Fiscal year 2016 enacted level......................... 5,000 (-435,000) 22,000
Fiscal year 2017 budget request........................ - - - - - - - - -
----------------------------------------------------------------------------------------------------------------
This appropriation covers the subsidy cost of direct loans
for vocational rehabilitation of eligible veterans and includes
administrative expenses necessary to carry out the direct loan
program. Loans of up to $1,210 (based on indexed chapter 31
subsistence allowance rates) are available to service-connected
disabled veterans enrolled in vocational rehabilitation
programs when the veteran is temporarily in need of additional
assistance. Repayment is made in monthly installments, without
interest, through deductions from future payments of
compensation, pension, subsistence allowance, educational
assistance allowance, or retirement pay. Most loans are repaid
in full in less than one year. The Federal Credit Reform Act of
1990 requires budgetary resources to be available prior to
incurring a direct loan obligation.
It is estimated that the Department will make 2,618 loans
in fiscal year 2017, with an average amount of $962.
NATIVE AMERICAN VETERAN HOUSING LOAN PROGRAM ACCOUNT
Administrative expenses:
Fiscal year 2016 enacted level........................ $1,134,000
Fiscal year 2017 budget request....................... 1,163,000
Committee recommendation in the bill.................. 1,163,000
Comparison with:
Fiscal year 2016 enacted level.................... 29,000
Fiscal year 2017 budget request................... - - -
The Native American Veteran Housing Loan Program, as
authorized by title 38 United States Code, chapter 37,
subchapter V, provides the Secretary with authority to make
direct housing loans to Native American veterans for the
purpose of purchasing, constructing, or improving dwellings on
trust lands. The program will not require a new subsidy
appropriation and has an unobligated indefinite subsidy
authority balance of $2,256,000.
Veterans Health Administration (VHA)
The Department operates the largest Federal medical care
delivery system in the country, with 144 hospitals, 113
domiciliary rehabilitation treatment programs, 135 nursing
homes, 300 Vet Centers, 80 mobile Vet Centers, and 755
outpatient clinics which include independent, satellite,
community-based, and rural outreach clinics. Almost 7,000,000
patients will be treated in 2017.
The Veterans Health Administration is comprised of five
accounts: Medical Services, Medical Community Care, Medical
Support and Compliance, Medical Facilities, and Medical and
Prosthetic Research. For the first four accounts, the
Administration has requested total resources for fiscal year
2018 of $66,385,032,000 in direct appropriations to fund the
four advance appropriations of the VHA. In addition, VA will
receive an estimated $2,637,000,000 in the Medical Care
Collections Fund in fiscal year 2017. The Committee also
provides $663,366,000 for medical and prosthetic research.
Medical Services
Fiscal year 2016 enacted level..................... $49,972,360,000
Fiscal year 2017 enacted level..................... 51,673,000,000
Fiscal year 2017 additional request................ 1,078,993,000
Committee 2017 additional recommendation........... 850,000,000
Fiscal year 2018 advance budget request............ 44,886,554,000
Committee 2018 recommendation in the bill.......... 44,886,554,000
Comparison with:
Fiscal year 2017 enacted level................. *(6,786,446,000)
Fiscal year 2018 budget request................ - - -
*due to establishment of the new Medical Community Care account
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. VA also
supports hospital and outpatient care through the private
sector for certain dependents and survivors of veterans under
the DOD civilian health and medical programs.
The bill includes $850,000,000 of the $1,078,993,000
current year budget request, which is in addition to the
advance appropriation that has already been provided. Within
the funds provided, the Committee expects the resources to be
used at the request level for hepatitis C, homeless programs,
the post-9/11 caregiver program, longterm care, and the
staffing costs VA must absorb as the Choice Act section 801
funds evaporate.
The Committee has included requested bill language to make
available through September 30, 2019, $1,400,000,000 of the
Medical Services appropriation for fiscal year 2018.
Funding identified in the bill is in addition to the
anticipated $5,482,975,000 for medical services from the
Veterans Choice Act in fiscal year 2017.
Uncertainties in advance appropriation requirements.--The
Committee has become accustomed to the estimating problems
inherent in providing large appropriations one year in advance.
Each year, the ``second bite at the apple'' request for
additional funding is a tell-tale sign of the shortcomings in
the advance appropriation concept. But fiscal year 2018 seems
like a watershed year for inaccuracy in estimating the advance
appropriation. The Committee has provided the full advance
request, but feels certain it is way off the mark. When
considering the consolidated estimates for VA-provided care and
the care in the community program, the budget request for the
advance appropriation is more than four billion dollars below
the equivalent program level for fiscal year 2017. Given recent
history, it is inconceivable that VA health care costs would
decline, especially with more veterans demanding more intensive
services. The budget documents reveal that the budget estimate
would require a reduction of almost 14,000 medical staff in
2018 and major cuts to programs like hepatitis C treatment and
homeless assistance. A request that assumes such cuts to staff
and services is irresponsible and is counter to the stability
that VA says it needs. The Committee will expect periodic
updates throughout the year as VA tries to generate a more
realistic estimate.
Changes in funding requirements due to modeling.--The
Committee expects VA to continue to include in the sufficiency
letter required by section 117(d) of title 38, United States
Code, that is due to the Congress on July 31 of each year, a
description of any changes exceeding $250,000,000 in funding
requirements for the Medical Services account resulting from
the spring recalculation of the Enrollee Healthcare Projection
Model.
Allocation of health funding.--The Committee continues to
be concerned that the process VA uses to allocate the health
services appropriation through the Veterans Integrated Service
Networks (VISNs) and from them to the medical centers may
shortchange the ultimate users because of excessive funding
retained at headquarters or at the VISNs. The Committee
continues to request a report each year not later than 30 days
after VA allocates the medical services appropriation to the
VISNs that identifies: (1) the amount of general purpose
funding that is allocated to each VISN; (2) the amount of
funding that is retained by central headquarters for specific
purposes, with amounts identified for each purpose; and (3) the
amount of funding that is retained by each VISN before
allocating it to the medical centers, identifying separately
the amounts retained for purposes such as network operations,
network initiatives, and emergencies.
Hepatitis C
Hepatitis C treatment initiative.--One of the Committee's
highest priorities is treatment services for veterans suffering
from Hepatitis C. The veteran population has a much higher
incidence of hepatitis C than the general population. VA
indicates that 157,000 veterans in the VA healthcare system are
potential candidates for hepatitis C treatment. Making
investments now to provide the highly effective medications
available will have profound effects in preventing liver
disease and cancer for those veterans as well as the costs
otherwise borne by VA for treating these illnesses. The VA
healthcare system is uniquely positioned to treat its hepatitis
C patients with trained clinicians and the necessary
infrastructure. VA provides the full continuum of care that
includes screening, linkage to care, adequate treatment, and
follow up. Recent reductions in the price of hepatitis C drugs
will make it possible for VA to treat as many as 1,500 new
patients per week, with possible treatment of all cases within
three years. To enable VA to reach these goals, the bill
provides $1,500,000,000 for hepatitis C treatment in fiscal
year 2017, the same amount as fiscal year 2016 and the
administration request.
Hepatitis C-related liver disease.--The Committee is
pleased that the Department leads the country in hepatitis
screening, testing, treatment, and research and requests the
Department to lead research and prevention activities for
Hepatitis C-related liver disease, cirrhosis, liver failure,
and liver cancer.
Homeless assistance
The Committee provides the full fiscal year 2017 budget
request of $1,591,365,000 for VA homeless assistance programs,
in addition to an estimated $5,643,053,000 for homeless
veterans treatment costs. These programs include the Homeless
Providers Grant and Per Diem, the Domiciliary Care for Homeless
Veterans, the Supportive Services for Low-Income Veterans and
Families, and the Department of Housing and Urban Development--
Department of Veterans Affairs Supported Housing (HUD-VASH)
programs.
Female homeless veterans.--The Committee remains committed
to helping homeless veterans and commends VA for its efforts in
reducing homelessness among the veteran population. However,
the Committee is concerned about VA's efforts to reduce
homelessness among female veterans, and particularly those with
dependent children. Dependent children often present additional
challenges to those providing resources to homeless veterans.
The Committee urges VA to work to provide equal treatment and
assistance for female veterans and veterans with children.
Additional housing options.--The Department has made great
efforts to find housing for homeless veterans and their
families. However, to date, VA has not tested the concept of
awarding grants to eligible entities to purchase and renovate
abandoned homes for homeless veterans, who would then make rent
or mortgage payments to the grantee. This approach could
provide a pathway to stable housing for veterans, as well as
address the problem of abandoned or foreclosed properties in
some communities. The Committee directs the Department to
outline what legislative changes would be required to establish
such a program on a pilot basis and the feasibility and
estimated cost of the concept. The report should be provided to
the Committee not later than 60 days after enactment of this
Act.
Related needs of homeless veterans.--While VA has made
strides in reducing veteran homelessness, its program clients
need additional support beyond shelter. The Committee remains
interested in the feasibility, advisability and cost of VA
conducting a pilot program to award grants to eligible
organizations to provide furniture, household items, and other
assistance to formerly homeless veterans who have transitioned
to permanent housing. The Committee requests a report on this
concept not later than 60 days after enactment of this Act.
HUD-VASH program.--The Committee recognizes the important
contributions the HUD-VASH program has made in reducing the
number of homeless veterans and commends VA for implementing a
case management system that keeps veterans housed longer by
providing the supportive care many of them require. The
Committee encourages VA to more creatively and collaboratively
work with local social service agencies, especially in rural
and small communities, to ensure that HUD-VASH voucher
recipients are receiving the most comprehensive services
available to them. Multiple jurisdictions around the country
are implementing their own coordinated care initiatives
alongside public housing programs, and in the interest of
maximizing public investment and providing the best, most
comprehensive care available, VA should seek to partner with
local and State governments when possible. The Committee
requests a report not later than 60 days after enactment of
this Act identifying how many HUD-VASH vouchers are given to
female veterans with children, female veterans without
children, male veterans with children, and male veterans
without children in each State. The report should also include
the number of HUD-VASH vouchers distributed to veterans in
rural, suburban, and urban areas per State.
Mental health issues
The Committee provides the full fiscal year 2017 budget
request of $7,831,890,000 for mental health programs. Of the
amounts provided for mental health programs in fiscal year
2017, $164,305,000 shall be used for suicide prevention
outreach. Of the funds provided in the fiscal year 2018 advance
appropriation, $186,128,000 shall be used for suicide
prevention outreach. The Department is directed to provide a
report to the Committee not later than 30 days after enactment
of this Act identifying a detailed expenditure plan for all
suicide outreach programs for both fiscal years.
Veterans crisis line.--In light of the alarming number of
suicides committed by veterans each day, the Committee is very
concerned by recent failures involving the Veterans Crisis Line
(VCL). As reported by the VA Inspector General (IG), some calls
directed to the VCL were not answered or sent to voicemail or
were answered by untrained volunteers, with a lack of quality
control. The Committee includes bill language requiring the
Secretary to ensure that the hotline provides immediate
assistance from a trained professional for those who call and
that the VCL adheres to all prevailing suicide counseling
provider standards. The Committee is pleased that VA has
already responded to the troubling IG report by increasing
staffing, hiring a new program manager with proven experience
running a mental health call center, establishing a larger
working space for the VCL, and enhancing training.
Suicide among female veterans.--Female veterans are six
times more likely to commit suicide than women in the general
population. This alarming trend must be addressed by the
Department without delay. The Committee directs VA to renew its
focus on improving access to mental health services for female
veterans and ensure that female mental health needs, which
often differ from male needs in prevalence and expression, are
met.
Collaboration with research universities.--The Committee
continues to encourage VA to establish collaborations with
research universities and teaching hospitals for the treatment
of and research on mental health disorders, such as
postraumatic stress disorder (PTSD) and traumatic brain injury
(TBI), to improve the psychological health of veterans and
train mental health professionals so they will understand the
unique needs of veterans. The Committee requests a report on
current VA-university partnerships on mental health research
and training not later than 90 days after enactment of this
Act.
Law enforcement liaison.--The Department is urged to
implement a program that would designate a VA liaison to work
with local law enforcement to ensure that the subsequent needs
of veterans who are considered an immediate threat to
themselves and others are addressed in a humane and respectful
manner.
Mental health provider training.--The Committee is
concerned about the impact of VA's flawed accreditation process
that excludes qualified marriage and family therapists (MFTs)
from employment at VA, unnecessarily causing vacant mental
health provider positions within the VHA system at a time when
these services are in critical need. The bill includes language
requiring that marriage and family therapists meeting certain
rigorous requirements be permitted to participate in VA
healthcare. The requirements that must be met by the MFTs are:
1) holding at least a master's degree in marriage and family
therapy, or a related field, from a regionally accredited
program; 2) being licensed as an MFT in a U.S. jurisdiction and
possessing the highest level of licensure offered from the
State, the District of Columbia, or U.S. territory in which
they are licensed; and 3) passing the Association of Marital
and Family Therapy Regulatory Board Examination in Marital and
Family Therapy (AMFTRB-EMFT) or California MFT Exam.
Clinical psychology training.--The Committee understands
that after long delay VHA is close to completing the process of
modifying its regulations to permit the training and employment
of psychologists who are graduates of the Psychological
Clinical Science Accreditation System (PCSAS), which now
accredits 29 university-based PhD clinical psychology programs.
The Committee urges VHA to complete this regulatory process to
help increase the number of mental health clinicians available
to the VA health care system.
Relationships with outside voluntary organizations.--The
Committee urges VA to continue utilizing funds to establish and
bolster existing relationships with veterans service
organizations working closely with veterans suffering mental
health issues, and to partner with organizations that work with
both male and female survivors of sexual assault.
Mental health treatments.--The Committee is deeply
concerned about the mental health of veterans and wants to
ensure that all necessary tools for healing and successfully
re-integrating into society are made available to them. One
such tool is handheld all-in-one therapeutic listening devices.
Over 200 medical studies, including several conducted within
the VA system, have found improved mental health outcomes from
using such tools, such as reduced symptoms of PTSD. The
Committee is concerned that VA's use of these devices has
decreased since their provision was shifted from the Prosthetic
and Sensory Aids Service to individual medical centers. The
Committee urges VA to emphasize to local medical centers the
utility of therapeutic listening devices as an important
component of treatment for a variety of mental health issues.
Access issues
Choice program.--The implementation of the Choice program
has been rocky, and its effect on the use of VA appropriated
funds has been very dynamic. The program started with slow
usage but attracted veterans to use the traditional VA
healthcare system for additional medical conditions. As VA
appropriated funds ran short during 2015, funds were
transferred from Choice on an emergency basis to prevent
hospital closures. Currently, VA predicts that usage of Choice
will accelerate and that Choice funding for section 801 of the
program will begin to be exhausted in fiscal year 2016, with
all Choice funds being spent by the end of fiscal year 2017.
The unfortunate consequence is that appropriated VA funding
will be required to backfill the substantial base of medical
care created by the Choice Act. For fiscal year 2017, these
additional costs to the appropriated funds included in the
request are $885,000,000, which come with no adjustment in
overall appropriated discretionary caps. The fiscal year 2018
costs related to extension of services for veterans formerly
provided by Choice will be in the billions of dollars, and
discretionary caps are not likely to accommodate such growth.
Communication problems within the Choice Program.--The
Committee is concerned about communication gaps between
contract care providers and veterans and the Choice third party
administrators. The Committee is aware of numerous complaints
from veterans and providers in some areas that they have
experienced communication issues when scheduling appointments
or resolving payment issues. Furthermore, even when veterans
are able to connect with a contract provider, referrals are not
always timely or within a reasonable geographic distance to
receive care. There have been reports of veterans receiving
questionable care and treatment from facilities to which they
were directed. To address these problems, the Committee urges
VA to work with outside contractors to hire personnel in
underserved areas to strengthen the Choice Program's provider
network based on existing and projected need.
Further expansion of Choice Program eligibility.--
Subsequent eligibility expansions of the Choice Program by VA
and by legislation have been welcome developments. These
expansions, particularly those regarding geographic distance
factors, have opened the aperture for the Choice Program and
will allow more veterans to utilize non-VA care options. The
Department is encouraged to implement these eligibility changes
to the Choice Program in an expedited manner and to consider
including travel time and total distance to a VA medical
facility, which can address the veteran's specific healthcare
needs, when determining eligibility for the Choice Program.
The Committee encourages VA to continue exploring options
to further broaden the Veterans Choice Program so that more
veterans can utilize non-VA care options when their health
circumstances warrant a waiver. Specifically, the Committee
requests the Department to consider, when approving waivers for
treatment, the veteran's ability to travel given their medical
and/or physical condition, in particular, when seeking
treatment for chemotherapy or dialysis. The Committee requests
a report not later than 90 days after enactment of this Act on
the number of instances where waiver requests submitted by
veterans were granted and/or denied.
Choice access problems in rural areas.--The Committee
remains concerned about issues with access to healthcare in
rural areas for veterans. A number of these veterans are having
difficulties with a lack of network providers in the Choice
Program. There are also concerns about access to specialized
care within a reasonable distance. The Department is instructed
to submit a report to the Committee not later than 180 days
after enactment of this Act that shows a plan of action to
address the deficiencies in access to care, both primary and
specialty, in rural areas.
Choice Act staffing increases.--The Committee requests a
report not later than 90 days after enactment of this Act that
describes the amount of Choice Act funding each VISN received
to hire additional staff; the number of staff hired; the number
of employees who left VA in the same period; and the net gain
for each of the following position categories--primary care,
specialty care physicians and medical staff--at each VA VISN.
Medical staff retention.--The Committee expects VA to
continue to report every six months on the number of medical
staff who have left the VA system, including a summary of the
principal reasons explaining their departure, and a detailed
plan of how VA will address and mitigate the principal reasons
providers leave. The report should also identify the percentage
of staff in primary care versus specialty care, and the
percentage of medical staff at each facility, who complete an
exit survey upon their departure.
Consolidation of non-VA care Programs.--The Committee is
pleased that VA has submitted to Congress a comprehensive plan
to restructure the Choice Program and consolidate it with the
myriad other non-VA care programs operated by the Department.
The Committee believes that a Choice-type model will be an
important component of providing healthcare to veterans and
encourages VA to embrace such changes.
Community health care center participation in the Choice
Program.--The Committee understands that returning warfighters
often prefer to receive care close to home and their families,
and notes the high quality services provided by community
health centers (CHCs). The Committee is pleased that some CHCs
serve veterans through the Choice program by participating as
part of local Choice networks. The Committee encourages the
third party administrators currently operating these networks
to enhance the quality of services they provide to veterans by
recruiting additional CHCs as providers.
Integration of services.--The Committee is aware of private
sector programs that effectively and efficiently leverage
information technology and data interoperability capabilities
to better coordinate and integrate health services for veterans
across care settings. The Department is encouraged to consider
the use of these private sector programs as a way to develop
service integration and data sharing; monitor protocols;
conduct performance metrics and trend analysis; and complete
predictive analytics and systems improvement.
Comparison of care between in-house VA care and the Choice
Program.--The Government Accountability Office (GAO) is
directed to submit to the Committee not later than six months
after enactment of this Act a report that evaluates from a
sample survey the quality of care for veterans with respect to
receiving correct medication, counseling, and the ability to
see specialists in a timely manner. The GAO report should
compare and contrast veterans who regularly go to a VA facility
versus those who use the Choice Program and highlight the
relative deficiencies or achievements in quality of care.
Access in outlying areas.--The Committee directs GAO to
review the staffing, outreach, scheduling, and access
management practices at the Department of Veterans Affairs
Pacific Islands Healthcare System and report to the Committee
not later than six months after enactment of this Act. The
report should include comparisons between the VA Pacific
Islands Healthcare System and VA healthcare in the continental
U.S. on the following measures: healthcare quality; patient
waiting times; follow up care appointment delays; community-
based outpatient clinic (CBOC) staffing levels and retention;
staff working environment; and outreach programs.
Shared DOD-VA medical resources.--The Committee is
concerned that veterans continue to experience delays in
accessing medical treatment in a timely fashion following the
enactment of the Choice Act. Since 2012, VA and DOD have agreed
to share resources to improve access to quality health care or
increase cost-effectiveness of the health care provided by the
Military Health System and the VHA as authorized in Section
8111 of title 38 USC and section 1104 of title 10 USC. The
Committee encourages the Secretary to direct the network
director of each of the VISNs to work with the appropriate
representative of the armed services and enter into agreements
with the military treatment facilities within their geographic
footprint, as authorized, to increase access to care for
veterans willing to be treated at those locations. Furthermore,
the Committee requests that the Secretary report to the
Committee not later than 60 days after enactment of this Act
about the plan to execute this request.
Delayed payments.--The Committee is concerned with reports
of delayed payments by VA to community care providers. Ensuring
prompt payment to these providers is essential to encouraging
their participation in an expansion of access to healthcare
outside of the traditional VA system. Accordingly, VA is
expected to comply with section 1315 of Title 5, Code of
Federal Regulations, commonly referred to as the Prompt Pay
rule. Not later than 90 days after enactment of this Act, VA is
directed to provide to the Committee a comprehensive report
detailing the reimbursements owed to outside providers in each
State. The report will also document the dollar value of
outstanding invoices more than six months overdue and the
corrective actions being implemented to address these
outstanding balances. This report should also describe the
agency's plans to correct this delayed payment problem in the
future.
Payments to veterans for emergency care.--The Committee
directs VA to report to the Committee not later than 60 days
after the enactment of this Act how VA intends to process
emergency room care payments to veterans within 60 days of
receipt of the bill.
Office of Rural Health.--The Committee provides the full
fiscal year 2017 and 2018 budget requests of $250,000,000 to
improve access and quality of care for the 3,000,000 veterans
residing in rural and highly rural areas. The Committee directs
the Office of Rural Health to submit to the Committee not later
than 30 days after enactment of this Act an operating plan for
this funding, as well as any changes to that operating plan at
the start of the fiscal year for which the funds are provided.
Caregivers in rural areas.--Recent studies have indicated
that, while there are many similarities in tasks for caregivers
of aging veterans in urban and rural areas, there are also a
number of issues and needs unique to rural caregivers. The
Department is requested to provide a report to the Committee
not later than 90 days after enactment of this Act identifying
the needs of caregivers for veterans in rural areas that may
not be addressed by existing VA assistance and outreach
programs.
Use of telemedicine.--The Committee remains concerned about
rural veterans' access to care and encourages VA to explore and
implement innovative uses of telemedicine to provide care for
rural and infirm veterans who do not have easy access to
medical facilities.
Disruption in medical facility moves.--The Committee is
concerned about past instances when VA announced plans to close
a CBOC without any publicly announced plan for alternative
facilities to serve the veterans affected. To prevent future
disruptions, the Committee directs VA to submit a written
notification to the community and to the State's Congressional
delegation 30 days before it plans to close a healthcare
facility. Such notification should identify the alternative
facility or facilities where VA plans for veterans in the area
to receive care; address distance and travel concerns that may
occur for veterans; and provide information on the type of care
available at the alternative facilities.
Access expansion.--The Committee encourages VA to identify
CBOC facilities for expansion possibilities in order to
accommodate additional patients and provide enhanced services,
particularly in rural areas. The VA is encouraged to consider
existing CBOCs which are operating at full capacity, have a
proven record of delivering services, and have community
support to expand the facility.
Women's issues
Challenges for women veterans' care.--The Committee
appreciates the progress made within the VA health care system
to address the growing needs of women veterans, but it realizes
that there is more to be done. Therefore, the Committee
requests an analysis of the challenges facing female veterans
within the VA health care system and the means within VA to
address those challenges. The report should include what VA has
accomplished and how it plans to bring more services to women.
The report should be provided not later than 90 days after
enactment of this Act.
Facility inadequacies for female VA patients.--VA
healthcare facilities are often not structured to address the
unique healthcare requirements presented by women veterans. In
many cases, facilities lack the equipment and cannot execute
the medical procedures that women expect when visiting their
healthcare providers. VA is directed to ensure that all VA
medical facilities meet VA standards to provide the specific
health care needs of female veterans.
Delivery of gender-specific care to female VA patients.--
The Committee is concerned that VA is not adequately addressing
the health needs of female veterans, including obstetrics and
gynecological care, and treatment for gender-specific
conditions and diseases, whether through direct VA or contract
care. The Committee is also concerned that VA services do not
adequately address female veterans' unique needs in the
research and treatment of PTSD. VA shall report to the
Committee not later than 60 days after enactment of this Act on
its efforts to improve the delivery of health care for female
veterans, particularly in regard to these specific disease
areas.
Female providers.--The Committee urges the Secretary to
seek to hire more female health care professionals in order to
provide female veterans greater opportunities to choose the
gender of their healthcare provider.
Women's mobile medical care.--The Committee encourages VA
to consider the provision of female veterans' healthcare
through mobile units that could operate in either rural or
urban underserved areas. These units would have the capacity to
provide preventive and primary healthcare services, education
about the availability of benefits for female veterans, and
outreach. VA is requested to provide a report to the Committee
not later than 60 days after enactment of this Act describing
how a mobile medical unit program designed for women would be
structured, whether the geographic concentration of female
veterans makes such a program feasible, areas in the country
with female veterans who currently lack access and for whom the
mobile units would be appropriate, and the likely cost of a
mobile unit program, including vehicles, equipment, staffing,
and information technology.
Prescription drug abuse
Opioid epidemic.--The Committee is concerned with the
ongoing opioid epidemic impacting the veteran community and
requests a report on the availability of treatment and wait
times for services for veterans with opioid addiction seeking
care within the VA health care system. The report should
include what VA has accomplished and how it would bring more
services to those veterans. The Committee requests that this
report be provided not later than 90 days after enactment of
this Act.
Full spectrum of treatment options for opioid abuse.--The
Committee is pleased that the Department has established and is
implementing the VA Opioid Safety Initiative and is encouraged
by the results it is producing in reducing the dependence of
veterans on prescription opioids. However, the Committee is
concerned that VA is not utilizing the full spectrum of
treatment options for dealing with opioid addiction recommended
by the Substance Abuse and Mental Health Services
Administration. The Committee encourages VA to expand the use
of medication-assisted treatment and other clinically
appropriate services to achieve and maintain abstinence from
all opioids and heroin. The Committee directs VA to submit a
report not later than 90 days after enactment of this Act on
VA's ongoing review of prescription practices and addiction
treatment protocols.
State prescription drug monitoring programs.--The Committee
notes that, with the problem of opioid use disorders escalating
among veterans, it is important that VA continue its efforts to
partner with States to ensure that they have the capacity to
exchange prescription drug information with VA. The Committee
understands that 36 States currently have installed the
technology to exchange data from their State prescription drug
monitoring boards with VA and that 12 additional States will
achieve that capacity by the end of 2016. VA is urged to assist
these remaining States to speed their exchange capacity.
Other health issues
Nursing full practice authority.--The Committee understands
that VHA will soon publish a proposed regulation to recognize
the full practice authority of advanced practice registered
nurses working at VHA. The Committee encourages VHA to seek
input from appropriate external professional stakeholders and
to give consideration to the policies of existing Handbooks,
prior to publishing the final regulation. The Committee
believes all possible outreach efforts should be used to
communicate the proposed changes, to gather public comment, and
to collaborate with Congress, stakeholders, VA medical staff,
and external organizations.
Collaboration with historically black health professions
schools.--Since 2008, the Committee has encouraged improved
collaboration between VA healthcare facilities and Historically
Black Colleges and Universities (HBCUs) health professions
schools. The Committee acknowledges the progress made but
recognizes that almost all improvements have been with smaller
CBOCs, not the larger, urban VA hospitals. Although the
Committee finally received the report on medical school
affiliations well after the 90 day deadline, VA has yet to
organize a national symposium of VA headquarters and VISN
health leaders and leaders of the HBCU health professions
schools, despite several Committee directives. Therefore, the
Secretary is directed, again, to convene a symposium where
minority collaboration concerns are discussed and addressed. A
plan for this symposium should be submitted to the Committee
not later than 60 days after enactment of this Act.
Hispanic-Serving Institution affiliations with VA health
care facilities.--The Committee continues to be concerned by
the lack of Hispanic-Serving Institutions (HSIs) medical school
participation and collaboration with local VA hospitals in
areas where HSI medical schools are located. The Committee
urges the Secretary to develop a plan to expand local VA
medical facilities' participation with HSI medical schools.
Hepatitis B virus (HBV).--The Committee is aware that: (1)
Hepatitis B is more common among veterans than in the general
population; (2) rates of testing of veteran patients fail to
meet the guidelines recommended by the medical profession; and
(3) only a fraction of those veterans who test positive receive
treatment. Hepatitis B, if left untreated, may lead to advanced
liver disease, liver cancer and the need for liver transplants,
placing a greater financial burden on the veteran health care
system. The Committee urges an aggressive and targeted outreach
program, consistent with the Centers for Disease Control and
Prevention's viral hepatitis testing and treatment
recommendations, to identify veterans with Hepatitis B and to
facilitate and encourage treatment for those identified with
the disease.
Infectious diseases screening.--The Committee applauds VHA
for developing electronic clinical reminders for recommended
HIV/AIDS and viral hepatitis screening and urges VHA to
implement these reminders in all appropriate settings. To
further improve screening rates, the Committee urges VHA to
offer support to VISNs to implement recommended screening,
including innovative strategies like point-of-care testing.
Blast injury treatment.--The nature of the current military
conflict and increasing use of improvised explosive devices has
left some servicemembers with blast injuries that include
spinal cord injury and trauma to the reproductive and urinary
tracts. The Committee is concerned about the care of these
injured servicemembers after they return home, and notes that
there is not parity between the DOD and VA treatment of
servicemembers with these injuries. In House Report 114-92, the
Committee directed VA to provide a report not later than 180
days after enactment of that Act detailing the scope and extent
of veterans facing infertility issues due to military service
during Operation Iraqi Freedom (OIF) and Operation Enduring
Freedom (OEF). The Committee expects to receive this report
within the mandated timeframe.
End of life care.--Veterans often have unique physical,
psychological and emotional needs at the end of life, including
PTSD, service-related disabilities, and other emotional and
spiritual needs. The Committee applauds VA for its efforts to
develop and/or strengthen partnerships with local hospice
organizations, increase access to hospice and palliative care
for veterans in their communities, and provide information and
resources to improve end-of-life care for veterans. The
Committee encourages the Department to continue to foster
delivery models that allow veterans to receive concurrent
hospice or palliative care while receiving active disease
treatment.
Medical opinions from non-VA health care providers.--In
order to conserve VA's resources, enable faster rating
decisions, and reduce the number of appeals, the Committee
encourages VA to accept medical opinions from non-VA health
care providers when the evidence is sufficient for rating
purposes.
Volunteer physicians.--The Committee is concerned with the
delay in required reporting on and implementation of the
Physician Ambassadors Helping Veterans Program. The pilot
program continues to remain a priority of the Committee and the
delays in implementation and reporting as required by P.L. 113-
235 are of significant concern. The Committee directs VA to
submit the required reports not later than 30 days after
enactment of this Act.
Marketing and outreach efforts.--The Committee requests VA
to submit a report not later than 90 days after enactment of
this Act identifying the range, scope and cost of its current
marketing and outreach efforts, both for traditional VA
programs and the Choice Act.
Eligibility for vet centers.--The Committee is aware of the
barriers that prohibit former members of the military from
obtaining care for service-related disabilities if they were
separated from the military in an other than honorable status.
The Committee recognizes that veterans who separated from the
armed forces in an other than honorable status may be treated
through the Vet Center Program as long as they meet the
eligibility requirements of 38 U.S.C. Section 1712A(c).
Recognizing that the provision of treatment to this population
is in the best interest of the individual, the Committee
encourages the Secretary to reach out proactively to veterans
who were separated from the armed forces in an other than
honorable status to notify them of the services they may obtain
at Vet Centers.
Caregiver program.--The Committee recognizes the value
provided to caregivers by the VA Caregiver Support program.
However, eligibility for the Caregiver Support Program extends
only to those veterans who served on or after September 11,
2001. The Committee requests that the Department provide a
report to the Committee not later than six months after
enactment of this Act which identifies: (1) the estimated
population of veterans who would be eligible for the Caregiver
Support Program, if program eligibility were made available to
veterans of all service eras; (2) estimated projections of the
number of veteran caregivers who would seek to enroll and
participate in the Caregiver Support Program, if program
eligibility were made available to veterans of all service
eras; and (3) the estimated cost and resources necessary to
incorporate all service era veterans in the Caregiver Support
Program.
VA teleradiology program.--The Committee is aware that VA
provides much of its teleradiology service through its national
program, but understands that, with the initiation of the
Choice program, VA has additional options for radiology
services through non-VA providers. The Committee requests a
report not later than 60 days after enactment of this Act
describing the agency's long-term plan to provide radiology
services, identifying the relative costs and efficiencies of
the options that have been considered relative to its final
plan.
Vaccine procurement.--The Committee encourages VA to
consider including vaccines produced through recombinant DNA
technology in addition to traditionally produced vaccines in
future solicitations to facilitate the competitive process for
all vaccine manufacturers.
Data-driven veterans prosthetic care outcomes.--The
Committee commends the Department for deploying advanced,
proven lower-limb prosthetic digital health technology to
provide real-world data documenting activity in the community
for veterans with lower limb prostheses. Accurate activity data
documenting how veterans function with their prosthetic devices
offers new opportunities to improve outcomes, increase
activity, and improve the quality of life for veterans who have
lost limbs. The Committee requests the Prosthetics and Sensory
Aids Service to provide a report not later than 120 days after
enactment of this Act detailing the location of VA medical
centers and other VA facilities where this technology is
available; the number of veterans who have utilized the
technology; and plans for making the technology more widely
available to benefit veterans with limb loss, including
possible plans to making the collection of such outcomes data
the standard of care throughout VHA.
Reporting VA care capacity for severely disabled
veterans.--The Committee encourages VA to reinstate the
reporting initially required in the Veterans Health Care
Eligibility Reform Act of 1996 on the Department's capacity to
provide for the health care needs of severely disabled
veterans, including veterans with spinal cord dysfunction,
blindness, amputations, and mental illness. This reporting
requirement should be presented by facility and by VISN. The
information will assist Congress in determining whether VA has
maintained its capacity to provide for the special and
rehabilitative needs of veterans.
Use of antimicrobial cleaning technology.--The Committee
requests VA to submit a report to the Committee not later than
180 days after enactment of this Act detailing the VA's current
use of antimicrobial cleaning agents in its facilities, the
cost of such cleaning supplies and the application process, and
the potential cost and safety benefits of utilizing
antimicrobial cleaning technology that has the ability to
reduce toxicity and remain active and effective on surfaces and
equipment over a multi-day period.
PTEN mutation awareness.--The Committee encourages VA to
ensure that screening for the phosphatase and tensin homolog
(PTEN) tumor suppression gene and its possible mutations are
included in its cancer panels, when appropriate, and that
medical staff are trained to recognize cancer genetic
syndromes, including PTEN. The Committee understands that the
mutation may pass from generation to generation, with evidence
that families of Vietnam veterans are particularly affected.
National Veterans Sport Programs.--The bill includes for
fiscal year 2017 the fiscal year 2016 level of $9,005,000 for
the Office of National Veterans Sports Programs and Special
Events.
VA Pre-Medicine Internship Program.--Pre-medicine
internships are designed to help interested individuals
understand the realities of life as a doctor. One of the common
pieces missing in applications is the experience of shadowing.
The Committee recognizes the obstacles young professionals face
in obtaining shadowing opportunities required for entrance into
many healthcare professional schools. The Committee also
understands that while VA allows shadowing there is no formal
shadowing program at VA. The Committee urges VA to explore the
feasibility of creating a system to facilitate shadowing
opportunities with VA medical professionals for individuals
pursuing advanced medical training.
Medical Community Care
Fiscal year 2018 advance appropriation request........ $9,409,118,000
Committee 2018 advance appropriation recommendation... 9,409,118,000
Comparison with:
Fiscal year 2017 enacted level.................... +$9,409,118,000
Fiscal year 2018 advance budget request........... - - -
The Medical Community Care account was created in the
Surface Transportation and Veterans Health Care Choice
Improvement Act of 2015. It is intended to consolidate all
community care programs under a single appropriation. For
fiscal year 2017, the bill finances the account through a
transfer of $7,246,181,000 from the advance-funded Medical Care
accounts. The amount transferred is equivalent to the funding
of the separate non-VA community care programs that are being
consolidated through an authorizing bill. Funding of the
account for fiscal year 2018 is provided in the bill through an
advance appropriation of $9,409,118,000, comparable to the
advance appropriations for the other Medical Care accounts. Of
the 2018 advance appropriation, $1,500,000,000 is available
until September 30, 2019.
Medical Support and Compliance
Fiscal year 2016 enacted level........................ $6,144,000,000
Fiscal year 2017 enacted level........................ 6,524,000,000
Fiscal year 2018 advance budget request............... 6,654,480,000
Committee 2018 recommendation in the bill............. 6,654,480,000
Comparison with:
Fiscal year 2017 enacted level.................... 130,480,000
Fiscal year 2018 advance budget request........... - - -
The Medical Support and Compliance appropriation funds the
expenses of management and administration of the Department's
health care system, including financial management, public
health and environmental hazard, quality and performance
management, medical inspection, human research oversight,
training programs and continuing education, security, volunteer
operations, and human resources.
The Committee has included requested bill language to make
available through September 30, 2019, $100,000,000 of the
Medical Support and Compliance appropriation for fiscal year
2018.
Funding identified in the bill is in addition to the
anticipated $16,262,000 for medical support and compliance from
the Veterans Choice Act in fiscal year 2017.
Medical Facilities
Fiscal year 2016 enacted level........................ $5,020,132,000
Fiscal year 2017 enacted level........................ 5,074,000,000
Fiscal year 2017 additional request................... 649,000,000
Committee 2017 additional recommendation.............. - - -
Fiscal year 2018 advance budget request............... 5,434,880,000
Committee 2018 recommendation in the bill............. 5,434,880,000
Comparison with:
Fiscal year 2017 enacted level.................... 360,880,000
Fiscal year 2018 advance budget request........... - - -
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, grounds
keeping, garbage, housekeeping, facility repair, and property
disposition and acquisition.
The bill does not include the current year budget request
of $649,000,000, which would be in addition to the advance
appropriation that has already been provided. If the Secretary
determines that additional fiscal year 2017 funds are required,
he can request a transfer from the other Medical Care accounts.
The Committee has included requested bill language to make
available through September 30, 2019, $250,000,000 of the
advance Medical Facilities appropriation for fiscal year 2018.
Funding identified in the bill is in addition to the
anticipated $15,512,000 for medical facilities from the
Veterans Choice Act in fiscal year 2017.
Within the funds provided for the green management program,
no funding shall be used for solar or wind projects due to
concerns about mismanagement of previous projects.
Medical imaging equipment.--The Committee remains committed
to helping VA in its efforts to ensure a timely process for VA
medical centers to receive the medical imaging equipment that
they need to take care of veterans. The Committee urges VA to
strive for a 120-day turnaround for these equipment orders. The
Committee requests that VA consider more education at
individual VA medical centers regarding high-tech medical
equipment purchasing processes and seek ways to eliminate
redundant paperwork requirements for such orders. The Committee
encourages VA to add information regarding procurement
processes in the area of high-tech medical equipment, including
support for VISN Imaging Committees, to its existing
educational opportunities. In addition, the Committee urges VA
to coordinate between capital equipment purchases, facilities
funding for site readiness, and training of staff to use the
equipment to ensure that facilities can use it as quickly as
possible after purchase.
Mechanical insulation assessments.--The Committee
acknowledges the cost savings possible through energy savings
associated with proper insulation, and encourages VA to work in
collaboration with industry partners to conduct a mechanical
insulation energy and water assessment at several
representative VA hospitals. The assessment should study the
potential for improved energy and water efficiency of the
selected medical center mechanical systems by applying
mechanical insulation in repair, replacement, or upgrade
applications. Assessment results shall be shared through a
report to the Committee not later than 60 days after enactment
of this Act.
Bakersfield outpatient clinic.--The Committee is concerned
with the lengthy period VA has taken to lease a new outpatient
clinic in Bakersfield, CA pursuant to Public Law 111-82.
Outpatient clinics greatly reduce the need for veterans to
travel long distances for care by providing reliable medical
services closer to a veteran's home. The new outpatient clinic
would replace the Bakersfield community-based outpatient clinic
and would provide expanded primary care and mental health
services while offering a range of specialty care clinics. This
project would simultaneously increase veterans' access to
healthcare locally as well as reduce the caseload at other
facilities in the VA Greater Los Angeles Healthcare System.
While VA received congressional authorization for the project
in fiscal year 2010 and has allocated funding for it, the
project has been delayed for years and is still in the
acquisition phase. The Committee urges the Department to
expedite the project in light of the urgent need for expanded
healthcare services. The Committee directs the Secretary to
report to the Committee not later than 60 days after enactment
of this Act on past actions and the future plan forward,
including the timeline for this project, and to provide
periodic progress reports to the Committee every 120 days.
These periodic progress reports shall include an explanation of
any changes to: (1) the project's status; (2) the expected cost
of the lease; and (3) the projected completion date.
Medical and Prosthetic Research
Fiscal year 2016 enacted level........................ $630,735,000
Fiscal year 2017 budget request....................... 663,366,000
Committee recommendation in the bill.................. 663,366,000
Comparison with:
Fiscal year 2016 enacted level.................... 32,631,000
Fiscal year 2017 budget request................... - - -
This appropriation provides for medical, rehabilitative,
and health services research. The bill makes this account
funding available through September 30, 2018. 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 services research program provides
unique opportunities to improve the effectiveness and
efficiency of the health care delivery system. Budgetary
resources from a number of areas, including appropriations from
the medical care accounts, reimbursements from DOD, grants from
the National Institutes of Health, private proprietary sources,
and voluntary organizations, provide support for the
Department's researchers. Estimated 2017 research resources
beyond the research account are $1,249,000,000.
PTSD research.--The National Center for Posttraumatic
Stress Disorder sets the VA agenda for research and education
on PTSD, with seven research divisions located at VA
facilities. The Center also conducts education and training,
and coordinates the VA National PTSD Brain Bank. The bill
provides up to $40,000,000 for the Center in fiscal year 2017,
compared to the budget request of $19,107,000.
The Committee recognizes the importance of the VA National
Center for PTSD in promoting better prevention, diagnoses, and
treatment of PTSD. The Committee further recognizes the
importance of this research for veterans, their family members
and those experiencing community violence. The Committee
encourages the National Center to conduct further research on
the effects of PTSD for veterans who live in communities
affected by violence, particularly in low-income areas and
communities of color.
Respiratory diseases.--The Committee notes the high rates
of respiratory diseases in returning OEF and OIF veterans, and
encourages VA to expand its research portfolio to better
understand the causes of these respiratory diseases and
potential treatment options.
Innovative treatments.--The Committee recognizes that VA
rightly provides only those medical treatments that are based
on sound clinical research results. On occasion, practitioners
and companies have brought to VA new treatments which seem
promising, but which lack clinical trial-tested results on
large groups of subjects. The Committee understands that VA has
recognized the difficulties practitioners face in gathering
enough clinical evidence to justify their treatments and is
considering developing a Center of Innovation for research
support. The Committee encourages VA to start such a Center and
suggests two possible treatments as appropriate candidates for
initial research--hyperbaric oxygen therapy and magnetic EEG/
EKG-guided resonance therapy.
The Committee understands that private clinical
studies have demonstrated that hyperbaric oxygen therapy can
provide positive results for patients suffering from PTSD and
TBI. The Committee encourages VA to begin studies through the
Center to develop evidence that would more conclusively
demonstrate the effectiveness of this treatment. Studies should
explore partnering with private clinics currently providing
hyperbaric oxygen therapy, provided that such clinics meet
appropriate standards and guidelines for the screening of
patients and provision of care.
The Committee understands that magnetic EEG/EKG-
guided resonance therapy (MeRT) has successfully treated a
number of veterans with PTSD, TBI, chronic pain, and opiate
addiction. Recent clinical trials have produced promising
results in the evolution of MeRT treatment. The Center is
encouraged to conduct research on the possible benefits of EEG/
EKG-guided resonance therapy with a larger population of
veterans suffering from PTSD, TBI, chronic pain, and opiate
addiction.
Stroke research.--The Committee understands that in the
aftermath of the closure of the VA QUERI stroke health services
research center in fiscal year 2015, VA has lacked a central
entity to focus research on the disease. The Committee
encourages VA to designate a centralized research hub for
stroke research to bring together treatment, research, and
education to support health provider competencies; identify
gaps in medical research and coordinate research efforts; and
integrate new knowledge and the latest technology--such as
adaptive software-enabled robotic exoskeleton rehabilitation
and robotic prosthetics--into stroke patient care delivery
across VA.
Exoskeleton research.--The Committee recommends that VA
investigate the possible cardiovascular, musculoskeletal, and
economic benefits of powered exoskeletons, provided by multiple
manufacturers, for spinal cord injury and stroke rehabilitation
and home/community use.
Canine therapy.--The Committee is aware that canine therapy
for treatment of PTSD and TBI symptoms is an emerging
alternative therapy to pharmaceutical treatments. While still
experimental, canine therapy has demonstrated effectiveness in
treating PTSD and other psychological disorders for psychiatric
patients, patients with substance abuse problems, and victims
of trauma. The Committee notes that canine therapy is a
promising area for further research as a complementary or
alternative treatment for the signature wounds of the wars in
Iraq and Afghanistan. The Committee continues to encourage VA
to expand its research on canine therapy to validate its
therapeutic effectiveness in the treatment of PTSD and TBI.
Sleep research.--The Committee is encouraged by the robust
VA portfolio of basic and clinical sleep research and requests
the Department to explore the linkages between sleep and
cognitive functioning in veterans.
Intergenerational effects of toxic exposures.--The
Committee understands that exposure to toxic chemicals can have
lifelong and intergenerational effects, the impacts of which
are still being determined. The Committee recognizes that the
generational effects of toxic exposure have not been
sufficiently studied to determine what conditions children and
grandchildren of exposed veterans may face. The Committee
encourages VA to continue to monitor scientific studies
regarding the effects of toxic exposure on veterans and their
family members.
Prosthetics for females.--The Committee believes that a
proportionate amount of prosthetics research should be focused
on prosthetics meant for females, based on the number of female
veterans with prostheses. The need for this type of research is
acute, as most prostheses are designed to fit male veterans.
The Committee repeats its direction that VA, in collaboration
with the Prosthetic Women's Workgroup, issue a comprehensive
report on female veteran amputees and their access to
prosthetics. This report shall be submitted to the Committee
not later than 90 days after enactment of this Act.
Colorectal cancer research.--Colorectal cancer is treatable
if detected early, yet it is the second leading cause of cancer
death in America. The National Cancer Institute estimates the
annual cost of colorectal cancer will be almost $20 billion by
2020, with Medicare and VA responsible for much of that cost.
VA has made screening patients for colorectal cancer a
priority. The Committee encourages VA to support additional
research and development in the field, including investigation
of a less costly diagnostic blood test and a stool-based
screening test.
Alzheimer's disease research.--The Committee is aware of
recent research that suggests TBI and PTSD may increase the
chances of Alzheimer's disease or related dementias.
Furthermore, the Committee is concerned by VA estimates that
the number of veterans with dementia will be as high as 218,000
in fiscal year 2017, a more than five-fold increase in the last
decade. Therefore, the Committee encourages VA to conduct
additional peer-reviewed research on Alzheimer's disease. To
the maximum extent possible, VA should target its research
activities to the milestones issued in the National Plan to
Address Alzheimer's Disease and coordinate its efforts with the
National Institutes of Health.
Antimalarial medications.--Mefloquine is an antimalarial
medication, both discovered and utilized by DOD. It is known to
have specific acute side effects such as dreams, and its use
has raised concern about possible long-term adverse health
effects. Although DOD has initiated two research studies
intended to review the potential adverse health effects of this
medication, the studies have been hampered by the poor quality
of data available on deployed troops who took the medication
and what health care they received. The Committee understands
that VA currently has a survey underway which asks veterans
about the use of antimalarial medications and symptoms
experienced, such as imbalance, dizziness or lightheadedness,
vertigo, and fatigue. The Committee requests VA to provide to
the Committee not later than 90 days after enactment of this
Act a summary of the survey results when complete and to
outline what possible research projects the survey data
suggest.
Research coordination.--The Committee recognizes the
critical gap between basic research and clinical implementation
of effective treatments for PTSD and TBI for veterans and urges
VA to share its research on neuroscience with the private
sector and consider establishing a consortium to coordinate
with private sector research efforts. If a consortium is
feasible, VA should organize public-private partners to work
together to drive collaborative and innovative research on the
neurobiology of PTSD with regard to trauma-associated genetic,
epigenetic and transcriptional mechanisms and to galvanize
efforts across basic research, translational science, and
clinical delivery of treatments for TBI.
Medical Care Collections Fund
The Department of Veterans Affairs Medical Care Collections
Fund (MCCF) was established by the Balanced Budget Act of 1997
(Public Law 105-33). The Department deposits first-party and
pharmacy co-payments, third-party insurance payments and
enhanced-use collections, long-term care co-payments,
Compensated Work Therapy Program collections, Compensation and
Pension Living Expenses Program collections, and Parking
Program fees into the MCCF. The Department uses these funds for
medical care and services to veterans. The estimate of fees
that will be collected in fiscal year 2017 is $2,637,000,000.
National Cemetery Administration
Fiscal year 2016 enacted level........................ $271,220,000
Fiscal year 2017 budget request....................... 286,193,000
Committee recommendation in the bill.................. 271,220,000
Comparison with:
Fiscal year 2016 enacted level.................... - - -
Fiscal year 2017 budget request................... (14,973)
The National Cemetery Administration was established in
accordance with Public Law 93-43, the National Cemeteries Act
of 1973. It has a fourfold mission: to provide for the
interment of, in any national cemetery with available grave
space, the remains of eligible deceased servicemembers and
discharged veterans, together with their spouses and certain
dependents, and to permanently maintain their graves; to
provide headstones for, and to mark graves of eligible persons
in national, State and tribal, and private cemeteries; to
administer the grant program for aid to States and tribal
governments in establishing, expanding, or improving State and
tribal government veterans' cemeteries; and to administer the
Presidential Memorial Certificate Program. This appropriation
will provide for the operation and maintenance of 134
operational national cemeteries, two rural National Veterans
Burial Grounds, and 33 other cemeterial installations.
The bill includes language making $26,600,000 of the total
available until September 30, 2018.
Placement of emblems of belief on headstones of unclaimed,
deceased veterans.--The Committee encourages the Secretary to
permit the placement of emblems of belief on headstones of
unclaimed, deceased veterans if reliable, recent documentation
of the veteran's beliefs can be produced (such as through dog
tags or other military identification documents).
Rural burial access.--The Committee continues to be
concerned that there are geographic pockets in the country that
would qualify for the VA rural veterans burial grounds
initiative, but which are not served because their State as a
whole does not qualify for it. Since eight percent of veterans
live in areas that do not meet the VA goal of having access to
a burial option within 75 miles of their home, the Committee
requests a report not later than 90 days after enactment of
this Act describing VA's future plans to narrow the gap of
veterans without reasonable access to burial. The Committee
encourages VA to include in its plans consideration of options
in which private entities would donate land to establish rural
cemeteries and the establishment of satellite cemeteries.
Departmental Administration
GENERAL ADMINISTRATION
(INCLUDING TRANSFER OF FUNDS)
Fiscal year 2016 enacted level........................ $336,659,000
Fiscal year 2017 budget request....................... 417,959,000
Committee recommendation in the bill.................. 336,659,000
Comparison with:
Fiscal year 2016 enacted level.................... - - -
Fiscal year 2017 budget request................... (81,300)
The General Administration account provides funds for the
Office of the Secretary, six Assistant Secretaries, and three
independent staff offices. The Committee has included bill
language to make available through September 30, 2018, up to
$10,000,000 of these funds and to permit the transfer of funds
in this account to the General Operating Expenses, Veterans
Benefits Administration account.
The bulk of the requested increase for General
Administration--$72,600,000 and 204 additional fulltime
equivalent staff--is intended for the establishment of the
Veterans Experience Office. While the Committee supports the
Secretary's efforts to improve the ways VA interacts with
veterans, it has doubts about the wisdom of establishing a
large new office with regional staffing at this late date in
the administration. The bill does not include specific funding
for this purpose.
Position vacancies.--The Committee is concerned about the
large number of vacancies among senior positions at VA medical
centers throughout the country. The Committee directs the
Secretary to develop and submit to Congress not later than 30
days after enactment of this Act a plan to: (1) hire highly
qualified medical directors for each medical center that lacks
a permanent director; (2) identify possible impediments to
staffing facilities with permanent directors; and (3) assess
the possibility of promoting and training qualified candidates
from within VA for promotion to Senior Executive Service
positions.
Delays in hiring.--The Committee is concerned about whether
the hiring and credentialing process may contribute to longer
wait times for veterans seeking healthcare. The Committee
requests a report on the average length of time to fill a
healthcare provider slot at a representative sample of medical
centers, including: the time it takes the resource board to
approve the hire of a new position; the time it takes to post
the job announcement; how long the interview process takes; and
the length of time for credentialing; as well as any internal
VA goals that exist for the time each step in the process
should take. The report should also describe how often a
healthcare provider reaches the credentialing process phase of
the process, but does not end up hired because of another
hiring opportunity outside VA. If VA does not collect this data
in a systematic way, it should report this to the Committee and
begin efforts to collect it in the future. This report should
be provided to the Committee not later than 60 days after
enactment of this Act.
VA budget office communication.--The Committee has
traditionally channeled most of its inquiries and requests for
information and assistance through the VA budget office. The
Committee reiterates its longstanding position that, while the
Committee reserves the right to call upon all VA offices, the
primary communication between the Committee and VA should
normally be through the budget office. Responses to Committee
inquiries, regardless of whether they concern funding or
policy, are to be transmitted without delay by other offices
within VA, unless otherwise requested by the Committee. In
addition, to facilitate the work of the Committee, it expects
that the Department will make available to all personal and
committee staff of Members of the Committee the same direct
contact with the budget office. The Committee also expects that
a staff member of the VA budget office will be present at every
meeting held between the chairman and ranking member of the
Full Committee and Subcommittee and the Secretary or other
senior VA officials.
Additional budgetary information.--The Committee continues
its request that items described in the fiscal year 2015 House
report 113-416 continue to be included in the budget
justifications submitted each year. These items include:
displaying a current year estimate for all accounts and for the
budget year and the advance year; providing a reimbursable FTE
summary chart for the General Administration account; providing
an FTE by grade and regional/central office totals chart for
the Information Technology Systems account; and providing the
appeals caseload information requested for the Board of
Veterans Appeals. The Committee would also like a quarterly
report identifying the total amount the Department obligates
for outreach and awareness marketing campaigns, with a
description of each campaign supported.
In addition, in an effort to improve the Committee's
understanding of the Department's mental health services
treatment programs, the Committee requests the Secretary to
include the following data in the fiscal year 2018 budget
materials:
information on mental health treatment to
include the number of veterans treated, by each type of
VA medical facility, including hospitals, nursing
homes, CBOCs, and domiciliaries; the number of visits;
number of discharges; and the average length of stay
for inpatient and residential treatment;
the annual incidence of veteran suicides
nationwide;
the number of clinical fulltime equivalent
psychiatrists, advanced practice psychiatric nurses,
psychologists, social workers providing mental health
services, mental health counselors, and marriage and
family therapists reported by setting of care or
program type; and
a diagnostic composition of patients treated
based on the health problems listed in the
International Classification of Diseases.
The Committee requests that VA return in the 2018 budget to
prior year data presentation in the budget justifications in
several areas:
The Medical Care charts shown on pages VHA-
17-23 of the fiscal year 2017 budget justification
should be disaggregated as in prior years into the four
Medical Care accounts with Choice funding for each
account shown separately within the account.
Program area highlights should be aggregated
into one area of the justification rather than being
spread throughout the justification.
Explanations of changes from the budget year
to the advance budget year should be included for the
three mandatory accounts with advance appropriations.
Quarterly financial information reports.--The bill includes
an administrative provision which continues the requirement for
submission of the quarterly financial information required in
the Military Construction, Veterans Affairs, and Related
Agencies Appropriations Act, 2016.
Staff relocations within VA.--The bill continues the
administrative provision requiring written notification 15 days
prior to organizational changes which result in the transfer of
25 or more fulltime equivalent staff from one organizational
unit of the Department to another.
Data on women and minority veterans.--The Committee
recognizes the lack of data specific to women and minority
veterans that is made available to Congress by VA. The
Committee recommends, when applicable and when data exist, that
the Secretary display information in reports submitted to
Congress identifying information separately for women veterans
and minority veterans.
Asian American representation on the Advisory Committee on
Minority Veterans.--The Committee commends the Advisory
Committee for its work over the past calendar year, and
encourages the Secretary to consider appointing, in keeping
with the demographic make-up of America's veteran community, an
additional Asian American to the Advisory Committee in the
coming year.
Small, minority- and women-owned businesses.--The Committee
directs the Department to submit a quarterly report to the
Committee on its efforts to work with small, minority- and
women-owned businesses. The report shall specify the number of
small, minority- and women-owned businesses receiving contracts
from funds appropriated under this Act, and the amount awarded
to each small, minority- and women-owned business receiving
contracts from funds appropriated under this Act.
Customer service improvements.--As part of its new focus on
improving the veteran experience with the Department, the
Committee encourages VA to review and update its customer
service policies described in documents such as the Service
Recovery section of the Veterans Health Administration Handbook
(VHA Handbook 1003.2). The most recent update to this customer
service section was in August, 2003, more than 12 years ago.
The section specifically outlines the patient communication and
service improvement standards that VA employees should be
striving to meet. The provision of VA health services has
dramatically changed since this section of the handbook was
issued, along with the agency mission priorities advocated by
the Secretary. As part of the overall agency reboot of
procedures and culture that is underway, the handbook should be
overhauled.
Public relations and communications spending.--The
Committee has heard reports of substantial VA spending on
outside contracts for public relations and communication
activities. While the Committee supports the outreach services
for which VA has used external contracts, such as public
service announcements informing veterans of available mental
health and homelessness programs, the Committee feels it needs
to maintain a level of oversight for these contract activities.
The Department is requested to provide a biannual report
identifying the number of contracts signed with external
entities for public relations and communications activities
that are over $1,000,000 in value, along with a brief summary
of the purpose of the contracts.
Fee basis claims processing.--The Committee recognizes the
need for veterans and their community care providers to have
accurate and timely processing of veteran and vendor claims for
medical services. There have been multiple problems with
processing these claims, throwing some veterans and providers
into debt collection status because of VA's failure to pay
claims promptly. The contract for the current VA Fee Basis
Claims System (FBCS) will be recompeted at the end of the year.
The Committee understands that VA plans to use this opportunity
to standardize and redesign the capabilities of the system in
anticipation of higher rates of fee basis claims, as non-VA
care programs are consolidated. The Committee requests a report
once the new contract is awarded, identifying the system's
enhanced capabilities, improved timeliness, and imbedded
standardization and security features.
Randolph-Sheppard Act.--The Committee encourages VA's
activities pertaining to the Randolph-Sheppard Act, which
creates opportunities for blind business owners, including
veterans, to operate vending facilities on Federal properties.
The Committee requests a report not later than 90 days after
enactment of this Act identifying: (1) the universe of VA
facilities subject to the Randolph-Sheppard Act requirements to
extend to State licensing agencies the opportunity to seek
space for blind vendors to conduct business; (2) the number of
licensing opportunities that have been offered to State
licensing agencies; and (3) the number of facilities that
currently have a vending operation managed by a blind
entrepreneur.
Board of Veterans Appeals
Fiscal year 2016 enacted level........................ $109,884,000
Fiscal year 2017 budget request....................... 156,096,000
Committee recommendation in the bill.................. 156,096,000
Comparison with:
Fiscal year 2016 enacted level.................... 46,212,000
Fiscal year 2017 budget request................... - - -
The bill makes $15,610,000 of this funding available
through September 30, 2018.
The Board of Veterans Appeals (BVA) is the component of VA
responsible for making final decisions on behalf of the
Secretary for the thousands of claims for veterans benefits
that are presented to BVA for appellate review. The majority of
the BVA's workload derives from the benefit claims initiated at
the VBA regional offices. The appellate process has multiple
steps, most of which occur at the local regional office level.
If a veteran is not satisfied with a regional office
determination, he or she may appeal to BVA for a final agency
decision. BVA adjudicates appeals covering all areas of
veterans benefits, but most of the workload concerns appeals
for veterans' disability compensation or pension benefits. As
the disability compensations claims backlog at VBA dwindles,
the appeals workload at the Board increases correspondingly.
Pending appeals are projected to increase by 57 percent from
66,778 at the end of 2014 to 105,012 by the end of 2016.
The bulk of the requested fiscal year 2017 increase is
targeted to increasing staffing by 242 fulltime equivalents
that are needed to adjudicate and process appeals dispositions.
The Committee appreciates the Board's comprehensive analysis of
what future steps need to be taken to manage its burgeoning
backlog of cases. The solution proposed by the Board is a
combination of a time-limited increase in staffing aligned with
significant legislation changes to limit some of the statutory
provisions that produce long delays in appeals. Although VA is
working with affected stakeholders to develop legislation that
will win the support of veterans and Congress for the needed
statutory changes, the Committee is somewhat skeptical that the
Board's proposal will prevail during the current
administration's tenure. Nevertheless, the Committee supports
the budget request as a necessary step to address the appeals
backlog within the current statutory limitations.
The bill also provides the $19,100,000 requested in the
Information Technology Systems budget to support the Appeals
Modernization initiative. The initiative will convert the
Board's largely paper-based system to an electronic one that
will be integrated with the Veterans Benefits Management System
that is used to process initial disability claims.
GENERAL OPERATING EXPENSES, VETERANS BENEFITS ADMINISTRATION
Fiscal year 2016 enacted level........................ $2,707,734,000
Fiscal year 2017 budget request....................... 2,826,160,000
Committee recommendation in the bill.................. 2,826,160,000
Comparison with:
Fiscal year 2016 enacted level.................... 118,426,000
Fiscal year 2017 budget request................... - - -
The General Operating Expenses, Veterans Benefits
Administration (VBA) account provides funding for VBA to
administer entitlement programs such as service-connected
disability compensation, education benefits, and vocational
rehabilitation services.
The bill makes available through September 30, 2018, up to
$141,000,000 of these funds.
The Committee provides $2,826,160,000 for the General
Operating Expenses, VBA account. Despite the funding
constraints faced by the Committee, the Committee believes that
one of its top priorities must be to support the activities in
this request. The bill supports the full request of $26,695,000
for the centralized mail initiative to consolidate inbound
paper mail from the regional offices to a centralized intake
site and $152,924,000, $10,000,000 above the request, for the
Veterans Claims Intake Program (VCIP) to scan paper claims and
convert them into digital format. The Committee provides the
full request ($37,356,000 from VBA and $143,000,000 from IT)
for the Veterans Benefits Management System (VBMS), the
paperless claims processing system. VBMS allows VBA to
centrally manage the claims workload at the national level and
direct cases electronically across its network of regional
offices to match claims demand with available processing
capacity. Lastly, the bill provides $19,100,000 in IT for the
Board of Veterans Appeals modernization initiative to convert
its largely paper-based process to an automated, integrated
system.
Claims backlog.--VA has no greater responsibility than
ensuring veterans and their survivors receive timely, accurate
decisions on their disability compensation and pension claims.
For many years, too many veterans have waited too long to
receive their benefits. While the backlog has dropped
dramatically, the Committee directs the Department to continue
its efforts to address the remaining backlog of disability
benefit claims and develop and incorporate new information
technology and customer service enhancements to put VA on a
path to reach a functional zero backlog by the end of 2016. The
Committee further urges VA to continue to develop methods by
which it can work closely with DOD, the IRS, the SSA, and other
Federal partners to identify electronic data-sharing
opportunities and process reforms to streamline workflows and
limit paper claims filing.
Performance reporting.--The Committee directs VA to
continue the specific reporting requirements on claims
processing performance and backlog first identified in House
Report 113-416 and incorporated into section 229 of the
Military Construction, Veterans Affairs, and Related Agencies
Appropriations Act, 2016.
Claims processing deficiencies.--The Committee continues to
be concerned with the backlog at the Oakland, California VA
regional office (VARO). According to the January 2016, VA
Office of Inspector General report, the Oakland VARO continues
to have delays in processing informal claims and a number of
veterans whose claims were not processed in a timely manner
faced significant delays in benefit payments. The Committee
encourages the Oakland VARO Director to conduct a complete
review of all remaining claims that may be informal and ensure
adequate training for Oakland VARO staff on processing informal
claims. VBA is requested to submit a report not later than 30
days after the end of calendar year 2016 outlining the number
of claims received and processed at the Oakland regional office
in 2016; the accuracy scores for those claims; the average time
to complete a claim; employee scores on speed and quality of
rating; the amount and type of employee training that was
conducted; and the amount of overtime that was used.
Staffing levels.--The Committee appreciates the efforts by
VBA to reduce the disability compensation claims backlog.
However, the Committee urges VBA to reevaluate its staffing
levels at the regional office level and increase staff at a
rate similar to increases in claims receipts to help better
meet the needs of veterans.
Appeals claims processing.--The Committee has provided the
full request for VBA activities, including VBA activities at
the initiation of an appeal. It is essential that the growing
backlog in veteran appeals claims be addressed by VA. VBA has
neglected its share of responsibility for the first stage of
appeals of veteran claims in its effort to reduce the initial
disability claims backlog and has lost sight of the appeals
process.
The Committee directs VBA to provide veterans with a
thorough explanation of the analysis and information used to
deny an initial claim when issuing its notification letter.
Population diversity.--The Committee recognizes the
diversity of the veteran population. Currently, VA recognizes
many special groups of veterans and tailors the delivery of
earned benefits and services to ensure that the particular
needs of these groups are met. The preferences of millennial
veterans pose specific challenges to the Department as it seeks
to fulfill its mission. The Committee encourages VA to
recognize millennial veterans as a special group within the
veteran population and to establish a panel of millennial
veterans to provide advice and insight to the Secretary into
Department efforts, with additional emphasis on military-to-
civilian transition and retraining opportunities.
Administrative relief.--House Report 114-92 urged the
Secretary to continue to grant or extend equitable relief to
eligible veterans initially deemed eligible in instances of
administrative error. In addition, the report also directed the
Secretary to provide a report containing a statement as to the
disposition of each case recommended to the Secretary for
equitable relief under 38 U.S.C. 503 for each preceding year.
The Committee expects this report to be submitted on time and
looks forward to the Equitable Relief report and a resolution
on this issue.
Access in underserved areas.--The Committee urges VBA to
increase its presence and outreach to veterans living in remote
and underserved areas such as the Commonwealth of the Northern
Mariana Islands by sending VBA staff to areas beyond the VA
offices every 3 to 4 months, especially areas where veterans
are unable to travel by car or ferry to reach a VBA office.
Veterans living in these areas, particularly elderly and
disabled veterans who may have difficulty accessing VBA
services via the internet or phone, should have an opportunity
to speak, in-person, with VBA staff.
Military sexual assault (MST) claims.--The Committee
understands VBA is developing and implementing new training
initiatives and procedures for PTSD claims related to military
sexual trauma. The Committee is pleased with the increased
focus on this area and encourages VA to continue to build on
the strides that have been made, including intensive training
and identifying specialized claims employees for MST-related
claims. The Committee also directs VA to conduct veteran
outreach initiatives and publicize benefits veterans may be
entitled to as a result of MST. In addition, the Committee
recognizes that MST affects both female and male veterans and
encourages VA to continue its efforts to provide equal
treatment and assistance for both female and male veterans.
Transition to civilian jobs.--The Committee is aware of
efforts such as the Transition Assistance Program to help
servicemembers transition to civilian life. The Committee is
concerned about continued obstacles that veterans face in
transitioning to the civilian workforce, including to the
Federal workforce. The Committee strongly supports greater
coordination between Federal agencies to ensure that veterans
can successfully transition to the civilian workforce,
including through the facilitation of the licenses and
credentials to translate skills and training from the military
to civilian sector jobs.
Alternative use of education benefits.--With approximately
one million veterans settling into American communities in the
next three to five years, the Committee believes that it is
important to find innovative ways to support veterans in their
professional development. The Post-9/11 GI Bill provides post-
secondary education as the principal option for veterans when
they return. However, this may not meet the need of every
veteran, as each individual possesses unique skill sets and
experiences from their time in service that may be better
suited to pursuing a career as a business owner. Therefore, the
Committee encourages VA to work closely with the Small Business
Administration (SBA) to further improve entrepreneurial
opportunities for veterans. The Committee requests a report
from VA analyzing the feasibility of using Post-9/11 GI Bill
benefits for business capital formation for qualified veterans,
in consultation with the SBA's recommendations. This report
shall be due to the Committee not later than 90 days after
enactment of this Act.
Transition to law enforcement jobs.--The Committee is aware
of national and State-level recruitment efforts to help
veterans transition from military service to careers in
civilian law enforcement. The Committee requests that the
Secretary submit a report not later than 90 days after
enactment of this Act on the type of training and transition
assistance veterans receive to transition from military service
to law enforcement.
Intermediate care technician positions.--The Committee
encourages VA to establish veterans education connection
centers at VA medical centers, such as the one established at
the Louis Stokes Veterans Administration Medical Center (VAMC)
in Cleveland, Ohio. The Committee is pleased with VA's decision
to expand the number of intermediate care technician (ICT)
positions at VAMCs, since this program has the ability to
augment staffing by utilizing the military training, knowledge,
skills and experience of former DOD medics and corpsmen and
Coast Guard corpsmen. The Committee requests VA to report on
the impact analysis of the ICT program to guide possible future
expansion. This analysis should include the impact of the ICT
role on costs, access, and patient satisfaction, and innovative
ways clinics are using ICTs to improve the coordination of
patient care, particularly in the home healthcare arena. This
report shall be submitted to the Committee not later than 180
days after enactment of this Act.
Reducing fraud against veterans.--The Committee notes that
only agents or attorneys who have met all qualifications and
standards prescribed by VA are allowed to charge a reasonable
fee to assist a veteran in filing a claim or appeal with VA.
The Committee is concerned that financial predators across the
country are targeting veterans, offering to help with their
cases and charging very high fees, and providing them with
little or no assistance. The Committee recommends that the
Secretary be more aggressive in referring for criminal
prosecution individuals and entities that defraud a veteran of
benefits in order to discourage financial predators from
continuing to target and defraud veterans.
State and county veteran service officers receiving access
to VA records.--The Committee encourages the Secretary to work
with State and county Veteran Service Officers to explore
options for allowing authorized Veteran Service Officers ``read
only'' access to VBMS records for the purpose of identifying
individuals who may be eligible for State or local benefits in
addition to Federal VA benefits.
Service records loss through fire.--The 1973 fire at the
National Personnel Records Center in Overland, Missouri
destroyed millions of military service records. This loss has
created numerous challenges for some veterans and has prevented
them from accessing the benefits and decorations they have
earned through their service. While VA has an established
process for veterans affected by this fire, the coordination
between VA and DOD could be improved. The Committee urges the
two Departments to create a clear, coordinated plan to improve
the process to address the issue of proving military service
when a veteran's official service record has been lost or
destroyed while in possession of the Federal government.
INFORMATION TECHNOLOGY SYSTEMS
(INCLUDING TRANSFER OF FUNDS)
Fiscal year 2016 enacted level........................ $4,133,363,000
Fiscal year 2017 budget request....................... 4,278,259,000
Committee recommendation in the bill.................. 4,220,869,000
Comparison with:
Fiscal year 2016 enacted level.................... 87,506,000
Fiscal year 2017 budget request................... (57,390,000)
The Information Technology Systems account supports
information technology (IT) services such as systems
development and performance, operations and maintenance,
information protection, and customer support. The program
permits the effective and efficient delivery of veterans'
healthcare services and benefits programs.
Within the account total, the Committee allocates in bill
language $1,247,548,000 for pay and associated costs, which is
$25,000,000 below the budget request; $2,502,052,000 for
operations and maintenance, which is $32,390,000 below the
request; and $471,269,000 for development, modernization, and
enhancement, which is the same as the request. The bill makes
available $36,300,000 of pay and associated costs and
$177,900,000 of operations and maintenance funds until
September 30, 2018. All development, modernization, and
enhancement funds are available until September 30, 2018.
Although funding constraints require the Committee to
provide a funding level below the request, the level provided
includes a $87,506,000, or a 2.1 percent, increase over fiscal
year 2016, which will permit investment in high priority areas.
The Committee identifies in particular as high priorities:
$143,000,000 for the Veterans Benefits Management System (in
addition to $37,356,000 which is provided for VBMS in the
General Operating Expenses, Veterans Benefits Administration
account); $19,100,000 for the Board of Veterans Appeals
modernization effort; $20,000,000 for Section 508 compliance
efforts; $168,113,000 for VistA Evolution, the modernization of
the electronic health record (EHR); and $91,761,000 for
interoperability and Virtual Lifetime Electronic Record (VLER)
health.
The Committee has had a longtime interest in assuring that
DOD and VA health records for servicemembers and veterans can
be exchanged electronically so that doctors across the street
or across the world will be able to learn the patient's health
history. While disappointed that DOD and VA chose to develop
two different health record systems, the Committee has been
reassured by both agencies that the records will be fully
interoperable. Committee members were startled to learn during
the recent hearing with the Secretary that VA is rethinking the
approach it previously chose (to modernize its VistA electronic
health record) and is now considering other options, including
purchasing a commercial off-the-shelf product. The Committee is
concerned about what implications this detour will have on the
completion time for the project (previously promised for 2018),
its cost, and the usability of the VistA modernization products
already completed.
Consistent with previous appropriations bills, the
Committee includes language to fence a portion of the funding
provided for the electronic health record until VA provides
requested information listed in the bill language. The
Committee believes this fencing language is especially
important as VA changes direction on development of the
electronic health record. The language requires VA to: (1)
demonstrate it has met the interoperability required in the
2014 National Defense Authorization Act by December 31, 2016;
(2) provide the business case for VistA Evolution that is
guiding VA's considerations; (3) provide a strategic plan,
lifecycle cost estimate and master schedule for any system
chosen; and (4) describe the implementation plan for the
transition from the Project Management Accountability System
(PMAS) to its new project delivery framework, the Veteran-
focused Integration Process (VIP). The bill language fences the
$168,113,000 of funds requested for VistA Evolution until these
conditions are met, but does not restrict the funding provided
for interoperability or VLER Health.
An administrative provision limits the funding for the
electronic health record provided by the Veterans Health
Administration to $40,000,000 from the Medical Support and
Compliance account.
The Committee continues to include bill language
prohibiting obligation or expenditure of funds for information
technology systems development, modernization and enhancement
until VA submits to the Committees a certification of the
amounts. In addition, the Committee continues bill language
permitting the transfer of funding among the three subaccounts
upon approval of the Committees. The bill contains language
which allows for the reprogramming of funds among development,
modernization and enhancement projects upon prior notification
to, and approval by, the Committees. The bill continues to
include language indicating that funds for development,
modernization and enhancement are available only for the
projects and in the amounts specified in the report
accompanying the Act.
The chart below reflects the Administration's budget
request for development projects and includes the Committee's
recommendation for each. This chart will serve as the
Department's approved list of development projects, and all
requested changes are subject to the reprogramming guidelines
as outlined in the accompanying Act.
Information Technology Development Projects
[in thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Committee
Project Budget Request Recommendation
----------------------------------------------------------------------------------------------------------------
Electronic Health Record Interoperability and VLER Health..... 17,322 17,322
VistA Evolution............................................... 63,339 63,339
Veterans Benefits Management System (VBMS).................... 85,288 85,288
Virtual Lifetime Electronic Record (VLER)..................... 17,857 17,857
Veteran Customer Experience................................... 73,624 73,624
VHA Research IT Support Development........................... 15,066 15,066
Other IT Systems Development.................................. 198,773 198,773
-------------------------------------------------
Total All Development..................................... 471,269 471,269
----------------------------------------------------------------------------------------------------------------
The Committee expects the Office of Information Technology
to continue to provide an IT expenditure report to the
Committees on Appropriations on a monthly basis. This report
shall include a comparison to the project costs included in the
development, modernization, and enhancement project funding
chart included in the House report, and provide an explanation
for any differences in excess of $1,000,000.
Security concerns.--The Committee continues to be concerned
about the protection of veterans' personal and medical data. As
such, within six months of enactment of this Act, the Committee
requests the Department to submit a report on VA's use of
cybersecurity best practices as it applies to datacenter
security and mobile device management. This includes, but is
not limited to: data center perimeter security, segmentation to
improve lateral security within a data center or network,
mobile device management protocols, and security protocols and
identity management for remote access to data and applications.
The Department should also identify measures taken to
effectively contain and minimize a breach if it occurs.
Appointment scheduling system.--The Committee is frustrated
that VA has spent years attempting to modernize its appointment
scheduling system, investing in two systems and ultimately
abandoning them. The consequence of these failures has been
abundantly clear in the past several years as many VA
facilities were found to be manipulating scheduling systems and
failing to provide timely service to veterans. The Committee
understands that VA is again considering how to modernize and
standardize scheduling. The Department is directed to submit a
report to the Committee not later than 30 days after enactment
of this Act describing what alternatives VA has considered,
including promising private sector practices, what
functionalities a new system requires, and the anticipated
timeframe for installation of a new system nationwide. The
Department is encouraged to consider private sector scheduling
solutions that may include trained patient care managers and
strategies that have worked in other settings and develop a
pilot of feasible options.
OFFICE OF INSPECTOR GENERAL (OIG)
Fiscal year 2016 enacted level........................ $136,766,000
Fiscal year 2017 budget request....................... 160,106,000
Committee recommendation in the bill.................. 160,106,000
Comparison with:
Fiscal year 2016 enacted level.................... 23,340,000
Fiscal year 2017 budget request................... - - -
The OIG was established by the Inspector General Act of
1978 and is responsible for the audit, investigation, and
inspection of all VA programs and operations. The overall
operational objective is to focus available resources on areas
which would help improve services to veterans and their
beneficiaries, assist managers of Department programs to
operate economically in accomplishing program goals, and to
prevent and deter recurring and potential fraud, waste, and
inefficiencies.
The bill makes $14,800,000 of this funding available until
September 30, 2018.
The funding increase provided in the bill above the fiscal
year 2016 level is targeted to the OIG's increasing workload,
as it investigates myriad allegations of possible misconduct,
poor patient care, and claims processing inaccuracies. The
Committee understands the additional funding will be used to
hire 100 fulltime positions at both new and existing locations
nationwide, especially in areas in the southern and western
tiers of the country and areas where there is currently no
permanent OIG presence and a growing veteran population.
Transparency.--Due to recent accounts alleging unjustified
delays in release of reports pertaining to patient wait times
and criminal investigations to the general public, the
Committee believes that all reports prepared by the IG should
be released publicly within 30 days of completion. The OIG
could be perceived as biased by the public, and its
effectiveness undermined, when its actions do not fully support
transparency.
CONSTRUCTION, MAJOR PROJECTS
Fiscal year 2016 enacted level........................ $1,243,800,000
Fiscal year 2017 budget request....................... 528,110,000
Committee recommendation in the bill.................. 528,110,000
Comparison with:
Fiscal year 2016 enacted level.................... (715,690,000)
Fiscal year 2017 budget request................... - - -
The Construction, Major Projects appropriation provides for
constructing, altering, extending, and improving any of the
facilities under the jurisdiction of or for the use of VA,
including planning, architectural and engineering services,
assessments, and site acquisition where the estimated cost of a
project is $10,000,000 or more.
The Committee recommendation makes all but $33,800,000 of
these funds available for a five-year period.
Continuing the practice first established in fiscal year
2016, the bill restricts the availability of funding for major
construction projects costing more than $100,000,000 until VA
certifies it has signed an agreement with an appropriate non-VA
government entity to serve as the design and/or construction
agent for the project. For fiscal year 2017, two major
construction projects above the $100,000,000 threshold are
funded, with restricted funds totaling $222,620,000. Within the
account, the bill also provides $49,490,000 for the contract
fees for the outside agent chosen for the projects. The
Committee has taken this action in hopes that the gross
mismanagement of the Denver, Colorado VA hospital project will
never recur.
The bill funds the following items as requested in the
budget submission:
Construction, Major Projects
[in thousands of dollars]
------------------------------------------------------------------------
Location Description Funding
------------------------------------------------------------------------
VHA:
Long Beach, CA.............. Seismic 30,200
Corrections--Menta
l Health and Comm.
Living Center.
Reno, NV.................... Upgrade seismic, 192,420
safety, utilities,
and expand
clinical services.
Advance planning and design. Various Stations... 65,000
Major Construction Staff.... Various Stations... 24,000
Claims Analysis............. Various Stations... 5,000
Hazardous Waste............. Various Stations... 10,000
Judgment Fund............... Various Stations... 9,000
Non-Dept. Fed Entity Project Various Stations... 49,490
Management Support.
---------------------------------------
Total VHA............... ................... 385,110
National Cemetery Admin. (NCA):
Elmira, NY.................. New National 36,000
Cemetery--Western
NY.
Las Animas, CO.............. New National 36,000
Cemetery--Southern
CO.
Jacksonville, FL............ Gravesite Expansion 24,000
South Florida, FL........... Gravesite Expansion 31,000
Advance Planning and Design Various Stations... 10,000
Fund.
---------------------------------------
Total, NCA.............. ................... 137,000
Gen. Admin/Staff Offices:
Dept APDF for Major......... ................... 6,000
Total, Staff Offices.... ................... 6,000
=======================================
Major Construction ................... 528,110
Total.
------------------------------------------------------------------------
To enhance the Committee's capacity to conduct oversight on
VA's facility construction efforts, several administrative
provisions are continued in the bill: (1) no funding amount
greater than $5,000,000 may be reprogrammed between
construction projects unless approved by the Committees on
Appropriations of both House of Congress; (2) any change to the
scope of a construction project is not permitted without the
approval of the Committees; and (3) VA must report any bid
savings of $5,000,000 or more on projects as soon as they are
identified.
Budget justification materials.--The Committee was
disappointed that VA did not comply with the fiscal year 2016
conference report directive about additional information to be
included in the fiscal year 2017 VA budget justification
documents describing its major construction project requests.
The Committee expects that the fiscal year 2018 justifications
will include the information described in the 2016 conference
report.
Alternative financing.--The Committee is concerned about
meeting the need for access to high quality veterans health
care facilities, including in rural areas where access to
facilities, including clinics and hospitals, is more limited.
The Committee is pleased that VA is considering the creative
use of public-private partnerships to meet this need and that
the agency has developed the following criteria for possible
projects: (1) Congress has provided partial funding; (2) VA has
identified a need for the project through its long-range
capital planning process by listing the project on its
Strategic Capital Investment Planning (SCIP) priority list; and
(3) the local community has agreed to provide not less than 25
percent of construction costs. The Committee requests that VA
provide a list of facilities that meet these criteria and
provide it to the Committee not later than 30 days after
enactment of this Act. Such alternative financing mechanisms
could be an important corollary to the increasing use of
Medical Community Care in the future.
Research infrastructure.--The Committee notes the Final
Report on VA Research Infrastructure, completed in 2012,
documented significant deficiencies in VA research laboratories
across the VA system. The Committee is pleased the VA Office of
Research and Development is reviewing the status of those
deficiencies and looks forward to receiving updated reports on
each VISN as they are completed. The Committee urges VA to
allocate the appropriate resources needed to address the
remaining deficiencies identified in the reports.
Training for VA personnel engaged in facility management.--
The Committee continues to be concerned about the lack of
training and certification provided to engineering,
construction and facility management staff with regard to
building operations and maintenance. A recent GAO report found
that VA has not provided clear guidance to personnel regarding
required training from either the Engineering or Construction
and Facility Management Divisions. Therefore, the Committee
requests a report not later than 90 days after enactment of
this Act about the number of personnel trained and certified in
compliance with the Federal Buildings Personnel Training Act
and the actions VA is taking to demonstrate clear guidance on
training requirements for facility managers, building
engineers, operations and maintenance staff.
Use of the Treasury judgment fund.--In the past several
years, VA has had significant disputes with general contractors
managing its major construction projects. In some cases, the
claims disputes have had to be resolved with payments from the
Department of Treasury Judgment Fund. The Committee requests
the OIG to review VA's claims and settlement practices relating
to payment of contractors for major medical construction
projects and the Department's reimbursement of Treasury's
Judgment Fund and submit a report not later than 60 days after
enactment of this Act. The report should include VA's total
required reimbursements to the Judgment Fund, the construction
projects for which the settlements were required, and whether
VA has fully reimbursed the Judgment Fund for all VA claims
paid through the Fund.
Construction Oversight.--The Committee is aware that
commercial off-the-shelf building information modeling systems
are routinely used in the private sector to manage the design
and construction of large-scale facilities. These models have
been proven to facilitate the delivery of large-scale
construction projects ahead of schedule with significant
savings. Therefore, the Committee encourages VA to examine if a
fully competitive acquisition and implementation of commercial
off-the-shelf building information modeling systems could be
used to improve the timeliness and cost of VA medical
facilities. The Committee requests a report not later than 60
days after enactment of this Act that describes: (1) how a
model project delivery system would be tailored to VA
construction needs at one or more projects included in the
Strategic Capital Investment Plan (SCIP); (2) the acquisition
of commercial building information modeling tools necessary to
produce or utilize high fidelity project information; and (3)
project management, reporting, and implementation support for
VA construction projects during design, construction, and
operations using 3D models to identify and mitigate cost,
schedule, or technical risk and to better manage engineering
change orders.
CONSTRUCTION, MINOR PROJECTS
Fiscal year 2016 enacted level........................ $406,200,000
Fiscal year 2017 budget request....................... 372,069,000
Committee recommendation in the bill.................. 372,069,000
Comparison with:
Fiscal year 2016 enacted level.................... (34,131,000)
Fiscal year 2017 budget request................... - - -
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.
As with the Major Construction account, the Committee
recommendation makes these funds available for a five-year
period.
Funding identified in the bill is in addition to the
anticipated $115,830,000 for minor construction from the
Veterans Choice Act in fiscal year 2017.
Mobile surgical units.--In P.L 114-113, the Consolidated
and Further Continuing Appropriations Act of 2015, Congress
directed VHA to establish two pilot projects at VA medical
centers designed to gauge the cost-savings and clinical
benefits of using mobile surgical units to cover for operating
rooms taken out of service for repair or refurbishment. The
Committee urges VHA to expedite selection of two pilot projects
and report to the Committee not later than 90 days after
enactment of this Act about the status and preliminary results
of the pilots.
GRANTS FOR CONSTRUCTION OF STATE EXTENDED CARE FACILITIES
Fiscal year 2016 enacted level........................ $120,000,000
Fiscal year 2017 budget request....................... 80,000,000
Committee recommendation in the bill.................. 80,000,000
Comparison with:
Fiscal year 2016 enacted level.................... (40,000,000)
Fiscal year 2017 budget request................... - - -
This appropriation 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. The bill
makes this funding available until expended.
GRANTS FOR CONSTRUCTION OF VETERANS CEMETERIES
Fiscal year 2016 enacted level........................ $46,000,000
Fiscal year 2017 budget request....................... 45,000,000
Committee recommendation in the bill.................. 45,000,000
Comparison with:
Fiscal year 2016 enacted level.................... (1,000,000)
Fiscal year 2017 budget request................... - - -
This program provides grants to assist States and tribal
governments with the establishment, expansion, and improvement
of veterans cemeteries which are operated and permanently
maintained by the States and tribal governments. Grants under
this program fund up to 100 percent of construction costs and
the initial equipment expenses when the cemetery is
established. The States and tribal governments 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. The bill makes this funding available until
expended.
Public-private partnerships.--In order to provide a burial
option to those veterans who may not have reasonable access to
a national cemetery or State cemetery, the Committee encourages
VA to prioritize funding under the State Veterans Cemetery
Grant program for the establishment of veterans cemeteries in
rural and highly rural areas. Additionally, States and local
governments are encouraged to utilize public-private
partnerships that are currently available to help defray the
cost of operation and maintenance of a State veterans cemetery.
Administrative Provisions
The bill includes 38 administrative provisions, 32 of which
were included in the fiscal year 2016 bill and six of which are
new.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 201 allowing for the transfer of
funds among three mandatory appropriations. The Administration
proposal to modify this provision is not adopted.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 202 allowing the Department to
transfer funding among the four medical appropriations accounts
in fiscal year 2017. The Administration proposal to modify this
provision is not adopted.
The bill includes section 203 allowing for salaries and
expenses funds to be used for hire of passenger vehicles, lease
of facilities or land, and purchase of uniforms.
The bill includes section 204 providing that only funding
in ``Construction, Major Projects'' and ``Construction, Minor
Projects'' can be used for the purchase of any site for any new
hospital or home or to construct any new hospital or home.
The bill includes section 205 requiring the Department to
be reimbursed for medical services it provides to any person
not defined as a beneficiary to ensure the Department is
receiving payment for all medical services provided.
The bill includes section 206 allowing for the use of funds
appropriated in fiscal year 2017 for ``Compensation and
Pensions'', ``Readjustment Benefits'', and ``Veterans Insurance
and Indemnities'' for payment of accrued obligations recorded
in the last quarter of fiscal year 2016.
The bill includes section 207 allowing for the use of
fiscal year 2017 funds to pay prior year obligations resulting
from implementation of sections 3328(a), 3334, and 3712(a) of
title 31, United States Code.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 208 allowing the Department to
use surplus earnings from the national service life insurance,
U.S. Government life insurance, and veterans special life
insurance program to administer these programs.
The bill includes section 209 allowing the Department to
obligate enhanced-use lease proceeds for administrative
expenses that were incurred in a prior fiscal year during the
year funds are received.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 210 limiting the amount of
reimbursement the Office of Resolution Management and the
Office of Employment Discrimination Complaint Adjudication can
charge other offices and accounts of the Department for
services provided.
The bill includes section 211 requiring the Department to
collect current and accurate third-party reimbursement
information for the purposes of third-party insurance
collections. If persons receiving care or medical services do
not disclose this information, the Department is allowed to
bill them reasonable charges for services provided.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 212 allowing the Department to
use enhanced-use lease funds for construction and alteration of
medical facilities.
The bill includes section 213 allowing the Department to
use the Medical Services appropriation for expenses related to
the broader mission of medical care to veterans.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 214 allowing the Department to
transfer Medical Care Collections to the ``Medical Services''
and ``Medical Community Care'' accounts to be used for veterans
medical care and makes those funds available until expended.
The bill includes section 215 allowing veterans who reside
in Alaska to obtain medical services from medical facilities
supported by the Indian Health Service or tribal organizations,
and provides for reimbursement for those services from VA.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 216 allowing the Department to
transfer the proceeds received from the transfer of real
property deposited into the VA Capital Asset Fund to the major
and minor construction appropriations accounts and makes those
funds available until expended.
The bill includes section 217 providing that no funds may
be used to prohibit Directors of the VISNs from conducting
outreach or marketing programs. The Administration proposed to
delete this provision.
The bill includes section 218 requiring the Secretary to
submit quarterly reports to the Committees on Appropriations of
both Houses of Congress on the financial status of the Veterans
Health Administration. The Administration proposed to delete
this provision.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 219 prohibiting the Department
from transferring more than ten percent of the total
Information Technology appropriation to or from the Information
Technology account and requires the Department to receive
approval from the Committees on Appropriations before such
transfer. The Administration proposal to modify this provision
is not adopted.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 220 permitting the transfer of
$274,731,000 appropriated for medical accounts, minor
construction, and information technology systems to the Joint
Department of Defense-Department of Veterans Affairs Medical
Facility Demonstration Fund for the operation of facilities
designated as combined Federal medical facilities.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 221 permitting the transfer of
$280,802,000 of fiscal year 2018 advance funding appropriated
for medical accounts to the Joint Department of Defense-
Department of Veterans Affairs Medical Facility Demonstration
Fund for the operation of facilities designated as combined
Federal medical facilities.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 222 permitting the transfer of
funds deposited in the Medical Care Collections Fund to the
Joint Medical Facility Demonstration Fund for facilities
designated as combined Federal medical facilities.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 223 directing that a minimum of
$15,000,000 shall be transferred from the four medical care
appropriations to the Department of Defense/Department of
Veterans Affairs Health Care Sharing Incentive Fund, to be
available until expended.
The bill includes section 224 requiring the Secretary to
notify the Committees on Appropriations of both Houses of
Congress of all bid savings when identified in Major
Construction projects that total at least $5,000,000 or 5
percent of the programmed amount of the project. The
Administration proposal to delete this provision is not
adopted.
The bill includes section 225 prohibiting the original
scope of work for a Major Construction project from being
increased above the scope specified for that project in the
original justification data provided to the Congress unless
approved by the Committees. The budget request proposed to
delete this provision.
The bill includes section 226 identifying the maximum
funding that may be obligated for VHA VistA Evolution and
electronic health record interoperability activities. The
budget request proposed to delete this provision.
The bill includes section 227 requiring advance written
notification to the Committees on Appropriations of both Houses
of Congress 15 days prior to organizational changes which
result in the transfer of 25 or more full-time equivalent staff
from one organizational unit to another. The budget request
proposed to delete this provision.
The bill includes section 228 requiring the Secretary to
provide on a quarterly basis to the Committees on
Appropriations of both Houses of Congress notification of any
single national outreach and awareness marketing campaign in
which obligations exceed $2,000,000. The budget request
proposed to delete this provision.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 229 permitting the transfer to
``Medical Services'' from any discretionary program except
``General Operating Expenses, Veterans Benefits
Administration'' upon approval of both Appropriations
Committees. This provision is intended to give VA flexibility
as it administers the changes to its traditional health care
program and the Choice Act. The budget request to modify this
provision is not adopted.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 230 permitting the transfer of
funds between the ``Board of Veterans Appeals'' and ``General
Operating Expenses, Veterans Benefits Administration'' upon
approval of both Appropriations Committees. The budget request
to modify this provision is not adopted.
The bill includes section 231 prohibiting the reprogramming
of funds exceeding $5,000,000 among the major construction
projects unless both Appropriations Committees approve the
request. The budget request proposed to delete this provision.
(RESCISSION OF FUNDS)
The bill includes section 232 rescinding $30,000,000 of
unobligated balances within the ``DOD-VA Health Care Sharing
Incentive Fund''.
(RESCISSIONS OF FUNDS)
The bill includes section 233 which rescinds Medical Care
advance funding and section 234 which reduces funding in
current year-funded accounts to incorporate assumed absorption
of the proposed 1.6 percent payraise. The Department has
authority to use whatever appropriated funds are available to
support the payraise if it chooses to do so.
The bill includes section 235 requiring the Secretary to
ensure that the toll-free suicide hotline provides immediate
assistance from a trained professional and adheres to all
requirements of the American Association of Suicidology.
The bill includes section 236 requiring the Secretary to
treat a marriage and family therapist as qualified to serve in
VA if the therapist meets certain educational and licensing
requirements.
The bill includes section 237 directing that none of the
funds in the Act may be used to pay a performance award under
section 5384 of title 5, United States Code.
The bill includes section 238 prohibiting the use of funds
to end or relocate hospital-based services of a VA healthcare
facility that is the subject of an environmental impact
statement; designated as a National Historic Landmark by the
National Park Service; and located in a highly rural area.
The bill does not include section 224 as requested to
provide additional transfer authority to the Secretary of
Veterans Affairs.
TITLE III
RELATED AGENCIES
American Battle Monuments Commission
SALARIES AND EXPENSES
The recommendation includes $75,100,000 for Salaries and
Expenses of the American Battle Monuments Commission (ABMC), as
requested.
The Committee notes that ABMC was provided with $30,000,000
in the Fiscal Year 2016 Appropriations Act to support large,
planned projects such as the Manila Visitor Center, adequate
and appropriate security at ABMC sites, significant repairs and
refurbishing, and interpretive work supporting the World War I
centennial. The Committee approves the spend plan for these
funds provided by the Secretary and requires regular updates on
the progress of the projects and a report on obligation of the
funds.
The Committee recognizes the critical work of ABMC to
preserve commemorative and historical sites, and to educate the
public about the United States Armed Forces. The Committee
further recognizes the critical role that African Americans and
other minorities played during World War II. The Committee
urges the ABMC to partner with Department of Defense historians
to ensure that these servicemembers and support staff are
properly recognized at ABMC sites. Further, the Committee
directs the ABMC to appropriately incorporate the contributions
that African Americans and other minorities made into ABMC's
interpretive exhibits and on the ABMC website.
FOREIGN CURRENCY FLUCTUATIONS ACCOUNT
The recommendation includes such sums as necessary for the
Foreign Currency Fluctuations Account. It is not expected that
additional funds will be required for fiscal year 2017 due to
favorable exchange rates.
United States Court of Appeals for Veterans Claims
SALARIES AND EXPENSES
The recommendation includes $30,945,000 for Salaries and
Expenses for the United States Court of Appeals for Veterans
Claims, as requested.
Department of Defense--Civil Cemeterial Expenses, Army
SALARIES AND EXPENSES
The agreement provides $70,800,000 for Salaries and
Expenses for Arlington National Cemetery (ANC), as requested.
The Committee appreciates ANC's emphasis on acquisition
improvements, including training, certification and workforce
hiring, to improve procurement and accountability. The
Committee notes that $8,716,000 was provided in the Fiscal Year
2016 Appropriations Act to address deferred maintenance and
infrastructure repairs at Arlington National Cemetery and a
spend plan for use of those funds was required within 30 days
of enactment. The spend plan has not been officially submitted
and therefore the Committee repeats the requirement so that it
can determine if the plan is acceptable.
Armed Forces Retirement Home Trust Fund
The recommendation includes $64,300,000 for the Armed
Forces Retirement Home (AFRH), which is the same as the total
amount requested, although $22,000,000 of the total is provided
from a different source than requested. The Committee notes
that there are major challenges for the near and long-term
sustainability of the Trust Fund, which was created to provide
all resources required for operations and expenses of the two
AFRH locations. The Trust Fund is replenished from a variety of
sources, including fines and forfeitures and Active Duty
Withholding. However, the largest source of funds, which is
derived from fines and forfeitures, is diminishing. Annual
outlays for the Fund have exceeded revenues since 2011, and in
November 2015 the Department of Defense and AFRH officials
informed the Committee that, counter to the assumptions in the
fiscal year 2016 budget request, the Trust Fund balances were
not sufficient to support the expenses of AFRH; therefore, the
Fund was projected to be insolvent by April 2016. As an
emergency measure to assure solvency for AFRH, in the Fiscal
Year 2016 Appropriations Act, AFRH was provided with
$20,000,000 from the General Fund.
Although AFRH and the Department of Defense (DOD) were
directed by Congress to develop an approach that will replenish
the Trust Fund in a sustainable, reliable manner and to present
that approach to the Congress in the President's Request for
fiscal year 2017, along with legislative proposals, the
Administration did not do so. Instead, the budget request for
AFRH for Fiscal Year 2017 includes an indefinite transfer from
the Department of Defense Operations and Maintenance account,
which the Committee does not support. AFRH's budget request
notes that DOD has commissioned a study of AFRH operations to
include benchmarking and potential legislative changes to
revise AFRH's funding model. The Committee requests further
information from DOD regarding the study, including a report on
its cost, scope of work, deliverables, and timeline not later
than 60 days after enactment of this Act.
The Committee again asserts that the use of the General
Fund is a not a long-term solution, and AFRH is directed to
work with DOD to develop an alternative during fiscal year
2017, to be included in the fiscal year 2018 budget request. In
addition, AFRH is directed to report quarterly to the Committee
on the Trust Fund balance, receipts and expenditures, and the
progress of its efforts to lease property at the Washington,
D.C. facility, starting not later than 30 days after enactment
of this Act.
Administrative Provisions
The bill includes two provisions that were in effect in
fiscal year 2016. The administrative provisions included in the
bill are as follows:
The bill includes section 301 permitting Arlington National
Cemetery to provide funds to Arlington County to relocate a
water main.
The bill includes section 302 permitting funds from
concessions at Army National Military Cemeteries to be used to
support activities at the Cemeteries.
TITLE IV
OVERSEAS CONTINGENCY OPERATIONS
Department of Defense
Fiscal year 2016 enacted level........................ $- - -
Fiscal year 2017 budget request....................... 172,449,000
Committee recommendation in the bill.................. 172,000,000
Comparison with:
Fiscal year 2016 enacted level.................... 172,000,000
Fiscal year 2017 budget request................... (449,000)
The Committee recommendation includes Overseas Contingency
Operations for military construction projects, unspecified
minor construction and planning and design related to the
Global War on Terrorism, Counter-Terrorism Support, and
European Reassurance Initiative projects as requested in the
fiscal year 2017 Overseas Contingency Operations budget
request.
Planning and Design.--The Committee is providing the
planning and design as requested. However, the Committee
directs that any future planning and design funds in fiscal
year 2018 and beyond are to be requested as part of the base
request. The Committee further directs the Secretary of Defense
to submit 10 U.S.C. 2807 notifications to the congressional
defense committees prior to obligation of the funds.
Unspecified Minor Construction.--The Committee is providing
the $5,000,000 as requested by the Joint Staff in Military
Construction Defense-Wide. The Committee directs the Chief of
the Joint Staff to submit to the congressional defense
committees a spend plan for the $5,000,000 and 10 U.S.C. 2805
notifications prior to obligation of any of the funds.
Counter-Terrorism support.--The Committee is providing the
$8,551,000 within Military Construction, Air Force for planning
and design of an undetermined project in the Levant. The
Committee is concerned that requesting funding for an
undetermined project, as well as inadequate planning and design
of three percent of the expected total cost rather than ten
percent, is not an appropriate practice by the Department of
Defense. The Committee therefore directs the Department of
Defense to provide a spend plan for the $8,551,000 and 10
U.S.C. 2807 notifications prior to obligation of any of the
funds.
Overseas Contingency Operations Future Year Defense
Program.--The Committee is concerned that funding requested for
Overseas Contingency Operations (OCO) does not follow the same
process as the Department of Defense (DOD) process for
planning, programming, budgeting and execution of funds
required to support military operations, readiness,
infrastructure and military force modernization. Further, the
projects requested as part of OCO do not have the associated
planning and design or future year defense program. Therefore,
the Committee directs the Secretary of Defense to provide to
the congressional defense committee a future year defense
program for OCO projects beginning with fiscal year 2015 and
each subsequent year in which military construction funds have
been or are to be requested in an OCO budget submission not
later than 60 days after enactment of this Act.
Military Construction, Army
The Committee recommendation includes $18,900,000 for Army
military construction planning and design for a European
Reassurance Initiative project.
Military Construction, Navy and Marine Corps
The Committee recommendation includes $59,809,000 for Navy
and Marine Corps military construction and planning and design
for Overseas Contingency Operations and European Reassurance
Initiative projects.
Military Construction, Air Force
The Committee recommendation includes $88,291,000 for Air
Force military construction and planning and design for
Overseas Contingency Operations, Counter-Terrorism, and
European Reassurance Initiative projects.
Military Construction, Defense-Wide
The Committee recommendation includes $5,000,000 for
Defense-Wide unspecified minor construction for the Joint Staff
for the European Reassurance Initiative.
TITLE V
GENERAL PROVISIONS
The bill includes 14 provisions--12 provisions that are
effective in fiscal year 2016 and two new provisions as
follows:
The bill includes section 501 prohibiting the obligation of
funds beyond the current fiscal year unless expressly so
provided.
The bill includes section 502 prohibiting the use of funds
for programs, projects or activities not in compliance with
Federal law relating to risk assessment, the protection of
private property rights, or unfunded mandates.
The bill includes section 503 encouraging all departments
and agencies funded in this Act to expand the use of ``E-
Commerce'' technologies and procedures.
The bill includes section 504 specifying the Congressional
committees that are to receive all reports and notifications.
The bill includes section 505 prohibiting the transfer of
funds to any instrumentality of the United States Government
without authority from an appropriations Act.
The bill includes section 506 prohibiting any funds in this
Act to be used for a project or program named for an individual
serving as a Member, Delegate, or Resident Commissioner of the
United States House of Representatives.
The bill includes section 507 requiring all reports
submitted to the Congress to be posted on official websites of
the submitting agency.
The bill includes section 508 prohibiting the use of funds
to establish or maintain a computer network unless such network
blocks the viewing, downloading, and exchanging of pornography,
except for law enforcement investigation, prosecution or
adjudication activities.
The bill includes section 509 prohibiting the use of funds
for payment of first-class travel by an employee of the
executive branch.
The bill includes section 510 prohibiting the use of funds
in this Act for any contract where the contractor has not
complied with E-Verify requirements.
The bill includes section 511 prohibiting the use of funds
in this Act by the Department of Defense or the Department of
Veterans Affairs for the purchase or lease of a new vehicle
except in accordance with Presidential Memorandum--Federal
Fleet Performance, dated May 24, 2011.
The bill includes section 512 prohibiting the use of funds
in this Act for the renovation, expansion, or construction of
any facility in the United States, its territories or
possessions, for the purpose of housing any individual who has
been detained at the United States Naval Station, Guantanamo
Bay, Cuba.
The bill includes a new provision, section 513, to allow
unobligated balances of amounts appropriated for the Ebola
outbreak to be available to prevent, prepare for, and respond
to the Zika virus.
The bill includes a new provision, section 514 establishing
a ``Spending Reduction Account'' in the bill.
House of Representatives Report Requirements
The following items are included in accordance with various
requirements of the Rules of the House of Representatives.
Statement of General Performance Goals and Objectives
Pursuant to clause 3(c)(4) of rule XIII of the Rules of the
House of Representatives, the following is a statement of
general performance goals and objectives for which this measure
authorizes funding:
The Committee on Appropriations considers program
performance, including a program's success in developing and
attaining outcome-related goals and objectives, in developing
funding recommendations.
RESCISSIONS
Pursuant to clause 3(f)(2) of rule XIII of the Rules of the
House of Representatives, the following table lists the
rescissions in the accompanying bill:
Department/Activity
AMOUNTS RECOMMENDED FOR RESCISSION
Department of Defense, Military Construction, Army 25,000,000
(Sec. 125)...........................................
Department of Defense, Military Construction, Navy and 51,848,000
Marine Corps (Sec. 126)..............................
Department of Defense, Defense-Wide (Sec. 127)........ 37,377,000
42 USC 3374 (Sec. 133)................................ 25,000,000
NATO Security Investment Program (Sec. 135)........... 30,000,000
DOD-VA Health Care Sharing Incentive Fund (Sec. 232).. 30,000,000
Department of Veterans Affairs, Medical Services (Sec. 266,760,000
233).................................................
Department of Veterans Affairs, Medical Support and 52,031,000
Compliance (Sec. 233)................................
Department of Veterans Affairs, Medical Facilities 18,591,000
(Sec. 233)...........................................
Transfer of Funds
Pursuant to clause 3(f)(2) of rule XIII of the Rules of the
House of Representatives, the following statements are
submitted describing the transfer of funds provided in the
accompanying bill.
Language is included to allow for the transfer of funds
from Family Housing, Construction accounts to the Department of
Defense Family Housing Improvement Fund and funds from Military
Construction accounts to the Department of Defense Military
Unaccompanied Housing Improvement Fund.
Language is included to provide transfer authority from the
BRAC account to the Homeowners Assistance Program.
Language is included to allow the transfer of expired funds
to the ``Foreign Currency Fluctuations, Construction, Defense''
account.
Language is included to transfer not to exceed $17,224,000
in fiscal year 2018 from Compensation and Pensions to General
Operating Expenses, Veterans Benefits Administration and
Information Technology Systems. These funds are for the
administrative costs of implementing cost-savings proposals
required by the Omnibus Budget Reconciliation Act of 1990 and
the Veterans' Benefits Act of 1992. Language is also included
transferring funds to the medical care collections fund to
augment funding of medical facilities for nursing home care
provided to pensioners.
Language is included to permit the transfer of funds from
General Administration to General Operating Expenses, Veterans
Benefits Administration.
Language is included to permit $7,246,181,000 to be derived
from the Medical Care accounts to become available for Medical
Community Care for fiscal year 2017.
Language is included to permit the transfer of funds
between Information Technology Systems development projects and
among the three sub-accounts identified in bill language
subject to the approval of the Committee.
Language is included to provide authority for the
Department of Veterans Affairs for any funds appropriated in
2017 for Compensation and Pensions, Readjustment Benefits, and
Veterans Insurance and Indemnities to be transferred among
those three accounts.
Language is included to transfer funds among the Medical
Services, Medical Support and Compliance, and Medical
Facilities accounts.
Language is included to permit the funds from three life
insurance funds to be transferred to General Operating
Expenses, Veterans Benefits Administration and Information
Technology Systems for the costs of administering such
programs.
Language is included to permit up to $51,200,000 to be
transferred to General Administration and Information
Technology Systems from any funds appropriated in fiscal year
2017 to reimburse the Office of Resolution Management and the
Office of Employment Discrimination Complaint Adjudication for
services provided.
Language is included to transfer certain funds derived from
enhanced-use leasing activities to the Construction, Major
Projects and Construction, Minor Projects accounts.
Language is included to transfer funds from the Medical
Care Collections Fund to the Medical Services account.
Language is included to allow the transfer of funds from
the Capital Asset Fund to the Construction, Major Projects and
Construction, Minor Projects accounts.
Language is included to allow the transfer of funds from
various accounts to the Information Technology Systems account
in an aggregate amount not to exceed ten percent of the account
appropriation, subject to approval by the Committee.
Language is included to allow the transfer of funds in
fiscal years 2017 and 2018 provided for the Department of
Veterans Affairs to the Joint Department of Defense-Department
of Veterans Affairs Medical Facility Demonstration Fund.
Language is included permitting funds deposited to the
Medical Care Collections Fund for health care provided at a
combined Federal medical facility to be transferred to the
Joint Department of Defense-Department of Veterans Affairs
Medical Facility Demonstration Fund.
Language is included under the Department of Veterans
Affairs that would transfer no less than $15,000,000 for the
DOD/VA Health Care Sharing Incentive Fund as authorized by
section 8111(d) of title 38, United States Code.
Language is included that permits the transfer from all
discretionary accounts except General Operating Expenses,
Veterans Benefits Administration, to Medical Services, subject
to approval by the Committee.
Language is included that permits transfer of funds between
General Operating Expenses, Veterans Benefits Administration
and the Board of Veterans Appeals, subject to approval by the
Committee.
Disclosure of Earmarks and Congressionally Directed Spending Items
Neither the bill nor the report contains any Congressional
earmarks, limited tax benefits, or limited tariff benefits as
defined in clause 9 of rule XXI.
Changes in Application of Existing Law
Pursuant to clause 3(f)(1)(A) of rule XIII of the Rules of
the House of Representatives, the following statements are
submitted describing the effect of provisions in the
accompanying bill that directly or indirectly change the
application of existing law.
Language is included in various parts of the bill to
continue on-going activities that require annual authorization
or additional legislation, which to date have not been enacted.
Language is included in various parts of the bill to place
limitations on the use of funds in the bill or change existing
limitations and which might, under some circumstances, be
construed as changing the application of existing law.
Language is included in various parts of the bill to allow
the Secretary of Defense to exceed certain limitations upon
notification to the Committee.
Language is included in various parts of the bill to allow
funding to be used for official reception and representation
expenses.
Language is included in various parts of the bill to enable
various appropriations to remain available for more than one
year for some programs for which the basic authority
legislation does not presently authorize such extended
availability.
Language is included in various parts of the bill to permit
the transfer of funds to other accounts.
Language is included under Title I to prohibit payments for
cost-plus-a-fixed-fee contracts under certain circumstances.
Language is included in various parts of the bill to allow
funds to be used for the hire of passenger motor vehicles.
Language is included under Title I to allow advances to the
Federal Highway Administration, Department of Transportation
under certain circumstances.
Language is included under Title I to prohibit the use of
funds to begin construction of new bases without specific
appropriations.
Language is included under Title I to prohibit the use of
funds for purchase of land or land easements under certain
circumstances.
Language is included under Title I to prohibit the use of
funds for land acquisition, site preparation, and utility
installation for family housing unless funds have been made
available in annual appropriations Acts.
Language is included under Title I to prohibit the use of
minor construction funds to transfer an activity between
installations without prior notification.
Language is included under Title I to prohibit the use of
funds for the procurement of steel for any activity if American
steel producers have been denied the opportunity to compete for
such steel procurements.
Language is included under Title I to prohibit the use of
funds to pay real property taxes in any foreign nation.
Language is included under Title I to prohibit the use of
funds to initiate a new installation overseas without prior
notification.
Language is included under Title I to limit the use of
funds for architect and engineer contracts under certain
circumstances.
Language is included under Title I to limit the use of
funds for awarding contracts to foreign contractors under
certain circumstances.
Language is included under Title I to require the
Department of Defense to notify the appropriate committees of
Congress of any proposed military exercises under certain
circumstances.
Language is included under Title I to allow prior year
construction funding to be available for currently authorized
projects.
Language is included under Title I to allow payment for the
cost associated with supervision, inspection, overhead,
engineering and design on family housing or military
construction projects that are being completed with expired or
lapsed funds.
Language is included under Title I to allow funds to be
expended on military construction projects for four fiscal
years after enactment under certain circumstances.
Language is included under Title I to allow construction
funds to be transferred to Housing Improvement Funds.
Language is included under Title I to allow for the
transfer of BRAC funds to the Homeowners Assistance Program.
Language is included under Title I to limit funds for the
operation and maintenance of family housing to those provided
in this appropriation and to limit amounts expended on repairs
of general and flag officer quarters under certain
circumstances.
Language is included under Title I to allow funds in the
Ford Island Improvement Account to be available until expended
for certain purposes.
Language is included under Title I to allow for the
transfer of expired funding to the Foreign Currency Fluctuation
Account under certain circumstances.
Language is included under Title I limiting movement of an
Army unit with a testing mission.
Language is included under Title I to allow for transfer of
funds among projects and activities in accordance with
reprogramming guidelines.
Language is included under Title I to prohibit funds to be
used for projects at Arlington Cemetery.
Language is included under Title I defining the
congressional defense committees.
Language is included under Title I to prohibit the closure
or realignment of Naval Station Guantanamo Bay.
Language is included under Title II to require that the
Secretary of Veterans Affairs establish a priority for
treatment of veterans who are service-connected disabled, lower
income, or have special needs.
Language is included under Title II to require that the
Secretary of Veterans Affairs give priority funding of basic
medical benefits to priority groups 1 through 6.
Language is included under Title II to allow the Secretary
of Veterans Affairs to dispense prescription drugs from VHA
facilities to enrolled veterans with privately written
prescriptions.
Language is included under Title II providing for the
reimbursement to the Department of Defense for the costs of
overseas employee mail.
Language is included under Title II to require approval of
a transfer between development, modernization, and enhancement
projects in the Information Technology Systems account.
Language is included under Title II restricting the use of
funding for VistA Evolution or any successor electronic health
record system until the Secretary certifies that the Department
has met multiple conditions regarding the development, cost,
schedule and interoperability of such a system.
Language is included under Title II restricting the
availability of funding for Major Construction projects in
excess of $100,000,000 until VA enters into an agreement with
an appropriate non-VA Federal entity to serve as the design
and/or construction agent for the project.
Language is included under Title II establishing time
limitations and reporting requirements concerning the
obligation of Major Construction funds, limiting the use of
funds, and allowing the use of funds for program costs.
Language is included under Title II to allow Minor
Construction funds to be used to repair non-medical facilities
damaged by natural disaster or catastrophe.
Language is included under Title II permitting transfers
between mandatory and discretionary accounts, limiting and
providing for the use of certain funds, funding administrative
expenses associated with life insurance programs from excess
program revenues, allowing reimbursement from enhanced-use
leases and for certain services, requiring notification of
construction bid savings, limiting reprogramming amount major
construction projects, restricting changes in the scope of
major construction projects, requiring disclosure of insurance
and income information, allowing a recovery audit collection
program, allowing veterans in the State of Alaska to use Indian
Health Service facilities under certain conditions, allowing
medical services funds for recreational and funeral expenses,
and requiring notification of organizational changes that
transfer 25 or more employees from one VA organizational unit
to another.
Language is included under Title II requiring the Secretary
to maintain certain requirements in operating the toll-free
suicide hotline.
Language is included under Title II permitting marriage and
family therapists who meet certain requirements to be eligible
for VA employment.
Language is included under Title II prohibiting funds from
being used to end, suspend, or relocate hospital-based services
in a health care facility that is the subject of an
environmental impact statement, is designated as a national
historic landmark, and is in a highly rural area.
Language is included under Title III United States Court of
Appeals for Veterans Claims, Salaries and Expenses, to permit
the use of funds for a pro bono program.
Language is included under Title III Cemeterial Expenses,
Army, Salaries and Expenses, to permit the use of funds for
parking maintenance and repairs.
Language is included under Title III Armed Forces
Retirement Home to permit payment from the general fund of the
Treasury to the Trust Fund.
Language is included under Title III to permit the use of
funds to relocate a water main.
Language is included under Title III to allow for the use
of concession fees.
Language is included under Title V to limit the use of
funds for Federal entities when they are not in compliance with
Federal law relating to risk assessment, the protection of
private property rights, or unfunded mandates.
Language is included under Title V to limit the use of
funds for publicity or propaganda designed to support or defeat
legislation pending before Congress.
Language is included under Title V to prohibit the use of
funds for a project or program named for a serving Member of
the United States Congress.
Language is included under Title V prohibiting funds from
being used to maintain or establish a computer network unless
such network blocks the viewing, downloading, and exchanging of
pornography.
Language is included under Title V prohibiting funds from
being used to pay for first class travel in violation of
federal regulations.
Language is included under Title V prohibiting funds from
being used to execute a contract for goods or services where a
contractor has not complied with Executive Order 12989.
Language is included under Title V prohibiting funds from
being used by the Department of Defense or the Department of
Veterans Affairs for the purchase or lease of a new vehicle
except in accordance with Presidential Memorandum--Federal
Fleet Performance, dated May 24, 2011.
Language is included under Title V prohibiting the use of
funds for renovation, expansion, or construction of a facility
in the United States to house any individual who has been
detained at the United States Naval Station, Guantanamo Bay,
Cuba.
Language is included under Title V allowing unobligated
balances of amounts appropriated for the Ebola outbreak to be
available to prevent, prepare for, and respond to the Zika
virus.
Appropriations Not Authorized by Law
Pursuant to clause 3(f)(1)(B) of rule XIII of the Rules of
the House of Representatives, the following table lists the
appropriations in the accompanying bill which are not
authorized by law for the period concerned:
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Program Duplication
No provision of this bill establishes or reauthorizes a
program of the Federal Government known to be duplicative of
another Federal program, a program that was included in any
report from the Government Accountability Office to Congress
pursuant to section 21 of Public Law 111-139, or a program
related to a program identified in the most recent Catalog of
Federal Domestic Assistance.
Directed Rule Making
The bill does not direct any rule making.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Compliance With Rule XIII, Cl. 3(e) (Ramseyer Rule)
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets):
SECTION 223 OF THE MILITARY CONSTRUCTION, VETERANS AFFAIRS, AND RELATED
AGENCIES APPROPRIATIONS ACT, 2016
(Public Law 114-113; division J)
[(including transfer of funds)
[Sec. 223. Of the amounts appropriated to the Department of
Veterans Affairs which become available on October 1, 2016, for
``Medical Services'', ``Medical Support and Compliance'', and
``Medical Facilities'', up to $265,675,000, plus
reimbursements, may be transferred to the Joint Department of
Defense-Department of Veterans Affairs Medical Facility
Demonstration Fund, established by section 1704 of the National
Defense Authorization Act for Fiscal Year 2010 (Public Law 111-
84; 123 Stat. 3571) and may be used for operation of the
facilities designated as combined Federal medical facilities as
described by section 706 of the Duncan Hunter National Defense
Authorization Act for Fiscal Year 2009 (Public Law 110-417; 122
Stat. 4500): Provided, That additional funds may be transferred
from accounts designated in this section to the Joint
Department of Defense-Department of Veterans Affairs Medical
Facility Demonstration Fund upon written notification by the
Secretary of Veterans Affairs to the Committees on
Appropriations of both Houses of Congress.]
Comparison With the Budget Resolution
Pursuant to clause 3(c)(2) of rule XIII of the Rules of the
House of Representatives and section 308(a)(1)(A) of the
Congressional Budget Act of 1974, the following table compares
the levels of new budget authority provided in the bill with
the appropriate allocation under section 302(b) of the Budget
Act.
[In millions of dollars]
------------------------------------------------------------------------
302(b) Allocation This bill
-------------------------------------------
Budget Budget
authority Outlays authority Outlays
------------------------------------------------------------------------
Mandatory................... 101,433 101,074 101,433 \1\101,07
4
Discretionary............... 81,643 82,988 81,643 82,988
General Purpose......... 81,471 82,987 81,471 82,987
Overseas Contingency 172 1 172 1
Operations.................
------------------------------------------------------------------------
\1\Includes outlays from prior-year authority.
Five-Year Projection of Outlays
Pursuant to clause 3(c)(2) of rule XIII of the Rules of the
House of Representatives and section 308(a)(1)(B) of the
Congressional Budget Act of 1974, the following table contains
five-year projections prepared by the Congressional Budget
Office of outlays associated with the budget authority provided
in the accompanying bill:
[Millions]
------------------------------------------------------------------------
Non-OCO OCO
------------------------------------------------------------------------
Outlays:
2017...................................... \2\109,744 1
2018...................................... 4,762 43
2019...................................... 3,359 66
2020...................................... 2,105 40
2021 and future years..................... 1,358 10
------------------------------------------------------------------------
\2\Excludes outlays from prior-year budget authority.
Assistance to State and Local Governments
Pursuant to clause 3(c)(2) of rule XIII of the Rules of the
House of Representatives and section 308(a)(1)(C) of the
Congressional Budget Act of 1974, the amount of financial
assistance to State and local governments is as follows:
Millions
Budget Authority........................................ \3\181
Fiscal Year 2017 outlays resulting therefrom............ 33
---------------------------------------------------------------------------
\3\Excludes outlays from prior-year budget authority.
---------------------------------------------------------------------------
State List
The following is a complete listing, by title, State and
country, of the Committee's recommendations for military
construction and family housing projects, including Overseas
Contingency Operations projects:
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
MINORITY VIEWS
The fiscal year 2017 Military Construction, Veterans
Affairs and Related Agencies appropriations bill funds critical
military construction, family housing and quality of life
improvements and enhancements for our brave men and women in
uniform and their families. This bill provides $81.6 billion in
total discretionary funding. This is $1.8 billion above the
2016 enacted funding level but $1.2 billion below the FY 2017
budget request.
The bill funds military construction at $5.6 billion, which
is $120 million below the FY 2017 request. For Department of
Veterans Affairs (VA) programs, the bill provides $73.5 billion
in discretionary funding, which is $2.1 billion above the FY
2016 enacted level but $1.4 billion below the President's
request. The recommendation also includes the budget request of
$66.3 billion in discretionary funds for the FY 2018 advance
appropriations for VA medical services. The bill includes $75.1
million for our heroes who have made the ultimate sacrifice and
are honored in the battle monuments and cemeteries funded in
this bill.
We are pleased that the bill continues to build on efforts
to end the veterans claims backlog that began in fiscal year
2014. First, the Committee bill continues both the aggressive
monthly reporting requirements from each specific regional
office on claims processing performance as well as quarterly
reports on remediation efforts at the poorest performing
regional offices. Second, the bill provides $180 million for
the paperless claims processing system, $153 million for
digital scanning of health records, and $27 million for
centralized mail. Finally, the bill provides $156 million, a
$46 million increase over the fiscal year 2016 level, for the
Board of Veterans Appeals to support 242 new staff to tackle
claims appeals, which have been ballooning as the number of
claims decisions has increased.
The bill continues to closely track the VA's development of
its electronic health record (EHR) system and fences off a
portion of the funding until certain information is provided to
the Committee. We believe that the fencing language is
especially important for FY 2017 as VA has indicated it will
change direction on the development of this platform. In
addition, the bill continues the practice started in 2013 to
require the VA to provide information on the VistA Evolution
system before funding is released. The Committee does not
intend to delay the progress of modernizing VistA but believes
continuing close oversight is necessary to ensure that the
modernization effort will have the necessary capabilities to
provide superior care.
We are also pleased that the bill provides the full FY 2017
budget request of $7.8 billion for mental health programs, of
which $164 million will be available for suicide prevention
outreach. In addition to the robust funding levels, language to
address the Veterans Crisis Line will have a meaningful impact
on our Nation's veterans when they are most vulnerable.
Furthermore, the report addresses the mental health needs of
female veterans, who are six times more likely to commit
suicide than women in the general population. This bill takes
positive steps to deal with this alarming trend.
While there are numerous measures to praise in the bill,
some shortcomings will have to be addressed. The inclusion of
bill language indiscriminately denying performance awards is
one example. This language does not distinguish between high-
quality executives and the supervisors and managers at
facilities where the Inspector General identified the use of
inappropriate scheduling practices. In the long-term, denying
SES bonus pay to high-performing executives will compound the
very problem it attempts to address. It will make it
significantly harder for the VA to recruit and retain quality
executive leaders. The talented individuals that the VA needs
to hire to solve problems for our nation's veterans will be
more inclined to take positions where employees in good
standing, achieving desired results, can be rewarded.
Addressing the Zika Crisis
On February 22, 2016, the Administration requested that
Congress provide nearly $1.9 billion to combat the spread of
the Zika virus. Nearly seven weeks later, the Republican
majority of Congress has not taken up the Administration's
request, even as the summer months approach and the threat of
Zika infected mosquitoes continue to grow in the continental
United States.
Americans should have confidence their government is doing
all it can to protect its citizens from the harmful effects of
this terrible virus. Scientists no longer have doubts that Zika
is a cause of microcephaly, a serious birth defect that can
result in miscarriage and disability or death of a child. In
addition, scientists continue to study the connection of Zika
and Guillain-Barre, a neurological condition that causes
paralysis. Funding is needed to not only respond to this virus,
but to fully understand its effects.
According to the Centers for Disease Control and Prevention
(CDC), as of April 13, 2016, travel-associated Zika cases stand
at 358 in the United States. Thirty-one of those cases are
pregnant women. In US territories, there are 471 cases of
locally acquired virus and four travel-associated cases. Fifty-
eight of those cases are pregnant women. It is unconscionable
to continue to do nothing as these numbers continue to grow.
During the first Committee meeting of the year, Committee
Democrats attempted to address the threat of the Zika virus by
offering an amendment to fund the Administration's request of
nearly $1.9 billion. The amendment offered by full Committee
Ranking Member Nita Lowey, along with subcommittee ranking
members Rosa DeLauro and Debbie Wasserman Schultz, would have
funded prevention, detection, and response to the Zika virus as
well as additional research, development, and procurement of
vaccines, therapeutics, and diagnostics. The Republican
majority blocked that effort through a procedural vote that
denied providing additional funds for a Zika response and
reneged on America's commitment to continue to fight Ebola even
as cases have resurfaced in Africa. The Republicans' logic is
to promote an inadequate response to both Zika and Ebola by
syphoning resources from Ebola response to partially fund a
Zika response. We must confront Zika immediately with dedicated
resources for CDC, the National Institutes of Health, and the
U.S. Agency for International Development. U.S. efforts to keep
Ebola at bay in Africa must not be weakened as we increase
response to the Zika virus in the Americas.
We must be prepared to respond to both public health
crises.
Conclusion
There is much to praise in the Military Construction VA
bill though several items in the bill weaken our support.
Moreover, Democrats will find it difficult to support
individual FY 2017 appropriations bills such as this one until
it is clear that Congress will provide needed resources in FY
2016 to respond to the Zika virus.
Nita M. Lowey.
Sanford D. Bishop, Jr.
ADDITIONAL VIEWS
During consideration of the 2017 Military Construction,
Veterans Affairs and Related Agencies Appropriations Bill, the
Committee recklessly adopted the Rogers amendment that
redirected the funding Congress provided to respond to Ebola
public health emergency to the emerging threat posed by the
Zika virus. This is unwise and places American lives at risk.
CDC has pledged to use this funding to support up to 30
poor and developing countries to improve their public health
infrastructure. If we abandon this commitment, which has helped
secure billions in funding from other countries, our partners
in will certainly follow suit. Improving the public health
infrastructure around the world makes Americans safer by
preventing future epidemics like Ebola and Zika from spiraling
out of control. It is shortsighted and irresponsible for us to
shift these funds to another crisis.
Instead Congress should immediately pass an emergency
supplemental appropriations bill to support our response to the
Zika virus. The Administration requested an emergency
appropriation of $1.9 billion to face the Zika threat.
Unfortunately, the administration has already been forced to
rob nearly $600 million from Ebola to respond to Zika. This is
dumbfounding. The Ebola crisis is not over. These funds are
being directed away from other-critical and threatening global
health risks and are being repurposed only as a last resort--
not because it is the right thing to do from a policy
perspective.
Democrats offered the Lowey-DeLauro-Wasserman Schultz
amendment, which would have fully funded the Administration's
request.
We must immediately fund the Administration's request and
invest in stopping the Zika virus. This past month, Dr Anthony
Fauci, Director of the National Institute of Allergy and
Infectious Diseases said the following about Zika ``Everything
we see is bad. Every week, every month it tends to surprise us.
There was no reason to think that it would be this bad.''
Just this week Brazilian scientists and researchers
uncovered a concerning links between the Zika virus and serious
brain issues--Guillain Barre Syndrome and ADEM. Guillain Barre
causes the immune system to attack the nerves, and can lead to
paralysis. ADEM causes swelling in the brain and spinal cord
and presents such similar symptoms to multiple sclerosis that
many doctors cannot distinguish between the two. As Anne
Schuchat, principal deputy director of the U.S. Centers for
Disease Control and Prevention put it, ``Everything we look at
with this virus seems to be a bit scarier than we initially
thought.''
Zika is already infecting travelers returning to the United
States, and is even being transmitted sexually--so men, as well
as women, are at risk. We are about to send hundreds of
American athletes to Rio for the Olympics, and thousands more
will attend as spectators.
The Zika virus has already wreaked havoc across Latin
America. In areas affected by Zika, we have seen thousands of
babies born with microcephaly--a rare neurological condition
characterized by incomplete brain development and an infant's
head being significantly smaller than the heads of other
children. One of the mosquitos that transmits Zika is found in
30 U.S. states where millions of babies are born each year.
In the Gulf Coast states of the U.S.--Texas, Louisiana,
Mississippi, Alabama, and Florida--where large concentrations
of the Aedes aegypti mosquito--the primary carrier of the Zika
virus--are found, there were 783,000 births in 2014. Along the
Gulf Coast, temperatures are already reaching the 80s in the
afternoon. By May and June, these areas will begin to see these
mosquitoes in larger numbers.
Even Senator Marco Rubio said this week: ``the Zika virus
is impacting Florida, [Puerto Rico, and South America] and we
must be prepared for what is predicted to be an even more
explosive outbreak.''
We need to immediately fund our response effort. What will
happen to our blood supply when Zika transmission increases as
more and more mosquitoes are born in the U.S. this summer? We
need to reduce the population of Zika-carrying mosquitoes; we
need to ensure the safety of the blood supply; and we need to
enhance laboratory capacity and surveillance data. We need to
develop advanced diagnostics to test more rapidly and
accurately for Zika, and we need to develop a Zika vaccine.
Congress needs to act immediately to protect millions of
pregnant women and newborns from this serious threat. I urge my
colleagues to oppose the inclusion of the Rogers Amendment in
the 2017 Military Construction, Veterans Affairs and Related
Agencies Appropriations Bill.
Rosa L. DeLauro.
[all]