[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]