[Senate Report 115-269]
[From the U.S. Government Publishing Office]
Calendar No. 446
115th Congress } { Report
SENATE
2d Session } { 115-269
======================================================================
MILITARY CONSTRUCTION, VETERANS AFFAIRS, AND RELATED AGENCIES
APPROPRIATION BILL, 2019
_______
June 7, 2018.--Ordered to be printed
_______
Mr. Boozman, from the Committee on Appropriations,
submitted the following
REPORT
[To accompany S. 3024]
The Committee on Appropriations reports the bill (S. 3024)
making appropriations for military construction, the Department
of Veterans Affairs, and related agencies for the fiscal year
ending September 30, 2019, and for other purposes, reports
favorably thereon and recommends that the bill do pass.
Amounts in new budget authority
Total of bill as reported to the Senate.................$225,565,468,000
Amount of 2018 appropriations........................... 205,791,908,000
Amount of 2019 budget estimate.......................... 224,608,740,000
Bill as recommended to Senate compared to--
2018 appropriations................................. +19,773,560,000
2019 budget estimate................................ +956,728,000
CONTENTS
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Page
Background:
Purpose of the Bill.......................................... 4
Committee Recommendation..................................... 4
Overview and Summary of Bill................................. 4
Title I:
Military Construction:
Items of Special Interest:
Hearings............................................. 6
Summary of Committee Recommendations................. 6
Reprogramming Guidelines............................. 6
Real Property Maintenance............................ 7
Incremental Funding.................................. 7
Other Matters........................................ 7
Military Construction Overview........................... 13
Military Construction, Army.............................. 14
Military Construction, Navy and Marine Corps............. 16
Military Construction, Air Force......................... 17
Military Construction, Defense-Wide...................... 18
Military Construction, Army National Guard............... 18
Military Construction, Air National Guard................ 19
Military Construction, Army Reserve...................... 19
Military Construction, Navy Reserve...................... 19
Military Construction, Air Force Reserve................. 19
North Atlantic Treaty Organization Security Investment
Program................................................ 20
Department of Defense Base Closure Account............... 20
Family Housing Overview.................................. 21
Family Housing Construction, Army........................ 21
Family Housing Operation and Maintenance, Army........... 21
Family Housing Construction, Navy and Marine Corps....... 21
Family Housing Operation and Maintenance, Navy and Marine
Corps.................................................. 22
Family Housing Construction, Air Force................... 22
Family Housing Operation and Maintenance, Air Force...... 22
Family Housing Operation and Maintenance, Defense-Wide... 23
Department of Defense Family Housing Improvement Fund.... 23
Department of Defense Military Unaccompanied Housing
Improvement Fund....................................... 23
Administrative Provisions................................ 24
Title II:
Department of Veterans Affairs:
Items of Special Interest:
Hearings............................................. 26
Summary of Committee Recommendations................. 26
Department Overview.................................. 26
Veterans Benefits Administration......................... 30
Compensation and Pensions............................ 31
Readjustment Benefits................................ 32
Veterans Insurance and Indemnities................... 33
Veterans Housing Benefit Program Fund................ 33
Vocational Rehabilitation Loans Program Account...... 34
Native American Veteran Housing Loan Program Account. 34
General Operating Expenses, Veteran Benefits
Administration..................................... 35
Veterans Health Administration........................... 37
Medical Services..................................... 42
Medical Community Care............................... 62
Medical Support and Compliance....................... 63
Medical Facilities................................... 63
Medical and Prosthetic Research...................... 64
Medical Care Cost Recovery Collections............... 67
National Cemetery Administration......................... 67
Departmental Administration.............................. 68
General Administration............................... 68
Board of Veterans Appeals............................ 68
Information Technology Systems....................... 69
Office of Inspector General.......................... 72
Construction, Major Projects......................... 72
Construction, Minor Projects......................... 73
Grants for Construction of State Extended Care
Facilities......................................... 74
Grants for Construction of Veterans Cemeteries....... 75
Administrative Provisions................................ 75
Title III:
Related Agencies:
American Battle Monuments Commission:
Salaries and Expenses................................ 79
Foreign Currency Fluctuations........................ 80
United States Court of Appeals for Veterans Claims:
Salaries and Expenses.................................. 80
Department of Defense--Civil: Cemeterial Expenses, Army:
Salaries and Expenses................................ 81
Armed Forces Retirement Home: Trust Fund................. 82
Administrative Provision................................. 82
Title IV: Overseas Contingency Operations........................ 83
Title V: General Provisions...................................... 85
Program, Project, and Activity................................... 86
Compliance With Paragraph 7, Rule XVI, of the Standing Rules of
the
Senate......................................................... 86
Compliance With Paragraph 7(c), Rule XXVI of the Standing Rules
of the Senate.................................................. 88
Compliance With Paragraph 12, Rule XXVI of the Standing Rules of
the Senate..................................................... 89
Budgetary Impact of Bill......................................... 90
Military Construction Project Listing by Location................ 91
Overseas Contingency Operations.................................. 106
Comparative Statement of Budget Authority........................ 108
BACKGROUND
Purpose of the Bill
The Military Construction, Veterans Affairs, and Related
Agencies appropriations bill provides necessary funding for the
planning, design, construction, alteration, and improvement of
military facilities worldwide. It also finances the cost of
military family housing and the U.S. share of the NATO Security
Investment Program. In addition, the bill provides funding,
including environmental remediation, for base closures and
realignments authorized by law. The bill provides resources to
the Department of Veterans Affairs for veterans benefits and
healthcare and funding for U.S. cemeteries and battlefield
monuments both in the United States and abroad, including the
American Battle Monuments Commission and Arlington National
Cemetery. Additionally, the bill funds the U.S. Court of
Appeals for Veterans Claims and the Armed Forces Retirement
Homes.
Committee Recommendation
The Committee recommends new budget authority totaling
$225,565,468,000 for fiscal years 2019 and 2020 military
construction, family housing, base closure, veterans healthcare
and benefits, including fiscal year 2020 advance appropriations
for veterans medical care and appropriated mandatories, and
related agencies. This includes $122,706,761,000 in mandatory
funding and $102,858,707,000 in discretionary funding. The
table at the end of the report displays the Committee
recommendation in comparison with the current fiscal year and
the President's fiscal year 2019 request. The following table
shows total budget authority available for fiscal year 2019.
APPROPRIATIONS FOR FISCAL YEAR 2019
------------------------------------------------------------------------
Senate
Budget request recommendation
------------------------------------------------------------------------
New budget authority........ $224,608,740,000 $225,565,468,000
Previous advances provided 70,699,313,000 70,699,313,000
for fiscal year 2019 for
medical care...............
Previous advances provided 107,709,727,000 107,709,727,000
for fiscal year 2019 for
appropriated mandatories...
Less advances provided for -75,550,600,000 -75,550,600,000
fiscal year 2020 for
medical care...............
Less advances provided for -121,296,429,000 -121,296,429,000
fiscal year 2020 for
appropriated mandatories...
-------------------------------------------
Total appropriations 206,170,751,000 207,127,479,000
for fiscal year 2019.
------------------------------------------------------------------------
Overview and Summary of Bill
The Military Construction, Veterans Affairs, and Related
Agencies appropriations bill funds an array of programs that
are vital to America's military personnel and their families,
and to the Nations' veterans. For U.S. military forces and
their families worldwide, the bill funds critical
infrastructure, ranging from mission essential operational and
training facilities, such as command and control centers,
airfield improvements, and ranges, to key quality-of-life
facilities, including barracks, family housing, child care
centers, schools, and hospitals.
For America's 20 million veterans, the bill provides the
necessary funding for veterans benefits and healthcare, from
prescription drugs and clinical services to the construction of
hospitals and other medical facilities throughout the Nation.
The bill also funds veterans cemeteries in the United
States and provides funding for four independent agencies--the
American Battle Monuments Commission, the U.S. Court of Appeals
for Veterans Claims, Arlington National Cemetery, and the Armed
Forces Retirement Homes.
TITLE I
MILITARY CONSTRUCTION
Items of Special Interest
HEARINGS
The Subcommittee on Military Construction, Veterans
Affairs, and Related Agencies held one hearing related to the
fiscal year 2019 military construction budget request.
Witnesses included representatives of the Army, Navy, Marine
Corps, Air Force, and the Office of the Secretary of Defense.
SUMMARY OF COMMITTEE RECOMMENDATIONS
The fiscal year 2019 budget request for military
construction and family housing totals $10,462,617,000. The
Committee recommends $10,319,000,000, which is $143,617,000
below the President's budget request.
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
reprogrammings to an item specifically reduced below the
threshold by the Congress are permitted.
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, provided that 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.
Furthermore, in instances where prior approval of a
reprogramming request for a project or account has been
received from the Committee, the adjusted amount approved
becomes the new base for any future increase or decrease via
below-threshold reprogrammings (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
reprogrammings and notifications, including the pertinent
statutory authorities contained in Department of Defense [DOD]
Financial Management Regulation 7000.14-R and relevant updates
and policy memoranda.
REAL PROPERTY MAINTENANCE
The Committee recommends a continuation of the following
general rules for repairing a facility under ``Operation and
Maintenance'' account funding:
--Components of the facility may be repaired by replacement,
and such replacement may be up to current standards or
code.
--Interior arrangements and restorations may be included as
repair, but additions, new facilities, and functional
conversions must be performed as military construction
projects.
--Such projects may be done concurrent with repair projects,
as long as the final conjunctively funded project is a
complete and usable facility.
--The appropriate Service Secretary shall submit a 21-day
notification prior to carrying out any repair project
with an estimated cost in excess of $7,500,000.
The Department is directed to continue to report on the
real property maintenance backlog at all installations for
which there is a requested construction project in future
budget requests. This information is to be provided on the form
1390. In addition, for all troop housing requests, the form
1391 is to continue to show all real property maintenance
conducted in the past 2 years and all future requirements for
unaccompanied housing at that installation.
INCREMENTAL FUNDING
In general, the Committee supports full funding for
military construction projects. However, it continues to be the
practice of the Committee to provide incremental funding for
certain large projects, despite administration policy to the
contrary, to enable the services to more efficiently allocate
military construction dollars among projects that can be
executed in the year of appropriation. Therefore, the Committee
has recommended incremental funding for six projects.
OTHER MATTERS
Military Construction Funding Initiatives.--The Committee
is disappointed that military construction request levels do
not reflect the level of investment needed to ensure both
current and future force readiness. After years of deliberately
``taking risk'' by underfunding known military construction
requirements, when the Department finally had the opportunity
to take advantage of the significant resources provided under
the 2018 budget agreement, the Department once again chose to
ignore its growing list of infrastructure and construction
needs. The fiscal year 2019 military construction budget
request comprises less than 1.5 percent of the Department's
$686 billion total request. Continued underfunding of
infrastructure requirements will yield disastrous results as
facilities deteriorate and resources for repair or replacement
are not available.
In addition to the long list of deferred recapitalization
and critical vulnerabilities, there are several multi-billion
dollar high priority initiatives critical to rebuilding
readiness and enabling joint warfighter capabilities that the
Department has been tasked with funding and executing. For
example, the Army has been tasked with funding a
$17,000,000,000 modernization of Readiness Centers across the
country. The Navy is taking steps to execute its Shipyard
Infrastructure Optimization Plan, which will require a
$21,000,000,000 investment over the next 20 years. The Air
Force is undertaking a Ground Based Strategic Deterrent
facility modernization. All of this competes with ongoing and
upcoming platform beddown and facility upgrade projects.
The Committee is concerned that reversing years of
underfunding while simultaneously trying to accommodate the
initiatives needed to provide ready and resilient installations
that enable a platform for global operations is not viable
without additional investment. The Committee urges the
Secretary of Defense to ensure adequate funding for military
construction in its planning, programming and budgeting
processes. Further, the Committee directs the Secretary of each
Service to provide an assessment at the time of submission of
the fiscal year 2020 budget request identifying all military
construction initiatives and targeted investments, such as the
aforementioned, with a total estimated cost in excess of
$1,000,000,000 and how the request ensures sufficient progress
in buying down these infrastructure needs.
The Committee also notes that major defense acquisition
programs, particularly in the Air Force and Navy, do not
adequately consider associated beddown and related
infrastructure, which can result in late to need facilities,
deferred recapitalization, and avoidable miscalculations in
budget development. Therefore, the Committee also directs the
Secretary of each Service to include in the above assessment
expected military construction costs associated with new
platform beddown by fiscal year, and process improvements to
better identify these needs as well as obstacles in fully
accounting for future projected infrastructure requirements.
Energy Assurance.--The Committee recognizes DOD's efforts
to understand the vulnerability of its power generation,
distribution, and storage systems on all of its military
installations and to develop technologies, plans, and policies
to mitigate its risks. However, the Committee remains concerned
that DOD's plan to 'island' its military bases in an emergency
is not a solution to addressing the hazards that exist outside
the DOD property line, where vulnerabilities to civilian energy
infrastructure pose a risk to troops, DOD civilians, and other
mission-critical personnel living in the community. The
Committee directs the Secretary to provide a report within 180
days of enactment of this act on the Department's efforts to
address risks to critical energy systems outside of DOD
property. The report should assess the ability of military
installations to develop and sustain relationships with public
utilities regardless of leadership rotations; the necessary
legal authorities to enter arrangements with private or public
companies to make improvements to energy infrastructure outside
of DOD property; what, if any, plans exist for local military
bases to provide excess base load power to communities during
long-term emergencies; and the efficacy of appointing an
executive agent charged with department-wide decisionmaking and
funding of resiliency projects outside of DOD property.
Joint Strike Fighter [JSF] Initial Joint Training Site.--
The 2005 Base Realignment and Closure [BRAC] Commission
recommended Eglin Air Force Base [AFB], Florida, as an Initial
Joint Training Site [IJTS] that teaches entry-level aviators
and maintenance technicians how to safely operate and maintain
the new Joint Strike Fighter [JSF] [F-35] aircraft. To
implement the JSF IJTS, the Air Force, Navy, and Marines
identified the need for a cantonment area, sufficient airspace,
and ground targets to support 107 F-35 Primary Assigned
Aircraft [PAA] comprised of Air Force, Marine, and Navy
variants. Development plans included training and maintenance
facilities, hangars, dormitories, munitions storage and loading
facilities as well as airfields, airspace and ground support to
accommodate 107 PAA. The Committee is aware that since the
selection of Eglin AFB as the site for JSF IJTS, the PAA has
been reduced from 107 to 59 and that some Services conduct JSF
training at installations other than Eglin AFB. The Committee
is concerned that building construction, renovation and
demolition may have already started to support the initial plan
of 107 PAA and the full training mission. Therefore, the
Committee directs the Secretary of Defense to report no later
than 180 days after enactment of this act on the infrastructure
plan supporting the JSF IJTS at Eglin AFB, to include completed
facilities and associated capacity and current utilization, and
how remaining infrastructure requirements have been adjusted to
adapt to the reduced PAA and training mission. Additionally,
the report should include the status of the Department's
compliance with the 2005 BRAC decision to establish Eglin AFB
as the JSF IJTS and the rationale and impact of not fully
implementing the decision.
DOD Installation Energy Policy.--The Committee notes that
DOD continues to take steps to increase installation energy
efficiency and reduce overall energy consumption. However, more
can be done bring down energy costs, and DOD must also ramp up
its efforts to enhance energy security on its installations
through a range of actions, to include exploring ways to
mitigate potential vulnerabilities where installations draw
from off-base energy sources.
The Committee supports DOD's investments in energy
efficiency, renewable energy systems, and energy security,
including through the Energy Resilience and Conservation
Investment Program [ERCIP], however, is concerned that funding
requested for the program has not increased since fiscal year
2014. This has resulted in a continued reduction of projects
that can be undertaken, down to 18 this year from 33 projects
in fiscal year 2016. The Committee directs the Secretary of
Defense to provide a report within 90 days of enactment
detailing how DOD integrates and prioritizes ERCIP projects in
the future years defense program and to certify whether there
are unfunded requirements within the program. The Committee
recommends an increase of $45,000,000 above the request for
ERCIP and encourages the Department to prioritize funding for
energy-related projects, including renewable energy projects,
to mitigate risk to mission-critical assets and promote energy
security and efficiency at military installations.
Defense Access Roads.--The Committee is concerned about the
lack of future planning for Defense Access Roads [DAR] and
transportation infrastructure needs as flooding on roads at
domestic installations that are vital to military operations
increases in frequency and severity. The Committee directs the
Secretary of Defense, in consultation with the Secretary of
Transportation, to establish a process for assessing the flood
risk to defense access roads, with particular attention to
communities that have experienced severe flooding from non-
storm surge flooding and flooding due to storm surge. The
Committee expects that process to be informed by the best
available science regarding flood risk in the United States.
Further, the Committee directs the Secretary of Defense to
report no later than 90 days after enactment of this act on the
national security risks of neglected DAR roads and projects
affected by flooding due to storm surge, including what data
and other appropriate information it is using to inform its
risk and need assessment, and any relevant obstacles, to
include legal, in carrying out such projects.
Reserve Component Parity.--The Committee notes significant
decreases in funding across the Reserve Component in the fiscal
year 2019 Military Construction request from the fiscal year
2018 level. While the Committee understands that critical
demand fluctuates by year and ongoing large-scale initiatives
can skew data, it is concerned that reliance on the Real
Property Asset Database [RPAD] as a key criterion does not
accurately reflect current and future infrastructure needs
across the components based on evolving operational
requirements. Furthermore, despite steps taken by the
Department to improve oversight of its global real property
portfolio, multiple reports by the Government Accountability
Office have found deficiencies in its tracking of real property
assets and leased facilities, further undermining the
credibility of this data. Therefore, the Committee directs the
Secretaries of each Service to provide a report within 90 days
of enactment of this act on if and how each determines base
ratios for respective Active and Reserve Component military
construction funding allocations, to include what data is used,
specifically the extent to which the RPAD is weighted, and how
frequently these ratios are updated.
Flight Line Infrastructure.--The Committee is concerned
with the lack of sufficient flight line infrastructure and the
potentially adverse impact it may have on aircraft and
personnel. There are many examples throughout the Department
where improvements in facilities and airfield infrastructure
would save resources, and improve personnel and aircraft
readiness. For example, at Laughlin Air Force Base, 82 percent
of the T-1 fleet was unsheltered and damaged in a hail storm.
The damaged aircraft were grounded, resulting in an 80 percent
loss of T-1 pilot training production capability. At Al Dhafra
Air Base, host nation sun shades are utilized to help protect
F-22s from extreme heat and sunlight but are not always
available. Adequate flight line infrastructure can help protect
the Department's assets from not only damage but resulting
decreased mission accomplishment. The Committee recommends the
Secretary of Defense review flight line infrastructure for both
minor and major revitalization and recapitalization
opportunities. This could include simple infrastructure such as
sun shelters that protect both personnel and equipment from
extreme heat and inclement weather, to more elaborate
construction and maintenance projects such as repairing
drainage issues on flight lines to keep ramp areas useable
during extended rainy periods and prevent aircraft from sitting
in standing water. The Committee urges the Department to
prioritize these projects in future budget submissions.
Water Conservation on Military Installations.--Senate
Report 115-130 reiterated a directive from Senate Report 114-
237 requesting the Secretary of Defense provide a report on
water usage and conservation on military installations. The
Committee notes that the report is currently overdue and
directs the Secretary to provide the report no later than
October 1, 2018.
Federal, State and Local Intelligence Collaboration.--The
Committee remains supportive of collaborative intelligence
fusion centers that utilize National Guard facilities. These
centers allow Federal, state, local, and tribal law enforcement
officials to collaborate and share intelligence and threat
information, and co-locating them with National Guard
facilities offers opportunities for cost savings. The Committee
urges the Department, the services, and the National Guard
Bureau to prioritize needed workplace replacement projects,
including Sensitive Compartmented Information Facility [SCIF]
projects to conduct state and Federal intelligence analysis, in
the fiscal year 2020 and future budget submissions.
Major Range and Test Facility Base [MRTFB].--The Committee
remains concerned about the lack of investment and sustainment
in MRTFB facilities. These ranges, which include Army, Navy,
Air Force and Defense Agency facilities are critical to
developing and maintaining the Nation's military technological
superiority. In order to support development of emerging
advanced technologies, test and training range infrastructure
and instrumentation must be modernized. Senate Report 115-130
contained direction to the Secretary of Defense to submit a
comprehensive MRTFB modernization plan within 180 days of
enactment outlining a timetable and specific actions for
repair, replacement and renovation of infrastructure, equipment
and instrumentation at mission-critical facilities. The
Committee looks forward to receiving this report.
Family Housing Management.--The Committee is concerned that
at times military families are faced with housing unit
relocation or otherwise forced disposition due to untimely and
mismanaged family housing renovations, particularly when
service members and their families are in need of housing due
to a permanent change of station. To understand the scale of
this problem, the Committee directs the Department to assess
the management of family housing renovations and identify any
and all instances whereby military families have been relocated
or forced to move from their assigned housing unit because of
renovation or repair, specifically for government-controlled
housing [owned and leased], with a focus on instances on duty
stations outside the continental United States. The report
should also include detailed data on wait times, identification
of contributing factors, and potential mitigating solutions.
The Committee directs the Department to provide the report
within 120 days of enactment of this act.
Simulation Center Planning Bays.--The Committee notes that
combat maneuver simulation centers offer a valuable resource to
train combat forces in real world situations while reducing
cost, preserving equipment, enhancing training and decreasing
risk to the warfighter. Military students utilize these
centers, such as the Maneuver Center of Excellence and other
educational posts, to augment their training and enhance
readiness and should continue to do so at an increasing rate in
the coming years. These centers often do not have the capacity
for the entire unit to communicate, coordinate, and plan on
site during their training. Therefore, the Committee encourages
the Department to consider additional structures, such as
covered planning bay areas, that could enhance the value of
training by providing space to communicate, coordinate, and
plan on site amidst the simulation training. As such, the
Committee directs the Department to submit a report within 180
days of enactment of this Act assessing the value of having
covered planning bay areas adjacent to or within current
facilities that provide combat maneuver simulation training.
The report should identify potential installations where these
structures could be constructed adjacent to or within
simulations centers.
Information Technology Infrastructure for Military
Construction Projects.--The Committee recognizes that
information technology is an essential component in
constructing modern facilities for military missions as well as
planning for future requirements. Technological advancements
can lead to increased productivity and efficiencies on energy
and space, which impact military construction and modernization
projects. For example, the Committee is aware of technology
that can streamline historically compartmented classified
networks through cross domain solutions. Not only does this
drastically impact future productivity for the workforce but it
could also yield substantial savings and efficiencies on space,
energy, and HVAC requirements. The Committee urges the Services
to utilize such cost cutting solutions early in the planning
process to gain efficiencies and savings on military
construction projects.
Defense Workplace Facilities Improvements.--The Committee
is concerned that continued constraints on the Defense budget
in the face of increasing operational requirements is taking a
serious toll on the Department's aging and structurally
deficient workplace facilities inventory. The parking garage at
the National Maritime Intelligence Center [NMIC], which serves
a workforce of approximately 3,700 personnel, continues to be
certified as unsafe and structurally deficient. While
$12,000,000 has already been spent on repairs in an effort to
maintain the facility, the Committee remains concerned about
the deficient operational status. A Navy commissioned
engineering analysis validated the repairs as a stopgap measure
because of the severity of the structural flaws, but needed
investment continues to be deferred. In recognition of the fact
that aging and structurally deficient workplace and support
facility infrastructure has a significant impact on personnel
safety and operational readiness, the Committee urges the
Department and the services to prioritize needed workplace
replacement projects, including the NMIC parking structure, in
the fiscal year 2020 and future budget submissions.
Special Operations Command Planning and Design.--The
Committee is aware of numerous recent reprogramming requests
submitted by U.S. Special Operations Command [SOCOM]. The
additional funds requested, and delayed project execution
timelines, have largely been a result of poor planning and
design fundamentals, such as contracting design-build when
requirements necessitated design-bid-build. The committee is
encouraged that SOCOM is evaluating its planning and budgeting
process to ensure that projects requested are appropriately
scoped and prepared for execution. It also recognizes that
SOCOM manpower and infrastructure needs continue to increase in
demand. The committee urges SOCOM to continue to work with the
Army Corps of Engineers and Naval Facilities Engineering
Command to ensure best practices are being followed.
Fiscal Year 2018 Savings.--The Committee notes that the
Department based certain project funding levels in the fiscal
year 2019 Budget Request on lower expected appropriations than
were provided in Public Law 115-141. As a result, the fiscal
year 2019 requests for the Next NGA West Complex Phase 1 and
Presidential Aircraft Recapitalization Complex exceed need. The
Committee fully funds these projects as authorized in Public
Law 115-91.
Military Construction Funding Initiatives.--The bill
includes funding for military construction initiatives to
address important unfunded priorities included in the
Department of Defense's unfunded priority lists provided to
Congress. This includes an additional $77,600,000 for the Army,
$244,400,000 for the Navy and Marine Corps, $118,516,000 for
the Air Force, $22,000,000 for the Army National Guard,
$11,100,000 for the Air National Guard, $10,000,000 for the
Army Reserve, and $14,400,000 for the Air Force Reserve. All
additional funding is reserved for projects that were included
in the unfunded priority lists submitted to Congress.
Rescissions.--The Committee recommends an administrative
provision rescinding prior year unobligated funds due primarily
to project bid savings and the slow execution of projects.
Military Construction Overview
Appropriations, 2018\1\................................. $10,091,000,000
Budget estimate, 2019................................... 10,462,617,000
Committee recommendation................................ 10,319,000,000
\1\Total excludes $920,981,000 in emergency funding provided in Public
Law 115-123, the Further Additional Supplemental Appropriations for
Disaster Relief Requirements Act and Public Law 115-96, Continuing
Appropriations Act, Department of Defense Missile Defeat and Defense
Enhancements Appropriations Act, 2018.
---------------------------------------------------------------------------
MILITARY CONSTRUCTION ACCOUNTS--PROGRAM DESCRIPTION
The military construction appropriation provides for
acquisition, construction, installation, and equipment of
temporary or permanent public works, military installations,
facilities, and real property for the Department of Defense.
This appropriation also provides for facilities required as
well as funds for infrastructure projects and programs required
to support bases and installations around the world.
Military Construction, Army
Appropriations, 2018.................................... $923,994,000
Budget estimate, 2019................................... 1,011,768,000
Committee recommendation................................ 1,021,768,000
COMMITTEE RECOMMENDATION
The Committee recommends $1,021,768,000 for the Army for
fiscal year 2019. This amount is $97,774,000 above the fiscal
year 2018 enacted level and $10,000,000 above the budget
request. Further detail of the Committee's recommendation is
provided in the State table at the end of this report.
Army Training Schools.--The Committee is concerned about
the impact of deferred investments in Army schoolhouses,
especially those with aging facilities directly tied to
warfighter training and readiness across the components. In
particular, the Army Mountain Warfare School [AMWS], which
directly supports the Army's top priority of building and
sustaining readiness, continues to see increased demand with
insufficient and outdated space requirements, while deferred
maintenance compounds challenges with its aging infrastructure.
AMWS provides critical mountain warfare and cold weather
operations training to support the creation of an agile and
highly mobile force, but is nearly 40 years old and sited in a
flood plain, and has been forced to cap attendance due to
inadequate facilities, despite continual demand for throughput.
Therefore, the Committee urges the Secretary of the Army to
prioritize funding for ready-to-execute schoolhouse projects,
in particular those that support the growing demand for
mountaineering skills and training.
Defense Laboratory Enterprise Facilities and
Infrastructure.--The Committee remains concerned the
unspecified minor military construction [UMMC] request is
insufficient to support the Army Laboratories. As threats
continue to emerge and construction costs continue to rise,
outdated laboratory facilities lack the investment needed to
deliver next generation capability to the U.S. military. While
the Army can utilize funds from research, development, test and
evaluation or operations and maintenance to fund laboratory
projects, the higher UMMC threshold provided in Public Law 115-
91 is intended to allow the services greater opportunity to
keep up with threats that evolve faster than can be addressed
through the normal military construction planning process.
Therefore, an additional $10,000,000 is provided to supplement
Army unspecified minor construction projects. The committee
urges the Secretary of the Army to adequately prioritize UMMC
projects that support the Army Laboratories to ensure that Army
Science and Technology continue to lay the foundation for
future capabilities.
Army National Guard Readiness Center Investment.--The
Committee remains concerned that the Department of the Army has
not adequately prioritized funding to implement the
``Affordable Readiness'' strategy recommended by the 2014 Army
National Guard Readiness Center Transformation Master Plan
[RCTMP]. While the committee understands that the Army must
balance these additional costs with existing infrastructure
demands, the Committee also notes that the fiscal year 2019
Military Construction request for the Army National Guard was a
14 percent decrease from the fiscal year 2018 request,
representing its smallest portion of the Army military
construction budget since 2008. Except for the fiscal year 2015
budget request, the funding level is at its lowest in the post-
2001 era. The Committee urges the Army to provide additional
funding for the Army National Guard in its future years defense
program in order to expedite execution of the RCTMP.
Army Pacific Readiness.--The Committee remains concerned
about the risks that the Army, like the other military
Services, has taken in funding infrastructure and the continued
degradation these risks have on long-term readiness. The
Committee is aware of the Army's $2,600,000,000, 30-year plan
to improve readiness in the Pacific by addressing critical
shortfalls in aviation, operations, training, and munitions
facilities at Schofield Barracks, Wheeler Army Airfield, and
the Pohakuloa Training Area, in Hawaii. The Committee
recognizes that the planned investment of $300,000,000 over the
future years defense program is important to meeting the Army's
short- and long-term readiness needs and ensuring that U.S.
Army Garrison Hawaii remains a deployment platform from which
soldiers in the state can continue to meet critical national
defense missions across the Asia-Pacific region. The Committee
urges the Army to continue to obligate funding toward its long-
range plan to improve its readiness in the Pacific over the
next several decades.
Sunflower Army Ammunition Plant.--The Committee continues
to urge the Army to proactively manage the environmental
remediation of the former Sunflower Army Ammunition Plant
[SFAAP]. The Committee is encouraged that the Army has
addressed the need for improved communications with Sunflower
Redevelopment, LLC [SRL] and supports regular stakeholder
meetings and monthly conference calls with SRL to address
questions or issues related to cleanup and redevelopment of the
former SFAAP. The Committee expects the Army to continue its
risk assessments and evaluations, consistent with applicable
regulations and permit requirements, and to work with
regulatory agencies to ensure all response sites are remediated
to applicable and approved standards. The Committee further
expects the Army to continue work in consultation and
coordination with SRL and ensure SRL redevelopment priorities
are synchronized with Army managed cleanup activities.
Badger Army Ammunition Plant.--The Committee continues to
urge the Army to accelerate, to the extent practicable and
appropriate, its environmental remediation actions at the
former Badger Army Ammunition Plant and directs the Army to
hold regular public meetings to update and engage with local
stakeholders and to integrate local priorities in its
remediation plans and final groundwater remedy for the site and
affected surrounding communities. The Committee supports the
Army's decision to work with the U.S. Geological Survey to
review the current groundwater monitoring program and directs
the Army to use the results of the review to improve the
program to ensure that contaminated groundwater plumes are
monitored and private drinking water wells are protected. The
Committee recognizes that the Town of Merrimac, Wisconsin,
acted in good faith to partner with the Army on the now-
reversed plans to construct a municipal drinking water system,
and directs the Army to consider the construction of a such a
system as a remedial alternative.
Military Construction, Navy and Marine Corps
Appropriations, 2018\1\................................. $1,553,275,000
Budget estimate, 2019................................... 2,543,189,000
Committee recommendation................................ 2,222,522,000
\1\Total excludes $201,636,000 in emergency funding provided in Public
Law 115-123, the Further Additional Supplemental Appropriations for
Disaster Relief Requirements Act, 2018.
---------------------------------------------------------------------------
COMMITTEE RECOMMENDATION
The Committee recommends $2,222,522,000 for Navy and Marine
Corps military construction for fiscal year 2019. This amount
is $669,247,000 above the fiscal year 2018 enacted level and
$320,667,000 below the budget request. Further detail of the
Committee's recommendation is provided in the State table at
the end of this report.
Causeway, Boat Channel & Turning Basin.--The Committee
notes that the work in progress curve submitted with the budget
request shows that the Navy cannot execute the full request of
$117,830,000 in fiscal year 2019. Therefore the Committee
provides $60,000,000 for the first increment of this project.
Naval Shipyard Modernization.--The committee is aware of
the Shipyard Infrastructure Optimization Plan submitted to
Congress in February 2018. The plan seeks to, among other
requirements, assess existing facilities for efficiencies and
address future infrastructure requirements at public shipyards.
It also includes a master plan for each shipyard, including,
but not limited to, capital equipment and facility investment
requirements. The committee believes the Navy's assessment of
public shipyard dry dock capacity is particularly important, as
it identifies 68 deferred maintenance availabilities under the
status quo, 67 of which are restored upon making the public
shipyard dry dock investments within the timeframe recommended
by the plan. Accordingly, the Secretary of the Navy is urged to
adequately prioritize the timely funding of public shipyard
infrastructure, in particular dry dock and shore infrastructure
necessary to support critical maintenance of surface and
submarine fleets by public shipyards.
Navy Strategic Laydown and Dispersal.--The Committee
continues to recognize the inherent risk of natural and man-
made hazards associated with the stationing of U.S. capital
ships at major ports, and the Navy's corresponding requirement
for the strategic dispersal of its fleet in the Pacific and
Atlantic to mitigate that risk. The Navy's internal guidance on
making decisions regarding strategic basing requires that the
Navy consider strategic dispersal strategies and that these
strategies be factored into homeporting decisions to limit the
risk associated with natural disasters or man-made
catastrophes. The Committee continues to believe that strategic
dispersal should be a key consideration in expanding the fleet,
and that, as a first step, the Navy should program military
construction funding, to include planning and design funds, for
necessary infrastructure to achieve strategic dispersal of its
fleet, beginning with the budget request and future years
defense program for fiscal year 2020.
Military Construction, Air Force
Appropriations, 2018.................................... $1,543,558,000
Budget estimate, 2019................................... 1,725,707,000
Committee recommendation................................ 1,495,423,000
COMMITTEE RECOMMENDATION
The Committee recommends $1,495,423,000 for the Air Force
in fiscal year 2019. This amount is $48,135,000 below the
fiscal year 2018 enacted level and $230,284,000 below the
budget request. Further detail of the Committee's
recommendation is provided in the State table at the end of
this report.
Little Rock Air Force Base.--The Committee is concerned
with the failed attempt to repair the runway at Little Rock
AFB, Arkansas. Little Rock AFB, the nation's tactical airlift
Center of Excellence, has the world's largest fleet of C-130
aircraft and is the largest C-130 training base in the world,
training C-130 crews from the U.S. and 47 other nations. The
contract to repair the base's only runway, overseen by the Army
Corps of Engineers [the Corps], was awarded in September 2014
and terminated in June 2017 due to problems with the project.
Despite an estimated contract completion date of April 2017,
the project was only one quarter complete when the Corps
terminated the contract in June 2017. The Committee is
concerned with the issues that led to termination of the
contract, the coordination between the Air Force and the Corps,
and ensuring a follow-on replacement project is adequately
prioritized and funded. Prior Congressional inquiries have
yielded conflicting and inconsistent information. Therefore,
the Committee directs the Secretary of the Air Force to submit
a report coordinated with the Corps no later than 90 days after
enactment of this act providing the status on the cancelled
project and replacement project, including what happened to the
funding used for the original contract, a justification for the
increase in cost for the new project, if any of the completed
work from the cancelled project is salvageable, how the Air
Force is resolving the issues that led to contract termination
and ensuring, to the extent possible, that they are not
repeated in follow-on contracts, and how and when a future
project will be funded. Additionally, the Committee directs the
Air Force to appoint a senior official who shall be responsible
for the project and will provide quarterly project updates to
the congressional defense committees.
Air Force Ballistic Missile Facilities.--The Committee
remains concerned with the deteriorating infrastructure of the
ground-based intercontinental ballistic missile facilities at
Malmstrom AFB, Montana; Minot AFB, North Dakota; and F.E.
Warren AFB, Wyoming. The Missile Alert Facilities [MAF] at
these bases are in advanced states of disrepair. In February
2018, the Air Force provided the Committee a study that
highlighted the need to recapitalize the MAFs. Further, the
Committee understands that Air Force Global Strike Command
continues to be in the process of identifying, validating, and
finalizing facility requirements, as well as analyzing
commercial electrical power infrastructure to support the
missile fields. The Committee directs the Secretary of the Air
Force to provide compiled results as soon as they become
available.
Air Force Space Rapid Capabilities Office.--The Committee
notes that Air Force facilities supporting the space enterprise
reorganization are lacking the secure compartmentalized
information facility [SCIF] space needed to interact with all
commercial partners, especially small business partners that
may be developing cutting edge technology to aid the Air
Force's space capabilities. This includes both secure office/
meeting spaces as well as secure hardware development,
integration and testing spaces. Therefore, the Committee
directs the Air Force to submit an analysis within 180 days of
enactment of this Act detailing the SCIF needs for both secure
office/meeting spaces as well as secure hardware development,
integration and testing spaces that could improve small
business engagement with the Space RCO and the Space and
Missile Systems Center. The analysis shall include a sample of
current and would be business partners' needs, as well as
inputs from Space RCO, Space Command, and the Space and Missile
Systems Center.
Military Construction, Defense-Wide
(INCLUDING TRANSFER OF FUNDS)
Appropriations, 2018\1\................................. $2,811,513,000
Budget estimate, 2019................................... 2,693,324,000
Committee recommendation................................ 2,575,938,000
\1\Total excludes $200,000,000 in emergency funding provided in Public
Law 115-96, Continuing Appropriations Act, Department of Defense Missile
Defeat and Defense Enhancements Appropriations Act, 2018.
---------------------------------------------------------------------------
COMMITTEE RECOMMENDATION
The Committee recommends $2,575,938,000 for projects
considered within the Defense-Wide account in fiscal year 2019.
This amount is $235,575,000 below the fiscal year 2018 enacted
level and $117,386,000 below the budget request. Further detail
of the Committee's recommendation is provided in the State
table at the end of this report.
Hydrant Fuel Systems in Support of Humanitarian Assistance
and Disaster Relief Operations.--The Committee notes that the
Department of Defense has a long history of successfully
conducting urgently needed humanitarian assistance and disaster
relief [HADR] missions. In recent years HADR missions have
responded to major earthquakes, tsunamis, typhoons, hurricanes,
floods, and the nuclear disaster in Fukushima, Japan. The
Committee believes that hydrant fuel systems capable of
supporting large scale fueling of heavy aircraft are an
essential component of our HADR capability. The Committee
continues to encourage the services and the Defense Logistics
Agency to prioritize construction and enhancement of these
systems in locations that serve as staging bases for HADR
operations.
Military Construction, Army National Guard
Appropriations, 2018\1\................................. $220,652,000
Budget estimate, 2019................................... 180,122,000
Committee recommendation................................ 190,122,000
\1\Total excludes $519,345,000 in emergency funding provided in Public
Law 115-123, the Further Additional Supplemental Appropriations for
Disaster Relief Requirements Act, 2018.
---------------------------------------------------------------------------
COMMITTEE RECOMMENDATION
The Committee recommends $190,122,000 for Military
Construction, Army National Guard for fiscal year 2019. This
amount is $30,530,000 below the fiscal year 2018 enacted level
and $10,000,000 above the budget request. Further detail of the
Committee's recommendation is provided in the State table at
the end of this report.
Military Construction, Air National Guard
Appropriations, 2018.................................... $171,491,000
Budget estimate, 2019................................... 129,126,000
Committee recommendation................................ 139,126,000
COMMITTEE RECOMMENDATION
The Committee recommends $139,126,000 for Military
Construction, Air National Guard for fiscal year 2019. This
amount is $32,365,000 below the fiscal year 2018 enacted level
and $10,000,000 above the budget request. Further detail of the
Committee's recommendation is provided in the State table at
the end of this report.
Military Construction, Army Reserve
Appropriations, 2018.................................... $83,712,000
Budget estimate, 2019................................... 64,919,000
Committee recommendation................................ 64,919,000
COMMITTEE RECOMMENDATION
The Committee recommends $64,919,000 for Military
Construction, Army Reserve for fiscal year 2019. This amount is
$18,793,000 below the fiscal year 2018 enacted level and equal
to the budget request. Further detail of the Committee's
recommendation is provided in the State table at the end of
this report.
Military Construction, Navy Reserve
Appropriations, 2018.................................... $95,271,000
Budget estimate, 2019................................... 43,065,000
Committee recommendation................................ 43,065,000
COMMITTEE RECOMMENDATION
The Committee recommends $43,065,000 for Military
Construction, Navy Reserve for fiscal year 2019. This amount is
$52,206,000 below the fiscal year 2018 enacted level and equal
to the budget request. Further detail of the Committee's
recommendation is provided in the State table at the end of
this report.
Military Construction, Air Force Reserve
Appropriations, 2018.................................... $73,535,000
Budget estimate, 2019................................... 50,163,000
Committee recommendation................................ 50,163,000
COMMITTEE RECOMMENDATION
The Committee recommends $50,163,000 for Military
Construction, Air Force Reserve for fiscal year 2019. This
amount is $23,372,000 below the fiscal year 2018 enacted level
and equal to the budget request. Further detail of the
Committee's recommendation is provided in the State table at
the end of this report.
North Atlantic Treaty Organization
SECURITY INVESTMENT PROGRAM
Appropriations, 2018.................................... $177,932,000
Budget estimate, 2019................................... 171,064,000
Committee recommendation................................ 171,064,000
PROGRAM DESCRIPTION
The North Atlantic Treaty Organization [NATO] appropriation
provides for the U.S. cost share of the NATO Security
Investment Program for the acquisition and construction of
military facilities and installations (including international
military headquarters) and for related expenses for the
collective defense of the NATO Treaty area.
COMMITTEE RECOMMENDATION
The Committee recommends $171,064,000 for the North
Atlantic Treaty Organization Security Investment Program for
fiscal year 2019. This amount is $6,868,000 below the fiscal
year 2018 enacted level and equal to the budget request.
Department of Defense Base Closure Account
Appropriations, 2018.................................... $310,000,000
Budget estimate, 2019................................... 267,538,000
Committee recommendation................................ 277,538,000
PROGRAM DESCRIPTION
Section 2711 of the National Defense Authorization Act for
Fiscal Year 2014 (Public Law 112-239) consolidated the Base
Closure Account 1990 and the Base Closure Account 2005 into a
single Department of Defense Base Closure Account. The Base
Closure Account provides for cleanup and disposal of property
consistent with the four closure rounds required by the base
closure acts of 1988 and 1990, and with the 2005 closure round
required by the Defense Base Closure and Realignment Act of
1990 (10 U.S.C. 2687 note).
COMMITTEE RECOMMENDATION
The Committee recommends a total of $277,538,000 for the
Department of Defense Base Closure Account for fiscal year
2019. This amount is $32,462,000 below the fiscal year 2018
enacted level and $10,000,000 above the budget request. Funds
provided for fiscal year 2019 are for environmental cleanup and
ongoing operations and maintenance.
Perfluorooctane Sulfonate [PFOS] and Perfluorooctanoic Acid
[PFOA].--The Committee has provided $10,000,000 in additional
funds for identification, mitigation, and clean-up costs across
the Department of Defense for PFOS and PFOA. DOD is directed to
provide a spend plan for these additional funds to the
Committee no later than 30 days after enactment of this act.
Family Housing Overview
Appropriations, 2018.................................... $1,409,437,000
Budget estimate, 2019................................... 1,582,632,000
Committee recommendation................................ 1,582,632,000
FAMILY HOUSING ACCOUNTS--PROGRAM DESCRIPTION
The Family Housing appropriation provides funds for
military family housing construction activities, operation and
maintenance, the Family Housing Improvement Fund, and the
Homeowners Assistance Program. Construction accounts provide
funding for new construction, improvements and the Federal
Government share of housing privatization. Operation and
maintenance accounts fund costs associated with the maintenance
and leasing of military family housing, including utilities,
services, management, and furnishings.
COMMITTEE RECOMMENDATION
The Committee recommends $1,582,632,000 for Family Housing
Construction, Operations and Maintenance, and the Department's
family housing improvement fund for fiscal year 2019. This
amount is $173,195,000 above the fiscal year 2018 enacted level
and equal to the budget request.
Family Housing Construction, Army
Appropriations, 2018.................................... $182,662,000
Budget estimate, 2019................................... 330,660,000
Committee recommendation................................ 330,660,000
COMMITTEE RECOMMENDATION
The Committee recommends $330,660,000 for Army Family
Housing Construction in fiscal year 2019. This amount is
$147,998,000 above the fiscal year 2018 enacted level and equal
to the budget request. Further detail of the Committee's
recommendation is provided in the State table at the end of
this report.
Family Housing Operation and Maintenance, Army
Appropriations, 2018.................................... $348,907,000
Budget estimate, 2019................................... 376,509,000
Committee recommendation................................ 376,509,000
COMMITTEE RECOMMENDATION
The Committee recommends $376,509,000 for family housing
operation and maintenance, Army for fiscal year 2019. This
amount is $27,602,000 above the fiscal year 2018 enacted level
and equal to the budget request.
Family Housing Construction, Navy and Marine Corps
Appropriations, 2018.................................... $83,682,000
Budget estimate, 2019................................... 104,581,000
Committee recommendation................................ 104,581,000
COMMITTEE RECOMMENDATION
The Committee recommends $104,581,000 for Family Housing
Construction, Navy and Marine Corps. This amount is $20,899,000
above the fiscal year 2018 enacted level and equal to the
budget request. Further detail of the Committee's
recommendation is provided in the State table at the end of
this report.
Family Housing Operation and Maintenance, Navy and Marine Corps
Appropriations, 2018.................................... $328,282,000
Budget estimate, 2019................................... 314,536,000
Committee recommendation................................ 314,536,000
COMMITTEE RECOMMENDATION
The Committee recommends $314,536,000 for family housing
operation and maintenance, Navy and Marine Corps, in fiscal
year 2019. This amount is $13,746,000 below the fiscal year
2018 enacted level and equal to the budget request.
Naval Support Activity Bahrain General and Flag Officers
Quarters.--Public Law 115-141 provided $2,138,000 for the
construction of on-base housing. The Committee understands that
the Navy no longer intends to construct the housing facility,
and is in the process of determining a suitable alternative.
Therefore, the Committee rescinds $2,138,000 from the Navy
Family Housing Construction account. Furthermore, the Committee
is deeply concerned by the current off-base high cost lease and
directs the Secretary of the Navy to keep the Committee
apprised of progress on lease negotiation.
Family Housing Construction, Air Force
Appropriations, 2018.................................... $85,062,000
Budget estimate, 2019................................... 78,446,000
Committee recommendation................................ 78,446,000
COMMITTEE RECOMMENDATION
The Committee recommends $78,446,000 for Family Housing
Construction, Air Force, in fiscal year 2019. This amount is
$6,616,000 below the fiscal year 2018 enacted level and equal
to the budget request. Further detail of the Committee's
recommendation is provided in the State table at the end of
this report.
Family Housing Operation and Maintenance, Air Force
Appropriations, 2018.................................... $318,324,000
Budget estimate, 2019................................... 317,274,000
Committee recommendation................................ 317,274,000
COMMITTEE RECOMMENDATION
The Committee recommends $317,274,000 for family housing
operation and maintenance, Air Force, in fiscal year 2019. This
amount is $1,050,000 below the fiscal year 2018 enacted level
and equal to the budget request.
Family Housing Operation and Maintenance, Defense-Wide
Appropriations, 2018.................................... $59,169,000
Budget estimate, 2019................................... 58,373,000
Committee recommendation................................ 58,373,000
COMMITTEE RECOMMENDATION
The Committee recommends $58,373,000 for family housing
operation and maintenance, Defense-Wide, for fiscal year 2019.
This amount is $796,000 below the fiscal year 2018 enacted
level and equal to the budget request.
Department of Defense Family Housing Improvement Fund
Appropriations, 2018.................................... $2,726,000
Budget estimate, 2019................................... 1,653,000
Committee recommendation................................ 1,653,000
PROGRAM DESCRIPTION
The Family Housing Improvement Fund appropriation provides
for the Department of Defense to undertake housing initiatives
and to provide an alternative means of acquiring and improving
military family housing and supporting facilities. This account
provides seed money for housing privatization initiatives.
COMMITTEE RECOMMENDATION
The Committee recommends $1,653,000 for the Family Housing
Improvement Fund in fiscal year 2019. This amount is $1,073,000
below the fiscal year 2018 enacted level and equal to the
budget request.
Department of Defense Military Unaccompanied Housing Improvement Fund
Appropriations, 2018.................................... $623,000
Budget estimate, 2019................................... 600,000
Committee recommendation................................ 600,000
PROGRAM DESCRIPTION
The Military Unaccompanied Housing Improvement Fund
appropriation provides for the Department of Defense to
undertake housing initiatives and to provide an alternative
means of acquiring and improving military unaccompanied housing
and supporting facilities. This account provides seed money for
housing privatization initiatives.
COMMITTEE RECOMMENDATION
The Committee recommends $600,000 for the Military
Unaccompanied Housing Improvement Fund in fiscal year 2019.
This amount is $23,000 below the fiscal year 2018 enacted level
and equal to the budget request.
Administrative Provisions
Sec. 101. The Committee includes a provision that restricts
payments under a cost-plus-a-fixed-fee contract for work,
except in cases of contracts for environmental restoration at
base closure sites.
Sec. 102. The Committee includes a provision that permits
the use of funds for the hire of passenger motor vehicles.
Sec. 103. The Committee includes a provision that permits
the use of funds for defense access roads.
Sec. 104. The Committee includes a provision that prohibits
construction of new bases inside the continental United States
for which specific appropriations have not been made.
Sec. 105. The Committee includes a provision that limits
the use of funds for purchase of land or land easements.
Sec. 106. The Committee includes a provision that prohibits
the use of funds to acquire land, prepare a site, or install
utilities for any family housing except housing for which funds
have been made available.
Sec. 107. The Committee includes a provision that limits
the use of minor construction funds to transfer or relocate
activities among installations.
Sec. 108. The Committee includes a provision that prohibits
the procurement of steel unless American producers,
fabricators, and manufacturers have been allowed to compete.
Sec. 109. The Committee includes a provision that prohibits
payments of real property taxes in foreign nations.
Sec. 110. The Committee includes a provision that prohibits
construction of new bases overseas without prior notification.
Sec. 111. The Committee includes a provision that
establishes a threshold for American preference of $500,000
relating to architect and engineering services for overseas
projects.
Sec. 112. The Committee includes a provision that
establishes preference for American contractors for military
construction in the United States territories and possessions
in the Pacific, and on Kwajalein Atoll, or in countries
bordering the Arabian Gulf.
Sec. 113. The Committee includes a provision that requires
notification of military exercises involving construction in
excess of $100,000.
Sec. 114. The Committee includes a provision that permits
funds appropriated in prior years to be available for
construction authorized during the current session of Congress.
Sec. 115. The Committee includes a provision that permits
the use of expired or lapsed funds to pay the cost of
supervision for any project being completed with lapsed funds.
Sec. 116. The Committee includes a provision that permits
obligation of funds from more than 1 fiscal year to execute a
construction project, provided that the total obligation for
such project is consistent with the total amount appropriated
for the project.
Sec. 117. The Committee includes a provision that permits
the transfer of funds from Family Housing Construction accounts
to the DOD Family Housing Improvement Fund and from Military
Construction accounts to the DOD Military Unaccompanied Housing
Improvement Fund.
Sec. 118. The Committee includes a provision that provides
transfer authority to the Homeowners Assistance Fund.
Sec. 119. The Committee includes a provision that requires
all acts making appropriations for military construction be the
sole funding source of all operation and maintenance for family
housing, including flag and general officer quarters, and
limits the repair on flag and general officer quarters to
$35,000 per unit per year without prior notification to the
congressional defense committees.
Sec. 120. The Committee includes a provision that provides
authority to expend funds from the ``Ford Island Improvement''
account.
Sec. 121. The Committee includes a provision that allows
the transfer of expired funds to the Foreign Currency
Fluctuation, Construction, Defense Account.
Sec. 122. The Committee includes a provision that allows
the reprogramming of military construction and family housing
construction funds among projects and activities within the
account in which they are funded.
Sec. 123. The Committee includes a provision that prohibits
the use of funds in this title for planning and design and
construction of projects at Arlington National Cemetery.
Sec. 124. The Committee includes a provision providing
additional funds for unfunded military construction priorities.
Sec. 125. The Committee includes a provision rescinding
unobligated balances from various Military Construction
accounts.
Sec. 126. The Committee includes a provision defining the
congressional defense committees.
Sec. 127. The Committee includes a provision prohibiting
the use of funds in this title to close or realign Naval
Station Guantanamo Bay, Cuba. The provision is intended to
prevent the closure or transfer 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.
Sec. 128. The Committee includes a provision regarding the
consolidation or relocation of a U.S. Air Force RED HORSE
Squadron outside of the United States.
Sec. 129. The Committee includes a provision providing
additional funding for Defense Access Roads.
Sec. 130. The Committee includes a provision directing all
amounts appropriated to military construction accounts be
immediately available and allotted for the full scope of
authorized projects.
TITLE II
DEPARTMENT OF VETERANS AFFAIRS
Items of Special Interest
HEARINGS
The Subcommittee on Military Construction, Veterans
Affairs, and Related Agencies held one hearing related to the
fiscal year 2019 and 2020 Department of Veterans Affairs [VA]
budget request. The subcommittee heard testimony from The
Honorable Randy C. Reeves, Under Secretary for Memorial
Affairs, National Cemetery Administration; The Honorable Jon J.
Rychalski, Assistant Secretary for Management and Chief
Financial Officer, Department of Veterans Affairs; Carolyn M.
Clancy, M.D., Executive in Charge, Veterans Health
Administration; and Mr. Thomas J. Murphy, Executive in Charge,
Veterans Benefits Administration.
SUMMARY OF COMMITTEE RECOMMENDATIONS
The Committee recommendation includes $195,569,404,000 for
the Department of Veterans Affairs for fiscal year 2019,
including $109,120,059,000 in mandatory spending and
$86,449,345,000 in discretionary spending. The Committee also
recommends $75,550,600,000 in advance appropriations for
veterans medical care for fiscal year 2020 and $121,296,429,000
in advance appropriations for appropriated mandatories for
fiscal year 2020.
DEPARTMENT OVERVIEW
The Veterans Administration was established on July 21,
1930, as an independent agency by Executive Order 5398, in
accordance with the act of July 3, 1930 (46 Stat. 1016). This
act authorized the President to consolidate and coordinate
Federal agencies specially created for or concerned with the
administration of laws providing benefits to veterans,
including the Veterans' Bureau, the Bureau of Pensions, and the
National Home for Disabled Volunteer Soldiers. On March 15,
1989, the Veterans Administration was elevated to Cabinet-level
status as the Department of Veterans Affairs.
VA's mission is to serve America's veterans and their
families as their principal advocate in ensuring they receive
the care, support, and recognition they have earned in service
to the Nation. As of September 30, 2017, there were an
estimated 20 million living veterans, with 19.9 million of them
residing in the United States and Puerto Rico. There were an
estimated 23.5 million dependents (spouses and dependent
children) of living veterans in the United States and Puerto
Rico, and there were 579,000 survivors of deceased veterans
receiving VA survivor benefits in the United States and Puerto
Rico. Thus, approximately 44 million people, or 13.4 percent of
the total estimated resident population of the United States
and Puerto Rico, were recipients or potential recipients of
veterans benefits from the Federal Government. VA's operating
units include the Veterans Benefits Administration, Veterans
Health Administration, National Cemetery Administration, and
staff support offices.
The Veterans Benefits Administration [VBA] provides an
integrated program of nonmedical veterans benefits. VBA
administers a broad range of benefits to veterans and other
eligible beneficiaries through 56 regional offices; three
Pension Management Centers; six Fiduciary Hubs; three
Educational Regional Processing Offices; eight Regional Loan
Centers; one Insurance Center; eight National Call Centers; and
a records processing center in St. Louis, Missouri. The
benefits provided include: compensation for service-connected
disabilities; pensions for wartime, needy, and totally disabled
veterans; vocational rehabilitation assistance; educational and
training assistance; home buying assistance; estate protection
services for veterans under legal disability; information and
assistance through personalized contacts; and six life
insurance programs.
The Veterans Health Administration [VHA] develops,
maintains, and operates a national healthcare delivery system
for eligible veterans; carries out a program of education and
training of healthcare personnel; conducts medical research and
development; and furnishes health services to members of the
Armed Forces during periods of war or national emergency. A
system consisting of 145 VA Hospitals; 24 Health Care Centers
[HCC]; 199 Multi-Specialty Community-Based outpatient clinics;
544 Primary Care Community-Based outpatient clinics; 294
Outpatient Services Sites; 134 community living centers; 120
domiciliary residential rehabilitation treatment programs
[DRRTP]; 300 readjustment counseling vet centers; and 80 mobile
vet centers is maintained to meet the VA's medical mission.
The National Cemetery Administration [NCA] provides for the
interment of the remains of eligible deceased servicemembers
and discharged veterans in any national cemetery with available
grave space; permanently maintains these graves; provides
headstones and markers for the graves of eligible persons in
national and private cemeteries; administers the grant program
for aid to States in establishing, expanding, or improving
State veterans cemeteries; and provides certificates to
families of deceased veterans recognizing their contributions
and service to the Nation. In 2019, cemetery activities will
encompass 139 national cemeteries (including four new national
cemeteries), one national veterans' burial ground, and 33
soldiers' lots and monument sites.
Staff support offices include the Office of Inspector
General, Boards of Contract Appeals and Veterans Appeals, and
General Administration offices, which support the Secretary,
Deputy Secretary, Under Secretary for Benefits, Under Secretary
for Health, Under Secretary for Memorial Affairs, and General
Counsel.
Aligning Veteran Benefits with Veteran Medical Care.--The
Committee is concerned by reports that many veterans utilizing
education benefits are not also registered for health benefits
and are, therefore, not receiving adequate medical care for
treatable conditions such as mental health and musculoskeletal
ailments. Given the impact that untreated psychological and
physical ailments can have on educational success, the
Department is directed to submit to the Committees on
Appropriations of both Houses of Congress a report within 180
days of enactment of this act, detailing the number of veterans
enrolled in education benefits but not medical benefits and any
disparities in educational outcomes between veterans utilizing
medical benefits as compared to those who are not.
Transitioning Servicemembers.--The ability of communities
to build networks, including through public-private
partnerships, to provide resources to servicemembers, veterans,
and their families is critical for ensuring that transitioning
service members and veterans have the support they need in
their civilian lives. The Committee encourages the Department
to provide support for such networked approaches, including
through public-private partnerships.
Study and Measures to Address Regrettable Losses.--The
Committee is concerned that VA has failed to follow-up on
repeated recommendations of the Office of Inspector General to
review data on regrettable losses and consider implementing
measures to reduce such losses. Given the staffing demands on
the Department and the challenges it faces in recruiting
personnel, VA should work to retain those staff who could have
remained with the Department but left. The Secretary should
work expeditiously to better understand why personnel leave the
Agency and work to mitigate such losses.
Contractor Accountability.--The Committee is concerned
about the lack of transparency in the contract oversight
process, as well as the lack of visibility into contractor
performance. Whenever the Secretary provides notice to a
contracted service provider that the service provider is
failing to meet contractual obligations, VA must submit to the
Appropriations Committees and the Committees on Veterans'
Affairs of the Senate and the House of Representatives
notification of such failure. At a minimum, the notification
should include: (1) an explanation of the reasons for providing
such notice; (2) a description of the effect of such failure,
including with respect to cost, schedule, and requirements; (3)
a description of the actions taken by the Secretary to mitigate
such failure; and, (4) a description of the actions taken by
the contractor to address such failure.
Contracting Fraud.--The Committee is concerned by continued
incidents of willful misrepresentation of veteran or service-
disabled veteran status for the purposes of winning Federal
contract set-asides and believes that a more effective
disincentive is required to prevent this fraudulent behavior,
which harms legitimate veteran-owned and service-disabled
veteran owned small businesses. The Committee encourages the
Department, in consultation with relevant agency partners, to
examine potential regulatory and legislative actions to more
effectively prevent contracting fraud, including the
possibility of expanding the current VA mandatory 5-year
contracting debarment penalty to all Federal agencies.
Financial Hardship and Bankruptcy.--The Committee continues
to support VA programs that combat the root causes of veteran
and dependent financial hardship, which is a known contributory
factor to negative outcomes such as mental health issues,
substance use disorder, and suicide. For example, disability-
related benefits not only honor the service and sacrifice of
the veterans who receive them, but also help to replace lost
wages and provide a critical source of economic well-being. The
Committee continues to be concerned by an inequity in current
bankruptcy law that results in the inclusion of VA and DOD
disability benefits in the calculation of a debtor's disposable
income, while at the same time excluding Social Security
disability benefits for non-veterans. The Committee hopes that
this discrepancy between VA and Social Security disability
benefits with regard to calculating a debtor's disposable
income can be resolved in the near future.
Appeals Process.--The Committee directs the Secretary to
ensure the Department is in full compliance with all
requirements of the Veterans Appeals Improvement and
Modernization Act of 2017 (Public Law 115-55). Additionally,
the Committee urges the Department to fully implement the GAO's
recommendations to better ensure the successful implementation
of a new disability appeals process while attending to appeals
in the current process.
Public Private Partnerships.--The Committee is aware of the
need to expand the Department's research investment to leverage
non-Federal initiatives which provide the opportunity for
strong co-location of VA and university biomedical scientists
for translational investigation which has high potential for
precision medicine outcomes for wounded warriors and other high
at risk veteran's populations. The Committee notes the high
concentration of VA research enterprises on the Nation's two
coasts. The Committee urges the Undersecretary for Health
Affairs to expedite consideration of proposals for research
complexes where there is multi-disciplinary investigation
related to veterans and wounded warriors, including medicine,
engineering and veterinary science. Such consideration should
be timely to inform action in the fiscal year 2020 budget.
Improper Benefits.--The Department of Veterans Affairs [VA]
currently uses the Social Security Administration's [SSA] Death
Master File [DMF] as a tool for reducing improper benefits.
Following a Government Accountability Office [GAO] report that
highlighted the DMF did not always reflect the most current and
accurate data, SSA began to take steps to address these
shortcomings. The Committee encourages the Department to
explore the utilization of commercially available sources for
obtaining the most accurate and extensive deceased data
resources to identify, validate, and document deceased veterans
in order to prevent improper payment of benefits.
Security Risk Management.--The Committee understands the
challenges associated with providing secure and accessible
access to Department facilities. However, the Committee is
concerned that the Department's current risk management
policies are not sufficient to ensure medical facilities are
adequately protected. The Department is urged to, in
coordination with the Interagency Security Committee, review
and revise its current risk management process, and develop an
oversight strategy that allows the Department to properly
assess risk management programs in all VHA facilities. The
Department is directed to submit a report to the Committees on
Appropriations of both Houses of Congress no later than 180
days after enactment of this act detailing the findings of its
review and the steps taken to develop the oversight strategy.
Compensation Claims for Camp Lejeune Contaminated Water
Veterans.--There is concern regarding the lack of consistency
in the Department's handling of disability compensation claims
for veterans, former reservists, and former National Guard
members who served at Marine Corps Base Camp Lejeune for no
less than 30 days (consecutive or nonconsecutive) between
August 1, 1953 and December 31, 1987. VA established a
presumption of service connection for eight diseases associated
with exposure to contaminants in the water supply at Camp
Lejeune during that period. The Department made the decision to
subject nonpresumptive Camp Lejeune Contaminated Water [CLCW]
exposure claims to a higher level of scrutiny than is applied
to other exposure claims and did so without providing notice or
an opportunity for public comment. In addition, no other toxic
exposure claims require a positive medical opinion to warrant
service connection. The evidentiary burden VA requires for CLCW
nonpresumptive exposure claims is significantly greater than
the standard used for Agent Orange or any other exposure
claims. Furthermore, there currently exists a wealth of
``competent medical evidence'' specific to diseases related to
exposure to contaminated water at Camp Lejeune, as published by
the Agency for Toxic Substances and Disease Registry [ATSDR],
the Institute of Medicine [IoM], and other government
sanctioned medical experts. Nevertheless, the Department's same
Clinical Subject Matter Experts, who provide medical opinions,
have routinely rejected ATSDR and IoM's findings without
providing any justification or explanation for doing so.
The Department was directed to conduct a Special Focus
Review for the CLCW claims process and submit the results of
the review in the Explanatory Statement accompanying Public Law
115-141, the Consolidated Appropriations Act, 2018. The
Committee looks forward to receiving this report in a timely
manner.
Community Wellness Programs.--Public Law 115-141, the
Consolidated Appropriations Act, 2018, established a 2-year
program for VA to award grants to nonprofit Veterans Services
Organizations [VSOs] to upgrade, through construction and
repair, VSO community facilities into health and wellness
centers, and to promote and expand complementary and
integrative wellness programs. Complementary and integrative
wellness programs are increasingly being recognized as useful
adjuncts to meet the needs of veterans who have experienced
trauma.
Veterans Benefits Administration
Appropriations, 2018
$107,038,649,000
Advance Appropriations, 2019
107,709,727,000
Budget estimate, 2019
4,481,437,000
Committee recommendation, 2019
4,568,858,000
Budget estimate, advance appropriations, 2020
121,296,429,000
Committee recommendation, advance appropriations, 2020
121,296,429,000
ADMINISTRATION OVERVIEW
The Veterans Benefits Administration is responsible for the
payment of compensation and pension benefits to eligible
service-connected disabled veterans, as well as education
benefits and housing loan guarantees.
COMMITTEE RECOMMENDATION
In fiscal year 2018, the Committee provided
$107,709,727,000 in advance appropriations for the Veterans
Benefits Administration for fiscal year 2019. This included
$95,768,462,000 for Compensation and pensions; $11,832,175,000
for Readjustment benefits; and $109,090,000 for Veterans
insurance and indemnities.
For fiscal year 2019, the Committee recommends an
additional $1,410,332,000 for Compensation and Pensions as
requested by the administration. Additionally, the Committee
recommendation includes $200,612,000 for the Veterans Housing
Benefit Program Fund administrative expenses; $39,000 for the
Vocational Rehabilitation Loans Program account, with $396,000
for administrative expenses; $1,163,000 for the Native American
Veteran Housing Loan Program account; $2,956,316,000 for
General Operating Expenses, Veterans Benefits Administration
account.
The Committee recommendation also provides $121,296,429,000
in advance appropriations for the Veterans Benefits
Administration's mandatory accounts for fiscal year 2020.
COMPENSATION AND PENSIONS
(INCLUDING TRANSFER OF FUNDS)
Appropriations, 2018.................................... $90,119,449,000
Advance Appropriations, 2019............................ 95,768,462,000
Budget estimate, 2019................................... 1,410,332,000
Committee recommendation, 2019.......................... 1,410,332,000
Budget estimate, advance appropriations, 2020........... 107,119,807,000
Committee recommendation, advance appropriations, 2020.. 107,119,807,000
PROGRAM DESCRIPTION
Compensation is payable to living veterans who have
suffered impairment of earning power from service-connected
disabilities. The amount of compensation is based upon the
impact of disabilities on a veteran's earning capacity. Death
compensation or dependency and indemnity compensation is
payable to the surviving spouses and dependents of veterans
whose deaths occur while on active duty or result from service-
connected disabilities. A clothing allowance may also be
provided for service-connected veterans who use a prosthetic or
orthopedic device. In fiscal year 2019, the Department
estimates it will obligate $92,477,647,000 for payments to
4,850,289 veterans, 432,353 survivors, and 1,134 dependents
receiving special benefits.
Pensions are an income security benefit payable to needy
wartime veterans who are precluded from gainful employment due
to nonservice-connected disabilities which render them
permanently and totally disabled. Public Law 107-103, the
Veterans Education and Benefits Expansion Act of 2001, restored
the automatic presumption of permanent and total nonservice
connected disability for purposes of awarding a pension to
veterans age 65 and older, subject to the income limitations
that apply to all pensioners. Death pensions are payable to
needy surviving spouses and children of deceased wartime
veterans. The rate payable for both disability and death
pensions is determined on the basis of the annual income of the
veteran or their survivors. In fiscal year 2019, the Department
estimates that the Pensions program will provide benefits to
268,729 veterans and 199,972 survivors totaling $5,560,719,000.
The Compensation and Pensions program funds certain burial
benefits on behalf of eligible deceased veterans. These
benefits provide the purchase and transportation costs for
headstones and markers, graveliners, and pre-placed crypts; and
provide partial reimbursement for privately purchased outer
burial receptacles. In fiscal year 2019, the Department
estimates the Compensation and Pensions program will obligate
$261,943,000 providing burial benefits. This funding will
provide 62,184 burial allowances, 34,089 burial plot
allowances, 44,609 service-connected death awards, 497,644
burial flags, 378,701 headstones or markers, 42,295 graveliners
or reimbursement for privately purchased outer burial
receptacles, and 310 caskets and urns for the internment of the
remains of veterans without next of kin.
COMMITTEE RECOMMENDATION
In fiscal year 2018, the Committee provided an advance
appropriation of $95,768,462,000 for fiscal year 2019 for the
Compensation and Pensions account. The Committee recommendation
includes an additional $1,410,332,000 for Compensation and
Pensions as requested.
The Committee recommendation includes an advance
appropriation of $107,119,807,000 for Compensation and pensions
for fiscal year 2020.
READJUSTMENT BENEFITS
Appropriations, 2018.................................... $13,708,648,000
Advance Appropriations, 2019............................ 11,832,175,000
Budget estimate, advance appropriations, 2020........... 14,065,282,000
Committee recommendation, advance appropriations, 2020.. 14,065,282,000
PROGRAM DESCRIPTION
The Readjustment benefits appropriation finances the
education and training of veterans and servicemembers under
chapters 30, 31, 32, 33, 34, 35, 36, 37, 39, 41, 42 and 43 of
title 38, United States Code. These benefits include the All-
Volunteer Force Educational Assistance Program (Montgomery GI
bill) and the Post 9/11 Educational Assistance Program. Basic
benefits are funded through appropriations made to the
readjustment benefits appropriation and by transfers from the
Department of Defense. This account also finances vocational
rehabilitation, specially adapted housing grants, specially
adapted automobile grants for certain disabled veterans, and
educational assistance allowances for eligible dependents of
those veterans who died from service-connected causes or who
have a total permanent service-connected disability, as well as
dependents of servicemembers who were captured or missing in
action.
COMMITTEE RECOMMENDATION
In fiscal year 2018, the Committee provided an advance
appropriation of $11,832,175,000 for the Readjustment Benefits
account for fiscal year 2019.
The Committee recommendation includes an advance
appropriation of $14,065,282,000 for Readjustment benefits for
fiscal year 2020.
VETERANS INSURANCE AND INDEMNITIES
Appropriations, 2018.................................... $120,338,000
Advance Appropriations, 2019............................ 109,090,000
Budget estimate, advance appropriations, 2020........... 111,340,000
Committee recommendation, advance appropriations, 2020.. 111,340,000
PROGRAM DESCRIPTION
The Veterans insurance and indemnities appropriation
consists of the former appropriations for military and naval
insurance, applicable to World War I veterans; National Service
Life Insurance, applicable to certain World War II veterans;
servicemen's indemnities, applicable to Korean conflict
veterans; and veterans mortgage life insurance to individuals
who have received a grant for specially adapted housing.
COMMITTEE RECOMMENDATION
In fiscal year 2018, the Committee provided an advance
appropriation of $109,090,000 for fiscal year 2019 for the
Veterans Insurance and Indemnities account.
The Committee recommendation includes an advance
appropriation of $111,340,000 for Veterans insurance and
indemnities for fiscal year 2020.
VETERANS HOUSING BENEFIT PROGRAM FUND
------------------------------------------------------------------------
Administrative
Program account expenses
------------------------------------------------------------------------
Appropriations, 2018................ ................ $178,626,000
Budget estimate, 2019............... ................ 200,612,000
Committee recommendation............ ................ 200,612,000
------------------------------------------------------------------------
PROGRAM DESCRIPTION
The Veterans housing benefit program fund provides for all
costs associated with VA's direct and guaranteed housing loan
programs, with the exception of the Native American veteran
housing loan program.
VA loan guaranties are made to servicemembers, veterans,
reservists, and unremarried surviving spouses for the purchase
of homes, condominiums, and manufactured homes, and for
refinancing loans. VA guarantees part of the total loan,
permitting the purchaser to obtain a mortgage with a
competitive interest rate, even without a downpayment, if the
lender agrees. VA requires a downpayment be made for a
manufactured home. With a VA guaranty, the lender is protected
against loss up to the amount of the guaranty if the borrower
fails to repay the loan.
COMMITTEE RECOMMENDATION
The Committee recommends such sums as may be necessary for
funding subsidy payments, and $200,612,000 for administrative
expenses for fiscal year 2019. Bill language limits gross
obligations for direct loans for specially adapted housing to
$500,000.
VOCATIONAL REHABILITATION LOANS PROGRAM ACCOUNT
------------------------------------------------------------------------
Administrative
Program account expenses
------------------------------------------------------------------------
Appropriations, 2018................ $30,000 $395,000
Budget estimate, 2019............... 39,000 396,000
Committee recommendation............ 39,000 396,000
------------------------------------------------------------------------
PROGRAM DESCRIPTION
The Vocational Rehabilitation Loans Program account covers
the cost of direct loans for vocational rehabilitation of
eligible veterans and, in addition, includes administrative
expenses necessary to carry out the direct loan program. Loans
of up to $1,235 (based on the indexed chapter 31 subsistence
allowance rate) are currently available to service-connected
disabled veterans enrolled in vocational rehabilitation
programs, as provided under 38 U.S.C. chapter 31, 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. Virtually all loans are repaid in
full and most in less than one year.
COMMITTEE RECOMMENDATION
The Committee recommends $39,000 for program costs and
$396,000 for administrative expenses for the Vocational
Rehabilitation Loans Program account. The administrative
expenses may be paid to the General Operating Expenses,
Veterans Benefits Administration account. Bill language is
included limiting program direct loans to $2,037,366. It is
estimated VA will make 2,039 loans in fiscal year 2019, with an
average amount of $999.
NATIVE AMERICAN VETERAN HOUSING LOAN PROGRAM ACCOUNT
Appropriations, 2018.................................... $1,163,000
Budget estimate, 2019................................... 1,149,000
Committee recommendation................................ 1,163,000
PROGRAM DESCRIPTION
The Native American veteran housing loan program is
authorized by 38 U.S.C. chapter 37, section 3761 to provide
direct loans to Native American veterans living on trust lands.
The loans are available to purchase, construct, or improve
homes to be occupied as veteran residences or to refinance a
loan previously made under this program in order to lower the
interest rate. The principal amount of a loan under this
authority generally may not exceed $424,100; however, in some
locations, this limit may be higher depending on median area
home prices. Veterans pay a funding fee of 1.25 percent of the
loan amount, although veterans with a service-connected
disability are exempt from paying the fee. Before a direct loan
can be made, the veteran's tribal organization must sign a
memorandum of understanding with VA regarding the terms and
conditions of the loan. The Native American Veteran Housing
Loan Program began as a pilot program in 1993 and was made
permanent by Public Law 109-233, the Veterans Housing
Opportunity and Benefits Act of 2006.
COMMITTEE RECOMMENDATION
The Committee recommends $1,163,000 for administrative
expenses associated with this program. This is equal to the
fiscal year 2018 enacted level and $14,000 more than the budget
request.
GENERAL OPERATING EXPENSES, VETERANS BENEFITS ADMINISTRATION
Appropriations, 2018.................................... $2,910,000,000
Budget estimate, 2019................................... 2,868,909,000
Committee recommendation................................ 2,956,316,000
PROGRAM DESCRIPTION
The General Operating Expenses, Veterans Benefits
Administration account provides funding for the Veterans
Benefits Administration to administer entitlement programs such
as service-connected disability compensation, education
benefits, and vocational rehabilitation services.
COMMITTEE RECOMMENDATION
The Committee recommends $2,956,316,000 for the General
Operating Expenses, Veterans Benefits Administration account,
which is $46,316,000 above the fiscal year 2018 enacted level
and $87,407,000 above the budget request. The Committee has
included bill language to make available through September 30,
2020, up to 10 percent of the General Operating Expenses,
Veterans Benefits Administration account.
Disability Claims Processing.--The Committee has not only
fully funded the budget request for claims processing in recent
years, but has provided increases above the budget requests for
hiring and training claims processors, bolstering the migration
to electronic claims processing systems, and addressing the
increasing backlog of appeals at the Board of Veterans Appeals.
The Committee expects for the Department to utilize theses
resources effectively to not only protect against a recurrence
of a sizable disability backlog, but to also ensure that proper
staffing and resources are being utilized to reduce the wait
time and backlog of disability decisions on appeal and to meet
the demand for other benefit programs. To that end, the
Committee recommends an additional $87,407,000 for VBA, GOE to
hire additional claims and appellate staff, as well as to
increase staff for the Vocational Rehabilitation and Employment
Program. The VBA may also use these resources to support
increased resources for the Veterans Claims Intake Program
[VCIP] to scan and convert paper files into digital records.
The Committee will continue to require the Department to
provide monthly updates on performance measures for each
Regional Office.
Education Benefits.--The Committee is concerned about the
levels of overpayments and improper payments being paid to GI
Bill beneficiaries. The Committee directs VA to work with
education stakeholders to ensure that veteran educational
benefits are paid in a timely and accurate manner and that
efforts to recoup any overpayments or improper payments is done
fairly and in a manner that is not overly burdensome on student
veterans and their families. The Committee further directs VA,
in collaboration with the Department of Defense and Department
of Education, to provide an interagency report on the
development and continued implementation of the Principles of
Excellence, oversight of institutions complying with the
Principles, and appropriate and timely accountability measures
for educational programs receiving Federal funding. Lastly, the
Committee directs VA to continue to reform the compliance
survey process to allow early detection of fraudulent marketing
or predatory recruiting practices among institutions of higher
learning and to codify a set of tools that is sufficiently
agile enough to curtail the behavior of scamming institutions
that are wasting the VA education benefits of service members
and their families.
Education Data Collection and Sharing.--The Committee
believes that both students and VA should be able to make more
evidence-based decisions when it comes to veterans' education.
The Committee directs VA to work with the Department of
Education and Department of Defense to ensure that there is a
comprehensive database or at a minimum, a set of data-sharing
agreements in place between Federal entities involved in the
administration of Federal resources related to veteran
educational attainment. The Committee further directs VA, in
collaboration with the Department of Education and Department
of Defense, to provide an interagency report on data-sharing
priorities, the development and implementation of subsequent
data-sharing agreements, and the uses and effectiveness of the
data shared.
Gulf War Veterans Claims for Service-Connected Disability
Compensation.--The Committee continues to be concerned by the
Department's high rates of denial of Gulf War veterans' claims
for undiagnosed illnesses and chronic multi-symptom illnesses.
The Committee notes that according to the most recent VA data,
44 percent of Gulf War veterans develop Gulf War illness, but
only 26 percent receive benefits. The Committee also notes that
according to a 2016 GAO study, VA is still only approving 17
percent of Gulf War illness claims. To improve the accuracy and
fairness of claims evaluation, the Committee directs the
Department to adopt a single Disability Benefits Questionnaire
[DBQ] for Gulf War illness. The Department is directed to
submit to Committees on Appropriations of both Houses of
Congress a report explaining the reasons for the high denial
rate of claims, the Department's actions to increase the number
of approved claims, the Department's efforts to ensure claims
adjudicators are trained and held accountable for consistently
following the Compensation and Pension manual, and the
Department's timeline for finalizing the required DBQ.
Medical Disability Exams.--The Committee is concerned by
recent reports indicating that contract physicians with revoked
medical licenses have been performing medical disability
examinations on behalf of the Department. Consistent with
statute, the Committee directs the Department to ensure that
any non-VA physician contracted to conduct medical disability
examinations must have a current unrestricted license to
practice as a physician, and is not barred from practicing in
any State, the District of Columbia, or a Commonwealth,
Territory, or possession of the United States.
Veterans Health Administration
Appropriations, 2018\1\................................. $70,296,454,000
Advance appropriations, 2019............................ 70,699,313,000
Budget estimate, 2019\2\................................ 3,127,369,000
Committee recommendation, 2019.......................... 2,740,000,000
Budget estimate, advance appropriations, 2020........... 75,550,600,000
Committee recommendation, advance appropriations, 2020.. 75,550,600,000
\1\Total excludes $89,392,000 in emergency funding provided in Public
Law 115-123, the Further Additional Supplemental Appropriations for
Disaster Relief Requirements Act, 2018.
\2\Total includes $1,900,000,000 requested in discretionary funding for
the Mandatory Choice Program.
---------------------------------------------------------------------------
ADMINISTRATION OVERVIEW
The Veterans Health Administration [VHA] is home to the
United States' largest integrated healthcare system consisting
of 145 VA Hospitals; 24 Health Care Centers [HCC]; 199 Multi-
Specialty Community-Based outpatient clinics; 544 Primary Care
Community-Based outpatient clinics; 294 Outpatient Services
Sites; 134 community living centers; 120 domiciliary
residential rehabilitation treatment programs [DRRTP]; 300
readjustment counseling vet centers; and 80 mobile vet centers.
The Department of Veterans Affairs Medical Care Collections
Fund [MCCF] was established by the Balanced Budget Act of 1997
(Public Law 105-33). In fiscal year 2004, Public Law 108-199
allowed the Department to deposit first-party and
pharmaceutical 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 Parking Program provides funds for the construction,
alteration, and acquisition (by purchase or lease) of parking
garages at VA medical facilities authorized by 38 U.S.C. 8109.
The Secretary is required under certain circumstances to
establish and collect fees for the use of such garages and
parking facilities. Receipts from the parking fees are to be
deposited into the MCCF and are used for medical services
activities.
COMMITTEE RECOMMENDATION
In fiscal year 2018, the Committee provided $70,699,313,000
in advance appropriations for VA's medical care accounts for
fiscal year 2019. This included $49,161,165,000 for Medical
services, $8,384,704,000 for Medical community care,
$7,239,156,000 for Medical support and compliance, and
$5,914,288,000 for Medical facilities. The Committee also
includes an Administrative Provision allowing the Department to
carry forward into fiscal year 2019 certain amounts provided as
an advance for fiscal year 2018.
For fiscal year 2019, the Committee recommends an
additional $750,000,000 for Medical services, $1,000,000,000
for Medical community care, and $211,000,000 for Medical
facilities. Additionally, the Committee recommendation includes
$779,000,000 for Medical and prosthetic research. Medical care
collections are expected to be $3,590,000,000. The Committee
recommendation also provides $75,550,600,000 in advance
appropriations for VA's medical care accounts for fiscal year
2020.
Allocations.--At the beginning of fiscal year 2018, without
public notice, the Department considered fundamentally changing
the manner in which Medical Service allocations were made to
the Veterans Integrated Service Networks. Specifically,
consideration was being given to converting almost
$1,000,000,000 of Specific Purpose funding to General Purpose
funding. After consultation with Congress regarding the unknown
and potentially serious impacts the conversion could have to
programs, such as the successful Housing and Urban Development-
Veterans Affairs Supportive Services program, the Department
ceased implementation and determined that conversion to General
Purpose funding would not go forward in fiscal year 2018. In
the Explanatory Statement accompanying Public Law 115-141, the
Consolidated Appropriations Act of 2018, the Department was
directed to consult with the Committees on Appropriations and
the Committees on Veterans Affairs of both Houses of Congress
before any future attempts are made to realign these funds and
to propose such proposals in an annual budget submission. The
Committee notes, that no such consultation has occurred and
that the fiscal year 2019 budget submission did not reflect any
conversion of funding. Therefore, the Committee directs that
the Department not convert any Special Purpose funding to
General Purpose funding in fiscal year 2019.
Cross Government Credentialing of VA Healthcare
Providers.--In order to better facilitate active recruitment of
individuals who served in the healthcare field for the U.S.
Armed Forces or while on duty with the U.S. Coast Guard, the
Committee directs VA to establish coordinating relationships
with the appropriate personnel divisions dealing with
separating military personnel at the Departments of Defense and
Homeland Security. As part of this coordination, the Department
shall determine whether establishing a formal system for
receiving advanced notice of separating members of the armed
forces is feasible. The Committee further directs VHA to
conduct an internal audit of its procedures for the
recredentialing of providers when transferring within the VHA
system. The Committee directs VHA to institute such policies
and procedures to ensure the speedy and timely transfer of
licensed personnel between facilities and to remove the
unnecessary barrier of recredentialing triggered solely by a
provider transferring facilities.
National Intrepid Center of Excellence Satellite Strategic
Basing.--The Committee recognizes the value of the National
Intrepid Center of Excellence [NICoE] at Walter Reed National
Military Center as a global leader in traumatic brain injury
[TBI] care, research and education. In recent years, the NICoE
has broadened its reach to service members and families by
establishing a successful model of satellite centers, known as
Intrepid Spirit Centers, which are located in highly populated
military and defense communities. The Committee believes the
Departments of Defense and Veterans Affairs can benefit from a
similar model and joint project to serve both the active and
veteran populations in support of complementary and
comprehensive recovery from the effects of TBI. The Committee
directs the Departments to study the value and merit to
establishing a joint DOD/VA, NICoE Intrepid Spirit Center that
serves both the active duty and veteran populations for the
mutual benefit and growth in treatment and care. The study will
be reported to the Committees on Appropriations of both Houses
of Congress no later than 180 days after enactment of this act,
and include inputs from NICoE personnel and analysis regarding
localities in geographically rural areas that may have existing
DOD medical facilities that partner with the VA, academic
institutions specializing in neurology and are distant from
existing or planned NICoE satellite locations.
Unmet Healthcare Benefits Concerning Veterans in the
Commonwealth of the Northern Mariana Islands, American Samoa,
Guam, and Freely Associated States.--The Committee recognizes
the challenges for veterans residing in the Commonwealth of the
Northern Mariana Islands, American Samoa, Guam, and the Freely
Associated States to access quality healthcare and is
interested in exploring options to improve access and reduce
overall costs. The Committee directs the Government
Accountability Office to conduct a comparative analysis of
delivering care to these veterans through the Department of
Veterans Affairs Pacific Islands Health Care System [VAPIHCS]
versus foreign medical facilities nearby, including the
Philippines, Western Samoa, and New Zealand. The report should
review the costs of providing care for these veterans,
including travel and lodging costs in Hawaii and Guam; the
medical outcomes and financial and psychological impacts of
such referrals; and how veterans from other Pacific areas may
reduce access to care for veterans residing in Hawaii. The
report should also examine whether there is or needs to be
existing administrative or legislative authority authorizing
veteran care at foreign medical facilities.
In addition, as VA works to transform its Community Care
programs, the Committee directs the Secretary to provide the
Committees on Appropriations of both Houses of Congress with a
strategic plan to implement and improve the utilization of
healthcare services for veterans in outlying areas through
piloting the expansion of health services via telehealth or
other community care providers within 180 days of enactment of
this act. The plan should include an assessment of the number
of veterans residing in outlying areas who have utilized
services in the VAPIHCS facilities over the last three fiscal
years and an average estimated cost for these veterans to
access VA care; the estimated costs for providing telehealth
services in outlying areas through a pilot program;
identification of statutory authorities which may impede the
necessary steps to implement such a plan and; recommendations
for how VA can reduce burdensome restrictions under the Foreign
Medical Program under its existing authorities.
Furthermore, the Committee encourages the Department of
Veterans Affairs to work with Federal and non-Federal partners,
including the Departments of Defense, Interior, and Health and
Human Services, non-VA healthcare facilities, and educational
institutions to leverage shared resources and improve access
for delivery of care through collaboration.
Prompt Payment.--The Committee remains committed to
supporting VA's efforts to ensure timely reimbursement for non-
VA healthcare providers and facilities that provide necessary
care for our veterans. As VA plans to award new Community Care
Network contracts in 2018, the Committee encourages the
Department to provide stronger oversight and improve timely
payment to non-VA providers. The Committee also urges VA to
facilitate the completion of all outstanding reimbursement as
promptly as possible.
Veterans Integrated Service Networks.--The Committee is
aware that the Department intends to develop a plan to
reorganize several regional Veterans Integrated Services
Network [VISNs]. As the Department develops this reorganization
plan, the Committee urges the Department to consider
realignment strategies that keep whole States within the same
VISN.
Critical Need Occupations Staffing Model.--It is critical
that the Veterans Health Administration develop a staffing
model so that it can better understand, and more quickly
address, its staffing needs in critical need occupations. The
Committee remains concerned that after nearly 2 years, VA has
failed to follow-up on repeated recommendations of the Office
of Inspector General [OIG] regarding the development of
staffing models for critical need occupations, as well as set
forth milestones and a timetable for further critical need
occupations' staffing model development. The Committee
recognizes that the Department has put forward some effort to
move forward the process for creating a staffing model, but is
disappointed with the pace. As such, the Committee directs VA
to accelerate the creation of such a model so that veterans
have access to the care they need.
VHA Corporate Planning & Market Survey Functions.--Various
documents published by VHA, such as the Blueprint for
Excellence and the fiscal year 2016 Annual Restoring Trust in
Veterans Health Care Report, recognize the need for creating a
high-performing, integrated health network that includes VHA
providers and facilities, other federally funded providers and
facilities, and VHA-credentialed community providers and
facilities. To date, VA has not articulated an overarching
strategy to achieve such a goal, does not provide metrics to
show progress towards achieving stated goals, and has no
structure to identify accountable senior officials for such an
effort. Further, the Department's efforts in this area have
been stymied by litigation, leading to further delays. The
Committee recognizes that the complex and transformative nature
of creating a system capable of serving veterans in the future
requires direct and sustained VHA leadership involvement. To
achieve this goal, the Committee directs VHA to form a
corporate planning function patterned after high performing
commercial health care delivery systems. Such function must
include representation from VHA clinical leadership, and
leaders from VHA offices that control, oversee, or manage
facility investments, transition, facility operations, and
organizational change, as well as the appropriate VA offices
that are dedicated to the planning and procurement of capital
infrastructure, whether built or leased by VA. The corporate
planning function shall be responsible for planning and
implementing a high performing, integrated health network. The
Department shall report to Congress no later than 180 days
after enactment of this act detailing the corporate planning
function and a plan to achieve a high-performing, integrated
health network for the next 20 years. At a minimum, the plan
shall clearly articulate VA's vision of a future network,
include goals VA is working towards to achieve the vision, Key
Performance Indicators and other metrics VA will use to judge
success, and an organizational chart detailing the corporate
planning function's direct reporting relationship to the Under
Secretary of Health. The Committee recommends VA seek objective
analysis and recommendations from organizations outside VA that
have successfully created, implemented, or advised corporate
planning functions at high-performing community health care
systems. The Committee recommends VHA seek guidance from the
leadership of the Department of Defense's Military Health
System Facility Shared Service. Additionally, the Committee
understands that VHA is now conducting market surveys to
examine how VHA can develop a high-performing network by
looking at community health care supplies and VHA services and
capabilities. The Committee directs VHA to report back the
findings of these market surveys within 180 days of the
completion of the surveys.
Healthcare Fraud Prevention.--The Committee directs VA to
evaluate the feasibility and advisability of utilizing health
care fraud prevention initiatives to evaluate payments made to
private sector providers and third party administrators to
detect and prevent fraudulent billing by collecting data that
evaluates trends, recognizes patterns consistent with potential
fraud, and potentially uncover schemes or bad actors the Agency
could not otherwise identify using only its own information.
Retrofitting Facilities to Eliminate Barriers to Care for
Women Veterans.--The Committee is concerned about VA's lack of
progress in addressing privacy and environment of care issues
for women veterans, as highlighted in a 2016 GAO report.
Therefore, not later than 180 days after enactment, the
Committee directs VA to submit a report to the Committees on
Appropriations and the Committees on Veterans Affairs of both
Houses of Congress on the expenditures, including fixtures,
materials, and other outfitting measures funded by major
construction, minor construction, non-recurring maintenance, or
other facilities accounts that provide for and enhance the
privacy and environment of care for women veterans being
treated. The report should further include a plan to address
deficiencies in the environment of care for women veterans that
serve as barriers to accessing the care that they have earned.
MEDICAL SERVICES
(INCLUDING TRANSFER OF FUNDS)
Appropriations, 2018\1\................................. $46,849,538,000
Advance appropriations, 2019............................ 49,161,165,000
Budget estimate, 2019...................................................
Committee recommendation, 2019.......................... 750,000,000
Budget estimate, advance appropriations, 2020........... 48,747,988,000
Committee recommendations, advance appropriations, 2020. 51,411,165,000
\1\Total excludes $11,075,000 in emergency funding provided in Public
Law 115-123, the Further Additional Supplemental Appropriations for
Disaster Relief Requirements Act, 2018.
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PROGRAM DESCRIPTION
The Medical Services account provides for medical services
for eligible enrolled veterans and other beneficiaries in VA
healthcare facilities, including VA medical centers and VA
outpatient clinics.
COMMITTEE RECOMMENDATION
In fiscal year 2018, the Committee provided an advance
appropriation of $49,161,165,000 for fiscal year 2019 for the
Medical Services account. The recommendation for fiscal year
2019 includes an additional $750,000,000 which is $750,000,000
above the budget request. The additional appropriation coupled
with the advance appropriation provided for fiscal year 2019
provides the Department with total budget authority of
$49,911,165,000 which is $3,061,627,000 above the fiscal year
2018 enacted amount. In addition, VA has the authority to
retain co-payments and third-party collections, estimated to
total $3,590,000,000 in fiscal year 2019.
The Committee recommendation also includes an advance
appropriation of $51,411,165,000 for Medical services for
fiscal year 2020. This is $2,663,177,000 above the budget
request. The Administration's budget proposed to consolidate
the Medical Community Care account with the Medical Services
account. The Medical Services account is used primarily for in-
house VA medical care, while the Medical Community Care account
funds non-VA care. The proposed consolidation of these accounts
blurs the ability to readily identify how VA is executing
funding between in-house care and non-VA care. However,
according to the crosswalks contained in the justifications
accompanying the budget submission, VA intended on allocating
$14,419,786,000 to community care programs with the remaining
$48,747,988,000 being utilized on traditional in-house VA care.
This represented a proposed $413,177,000 reduction for services
provided under the current Medical Services account. In order
to continue to provide proper budgetary oversight of these two
important functions, the Committee recommendation rejects the
consolidation of these two accounts and adjusts the fiscal year
2020 advance appropriation for this account to better reflect
current utilization rates.
PREVENTING VETERANS HOMELESSNESS
The Committee remains strongly supportive of VA's homeless
prevention programs and as such the recommendation includes
$1,888,534,000 to support these programs. This total includes
an additional $130,000,000 over the current estimate of
$320,000,000 for the Supportive Services for Veterans Families
[SSVF] program and an additional $5,000,000 over the request
for the Justice Outreach Homeless Prevention program.
Limited Affordable Housing.--The Committee supports the
continued efforts of the Department to shelter homeless
veterans by providing case management services, housing grant
assistance and access to low and no income housing
opportunities, through programs such as the SSVF and HUD-VASH
voucher programs. The Department is directed to submit a report
to the Committees on Appropriations of both Houses of Congress
no later than 180 days after enactment of this act on the
impacts of limited affordable housing opportunities on
Department homelessness programs in rural communities and
recommendations on how the Department may better partner with
local housing entities to ensure rural access to housing
services.
In addition, the lack of affordable housing in many urban
areas hindered efforts to reduce the homeless veterans
population. Therefore, as part of the report, the Committee
directs VA to include a section addressing the feasibility of
piloting a demonstration through one of its existing programs
to provide housing and supportive services to homeless veterans
in high cost urban areas.
Veterans Justice Outreach Program.--The goal of the
Veterans Justice Outreach Program [VJO], authorized by section
2022 of title 38, United States Code, is to prevent
homelessness, and avoid the unnecessary criminalization of
mental illness and extended incarceration among veterans. This
is accomplished by ensuring that eligible veterans encountered
by police, and in jails or courts, have timely access to VA
services including: mental health, substance abuse, and
homeless programs. In 2017, the VJO program provided services
to over 46,500 justice-involved veterans, supported 461
Veterans Treatment Courts and other veteran-focused court
programs, and partnered with legal providers to offer 158 pro-
bono legal clinics to veterans on site at local VA hospitals.
In order to assist in the success of this program, the
Committee recommendation includes an additional $5,000,000 over
the budget request for this program.
Collaboration for Grant Per Diem Mix of Housing Services.--
The Committee agrees with the goal of ending veteran
homelessness by ensuring veterans' access to permanent,
affordable housing of their choice. However, the Committee
recognizes that service-intensive transitional housing provided
through the VA's Grant Per Diem Program [GPD] is an important
programmatic option, particularly in areas with low vacancy
rates, limited housing stock, and high market rates, and that
substance-free and service-intensive housing may be a critical
step for veterans at risk of relapse into substance abuse. The
most appropriate mix of housing services for veterans should be
determined through a collaborative process including local
housing partners, service providers, and the Department of
Veterans Affairs. The Department should continue to make
funding available for GPD beds based on a collaborative process
with the local VA Medical Centers and the Continuums of Care.
The Department is directed to submit a report to the Committees
on Appropriations of both Houses of Congress no later than 180
days after enactment of this act on the contingency and
remediation plan for veterans impacted by changes in
availability or losses of awards of Grant Per Diem Program
funds for current providers that serve rural or highly rural
areas that would result in the loss of veterans' access to
transitional housing assistance.
Veteran Homelessness in the Greater Los Angeles Region.--
The Committee is concerned by reports that the population of
veterans in Los Angeles experiencing homeless on any given
night increased by 57 percent between from 2016 and 2017 from
3,071 to 4,828. Given the increasing homeless population, in
many areas including the Greater Los Angeles Region, the
Committee urges the Department to ensure that additional case
management personnel and resources are being deployed to meet
the recommended 25-1 case management staffing ratio. Within 30
days of enactment of this act, the Department shall provide to
the Committees on Appropriations of both Houses of Congress a
report outlining the cost and feasibility of contracting with
local community-based agencies and non-profit organizations to
provide additional case management services in regions where
the Department does not meet is own case management ratio
goals.
Further, in order to better inform the Committee regarding
HUD-VASH case management, not later than 120 days after
enactment of this act, the Secretary shall submit to the
Committees on Appropriations of both Houses of Congress a
report that details the current ratio of HUD-VASH case managers
to veterans serviced; steps taken to recruit and retain case
managers for this program; a list of VA Medical Centers where
HUD-VASH cases are being contracted out; and, efforts currently
underway to assist HUD-VASH case management in highly rural
areas.
TELEHEALTH SERVICES
The Committee recommendation includes an additional
$30,000,000 to expand VA's telehealth capabilities. The
Department of Veterans Affairs along with the Department of
Defense have long been leaders in the field of emerging
technology and medicine. For VA, telehealth creates a bridge
between rural and urban centers--providers at an urban site can
diagnose and provide a care plan for veterans hundreds of miles
away, allowing, VA to expand the resources of one facility by
connecting those providers to providers in another area.
Through telehealth, the Department has the means and
flexibility to provide care to veterans who do not have easy
access to a VA hospital or access to a VA hospital staffed with
the care they need.
Telehealth is not only allowing the Department to expand
access to care in areas where services are limited, but
telehealth also allows care to be provided more effectively and
efficiently for veterans closer to home and also through direct
in-home access. While VA is once again leading the healthcare
industry in the expansion of in-home telehealth and remote
patient monitoring services, these services are often limited
by the lack of broadband service in remote and rural areas. In
order to better leverage other Federal partners, the Department
is directed to provide a report to the Committee on
Appropriations of both Houses of Congress by January 31, 2019,
regarding ongoing collaborations VA has with other Federal
agencies in targeting remote and rural areas with veteran
populations in order to ensure that grant programs administered
by other Federal agencies maximize coverage areas to veterans.
The Committee is also aware telehealth has a potential for
significant cost savings and cost avoidance for the Department,
and the Department is urged to maintain its focus on this type
of care, not only to better serve veterans, but also to be a
good steward of its financial resources. In order to ensure
cost effectiveness and faster deployment of telehealth
platforms, the Committee urges the Department to take advantage
of commercial-off-the-shelf technology solutions when
appropriate.
MENTAL HEALTH/PREVENTING VETERANS SUICIDE
National Center for Post-Traumatic Stress Disorder.--The
National Center for Post-Traumatic Stress Disorder [NCPTSD] is
the Federal Government's foremost center of expertise on
evidence-based treatment of post-traumatic stress. The
Committee continues to support the mission and work of the
NCPTSD and has provided $40,000,000 to continue the center's
advancement of the clinical care and social welfare of
America's veterans who have experienced trauma or suffer from
PTSD through research, education, and training in the science,
diagnosis, and treatment of PTSD and stress-related disorders.
The Committee supports the priorities for NCPTSD as described
in the Congressional budget submission, and directs the
Department to provide an assessment of the additional full time
staff needed to carry out those priorities, as well as a hiring
plan. Additionally, no later than 30 days after enactment of
this act, the Department is directed to submit to the
Committees on Appropriations of both Houses of Congress its
plan for ensuring that all community care mental health
providers receive information about NCPTSD and its consultation
program.
PTSD Treatment at VA Facilities.--Advances in evidenced-
based clinical treatments stemming from recent brain research
have significantly increased the ability to treat veterans
experiencing post-traumatic stress. However, the availability
of all levels of care remains inconsistent throughout the VA
system. Therefore, no later than 180 days after enactment of
this act, the Department is directed to submit to the
Committees on Appropriations of both Houses of Congress an
itemized cost estimate for the establishment of specialized
out-patient PTSD programs, specialized intensive PTSD programs,
and residential PTSD treatment program at every level two or
above VA facility.
Mental Health Staffing.--The Committee recognizes the
importance of maintaining the appropriate number of mental
health staff members at the Department of Veterans Affairs to
provide veterans timely, effective, high-quality care.
Therefore, the Committee urges the Department of Veterans
Affairs to sufficiently fund its Mental Health Hiring
Initiative in order to reach the recommended staffing ratio of
7.72 mental health outpatient staff to 1,000 veterans. Although
the Committee is aware that the Department of Veterans Affairs
currently seeks to increase the number of mental healthcare
providers by 1,000 staff members. The Department is directed to
keep the Committee apprised on a quarterly basis on meeting its
hiring goals.
Suicide Prevention.--The Committee recognizes that
preventing suicide among the veteran population requires a
comprehensive and consistent effort to enhance the quality,
continuity, and integration of mental healthcare. The Committee
commends the Department for strengthening its focus on suicide
prevention and urges the Department to increase support for
primary care-mental health integration and recovery models,
expand telemental health services, build on the success of
evidence-based psychotherapy initiatives, and guide treatment
decisions by measuring the outcomes of interventions.
Additionally, the Committee recommends VHA develop a veterans
suicide prevention strategy that is focused on preventing
suicide by increasing focus on ``upstream'' prevention based
interventions in order to more appropriately target
interventions with veterans before they are at a crisis point.
Interventions should be data-driven and executed in general
areas of large veteran populations in the community as well as
populations of at-risk veterans. The new strategy should
include training for all VA employees who interact with
veterans, not only those in the medical community, including
chaplains, attorneys, law enforcement, and volunteers. The
Department should also engage non-VA sectors such as employers,
first responders, and the healthcare industry to ensure that
all sectors are working across systems for suicide prevention.
Sleep Disorders.--The Committee recognizes the importance
of sleep, including its impacts on PTSD, traumatic brain
injury, and mental health. The Committee supports VA
considering all treatment options for these conditions,
including ensuring proper sleep health. The Committee continues
to recommend the Department assign a program manager for sleep
disorders, including sleep apnea, that affect at least 200,000
veterans of the Persian Gulf War and Operations Iraqi Freedom
and Enduring Freedom. The Department is directed to submit a
report to the Committees on Appropriations of both Houses of
Congress no later than 90 days after enactment of this act on
the status of this recommendation.
Trauma Management.--The Committee encourages the Secretary
to consider establishing a Trauma Management Therapy pilot
program utilizing exposure therapy involving virtual reality in
combination with group therapy for the treatment of individuals
with symptoms relating to PTSD. The Secretary shall submit a
report to the Committees on Appropriations of both Houses of
Congress no later than 180 days after enactment of this act
detailing the feasibility of such a pilot program and the
metrics required to determine the value of exposure therapy in
treating PTSD.
Mental Health/Suicide Prevention Best Practice Review.--The
Committee is concerned that despite significant focus, addition
of new programs, and increased funding, veterans suicide
statistics are not changing. The Committee supports the
Department's Research efforts to synthesize information about
successful practices and initiatives across the Department, and
would like this effort to be expanded. As such, the Committee
directs the Department to provide a report to the Committees on
Appropriations of both Houses of Congress within 90 days after
enactment, including:
--A complete list of all current and planned mental health
and suicide prevention programs available to veterans
within the VA and through community partnerships;
--For each program, the annual amount of funding and number
of veterans served;
--The number of veterans receiving treatment in each program
who ultimately committed suicide;
--The metrics used by the Department to track the efficacy of
its mental health programs, including how those metrics
are tracked longitudinally;
--Recommendations for additional metrics for VHA to better
measure the efficacy of each mental health program;
--The impacts of local mental health and suicide prevention
programs in rural communities; and
--Recommendations on how the Department may better partner
with local communities to ensure rural access to mental
health and suicide prevention programs.
Further, if the VA does not have a Veterans Suicide
Coordinator, the Committee directs the establishment of the
roll. That position will be responsible for tracking metrics on
suicides among veterans, annually reporting trends, and
providing feedback to VHA that can be used to adjust
programming for veterans' mental health and suicide prevention
to ensure funds are going to the most effective programs.
OPIOID REDUCTION AND SAFETY INITIATIVES
To continue to build upon opioid reduction efforts and
safety initiatives, Committee recommendation includes
$400,025,000 for Opioid Prevention and Treatment programs at
the VA. This includes $348,000,000 for prevention and treatment
programs, $18,000,000 above the budget request and $52,025,000
to continue implementation of the Comprehensive Addiction and
Recovery Act of 2016. The additional resources are to be used
to strengthen VA's Opioid Safety Initiative as well as to
develop programs aimed at ensuring that non-VA providers
treating veterans through the community care programs are
informed and in compliance with all VA standards for opioid
safety and prescription guidelines.
Office of Patient Advocate.--The Committee urges the
Department to prioritize continued implementation of the
reforms made to the patient advocacy program as required by the
Jason Simcakoski Memorial and Promise Act (Title IX, Public Law
114-198). The Committee believes that the law's establishment
of the Office of Patient Advocacy will ensure that patient
advocates are independent of local facility management, truly
work on behalf of veterans, and are properly trained according
to national standards. Accordingly, within 30 days of
enactment, the Committee directs VA to provide a report on its
progress implementing the relevant sections of Public Law 114-
198, including progress on patient advocate training at each
VAMC and any outstanding recommendations included in the
Inspector General's March 2017 audit of the patient advocacy
program's fiscal year 2015 operations [VA OIG 15-05379-146].
Improvement of Opioid Safety Initiative.--The Committee
supports VA's Opioid Safety Initiative [OSI] and encourages
continued implementation at all VA medical facilities, as
directed under Title IX of Public Law 114-198, the Jason
Simcakoski Memorial and Promise Act. The Committee believes
that it is imperative that all VA providers who prescribe
opioids continue to consistently use the Opioid Therapy Risk
Report tool under the OSI, including prior to initiating opioid
therapy, to ensure safe prescribing, and to help prevent
diversion, abuse, and double-prescribing. Under Public Law 114-
198, the Department must continue implementation of mandatory
use of such tool for all providers prior to initiating opioid
therapy for a patient to assess the risk for adverse outcomes;
routine and random drug tests standards; provider use of the
tool to access the State Prescription Drug Monitoring Program
[PDMP]; and inclusion of information identifying when health
care providers access the tool and the most recent urine drug
test for each veteran. The Committee also urges VA to further
improve the timeliness of data available in the tool to allow a
provider to have real-time access to data on a patient who was
prescribed opioid therapy by another facility, in another
State, or by mail order to prevent overprescribing and abuse
potential. Public Law 114-198 requires the Department to ensure
VA providers can access information in the State PDMP including
by seeking to enter into memoranda of understanding with States
to allow shared access of such information between VA and the
States. This is critical to ensure safe pain management care,
as many veterans also seek care from providers in the community
who may prescribe them medication. The Department must also
include such information in the Opioid Therapy Risk Report tool
and require VA providers to disclose certain veteran
information to State controlled substance or PDMPs. The
Department is directed to submit an updated report to the
Committees on Appropriations of both Houses of Congress no
later than 180 days after enactment of this act assessing
compliance with mandatory provider use of the tool and
utilization of and reporting to State PDMPs. The report must
also include an assessment of the feasibility of improving the
tool to allow for real-time tracking and feasibility of
implementing an indication for use linked to opioid
prescriptions in the tool to support oversight of safe opioid
prescribing.
Opioid Therapy Clinical Practice Guidelines and Training.--
The Committee believes that continued and robust implementation
and dissemination of the updated 2017 VA/DoD Clinical Practice
Guideline [CPG] for Management of Opioid Therapy for Chronic
Pain, as required under Public Law 114-198, is critical to
ensure that clinicians have routine access to the most updated
information to help inform safe and quality care and improve
pain management for veterans. In addition, to ensure that all
providers have access to most recent scientific evidence, it is
critical for opioid prescribing guidance to be as up to date
and as consistent as possible across Federal agencies. As such,
the Committee directs the Department to continue to routinely
coordinate and consult with the Centers for Disease Control and
Prevention and other relevant groups and Federal agencies on
continued implementation and compliance with the CPG and latest
scientific recommendations. As part of continued efforts to
enhance safe pain management and education across the
Department, the Committee directs the VA to ensure that all
clinicians, including pharmacists, receive guidance on
assessing the risks and benefits of critical drug interactions
with opioids when a pharmacists overrides such interaction
under section 913 of Public Law 114-198. The Committee further
directs VA to provide a report within 180 days after enactment
of this act on implementation of the new CPG, including
education and training of providers as well as certification
from the new pain management teams at each facility that all
health care professionals responsible for coordinating and
overseeing pain management therapy utilize the updated CPG.
Opioid Control Procedures.--The Committee is aware a recent
GAO report recommended that the Under Secretary for Health
should ensure that VAMCs have established an additional control
procedure, such as an alternate controlled substance
coordinator or a pool of extra inspectors, to help coordinators
meet their responsibilities and prevent missed inspections. The
Committee urges the Secretary to fully implement these
recommendations to improve oversight of the controlled
substance inspection program and to document its progress. The
Committee directs the Secretary to provide annual updates on
its progress regarding its adoption of the GAO recommendations.
Community Care Opioid Safety.--The Committee recognizes
that VA has made important progress increasing opioid safety
and reducing overprescribing within the VA health care system.
However, the Department has not made comparable progress
implementing opioid safety reforms in VA community care
programs. The Committee believes that the July 2017 VA Office
of Inspector General report on opioid prescribing in VA
community care programs provides further evidence that veterans
receiving opioid therapy from community care providers,
including through the VA Choice program, are at significant
risk. The Office of Inspector General found that contract
providers are not subject to many of the opioid safety reforms
included in Public Law 114-198, the Jason Simcakoski Memorial
and Promise Act, and implemented at VA [VA OIG 17-01846-316].
Specifically, community care providers are not aware of and
thus, not complying with, VA opioid therapy and safe
prescribing protocols. Furthermore, VA is not consistently
tracking opioid prescriptions from community care programs due
to significant information exchange gaps between VA and non-VA
providers. To ensure community care providers follow the same
safe opioid prescribing standards and have access to the same
up-to-date pain care information as VA practitioners, the
Committee directs the Department to implement the
recommendations in the OIG report, including ensuring that
community care providers review the safe opioid prescribing
guidelines and Opioid Safety Initiative protocols and
implementing a process to provide community care providers a
complete up-to-date list of medications and medical history of
the veteran during non-VA care consults. The Committee further
directs the Department to provide a progress report on
implementation of such recommendations within 180 days after
enactment of this act.
Complementary and Integrative Health.--Expanding access to
comprehensive pain management and complementary and integrative
health [CIH] services is vital to improving the delivery of
high-quality care for our veterans, especially those struggling
with co-occurring conditions like chronic pain, mental health
and substance use disorders. The Committee urges robust
implementation of VA's plan to expand the scope of research,
education, delivery, and integration of CIH into the health
care services provided to veterans. In addition, as required
under section 932 of Public Law 114-198, VA must continue to
prioritize implementation of the pilot program at VA medical
centers, including polytrauma rehabilitation centers, to assess
the feasibility and advisability and delivery using wellness-
based programs to complement pain management and related health
care services. The Committee has been concerned with previous
reports of VA's dangerous opioid prescription practices at
facilities, including at the Tomah VA Medical Center in
Wisconsin, where such practices led to the tragic death of
Marine veteran Jason Simcakoski in 2014. While the Committee
supports the progress being made to reduce misuse and abuse of
opioids and to improve pain care, the Committee believes that
consideration of VISNs or medical centers with a history of or
current prescription rates of opioids that are in conflict with
or are inconsistent with the standards of appropriate and safe
care should be given priority. The Committee encourages the
Department to continue to expand access to CIH services as part
of the VA's Whole Health System approach and directs VA to
report to the Committee on the progress of the 18 flagship
facilities being launched to effectuate this effort.
Implementation of VA Participation in State Prescription
Drug Monitoring Programs.--Within 90 days of enactment, VA
shall submit a report to the Committees on Appropriations of
both Houses of Congress regarding implementation of the VA
Prescription Data Accountability Act of 2017 (Public Law 115-
144) that requires VA to participate in State Prescription Drug
Monitoring Programs. The report shall indicate progress in
participation broken out by VISN and healthcare system,
identify with specificity impediments to participation in
particular State Prescription Drug Monitoring Programs and
establish benchmarks and timeframes for full participation. Not
later than February 1, 2020, VA shall submit an update report
to the Committees identifying progress toward full
participation during calendar year 2019. The committee also
encourages VA, to the maximum extent permitted by law, to share
prescription drug information with other Federal medical
facilities that may serve veterans, including DOD medical
facilities and Indian Health Service facilities.
LONG-TERM CARE
Long-Term Care.--The bill provides $9,024,330,000 as
requested by the Department for long-term care. This includes
the $6,168,524,000 for institutional care and $2,855,806,000
for non-institutional care. The Committee supports the
Department's efforts to broaden veterans' options regarding
non-institutional long-term care support and services. As the
Department realigns these programs under the Medical Community
Care account, the Committee encourages VA to continue to
prioritize veterans' preferences in receiving home based
services. The Committee notes the positive results of pilot
programs such as the Veterans Independence Program, a veterans-
directed Home and Community Based Services [HCBS] grant program
originally created as a pilot administered jointly by VA and
the Department of Health and Human Services [HHS]. The
Committee encourages enhanced cooperation with HHS to expand
and grow these programs. The Department is directed to submit a
report to the Committees on Appropriations of both Houses of
Congress no later than 180 days after enactment of this act on
the cost avoidance associated with various non-institutional
care programs. The report should include information on the
demand for HCBS among the veteran population, the number of
veterans currently being served by each program under HCBS, and
the Department's plans to expand the size and scope of HCBS.
Given the success of current HCBS pilot programs, the
Department should include a cost analysis of growing the
existing pilot programs prior to national expansion to leverage
coordination with HHS, in addition to detail regarding the
Department's efforts to coordinate with HHS on HCBS in future
years. Given that mandatory eligibility for certain types of
care is associated with disability levels adjudicated by VBA,
this report should also include recommendations for modernizing
the claims process for veterans requiring long-term care.
Home-Based Primary Care.--The Committee supports the
collaboration between VA and the Indian Health Service [IHS]
and collaboration by Federal agencies with Tribes to expand
access to care for Native veterans, including the recent
expansion of evidence-based home-based primary care [HBPC]
programs at 14 VA medical centers. This expansion is designed
to reach new populations of American Indian veterans living in
rural reservation communities, which are served by medical
facilities operated directly by the IHS or by Tribes and Tribal
organizations with funding provided by the IHS. The Committee
urges the Secretary to increase funding within the Office of
Rural Health to expand HBPC programs to additional American
Indian reservations and to other rural areas. Furthermore, the
Secretary should continue to improve planning coordination with
other Federal healthcare organizations. Planning efforts should
take into account conducting a population-based needs
assessment and allowing sufficient time to develop trusting
relationships with Native veterans, Tribal health and social
service personnel, IHS and Tribal community health
representatives, and Tribal communities. Planning efforts
should also consider availability of IHS and Tribal resources
for patients, as well as identify potential opportunities for
co-management to prevent unintended duplication of effort,
over-prescribing of medications, and other inefficiencies.
RURAL HEALTHCARE
Office of Rural Health.--Veterans residing in rural and
remote areas face unique barriers to receiving high-quality
mental health, primary healthcare, and specialty care services.
While enhanced community care programs offer veterans increased
flexibility to obtain care close to home, often this same gap
in services exists in the private market in rural and remote
communities. Over the past 9 years, the Office of Rural Health
and its Rural Health Initiative has played a critical role in
assisting VA in its efforts to increase access to care.
Therefore the Committee recommendation includes $270,000,000
for the Office of Rural Health [ORH] and the Rural Health
Initiative. This is $20,000,000 above the budget request.
Through collaborations with other VA program offices,
Federal partners, State partners, and rural communities, ORH
works to optimize the use of available and emerging
technologies, establish new access points to care, and employ
strategies to increase healthcare options for all rural
veterans. Currently, ORH identifies and implements initiatives
that support rural clinics and rural home-based primary care,
address barriers to access and quality of healthcare delivery
in rural areas, develop workforce recruitment and retention
initiatives, and accelerate and expand telehealth. ORH also
operates Rural Health Resource Centers and works with Federal
and non-Federal community partners to share resources and
expand access to care for rural veterans. Given the important
role these centers play in increasing access, the Committee
encourages the Department to increase the number of these
centers. Any expansion should also emphasize increasing access
to healthcare for women veterans, treating traumatic brain
injuries, and the recruitment and retention of healthcare
providers to serve rural and remote areas.
Rural Health Continuity of Care.--The Committee notes the
Access Received Closer to Home [ARCH] pilot program was highly
successful in some areas in providing healthcare services to
veterans who live in the rural and highly rural States in which
it operated, such as in northern Maine and in Kansas. During
the pilot, VISN analysis demonstrated that more than 90 percent
of veterans who received medical care through ARCH were
``completely satisfied'' with their care and cited
significantly shortened travel and wait times to receive care.
Furthermore, the Committee is pleased the Department has made
efforts to provide continuous, ARCH-like access to rural
healthcare in northern Maine through the use of provider
agreements. As the Department transitions away from the Choice
Program to a reformed community care program, the Committee
directs the Secretary to sustain continuity of care for rural
veterans through provider agreements, based on previous models
such as the ARCH program, to ensure veterans do not experience
a lapse in existing healthcare access during the transition to
the new community care program and any resulting integrated
networks. The Committee continues to support enabling the
Department to enter into provider agreements with non-VA long-
term care providers, including skilled nursing facilities, in
lieu of the current onerous Federal contracting requirements.
VA/Clergy Partnership for Rural Veterans.--The Committee
supports the continuation of the efforts of the Department's
Community Clergy Training to Support Rural Veterans Mental
Health Initiative. The Committee urges the Department to
increase the financial resources made available in order to
increase accessibility of this initiative to rural communities.
Further, the Committee directs the Department to provide a
report to the Committees on Appropriations of both Houses of
Congress, no later than 180 days after enactment, on the
participation rate of rural communities in this program and
recommendations on how the Department may better partner with
local faith-based organizations as well as the Department of
Defense, in conjunction with the ``Strong Bonds'' program, to
ensure access for veterans as well as total force
servicemembers.
Rural Recruitment.--To improve recruitment and retention
initiatives for healthcare providers in rural and highly rural
areas the Committee urges the Department to conform with the
recommendations contained in GAO report GAO-181-24.
Specifically, that the VHA:
--Develop and implement a process to accurately count all
physicians providing care at each medical center,
including physicians not employed by VHA;
--Develop and issue guidance to the VAMCs on determining
appropriate staffing levels for all mission-critical
physician occupations;
--Ensure that when multiple offices issue similar
productivity data on physician occupations, any
methodological differences are clearly communicated and
guidance is provided on how to interpret and reconcile
the data;
--Establish a system-wide method to share information about
physician trainees to help fill vacancies across VAMCs;
and
--Conduct a comprehensive, system-wide evaluation of the
physician recruitment and retention strategies used by
VAMCs to determine their overall effectiveness,
identify and implement improvements, ensure
coordination across VHA offices, and establish an
ongoing monitoring process.
Nurse Advice Line.--Last year, the Committee directed the
Department to pursue a pilot program for a nurse advice line
targeting rural areas and highly rural areas with a large
percentage of veterans. The pilot was to be based on and
improve upon the nurse advice line implemented by DOD for
beneficiaries under the TRICARE program. No later than 30 days
after enactment of this act, the Department is directed to
submit to the Committees on Appropriations of both Houses of
Congress a report detailing where the pilot was established and
the progress made in implementing the directive. The reports
shall also contain information on utilization of the pilot, to
include a description of the individuals who benefitted from
advice; a description of any impediments in carrying out, or
encountered by individuals accessing, the pilot program; a
description of any cost savings to the Department, and an
assessment of the feasibility and advisability of expanding the
pilot program to more veterans.
CAREGIVERS
The Committee recommendation includes $860,828,000 for the
VA's Caregivers Program, $364,796,000 above the current
estimate submitted with the budget request. The Committee
expects VA to dedicate this funding to the program and not to
divert the resources to other areas and notes that notification
should be provided to the Committee of any reprogramming of
this funding. In order to ensure proper budgetary oversight,
the Department is directed to report to the Committees on
Appropriations quarterly obligations for the Caregivers
Program.
Caregivers.--The Committee notes the robust usage of the
post-9/11 Caregiver program with its more than 21,000 approved
applications, as well as the consistent reviews by caregiver
families noting that the program's stipend, respite care,
formal training, and support structure are critical components
to its success. Given the demonstrated success of the program,
the Committee encourages the VA to ensure that the Caregiver
coordinators at each Medical Center are fully resourced and, to
the maximum extent possible, assigned designated Caregiver
duties as their chief and only responsibility. The Department
is also encouraged to work with the Department of Defense in
order to develop and share best practices.
Many caregivers for severely wounded veterans are working
dramatically reduced hours outside the home or have left the
workforce completely, often leading to financial hardship. This
reduction in outside earnings results in difficulties meeting
financial obligations, including student loan debt held by the
caregiver. The Committee directs the VA to survey all
caregivers currently in the program to identify the number
possessing outstanding student loan debt and to develop a plan
to monitor this issue, by developing methods to capture this
data routinely. The Department shall report to the Committees
on Appropriations of both Houses of Congress within 120 days of
enactment of this act survey results and details for future
monitoring.
WOMEN VETERANS HEALTHCARE
Women Veterans.--Women represent 15.5 percent of today's
active duty force and 19 percent of our National Guard and
Reserves. Accordingly, women veterans are enrolling in VA
healthcare at record levels, with the number of women veterans
using VA healthcare tripling since 2001. With the upward trend
of women serving in all branches of the Armed Forces, the
Department must continue to aggressively expand efforts that
address the current barriers to gender-specific healthcare
services and plan accordingly for the type and length of the
treatment needs of women veterans. The Committee continues to
believe VA must be poised to address the changing demographic
of today's and tomorrow's veterans in order to fulfill its
mission. Toward this end, the Committee recommendation includes
an additional $20,000,000 over the budget request for fiscal
year 2019 to support gender-specific healthcare services. The
Committee also encourages the Department to consider a mobile
healthcare pilot program, prioritizing rural and high need
areas, to provide gender-specific services, awareness of
benefits, and outreach to women veterans utilizing mobile
healthcare infrastructure. This innovative model is designed to
fill the current gap in gender-specific services as VA works to
expand infrastructure and hire the needed staff for specialty
care.
Female Primary Care and Mental Health Care Providers.--The
Committee urges VA to make every effort to hire more women
healthcare professionals and offer all women veterans the
opportunity to choose the gender of their primary care and
mental healthcare providers.
Intimate Partner Violence Program.--The VA Intimate Partner
Violence Program expands VA's screening, prevention, and
intervention services to veterans and strengthens collaboration
with community partners as well as the Caregivers Support
Program and VA programs to address homelessness. The program
focuses on developing a culture of safety and adopts a
holistic, trauma-informed, veteran-centered approach to
services and support for those veterans involved in a domestic
violence situation. In recent years, VHA has run this program
using general funds, and at times, the program has lapsed due
to a lack of funds. The Committee directs the Department to
fully resource this program at $17,000,000 in fiscal year 2019
and include it as a program of interest with budget detail in
the justifications accompanying the fiscal year 2020 budget
submission.
OTHER ITEMS OF INTEREST
Adaptive Sports.--The Committee recommendation includes
$16,000,000 for adaptive sports programs. The Adaptive Sports
Grant Program helps connect veterans with disabilities to
sports programs and remains one of the most popular programs
among veterans. Originally established to assist with training
for Paralympic athletes, the program now supports veterans of
all levels. The Committee recognizes that veterans have shown
marked improvements in mental and physical health from
participating in adaptive sports and recreational therapy and
that veterans have expressed the need for these activities to
be included in the healthcare services VA offers. The Committee
also recognizes that adaptive sports and recreational therapy
provide a low-cost alternative to other healthcare services
that produce similar health outcomes. Therefore, the Committee
requests that the Department provide a feasibility assessment
for the cost of expanding the grant program to include
recreational and lifelong sports, such as open-ocean swimming,
surfing, outrigger canoeing, hunting, and fishing, as well as
any legal barriers to expansion.
The Adaptive Sports Grants Program currently awards a
limited number of grants for equine therapy, mostly related to
physical disabilities. Therefore, of the increase provided,
$1,500,000 should be used by VA to increase its use of these
grants for the purpose of equine therapy targeted to mental
health issues.
Equine Therapy.--The Committee recommends that the
Department utilize funding to conduct a comprehensive program
evaluation to ensure the continued effectiveness of equine
therapy in addressing the mental health needs of veterans that
participate in these programs, including through the systematic
assessment and tracking of mental health issues and symptoms,
and the measurement of key outcomes, such as functional
improvement in veterans' different life domains.
Cancer Treatment.--The Committee seeks to ensure that
veterans have access to the highest quality cancer care
available. The Committee, therefore, applauds the ongoing
collaborative efforts between VA medical centers and NCI-
designated comprehensive cancer centers. The Committee supports
these efforts, especially as they relate to providing veterans
access to groundbreaking new treatments through clinical trials
led by academic cancer centers, as well as the linking of VA
oncology care with national research databases involving
patients at multiple academic cancer centers. The Committee is
also pleased that VA is engaged with the NCI and VA Interagency
Group to Accelerate Trials Enrollment partnership, which will
improve access to certain clinical trials at a number of VA
facilities. The Committee understands that initiating new
clinical trials is a resource-intensive process requiring
experienced coordination staff with specialized expertise in
data management and regulatory compliance. To improve its own
capacity to coordinate a full range of cancer clinical trials
with non-VA organizations, the Committee encourages VA to
provide resources for coordination staff and continue to
develop partnerships with non-VA organizations that have
initiated pilot clinical trials programs. The Committee also
requests a report, within 90 days of enactment of this act,
which provides an overview of VA's credentialing process for
non-VA clinical trial coordinators and recommendations, if any,
to improve this process.
Inpatient Drug Rehabilitation Report.--The Secretary of
Veterans Affairs, no later than 120 days after enactment, shall
submit to Congress a report that includes: (1) the number of VA
inpatient drug rehabilitation beds per VA Medical Center; (2)
Number of occurrences, per VA Medical Center, that the VA
furnished inpatient drug rehabilitation care in the community
in previous 24 months; and, (3) specific demographic data on
addicted veterans.
Beneficiary Travel.--The Committee is concerned about the
allocation of beneficiary travel to VISNs where unconventional
modes of travel, such as air, are the primary means for
veterans to visit a VA hospital. The Committee directs the
Secretary to conduct a review of the beneficiary travel program
for VISNs that have exhausted available funds in the first or
second quarter of the fiscal year. In conducting the review,
the Secretary shall consider whether the traditional mileage
reimbursement model remains appropriate for VISNs that serve
the non-contiguous states and other rural, highly rural, and
remote areas. The Secretary shall also report on the types of
clinical services for which veterans are traveling and seeking
reimbursement, and determine whether telemedicine could reduce
the need for such travel and, if so, a plan to make those
services available. Finally, the report shall assess how the
beneficiary travel allocation in impacted VISNs affects timely
reimbursements for veterans and what, if any, chilling effect
delayed reimbursements have on veterans choosing to seek care.
This report should be provided to the Committees on
Appropriations of both Houses of Congress no later than 180
days after enactment of this act.
Blood products.--The Committee is concerned about the
safety of blood products being transfused to veterans at VA
medical facilities given the aging and medically fragile
populations being treated. Therefore, the Committee urges VA to
request that all blood product providers use FDA-approved
pathogen reduction technology, where available, before
providing blood products for transfusion at VHA medical
facilities, including VA medical centers, outpatient clinics,
community-based outpatient clinics, and community living
centers.
Orthotics & Prosthetics Workforce.--The Committee is
concerned about the sustainability of the orthotics and
prosthetics workforce treating veterans, particularly with
retirements in an aging workforce and the lack of availability
of advanced degree programs necessary to train new
professionals. Reports indicate that up to 20 percent of the
field's 7,100 clinicians nationwide are either past retirement
age or within 5 years of retiring. The Committee recognizes the
contributions made by the VHA's Orthotic and Prosthetic
Residency Program to provide rotation opportunities through the
VA system, but acknowledges this program alone is inadequate to
ensure a sustainable workforce for the future, especially in
light of the skill set necessary to provide the increasingly
complex, state-of-the-art orthotics and prosthetics care for
Iraq and Afghanistan war veterans. The Committee directs the
VHA to explore cost effective opportunities to grow the
workforce pipeline in order to ensure the future orthotic and
prosthetic workforce required by the nation's new generation of
veterans and report findings to the Committees on
Appropriations of both Houses of Congress within 180 days of
enactment.
Sepsis Screening.--Sepsis is a major cause of mortality
among veterans with spinal cord injury. The Committee believes
that the Department, through its Center for Clinical Management
Research and its Spinal Cord Injuries and Disorders Centers,
can help improve the VA's diagnosis and management of Sepsis.
The Committee urges the Department to provide a report on its
costs related to sepsis management and how it has incorporated
latest improvements in sepsis screening and diagnostics,
including biomarker testing, across its healthcare facilities.
Veterans Exposed to Open Burn Pits and Airborne Hazards.--
In order to provide full and effective medical care it is
essential for the Department to better understand the impacts
exposure during service has had on the health of veterans.
Therefore the Committee includes $5,000,000 for VHA clinical
proposals, developed in conjunction with research, focusing on
post-deployment health for veterans exposed to airborne hazards
and open burn pits. Additionally, the Committee directs the
Secretary to provide an assessment of the process by which
veterans are informed by both VA and community care providers
about the Airborne Hazards and Open Burn Pit Registry and their
eligibility for registering. The assessment should include an
analysis of the process by which VA or community care providers
for veterans who may be suffering the effects of exposure to
airborne hazards are connected to the VA experts at the
Airborne Hazards Center of Excellence for additional resources
and assistance.
The Committee is aware that the Department may be
undertaking an effort to consolidate several health registries
at the VA. In order to better understand the impacts this might
have, the Department is directed to submit a report to the
Committees on Appropriations of both Houses of Congress no
later than 60 days after enactment of this act outlining the
number and type of registries being consolidated. The report
should also include how such consolidation will affect
implementation of the recommendations included in the National
Academies of Sciences, Engineering, and Medicine's Assessment
of the Department of Veterans Affairs Airborne Hazards and Open
Burn Pit Registry for improving the registry.
Hospice Care.--From 1964 to 1975, more than nine million
Americans served in the armed services, with more than one-
third of them having served in Vietnam. As these Vietnam-era
veterans age, many of them are facing unique end-of-life
challenges related to their combat experience that standard
hospice care and palliative services are not fully equipped to
address. These challenges include psychological and post-
traumatic stress disorders, a history of substance abuse, and
neurological conditions resulting from toxic chemical exposure.
While the VA provides hospice care and palliative services to
qualified veterans, the Committee is aware that many non-profit
organizations are developing programs designed to meet the
specific end-of-life care needs for Vietnam-era veterans. The
Committee also recognizes that such an approach could be
beneficial to Iraq and Afghanistan combat veterans in the
future.
The Committee supports the findings of the feasibility
study on hospice care protocols tailored to the unique needs of
combat veterans, including Vietnam-era veterans, as required in
fiscal year 2018. Therefore, the VA is urged to deploy a pilot
program to develop the techniques, best practices and support
mechanisms to serve these veterans and to further implement the
findings of the feasibility study. The Department is encouraged
to engage non-profit hospice and palliative care providers with
Vietnam veteran-centric programs. The Department is directed to
submit a report to the Committees on Appropriations of both
Houses of Congress no later than 180 days after enactment of
this act on this effort.
Veterans Transportation Service.--In order to ensure the
Veterans Transportation Service [VTS] is improving veterans'
access to healthcare and VA's ability to provide quality care
in a cost effective manner, the Department is directed to
submit a report to the Committees on Appropriations of both
Houses of Congress no later than 90 days after enactment of
this act outlining the progress made on these metrics. At a
minimum, the report should include analysis of the healthcare
costs impacted by non-emergency medical transportation, the
impact of VTS on missed appointment rates at facilities
utilizing the program, and VTS impact on health outcomes for
veterans.
Center for Compassionate Innovation.--The Committee
understands that VA has been operating a Center for
Compassionate Innovation. The Center's stated purpose is to
explore emerging therapies targeted to enhance veteran physical
and mental well-being when other treatments have not been
successful. The Committee encourages VA to always be testing
and researching new and innovative treatments that may benefit
veterans' lives. To more fully understand these treatments, the
Committee directs VA to report within 180 days of the enactment
of this act with a description of the proposals the Center
received in fiscal year 2018 and the cost and disposition of
such proposals. Further, the Committee directs VA to report on
the actions the Department took regarding the data or results
gleaned from these treatments and whether they have been
utilized by the Department to determine the efficacy of the
treatments.
Physician Assistants.--The Committee is concerned that VA
has failed to utilize existing authorities to hire and retain
Physician Assistants [PAs]. As such, the Committee directs VA
to accelerate the rollout of competitive pay for PAs, and
develop a plan on how to better utilize the Health Professional
Scholarship Program and Education Debt Reduction Program. In
addition, the Committee believes VA would benefit from the
creation of a staffing plan on how to utilize PAs within the
Department and directs the Agency to develop such a model.
Healthcare Workforce.--The Committee remains concerned with
VHA's ability to recruit and retain quality physicians.
Accordingly, the Committee directs the Department to fully
comply with GAO's recommendations to improve staffing,
recruitment, and retention strategies for physicians.
The Committee is aware of the ongoing challenges facing the
VA Caribbean Healthcare System as a result of the devastating
2017 hurricane season. The Committee directs the Department to
formulate a strategy to address the physician shortages
currently facing the VA Caribbean Healthcare System. The
Department is directed to submit a report to the Committees on
Appropriations of both Houses of Congress no later than 180
days after enactment of this act assessing the VA Caribbean
Healthcare System's emergency response to Hurricanes Irma and
Maria and identifying areas for improvement.
Licensed Professional Mental Health Counselors and Marriage
and Family Therapists.--The Committee directs VA to work with
the Office of Personnel Management [OPM] to create an
Occupational Series for Licensed Professional Mental Health
Counselors [LPMHCs] and Marriage and Family Therapists [MFTs].
The Committee also directs VA to create a staffing plan for
LPMHCs and MFTs to fill open positions and assess LPMHC and MFT
shortages.
Rehabilitation Therapy Outcomes.--The Committee believes
that rehabilitation therapy outcomes might be improved if VA
collected functional status data that includes; functional
status and improvement; effectiveness and efficiency of
treatment; and patient satisfaction. The Committee encourages
VA to pilot the collection of such data and compare outcomes
with a control group for which such data is not collected and
monitored.
Canadian Forces Base Gagetown.--The Committee is aware that
many National Guard veterans engaged in training activities at
Canadian Forces Base [CFB] Gagetown in the 1950s and 1960s. The
Committee is also aware that Veterans Affairs Canada approved
one-time, lump sum payments to eligible veterans exposed to
Agent Orange and other defoliants who served at CFB Gagetown,
and that American veterans who served there between June 20 and
June 24, 1964, are currently eligible for an Agent Orange
Registry Health Exam from the Veterans Health Administration.
The Committee urges the Department to establish and maintain a
health registry for American veterans who were stationed or
underwent training at CFB Gagetown between 1956 and 2006 and
who have subsequently experienced health problems which may be
attributed to Agent Orange or other defoliants. The Committee
further urges the Department to commission an independent study
tasked with investigating the linkage between service at CFB
Gagetown and the development of health problems and disease
associated with exposure to Agent Orange.
VA Special Mode Transportation.--The Committee is concerned
that blinded veterans are being denied transportation
assistance because their disability is not considered ``non-
ambulatory.'' The Committee directs VA to review this policy
and report back to the Committee regarding the circumstance
under which a denial of transportation assistance would be
issued.
Emergency Ambulance Reimbursement.--The Committee is
concerned that the Department's medical documentation
requirements for emergency ambulance services claims are
resulting in veterans receiving bills for expenses properly
borne by the VA. For example, the Committee is aware that the
Health Insurance Portability and Accountability Act [HIPAA]
frequently prevents ambulance providers from gathering the
required medical information for submission to the VA for
reimbursement. The Committee therefore urges the Department to
take any necessary actions to process such claims using the
``prudent layperson'' standard, as utilized by other Federal
health insurance programs such as Medicare and Medicaid. The
Department is directed to provide a brief to the Committees on
Appropriations of both Houses of Congress no later than 90 days
after enactment of this act to update the Committees on this
effort.
VA Transplant Centers.--The VA National Transplant Program
currently maintains 13 VA transplant centers [VATCs] across the
United States and performs approximately 300 organ transplants
per year, with significant differences in volume and types of
transplants being performed at the 13 facilities.
The Committee is very concerned with the inconsistent
volume of transplants being performed at the 13 VATCs. High
volume, particularly for complex procedures, is associated with
better outcomes, and research has demonstrated that there is
strong evidence for a volume-mortality relationship for
hospitals and physicians.
The Committee also acknowledges the Office of Special
Counsel's [OSC] report released in January 2018, which noted
that VA failed to address conflicting information regarding the
availability of transplant care in the community and the
coverage of organ harvesting and donor care through the CHOICE
Program.
Therefore, the Committee directs the Secretary of the VA to
deliver a report to the Committees on Appropriations of both
Houses of Congress not later than 180 days after the enactment
of this Act that addresses the following issues:
--The fully burdened annual cost of the Department's National
Transplant Program over the previous five fiscal years,
including a per year cost breakdown for maintaining and
operating each transplant center;
--A detailed accounting, by transplant center, of the number
of transplants, by organ type, performed over the
previous five fiscal years by month, indicating whether
or not those were performed at a VATC or at a non-VA
facility, and the average cost to the Department of
performing each type of organ transplant;
--For those transplants performed at a non-VA facility, a
listing of the statutory authority by which the
transplants were covered by the VA;
--A detailed accounting of the travel and lodging costs
associated with transporting veterans and authorized
support members to each of the Department's transplant
centers for pre-operative, operative, and post-
operative care for the previous five fiscal years with
a per year breakdown;
--VA's policy regarding the Veteran and his or her support
member when travel has been authorized, to include per
diem rates, dwelling options and travel allowances for
visiting home during treatment; and
--A cost comparison by organ type of the average cost to
perform an organ transplant, to include pre- and post-
operative care, for the Department versus the Centers
for Medicare & Medicaid Services.
The Committee directs the Secretary of the VA to provide
this information from the previous fiscal year to the House and
Senate Appropriations Committees and Veterans Affairs
Committees, on an annual basis, no later than 60 days after the
end of the fiscal year.
Pilot Program for Agritherapy.--An increasing number of
States now have programs that assist veterans in starting
farms, and many veterans turning to farming also suffer from
PTSD. The benefits of agritherapy have been reported in the
news media; however limited research and insufficient
opportunities exist to offer the benefits of agritherapy to
those suffering from PTSD. Therefore, the Department is urged
to consider agritherapy for inclusion among VA's Complementary
and Alternative Medicine therapies. Additionally, the Committee
directs no less than $4,000,000, made available through the
Office of Rural Health, toward a pilot program to train
veterans in agricultural vocations while also tending to
behavioral and mental health needs with behavioral healthcare
services and treatments from licensed providers at no fewer
than three locations. The pilot locations may be sites that
currently have an operational construct to train veterans for
agricultural vocations and have the potential to expand
operations that tend to veterans medical needs while creating a
pathway to employment in agriculture related fields.
Hepatitis C.--The Department is directed to continue its
quarterly updates to the Committees on Appropriations of both
Houses of Congress detailing the expenditures and obligations
of funding hepatitis C treatment, the number of veterans
treated, the number of veterans deemed cured, the projection of
spending, the number of new starts for drug treatment, and
number of veterans who have been cured.
Colorectal Cancer Screening.--In the explanatory statement
accompanying Public Law 115-141, the Department was directed to
offer all 7 colorectal cancer screening strategies recommended
by the United States Preventive Services Task Force and adopted
by the National Committee for Quality Assurance Healthcare
Effectiveness Data and Information Set measures, which are used
by more than 90 percent of U.S. health plans to measure
performance. The Committee reminds the Department that it is to
report to the Committees on Appropriations no later than June
23, 2018 if it determines that it is unable to comply with this
directive.
Lovell FHCC.--The Committee recognizes the innovative
collaboration between VA and DOD at the Captain James A. Lovell
Federal Health Care Center Demonstration Project, established
in 2010 under Public Law 111-84. Given the unique nature of
this joint facility, the Committee notes that the Lovell
Federal Health Care Center has significant potential to improve
access, quality, and cost-effectiveness of healthcare delivery
to veterans, service members, and their families. The Committee
also recognizes that the important work of this integration
effort must go on even as the two Departments continue to roll
out their respective EHR programs. Therefore, the Committee
directs the Department to provide, within 90 days of enactment,
a comprehensive assessment of the status of integration efforts
at Lovell FHCC, including an update on how to address ongoing
challenges related to workforce planning and electronic health
record and information technology systems integration, as well
as an assessment of whether the model of a joint facility can
be replicated in other parts of the country.
MEDICAL COMMUNITY CARE
Appropriations, 2018.................................... $9,828,294,000
Advance appropriations, 2019............................ 8,384,704,000
Budget estimate, 2019................................... 500,000,000
Committee recommendation, 2019.......................... 1,000,000,000
Budget estimate, advance appropriations, 2020........... 14,419,786,000
Committee recommendation, advance appropriations, 2020.. 10,758,399,000
PROGRAM DESCRIPTION
The Medical Community Care account provides for medical
services for eligible enrolled veterans and other beneficiaries
that is purchased from and provided by non-Department of
Veterans Affairs facilities and providers, including contract
hospitals, State homes, and outpatient services.
COMMITTEE RECOMMENDATION
In fiscal year 2018, the Committee provided an advance
appropriation of $8,384,704,000 for fiscal year 2019 for the
Medical Community Care account. The recommendation for fiscal
year 2019 includes an additional $1,000,000,000. The additional
appropriation coupled with the advance appropriation provided
for fiscal year 2019 provides the Department with total budget
authority of $9,384,704,000.
The Committee recommendation also includes an advance
appropriation of $10,758,399,000 for Medical community care for
fiscal year 2020.
VETERANS CHOICE FUND
Appropriations, 2018....................................................
Budget estimate, 2019................................... $1,900,000,000
Committee recommendation, 2019..........................................
PROGRAM DESCRIPTION
The Choice Fund was created in Public Law 113-146, the
legislation establishing the Choice program and providing
mandatory funding for it.
COMMITTEE RECOMMENDATION
The Committee recommendation does not provide any funding
for the Veterans Choice Fund. Since its inception, the
authorizers have provided nearly $20,000,000,000 in mandatory
funding, a significant portion of which was designated as an
emergency requirement, to support the Choice program. The
account has never received discretionary funding. The Committee
also notes the House of Representatives and the United States
Senate recently passed the VA MISSION Act of 2018, which
provided an additional mandatory appropriation of
$5,200,000,000.
MEDICAL SUPPORT AND COMPLIANCE
Appropriations, 2018\1\................................. $6,754,480,000
Advance appropriations, 2019............................ 7,239,156,000
Budget estimate, 2019...................................................
Committee recommendation, 2019..........................................
Budget estimate, advance appropriation, 2020............ 7,106,150,000
Committee recommendation, advance appropriation, 2020... 7,239,156,000
\1\Total excludes $3,209,000 in emergency funding provided in Public Law
115-123, the Further Additional Supplemental Appropriations for Disaster
Relief Requirements Act, 2018.
---------------------------------------------------------------------------
PROGRAM DESCRIPTION
The Medical Support and Compliance account provides funds
for management, security, and administrative expenses within
the VA healthcare system, in addition to providing costs
associated with the operation of VA medical centers and
clinics, VISN offices, and the VHA Central Office in
Washington, DC. This appropriation also covers Chief of Staff
and Facility Director operations, quality of care oversight,
legal services, billing and coding activities, procurement,
financial management, security, and human resource management.
COMMITTEE RECOMMENDATION
In fiscal year 2018, the Committee provided an advance
appropriation of $7,239,156,000 for fiscal year 2019 for the
Medical Support and Compliance account.
The Committee recommendation also includes an advance
appropriation of $7,239,156,000 for Medical support and
compliance for fiscal year 2020.
MEDICAL FACILITIES
Appropriations, 2018\1\................................. $6,141,880,000
Advance appropriations, 2019............................ 5,914,288,000
Budget estimate, 2019...................................................
Committee recommendation, 2019.......................... 211,000,000
Budget estimate, advance appropriation, 2020............ 5,276,676,000
Committee recommendation, advance appropriation, 2020... 6,141,880,000
\1\Total excludes $3,209,000 in emergency funding provided in Public Law
115-123, the Further Additional Supplemental Appropriations for Disaster
Relief Requirements Act, 2018.
---------------------------------------------------------------------------
PROGRAM DESCRIPTION
The Medical Facilities account provides funds for the
operation and maintenance of the VA healthcare system's vast
capital infrastructure. This appropriation provides for costs
associated with utilities, engineering, capital planning,
leases, laundry, groundskeeping, housekeeping, facility repair,
and property disposition and acquisition.
COMMITTEE RECOMMENDATION
In fiscal year 2018, the Committee provided an advance
appropriation of $5,914,288,000 for fiscal year 2019 for the
Medical Facilities account. The recommendation for fiscal year
2019 includes an additional $211,000,000 which is $211,000,000
above the budget request. The additional appropriation coupled
with the advance appropriation provided for fiscal year 2019
provides the Department with total budget authority of
$6,125,288,000 which is $16,592,000 below the fiscal year 2018
enacted amount.
For any VA renovation project for which energy systems are
involved, the committee encourages the VA to use energy related
Energy Savings Performance Contracting and Utility Energy
Service Contracting in concert with appropriated funds to
leverage more investment from the private sector.
VA Chapels.--The Committee has provided significant
investment for the upkeep and maintenance of Department
infrastructure. The Department owns and is responsible for
maintaining a variety of structures to include chapels and
other facilities to tend to the spiritual needs of veterans.
The Committee encourages the Secretary to prioritize funding
for maintenance and renovation of such sites owned by the
Department.
Facility Assessments.--The Committee supports VA's efforts
to obtain analysis that provides a more holistic view of VA
facilities and thereby allows the Department to make more
informed, data driven decisions about its facilities and
buildings. The Committee recognizes that annual analysis and
benchmarking across the Department's facilities will provide an
invaluable tool for long-term system-wide planning, needs
identification, and cost management for the Department.
Therefore, the Committee encourages the Department to utilize
an independent, third-party to provide facilities analysis,
benchmarking and recommendations for all VHA hospitals, nursing
homes, domiciliary facilities, and other necessary facilities.
MEDICAL AND PROSTHETIC RESEARCH
Appropriations, 2018.................................... $722,262,000
Budget estimate, 2019................................... 727,369,000
Committee recommendation................................ 779,000,000
PROGRAM DESCRIPTION
The Medical and Prosthetic Research account provides funds
for medical, rehabilitative, and health services research.
Medical research supports basic and clinical studies that
advance knowledge leading to improvements in the prevention,
diagnosis, and treatment of diseases and disabilities.
Rehabilitation research focuses on rehabilitation engineering
problems in the fields of prosthetics, orthotics, adaptive
equipment for vehicles, sensory aids and related areas. Health
services research focuses on improving the effectiveness and
economy of the delivery of health services.
COMMITTEE RECOMMENDATION
The Committee recommends $779,000,000 for the Medical and
Prosthetic Research account. This is $56,738,000 above the
fiscal year 2018 enacted level and $51,631,000 above the budget
request.
The Committee remains highly supportive of this program,
and recognizes its importance both in improving healthcare
services to veterans and recruiting and retaining high quality
medical professionals in the Veterans Health Administration.
Through the Department's research and development program,
VA has implemented a comprehensive research agenda to develop
new treatments and tools for clinicians to ease the physical
and psychological pain of men and women returning from war
zones, to improve access to VA healthcare services, and to
accelerate discoveries and applications, especially for
neurotrauma, sensory loss, amputation, polytrauma, and related
prosthetic needs. The Committee encourages VA to continue its
research into developing novel approaches to restoring veterans
with amputation, central nervous system injuries, loss of sight
or hearing, or other physical and cognitive impairments to full
and productive lives.
VA Cancer Moonshot Contribution.--The Committee supports
the Beau Biden Cancer Moonshot initiative, and the Department's
contribution utilizing advances in genomic science to provide
targeted treatment to veterans. The Department has identified
prostate cancer, triple-negative breast cancer, and colorectal
cancer as areas of priority. Due to the prevalence of various
skin cancers among service members, the Committee directs that
skin cancer be included as well.
Enewetak Atoll Registry Research.--The Committee is aware
that thousands of veterans served on the Enewetak Atoll to
clean up the island following its use for nuclear weapons
testing. The Committee is also aware of many instances of
veterans who conducted the cleanup suffering serious health
problems, such as brittle bones, cancers, and birth defects in
their children. The Committee urges the Department to study
whether there is a connection between certain illnesses and the
potential exposure of individuals to radiation related to
service at Enewetak Atoll between January 1, 1977, and December
31, 1980.
Veterans Exposed to Open Burn Pits and Airborne Hazards.--
The Committee directs the Secretary to provide an assessment of
the process by which veterans are informed by both VA and
community care providers about the Airborne Hazards and Open
Burn Pit Registry and their eligibility for registering. The
assessment should include an analysis of the process by which
VA or community care providers for veterans who may be
suffering the effects of exposure to airborne hazards are
connected to the VA experts at the Airborne Hazards Center of
Excellence for additional resources and assistance.
The Committee is also concerned about the need for a better
understanding of and treatment options for rare cancers
disproportionately impacting those who have served in the
military. The Committee encourages the Department to support
research to evaluate the health status of service members from
their time of deployment to Iraq and Afghanistan over many
years to determine their incidence of chronic diseases
including cancers that tend not to show up for decades. The
Committee further encourages the Department to establish a
collaboration with the Department of Defense to examine the
impact of rare cancers on those who serve and fund research in
delivering treatments for rare cancers that take a platform-
agnostic approach to developing new therapeutics.
Development of Veteran-Specific Therapies.--The Committee
recognizes that commercial firms have expressed challenges with
researching and developing veteran-specific therapies in light
of the nature of service-connected diseases and the relatively
small population served. However, the Committee believes it is
increasingly important for VA to better understand and develop
treatment options for veteran-specific afflictions in order to
fulfill its promise to provide timely access to care. The
Committee directs VA, where practicable, to leverage
appropriate research toward development of veteran-specific
therapies and to use existing contracting authorities to work
with commercial firms to deliver treatments that provide relief
for veterans with service-connected diseases.
Gulf War Illness Studies.--The Committee recommends the
Department continue to conduct epidemiological studies
regarding the prevalence of Gulf War illness, morbidity, and
mortality in Persian Gulf War veterans and the development of
effective treatments, preventions, and cures. The Committee is
concerned by the lack of public availability of the findings of
all research conducted by or for the Executive Branch relating
to the health consequences of military service in the Persian
Gulf theater of operations during the Persian Gulf War and by
the lack of coordination by the Department in ensuring the
public availability of this information. The Committee urges
the Department to publish disease-specific mortality data
related specifically to Persian Gulf War veterans. The
Committee remains concerned by VA's ever-evolving terminology
for the signature adverse health outcome of the Persian Gulf
War as recognized by the Institute of Medicine [IOM]--Gulf War
illness--and encourages the Department to utilize the term,
``Gulf War illness,'' as IOM has recommended. The Committee
continues to urge the Secretary to consider revising and
updating the Clinical Practice Guideline for Chronic Multi-
symptom Illness [CMI] consistent with the July 2011 Veterans
Health Initiative, ``Caring for Gulf War Veterans,'' in that
it, ``cannot be reliably ascribed to any known psychiatric
disorder,'' and to focus on recent Gulf War illness treatment
research findings and ongoing Gulf War illness treatment
research direction. Furthermore, the Committee once again
encourages VA to strengthen the training of primary, specialty,
and mental healthcare providers on the Gulf War illness case
definitions recommended by IOM.
VA/Department of Energy Computing Collaboration.--As
requested, the Committee includes $27,000,000 for VA to
collaborate with the Department of Energy through the Advanced
Computational and Translational Initiatives for Veterans and
the Million Veterans Program Cohort--Computational Health
Analytics for Medical Precision to Improve Outcomes Now [MVP-
CHAMPION] programs. The Committee encourages VA to take
advantage of the unique high-performance resources offered by
the Department of Energy Laboratories to address their most
pressing issues in veteran health data. Important research
collaborations, such as the MVP-CHAMPION project, have already
collected protected healthcare data for 23 million veterans and
is helping researchers better understand the role genes play in
our health. The Committee encourages VA to continue leveraging
the high performance computer facilities available through its
partnership with the Department of Energy.
MEDICAL CARE COST RECOVERY COLLECTIONS
MEDICAL CARE COLLECTION FUND
Appropriations, 2018.................................... $2,507,000,000
Budget estimate, 2019................................... 3,590,000,000
Committee recommendation................................ 3,590,000,000
MEDICAL CARE COLLECTION FUND--REVENUES APPLIED
Appropriations, 2018.................................... -$2,507,000,000
Budget estimate, 2019................................... -3,590,000,000
Committee recommendation................................ -3,590,000,000
PROGRAM DESCRIPTION
The Medical Care Collection Fund [MCCF] was established by
the Balanced Budget Act of 1997 (Public Law 105-33). In fiscal
year 2004, Public Law 108-199 allowed the Department of
Veterans Affairs to deposit first-party and pharmacy co-
payments; third-party insurance payments and enhanced-use
collections; long-term care co-payments; Compensated Work
Therapy Program collections; and Parking Program fees into the
MCCF. The Secretary of Veterans Affairs has the authority to
transfer funds from the MCCF to the Medical Services account.
COMMITTEE RECOMMENDATION
The Committee recommendation includes the authority to
retain co-payments and third-party collections, estimated to
total $3,590,000,000 in fiscal year 2019.
National Cemetery Administration
Appropriations, 2018.................................... $306,193,000
Budget estimate, 2019................................... 315,836,000
Committee recommendation................................ 315,836,000
ADMINISTRATION OVERVIEW
The National Cemetery Administration was established in
accordance with Public Law 93-94, the National Cemeteries Act
of 1973. It has a four-fold mission: to provide for the
interment in any national cemetery of the remains of eligible
deceased servicemembers and discharged veterans, together with
their spouses and certain dependents, and permanently maintain
their graves; to provide headstones for, and to mark graves of,
eligible persons in national, State, and private cemeteries; to
administer the grant program for aid to States in establishing,
expanding, or improving State veterans cemeteries; and to
administer the Presidential Memorial Certificate Program.
COMMITTEE RECOMMENDATION
The Committee recommends $315,836,000 for the National
Cemetery Administration. This is an increase of $9,643,000
above the fiscal year 2018 enacted level and equal to the
budget request.
The Committee has included bill language to make available
through September 30, 2020, up to 10 percent of the National
Cemetery Administration appropriation.
Departmental Administration
Appropriations, 2018\1\................................. $6,508,439,000
Budget estimate, 2019................................... 8,135,377,000
Committee recommendation................................ 7,746,670,000
\1\Total excludes $4,088,000 in emergency funding provided in Public Law
115-123, the Further Additional Supplemental Appropriations for Disaster
Relief Requirements Act, 2018.
---------------------------------------------------------------------------
ADMINISTRATION OVERVIEW
Departmental Administration provides for the administration
of veterans benefits through the Veterans Benefits
Administration, the executive direction of the Department,
several top level supporting offices, the Board of Contract
Appeals, and the Board of Veterans Appeals.
COMMITTEE RECOMMENDATION
The Committee recommends $7,746,670,000 for Departmental
Administration. The amount is composed of $365,976,000 for
General administration; $174,748,000 for the Board of Veterans
Appeals; $4,184,571,000 for Information technology systems;
$800,000,000 for the Electronic Health Record; $192,000,000 for
the Office of the Inspector General; $1,127,486,000 for
Construction, major projects; $706,889,000 for Construction,
minor projects; $150,000,000 for Grants for construction of
State extended care facilities; and $45,000,000 for Grants for
the construction of State veterans cemeteries.
GENERAL ADMINISTRATION
(INCLUDING TRANSFER OF FUNDS)
Appropriations, 2018.................................... $335,891,000
Budget estimate, 2019................................... 367,629,000
Committee recommendation................................ 365,976,000
PROGRAM DESCRIPTION
The General Administration account provides funding for the
Office of the Secretary, six assistant secretaries, and three
independent staff offices.
COMMITTEE RECOMMENDATION
The Committee recommends $365,976,000 for General
Administration. This amount is $30,085,000 above the fiscal
year 2018 enacted level and $1,653,000 below the budget
request. The Committee has included bill language to make
available through September 30, 2020, up to 10 percent of the
General Administration appropriation.
BOARD OF VETERANS APPEALS
Appropriations, 2018.................................... $161,048,000
Budget estimate, 2019................................... 174,748,000
Committee recommendation................................ 174,748,000
PROGRAM DESCRIPTION
As set forth in section 7101(a) of title 38 United States
Code, the Board of Veterans Appeals is responsible for making
final decisions on claims for veterans benefits presented to
the Board for appellate review. The vast majority of the
Board's workload derives from benefit claims initiated by the
Veterans Benefits Administration's 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 the Regional Office determination, he or she may appeal to
the Board for a final agency decision. The Board adjudicates
appeals covering all areas of veterans benefits, including:
service connection, increased disability ratings, total
disability ratings, pensions, insurance benefits, educational
benefits, home loan guaranties, vocational rehabilitation,
waivers of indebtedness, fee basis medical care, and dependency
and indemnity compensation.
COMMITTEE RECOMMENDATION
The Committee recommends $174,748,000 for the Board of
Veterans Appeals, which is $13,700,000 above fiscal year 2018
enacted level and equal to the budget request. The Committee
has included bill language to make available through September
30, 2020, up to 10 percent of the Board of Veterans Appeals
appropriation.
INFORMATION TECHNOLOGY SYSTEMS
Appropriations, 2018.................................... $4,055,500,000
Budget estimate, 2019................................... 4,184,571,000
Committee recommendation................................ 4,184,571,000
PROGRAM DESCRIPTION
The Information Technology [IT] Systems appropriation,
along with reimbursements, funds the costs of all IT staff
salaries and expenses, the operations and maintenance of all
existing information technology systems, and the development of
new projects and programs designed to improve the delivery of
service to veterans. This appropriation also funds the costs
associated with the Office of Information and Technology which
oversees the functions highlighted above.
COMMITTEE RECOMMENDATION
The Committee recommends $4,184,571,000 for the Information
Technology Systems account. This amount is $129,071,000 above
the fiscal year 2018 enacted level and equal to the budget
request. The Committee recommendation includes $1,243,220,000
for staff salaries and expenses, $2,560,780,000 for operation
and maintenance of existing programs, and $380,571,000 for
program development.
The Committee has appropriated the Information Technology
Systems account as three subaccounts. This funding structure
enhances the Committee's ability to ensure funds are executed
in a manner consistent with the Department's budget submission.
The Committee has provided sufficient flexibility within the
subaccounts by way of authorized carryover amounts and
reprogramming authority to give the Office of Information
Technology as much flexibility as possible to accomplish its
mission and goals, while ensuring proper accountability and
oversight. The Committee will continue to work with the
Department to ensure the IT projects currently underway, as
well as the projects planned for the future, have the resources
needed for success.
INFORMATION TECHNOLOGY DEVELOPMENT PROJECTS
[In thousands of dollars]
------------------------------------------------------------------------
Fiscal year 2019 Committee
Project budget request recommendation
------------------------------------------------------------------------
Clinical Applications
Access and Billing.............. 5,891 5,891
My HealtheVet................... 10,300 10,300
Health Data Interoperability.... 13,000 13,000
Registries...................... 3,228 3,228
-----------------------------------
Subtotal Clinical Applications 32,419 32,419
-----------------------------------
Health Management Platform
Digital Health Platform......... 15,682 15,682
Community Care.................. 25,303 25,303
Patient Record System........... 14,300 14,300
Purchased Care.................. 9,076 9,076
Telehealth...................... 6,030 6,030
-----------------------------------
Subtotal Health Management 70,391 70,391
Platform.....................
-----------------------------------
Benefits Systems
Benefits Appeals................ 2,500 2,500
Education Benefits.............. 37,830 37,830
Veterans Customer Experience.... 47,564 47,564
Veterans Benefits Management.... 10,000 10,000
Benefits Systems................ 31,721 31,721
-----------------------------------
Subtotal Benefits Systems..... 129,615 129,615
-----------------------------------
Memorial Affairs
Memorials Automation............ 18,800 18,800
-----------------------------------
Subtotal Memorial Affairs..... 18,800 18,800
-----------------------------------
Other IT Systems
Human Resources................. 12,600 12,600
Financial and Acquisition 65,971 65,971
Management Modernization.......
-----------------------------------
Subtotal Other IT Systems..... 78,571 78,571
-----------------------------------
Cyber Security...................... 17,000 17,000
Information/Infrastructure
Management
Data Integration and Management. 33,715 33,715
-----------------------------------
Subtotal Information/ 33,715 33,715
Infrastructure Management....
-----------------------------------
Total IT Development.......... 380,511 380,511
------------------------------------------------------------------------
Scheduling System.--For more than 15 years, the Department
has struggled to modernize the current patient scheduling
system and the Committee remains concerned about the lack of
progress. While the Department has made upgrades to the VistA
scheduling system, these modifications only provide a more user
friendly viewing environment and do not address more functional
problems with the current system. The Committee understands
that a scheduling system solution will be a component of the
new Electronic Health Record [EHR] program and that VA plans to
deploy this new system over a 10 year period, with the first
deployment to begin within the next 18 months. While the
Committee supports VA's efforts to replace the antiquated EHR
system currently in place and upgrade the deficient
infrastructure in the field to handle the new functionality, it
is concerning that many hospitals will not see functional
modernization of the current scheduling system for another 10
years. The Committee understands that VA is conducting pilot
programs involving commercial off-the-shelf solutions
scheduling systems to assess if they provide substantial value
over its current interim systems and whether the benefits of
deploying off-the-shelf technology outweighs costs during the
decade-long deployment plan to modernize the entire EHR is
implemented. The Committee believes that the Department must
provide an interim solution for those hospitals and clinics
that fall toward the end of the deployment schedule to improve
veteran access to care, shorten veteran wait times, allow the
VA to track and manage patient progress throughout the care
continuum, and improve resource utilization across the VA
healthcare system. Therefore the Committee directs the
Department to submit a scheduling modernization plan no later
than 60 days after enactment of this act, describing plans and
costs of utilizing off-the-shelf technology as an interim
solution during EHR modernization.
Enhancing Local Control of Information Technology Needs.--
The Committee is concerned that local facilities and VISN
leadership do not have the ability to quickly address IT issues
causing the disruption of patient care. Further, that they do
not have the ability to utilize the technologies they have
identified as enhancing patient experience, due to
centralization of IT resources. VA is therefore directed to
produce a report on the methods by which information technology
funds are allocated to the VISNs and to facilities, and any
plans to increase local control.
VETERANS ELECTRONIC HEALTH RECORD
Appropriations, 2018.................................... $782,000,000
Budget estimate, 2019................................... 1,207,000,000
Committee recommendation, 2019.......................... 800,000,000
PROGRAM DESCRIPTION
The Veterans Electronic Health Record account funds all
activities related to the acquisition, implementation,
preparation, development, interface, management, rollout, and
maintenance of a new electronic health record. The EHR solution
and implementation will include program management; an
enterprise-wide EHR system; change management; training;
testing; deployment services; sustainment and other solutions
encompassing the entire range of EHR requirements.
COMMITTEE RECOMMENDATION
The Committee recommends $800,000,000 for the Veterans
Electronic Health Record. This is $18,000,000 above the fiscal
year 2018 enacted level and $407,000,000 below the budget
request. In July 2017, the Secretary announced that Cerner
Corporation, which had participated in the DOD EHR acquisition,
had received the sole source contract to develop the VA EHR. In
support of this effort, the Committee appropriated $782,000,000
in fiscal year 2018, with the expectation that award of a
contract was imminent, however, execution of a contract became
delayed, with the contract not being awarded until May 2018.
It is incumbent on the Department to present detailed
justifications, including schedules and costs with any
acquisition of this size and magnitude. Yet, the Department's
justifications accompanying the budget submission lacked even
the most basic of detail. While the Committee remains
supportive of replacing the VA's current EHR with the same
being acquired by DOD, the Department must address how delays
in contracting, as well as slippage in timelines, including
DOD's deployment schedule of MHS Genesis, will impact budgetary
needs for fiscal year 2019 and beyond.
VA/DOD Interoperability.--As VA and DOD plan to deploy the
same EHR, VA must remain committed to working towards assuring
continued VA/DOD interoperability. The Committee directs VA and
DOD to maintain clear and agreed-upon metrics and goals for
interoperability, to establish clear timeframes for meeting
those goals, to ensure clinician feedback is sought and
considered as the respective electronic medical record systems
are modernized, and to update the VA/DOD Interagency Program
Office guidance to reflect agreed-upon metrics and goals. The
need for well-functioning, up-to-date electronic health record
technology is absolutely critical.
OFFICE OF INSPECTOR GENERAL
Appropriations, 2018.................................... $164,000,000
Budget estimate, 2019................................... 172,054,000
Committee recommendation................................ 192,000,000
PROGRAM DESCRIPTION
The Office of Inspector General [OIG] was established by
the Inspector General Act of 1978 and is responsible for the
audit, investigation, and inspection of all Department of
Veterans Affairs programs and operations.
COMMITTEE RECOMMENDATION
The Committee recommends $192,000,000 for the Office of
Inspector General. This is $28,000,000 above the fiscal year
2018 enacted level and $19,946,000 above the budget request.
The Committee has included bill language to make available
through September 30, 2020, up to 10 percent of the Office of
the Inspector General appropriation.
CONSTRUCTION, MAJOR PROJECTS
Appropriations, 2018.................................... $512,430,000
Budget estimate, 2019................................... 1,127,486,000
Committee recommendation................................ 1,127,486,000
PROGRAM DESCRIPTION
The Construction, Major Projects account provides for
constructing, altering, extending, and improving any of the
facilities (including parking projects) under the jurisdiction
or for the use of VA, including planning, architectural and
engineering services, needs assessment, and site acquisition
where the estimated cost of a project is more than the amount
set forth in 38 U.S.C. 8104(a)(3)(A). Proceeds realized from
Enhanced Use Lease activities may be deposited into the
Construction, Major Projects and Construction, Minor Projects
accounts.
COMMITTEE RECOMMENDATION
The Committee recommends an appropriation of $1,127,486,000
for the construction of major projects. This is $615,056,000
above the fiscal year 2018 enacted level and equal the budget
request.
The following table reflects the President's budget request
for major construction projects and the corresponding Committee
recommendations.
MAJOR CONSTRUCTION PROJECTS
[In thousands of dollars]
------------------------------------------------------------------------
Fiscal year 2019 Committee
Location and description budget request recommendation
------------------------------------------------------------------------
Veterans Health Administration
[VHA]:
St. Louis (JB), MO: Medical 34,400 34,400
Facility Improvements and
Cemetery Expansion.............
Canandaigua, NY: Construction 190,000 190,000
and Renovation.................
Dallas, TX: Spinal Cord Injury.. 135,686 135,686
North Chicago, IL: Renovate 6,000 6,000
Building 4.....................
Oklahoma City, OK: New Surgical 10,800 10,800
Intensive Care Unit............
Advance Planning Fund........... 95,000 95,000
Asbestos........................ 15,000 15,000
Major Construction Staff........ 27,500 27,500
Hazardous Waste................. 26,200 26,200
Judgment Fund................... 25,000 25,000
Non-Departmental Federal Entity 38,700 38,700
Project Management Support.....
Seismic Corrections Initiative.. 400,000 400,000
-----------------------------------
Total VHA..................... 1,004,286 1,004,286
===================================
National Cemetery Administration
[NCA]:
Ohio Western Reserve, OH: 29,000 29,000
Gravesite Expansion, Phase 3...
Great Lakes, MI: Gravesite 35,200 35,200
Expansion, Phase 2.............
Cape Canaveral, FL: Gravesite 38,000 38,000
Expansion Phase 2..............
Advance Planning Fund........... 10,000 10,000
NCA Land Acquisition Fund....... 5,000 5,000
-----------------------------------
Total NCA..................... 117,200 117,200
===================================
General Administration--Staff 6,000 6,000
Offices, Advance Planning Fund.....
-----------------------------------
Total Construction, Major 1,127,486 1,127,486
Projects.....................
------------------------------------------------------------------------
CONSTRUCTION, MINOR PROJECTS
Appropriations, 2018\1\................................. $342,570,000
Budget estimate, 2019................................... 706,889,000
Committee recommendation................................ 706,889,000
\1\Total excludes $4,088,000 in emergency funding provided in Public Law
115-123, the Further Additional Supplemental Appropriations for Disaster
Relief Requirements Act, 2018.
---------------------------------------------------------------------------
PROGRAM DESCRIPTION
The Construction, Minor Projects account provides for
constructing, altering, extending, and improving any of the
facilities (including parking) under the jurisdiction or for
the use of VA, including planning, assessment of needs,
architectural and engineering services, and site acquisition,
where the estimated cost of a project is equal to or less than
$20,000,000. Public Law 106-117, the Veterans Millennium Health
Care and Benefits Act of 1999, gave VA authority to make
capital contributions from minor construction in enhanced-use
leases. Proceeds realized from enhanced-use lease activities
may be deposited into the Construction, Major Projects and
Construction, Minor Projects accounts.
COMMITTEE RECOMMENDATION
The Committee recommends $706,889,000 for minor
construction. This is $364,319,000 above the fiscal year 2018
enacted level and equal to the budget request.
The recommendation includes $449,149,000 for the Veterans
Health Administration, $171,820,000 for the National Cemetery
Administration, $46,820,000 for the Veterans Benefits
Administration, and $39,100,000 for staff offices and the
Office of Information Technology. The Department is directed to
provide an expenditure plan to the Committees on Appropriations
of both Houses of Congress no later than 30 days after
enactment of this act for the amount appropriated for minor
construction.
GRANTS FOR CONSTRUCTION OF STATE EXTENDED CARE FACILITIES
Appropriations, 2018.................................... $110,000,000
Budget estimate, 2019................................... 150,000,000
Committee recommendation................................ 150,000,000
PROGRAM DESCRIPTION
This account is used to provide grants to assist States in
acquiring or constructing 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. The grant may not exceed 65 percent of the total
cost of the project. Public Law 102-585 granted permanent
authority for this program, and Public Law 106-117 provided
greater specificity in directing VA to prescribe regulations
for the number of beds for which grant assistance may be
furnished. This program has been a successful partnership
between States and VA in meeting the long-term care needs of
elderly veterans for decades.
COMMITTEE RECOMMENDATION
The Committee recommends $150,000,000 for Grants for
construction of State extended care facilities. This is equal
to the budget request.
State Extended Care Facility Construction.--The Committee
is concerned that VA continues to approve new grants for State
home construction projects without adequate resources to
fulfill the Federal cost share. In fiscal year 2018, VA
budgeted only $90,000,000 towards an outstanding list of 57
approved projects in 25 States valued at $639,000,000.
Recognizing this disparity, the Congress provided a one-time
appropriation of $575,000,000 in fiscal year 2018 to assist VA
in resolving its backlog. The Committee directs VA to provide
an update within 180 days of enactment of this act on the
execution of those funds, that specifically addresses the
projected schedule of execution by priority group, including
estimated completion dates for each project, as well as actions
the Department will take to prevent future backlogs.
GRANTS FOR CONSTRUCTION OF VETERANS CEMETERIES
Appropriations, 2018.................................... $45,000,000
Budget estimate, 2019................................... 45,000,000
Committee recommendation................................ 45,000,000
PROGRAM DESCRIPTION
Public Law 105-368 amended title 38 U.S.C. 2408 and
established authority to provide aid to States for
establishment, expansion, and improvement of State veterans
cemeteries, which are operated and permanently maintained by
the States. This statutory change increased the maximum Federal
share from 50 percent to 100 percent in order to fund
construction costs and initial equipment expenses when the
cemetery is established. States remain responsible for
providing the land and for paying all costs related to
operation and maintenance of the cemeteries, including the
costs for subsequent equipment purchases.
COMMITTEE RECOMMENDATION
The Committee recommends $45,000,000 for Grants for
construction of State veterans cemeteries. This is equal to the
budget request.
Administrative Provisions
(INCLUDING TRANSFERS AND RESCISSIONS OF FUNDS)
Sec. 201. The Committee includes a provision which outlines
transfer authority and responsibilities for the Veterans
Benefits Administration.
Sec. 202. The Committee includes a provision which outlines
transfer authority and responsibilities for the Veterans Health
Administration.
Sec. 203. The Committee includes a provision which outlines
the use of funds appropriated for salaries and expenses.
Sec. 204. The Committee includes a provision mandating that
only construction funds may be used for land procurement or the
construction of any new hospital or home.
Sec. 205. The Committee includes a provision allowing for
reimbursements to the Medical Services account.
Sec. 206. The Committee includes a provision allowing for
payments of prior year obligations.
Sec. 207. The Committee includes a provision which allows
for the use of funds for prior year obligations.
Sec. 208. The Committee includes a provision which allows
for payments from the National Service Life Insurance Fund.
Sec. 209. The Committee includes a provision which outlines
the use of funds from enhanced-use lease proceeds.
Sec. 210. The Committee includes a provision which provides
for funds for the Office of Resolution Management, the Office
of Employment Discrimination Complaint Adjudication, the Office
of Accountability and Whistleblower Protection, and the Office
of Diversity and Inclusion.
Sec. 211. The Committee includes a provision which requires
disclosure of third-party reimbursement information.
Sec. 212. The Committee includes a provision which allows
for the transfer of revenue derived from enhanced-use leases
into the construction accounts.
Sec. 213. The Committee includes a provision which outlines
authorized uses for Medical Services account funds.
Sec. 214. The Committee includes a provision which allows
funds in the Medical Care Collection Fund to be transferred
into the Medical Services and Medical Community Care accounts.
Sec. 215. The Committee includes a provision which allows
eligible veterans in the State of Alaska to obtain medical care
services.
Sec. 216. The Committee includes a provision which allows
for the transfer of funds into the construction accounts.
Sec. 217. The Committee includes a provision requiring the
Secretary of Veterans Affairs to submit quarterly financial
reports.
Sec. 218. The Committee includes a provision outlining
transfer authority for the Information Technology Systems
account.
Sec. 219. The Committee includes a provision allowing for
the transfer of funds from certain accounts to the Joint
Department of Defense/Department of Veterans Affairs Medical
Facility Demonstration Fund, as authorized by Public Law 111-
84.
Sec. 220. The Committee includes a provision allowing for
the transfer of funds from certain advance appropriation
accounts to the Joint Department of Defense/Department of
Veterans Affairs Medical Facility Demonstration Fund, as
authorized by Public Law 111-84.
Sec. 221. The Committee includes a provision allowing for
the transfer of certain funds deposited in the Medical Care
Collections Fund to the Joint Department of Defense/Department
of Veterans Affairs Medical Facility Demonstration Fund, as
authorized by Public Law 111-84.
Sec. 222. The Committee includes a provision directing a
minimum of $15,000,000 be transferred from Medical Services,
Medical Support and Compliance, and Medical Facilities to the
Department of Defense/Department of Veterans Affairs Health
Care Sharing Incentive Fund, as authorized by section 8111 of
title 38, United States Code.
Sec. 223. The Committee includes a provision prohibiting
funds available to the Department in this or any other act from
being used to replace the current system by which VISNs select
and contract for diabetes monitoring supplies and equipment.
Sec. 224. The Committee includes a provision requiring
notification of all bid savings for major construction
projects.
Sec. 225. The Committee includes a provision restricting
scope increases for major construction projects above that
specified in the original project justification.
Sec. 226. The Committee includes a provision requiring the
Department to submit reports relating to the Veterans Benefits
Administration on claims processing at Regional Offices.
Sec. 227. The Committee includes a provision requiring VA
to notify the Committee 15 days prior to any organizational
changes within VA of 25 or more FTE.
Sec. 228. The Committee includes a provision requiring the
Secretary to report to the Committees each quarter about any
single national outreach and awareness marketing campaign
exceeding $2,000,000.
Sec. 229. The Committee includes a provision permitting the
transfer to the Medical Services account of fiscal year
discretionary 2019 appropriated funds.
Sec. 230. The Committee includes a provision permitting the
transfer of funds between GOE, VBA and BVA.
Sec. 231. The Committee includes a provision prohibiting
the reprogramming of funds in excess of $7,000,000 among major
construction projects or programs.
Sec. 232. The Committee includes a provision mandating
certain professional standards for the veterans crisis hotline.
Sec. 233. The Committee includes a provision restricting
funds from being used to close certain medical facilities in
the absence of a national realignment strategy.
Sec. 234. The Committee includes a provision requiring VA
to use the mammography screening guidelines announced by the
Secretary on May 10, 2017.
Sec. 235. The Committee includes a provision allowing the
use of Medical Services funding for assisted reproductive
technology treatment and adoption reimbursement for veterans
and their spouses if the veteran has a service-connected
disability that results in being unable to procreate without
such fertility treatment.
Sec. 236. The Committee includes a provision rescinding
funds.
Sec. 237. The Committee includes a provision prohibiting
any funds to be used to contract out any functions performed by
more than 10 employees without a fair competition process.
Sec. 238. The Committee includes a provision pertaining to
Native Hawaiian small businesses.
Sec. 239. The Committee includes a provision directing the
discontinuation of the usage of social security numbers with
the Department of Veterans Affairs.
Sec. 240. The Committee includes a provision pertaining to
the certification of marriage and family therapists.
Sec. 241. The Committee includes a provision prohibiting
the transfer of funds from the Filipino Veterans Equity
Compensation Fund to any other VA account.
Sec. 242. The Committee includes a provision regarding a
childcare program.
Sec. 243. The Committee includes a reference to a provision
in the 2017 appropriations act identifying information which
may be used to verify the status of coastwise merchant seamen
who served during World War II for the purposes of eligibility
for medals, ribbons, or other military decorations.
Sec. 244. The Committee includes a provision ensuring
particular ratios of veterans to full-time employment
equivalents within any VA program of rehabilitation.
Sec. 245. The Committee includes a provision prohibiting
funds to be used to restrict an individual's ability to speak
with a Member of Congress or his or her staff.
Sec. 246. The Committee includes a provision requiring
certain data to be included in the budget justifications for
the Construction, Major account.
Sec. 247. The Committee includes a provision prohibiting
the use of canines in VA research unless: the scientific
objectives of the study can only be met by using canines; the
study has been directly approved by the Secretary; and the
study is consistent with the revised VA canine research policy
document released in December, 2017.
Sec. 248. The Committee includes a provision providing
$2,000,000,000 to be available until expended for VA
infrastructure needs, of which $1,000,000,000 is for Medical
Facilities for non-recurring maintenance; $500,000,000 is for
Minor Construction; and $500,000,000 is for Major Construction.
This funding is not made available until VA provides and the
Committees approve a detailed expenditure plan.
Sec. 249. The Committee includes a provision prohibiting
the use of funds to interfere with the ability of veterans to
participate in State-approved medicinal marijuana programs or
deny service to such veterans.
TITLE III
RELATED AGENCIES
American Battle Monuments Commission
OVERVIEW
The American Battle Monuments Commission [ABMC] was
established by Congress in 1923 and is responsible for the
following: designing, constructing, operating, and maintaining
permanent American cemeteries in foreign countries;
establishing and maintaining U.S. military memorials,
monuments, and markers where American Armed Forces have served
overseas since April 6, 1917, the date of the United States
entry into World War I, and within the United States when
directed by public law; and controlling the design and
construction of permanent U.S. military monuments and markers
by other U.S. citizens and organizations, both public and
private, and encouraging their maintenance. ABMC administers,
operates, and maintains 26 permanent American military
cemeteries, 29 Federal memorial, monuments, and markers, and 8
non-Federal memorials located in 15 foreign countries, the U.S.
Commonwealth of the Northern Mariana Islands, the British
Dependency of Gibraltar, and the United States of America.
SALARIES AND EXPENSES
Appropriations, 2018.................................... $79,000,000
Budget estimate, 2019................................... 75,100,000
Committee recommendation................................ 81,000,000
COMMITTEE RECOMMENDATION
The Committee recommends $81,000,000 for the Salaries and
Expenses account. This amount is $2,000,000 above the fiscal
year 2018 enacted level and $5,900,000 above the budget
request. The recommendation includes an additional $5,900,000
to bolster the Commission's maintenance and infrastructure
program, including the interpretive program. The additional
funds will restore the reduction proposed in the budget request
for this program and provide additional funds to accelerate the
Commission's 5-year plan, not only to maintain the cemeteries
and monuments honoring America's war dead, but also to preserve
and communicate these veterans' stories of courage and
sacrifice.
Nisei Veterans.--The Committee recognizes the legacy of the
100th Infantry Battalion which, with the 442nd Regiment and
Military Intelligence Service, became one the most decorated
military units of the Second World War. The Committee is aware
of the existence of exhibits and memorials dedicated to the
100th Infantry Battalion/442nd Regiment. However, the Committee
believes it is increasingly important to memorialize the
important part they, and all Nisei veterans, have played in our
country's history.
Not later than 90 days after enactment of this act, the
American Battle Monuments Commission shall conduct a
feasibility study to determine the viability of establishing a
national memorial in recognition of the 100th Infantry
Battalion/442nd Regiment. In conducting the feasibility study,
ABMC shall consider the importance of telling the story of the
100th Infantry Battalion/442nd Regiment in the context of the
contributions of all Nisei veterans and associated units during
the Second World War, and the ability to adequately reach
audiences, including Americans of Japanese ancestry, with the
story of these Nisei veterans through existing exhibits and
memorials.
National Memorial Cemetery of the Pacific Visitor Center.--
The Committee is aware that the American Battle Monuments
Commission prepared preliminary designs for a new visitors
center at the National Memorial Cemetery of the Pacific, also
known as the ``Punchbowl.'' The Committee understands that the
Punchbowl is the resting place of more than 13,000 Soldiers and
sailors who died during the Second World War and that a new
visitor center would enhance the story of Pacific Theatre of
the Second World War by giving context to the headstones and
columbaria through interpretive exhibits and other displays.
Not later than 90 days after enactment of this act, the
Committee directs the American Battle Monuments Commission to
report on the status of this project, including what, if any,
funding has been programmed in its future years' budgets.
FOREIGN CURRENCY FLUCTUATIONS
The Committee includes in the accompanying act, as proposed
by the administration, such sums as necessary for the Foreign
Currency Fluctuations account. Funding the account in this
manner allows the Commission to maintain cemeteries regardless
of the volatility of foreign currency fluctuations.
United States Court of Appeals for Veterans Claims
OVERVIEW
The United States Court of Appeals for Veterans Claims was
established by the Veterans' Judicial Review Act of 1988. The
Court is an independent judicial tribunal with exclusive
jurisdiction to review decisions of the Board of Veterans
Appeals. It has the authority to decide all relevant questions
of law; interpret constitutional, statutory, and regulatory
provisions; and determine the meaning or applicability of the
terms of an action by the Secretary of Veterans Affairs. It is
authorized to compel action by the Secretary. It is authorized
to hold unconstitutional or otherwise unlawful and set aside
decisions, findings, conclusions, rules, and regulations issued
or adopted by the Secretary of Veterans Affairs, the Board of
Veterans Appeals, or the Chairman of the Board that are found
to be arbitrary or capricious. The Court's principal office
location is Washington, DC; however, it is a national court,
empowered to sit anywhere in the United States.
SALARIES AND EXPENSES
Appropriations, 2018.................................... $33,600,000
Budget estimate, 2019................................... 107,455,000
Committee recommendation................................ 34,955,000
COMMITTEE RECOMMENDATION
The Committee recommends $34,955,000 for the U.S. Court of
Appeals for Veterans Claims. This amount is $1,355,000 above
the fiscal year 2018 enacted level and $72,500,000 below the
budget request. Public Law 115-141 included funding for a
feasibility study regarding a new courthouse. This study is not
complete, therefore, the Committee does not include the funds
requested for a new courthouse.
Department of Defense--Civil
Cemeterial Expenses, Army
OVERVIEW
The Secretary of the Army is responsible for the
administration, operation, and maintenance of Arlington
National Cemetery [ANC] and the Soldiers' and Airmen's Home
National Cemetery. In addition to its principal function as a
national cemetery, Arlington hosts more than 3,000 public
wreath laying ceremonies, approximately 100 distinguished
visitor honors wreath laying ceremonies, and approximately
4,000,000 visitors annually.
SALARIES AND EXPENSES
Appropriations, 2018.................................... $80,800,000
Budget estimate, 2019................................... 70,800,000
Committee recommendation................................ 80,800,000
COMMITTEE RECOMMENDATION
The Committee recommends $80,800,000 for the Salaries and
Expenses account. This amount is equal to the fiscal year 2018
enacted level and $10,000,000 above the budget request.
The Committee remains concerned that ANC's operating
account has been held artificially flat for a number of years,
and this action is beginning to have deleterious effects on the
Cemetery's performance and ability to meet its mission.
Arlington performs over 7,000 burial services each year for
veterans and family members and an average of 27-30 each
weekday. With this heavy workload, ANC cannot be under-
resourced, and accordingly, the Committee has provided an
additional $10,000,000 to correct this problem.
This Committee remains unwavering in its support for the
Cemetery and the successful completion of the Cemetery's truly
unique and honored mission. Accordingly, the Secretary of the
Army is again directed to include this increase in the
Cemetery's baseline budget and ensure future budget requests
provide ample resources for Arlington National Cemetery.
CONSTRUCTION
Appropriations, 2018.................................... $167,000,000
Budget estimate, 2019...................................................
Committee recommendation, 2019.......................... 56,600,000
Armed Forces Retirement Home
TRUST FUND
OVERVIEW
Appropriations, 2018.................................... $64,300,000
Budget estimate, 2019................................... 64,300,000
Committee recommendation................................ 64,300,000
COMMITTEE RECOMMENDATION
The Committee recommends authority to expend $64,300,000
from the Armed Forces Retirement Home Trust Fund to operate and
maintain the Armed Forces Retirement Home--Washington, DC, and
the Armed Forces Retirement Home--Gulfport, Mississippi.
Administrative Provision
Sec. 301. The Committee includes a provision making
available funds as authorized by 10 U.S.C. 4727.
TITLE IV
OVERSEAS CONTINGENCY OPERATIONS
DEPARTMENT OF DEFENSE
The Committee recommends title IV, Overseas Contingency
Operations, for military construction projects related to the
Global War on Terrorism and the European Reassurance Initiative
that were requested by the Administration in the Fiscal Year
2019 Overseas Contingency Operations budget request.
Military Construction, Army
The Committee recommends $192,250,000 for ``Military
Construction, Army'', as requested in the Fiscal Year 2019
Overseas Contingency Operations budget request, for military
construction and planning and design in support of Overseas
Contingency Operations and the European Reassurance Initiative.
Military Construction, Navy and Marine Corps
The Committee recommends $227,320,000 for ``Military
Construction, Navy and Marine Corps'', as requested in the
Fiscal Year 2019 Overseas Contingency Operations budget
request, for military construction and planning and design in
support of the European Reassurance Initiative.
Military Construction, Air Force
The Committee recommends $414,800,000 for ``Military
Construction, Air Force'', as requested in the Fiscal Year 2019
Overseas Contingency Operations budget request, for military
construction and planning and design in support of Overseas
Contingency Operations and the European Reassurance Initiative.
Military Construction, Defense-Wide
The Committee recommends $87,050,000 for ``Military
Construction, Defense-Wide'', as requested in the Fiscal Year
2019 Overseas Contingency Operations budget request, for
planning and design in support of the European Reassurance
Initiative.
Administrative Provisions
Sec. 401. The Committee includes a provision which provides
the contingent emergency designation for the Overseas
Contingency Operations accounts.
Sec. 402. The agreement includes section 402 which requires
the Department of Defense to provide a future year defense
program for European Deterrence/Reassurance Initiative to the
congressional defense committees.
TITLE V
GENERAL PROVISIONS
Sec. 501. The Committee includes a provision that prohibits
the obligation of funds beyond the current fiscal year unless
expressly so provided.
Sec. 502. The Committee includes a provision that prohibits
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.
Sec. 503. The Committee includes a provision that
encourages the expansion of E-commerce technologies and
procedures.
Sec. 504. The Committee includes a provision that specifies
the congressional committees that are to receive all reports
and notifications.
Sec. 505. The Committee includes a provision that limits
funds from being transferred from this appropriations measure
to any instrumentality of the United States Government without
authority from an appropriations act.
Sec. 506. The Committee includes a provision regarding the
posting of congressional reports on agency Web sites.
Sec. 507. The Committee includes a provision 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.
Sec. 508. The Committee includes a provision prohibiting
the use of funds for the payment of first-class travel by an
employee of the executive branch.
Sec. 509. The Committee includes a provision prohibiting
the use of funds in this act for any contract where the
contractor has not complied with E-Verify requirements.
Sec. 510. The Committee includes a provision 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.
Sec. 511. The Committee includes a provision limiting the
construction of facilities in the United States, its
territories, or possessions for the purposes of housing
individuals detained at Guantanamo Bay, Cuba.
PROGRAM, PROJECT, AND ACTIVITY
In fiscal year 2019, for purposes of the Balanced Budget
and Emergency Deficit Control Act of 1985 (Public Law 99-177)
or the Balanced Budget and Emergency Deficit Control
Reaffirmation Act of 1987 (Public Law 100-119), the following
information provides the definition of the term ``program,
project, and activity'' for departments, agencies and programs
under the jurisdiction of the Military Construction and
Veterans Affairs, and Related Agencies subcommittee. The term
``program, project, and activity'' shall include the most
specific level of budget items identified in the Military
Construction, Veterans Affairs, and Related Agencies
Appropriations Act, 2019, the House and Senate Committee
reports, and the conference report and accompanying joint
explanatory statement of managers of the committee of
conference.
If a sequestration order is necessary, in implementing the
Presidential order, departments, and agencies shall apply any
percentage reduction required for fiscal year 2019 pursuant to
the provisions of Public Law 99-177 or Public Law 100-119 to
all items specified in the justifications submitted to the
Committees on Appropriations of the Senate and House of
Representatives in support of the fiscal year 2019 budget
estimates, as amended, for such departments and agencies, as
modified by congressional action, and in addition, for the
Department of Defense, Military Construction, the definition
shall include specific construction locations as identified in
the explanatory notes.
COMPLIANCE WITH PARAGRAPH 7, RULE XVI, OF THE STANDING RULES OF THE
SENATE
Paragraph 7 of rule XVI requires that Committee reports
accompanying general appropriations bills identify each
recommended amendment which proposes an item of appropriation
which is not made to carry out the provisions of an existing
law, a treaty stipulation, or an act or resolution previously
passed by the Senate during that session.
The Committee recommends funding for the following programs
which currently lack authorization:
Title I: Department of Defense
Military Construction, Army
Military Construction, Navy and Marine Corps
Military Construction, Air Force
Military Construction, Defense-Wide
Military Construction, Army National Guard
Military Construction, Air National Guard
Military Construction, Army Reserve
Military Construction, Navy Reserve
Military Construction, Air Force Reserve
North Atlantic Treaty Organization Security Investment
Program
Department of Defense Base Closure Account
Family Housing Operation and Maintenance, Army
Family Housing Operation and Maintenance, Navy and Marine
Corps
Family Housing Operation and Maintenance, Air Force
Family Housing Operation and Maintenance, Defense-Wide
Family Housing Construction, Army
Family Housing Construction, Navy and Marine Corps
Family Housing Construction, Air Force
Department of Defense Family Housing Improvement Fund
Department of Defense Military Unaccompanied Housing
Improvement Fund
Title II: Department of Veterans Affairs
Veterans Benefits Administration
Veterans Health Administration
National Cemetery Administration
Departmental Administration
Title III: Related Agencies
American Battle Monuments Commission
U.S. Court of Appeals for Veterans Claims
Cemeterial Expenses, Army
Armed Forces Retirement Home
COMPLIANCE WITH PARAGRAPH 7(c), RULE XXVI OF THE STANDING RULES OF THE
SENATE
Pursuant to paragraph 7(c) of rule XXVI, on June 7, 2018,
the Committee ordered favorably reported a bill (S. 3024)
making appropriations for military construction, the Department
of Veterans Affairs, and related agencies for the fiscal year
ending September 30, 2019, and for other purposes, provided,
that the bill be subject to amendment and that the bill be
consistent with its budget allocation, and provided that the
Chairman of the Committee or his designee be authorized to
offer the substance of the original bill as a Committee
amendment in the nature of a substitute to the House companion
measure, by a recorded vote of 31-0, a quorum being present.
The vote was as follows:
Yeas Nays
Chairman Shelby
Mr. McConnell
Mr. Alexander
Ms. Collins
Ms. Murkowski
Mr. Graham
Mr. Blunt
Mr. Moran
Mr. Hoeven
Mr. Boozman
Mrs. Capito
Mr. Lankford
Mr. Daines
Mr. Kennedy
Mr. Rubio
Mrs. Hyde-Smith
Mr. Leahy
Mrs. Murray
Mrs. Feinstein
Mr. Durbin
Mr. Reed
Mr. Tester
Mr. Udall
Mrs. Shaheen
Mr. Merkley
Mr. Coons
Mr. Schatz
Ms. Baldwin
Mr. Murphy
Mr. Manchin
Mr. Van Hollen
COMPLIANCE WITH PARAGRAPH 12, RULE XXVI OF THE STANDING RULES OF THE
SENATE
Paragraph 12 of rule XXVI requires that Committee reports
on a bill or joint resolution repealing or amending any statute
or part of any statute include ``(a) the text of the statute or
part thereof which is proposed to be repealed; and (b) a
comparative print of that part of the bill or joint resolution
making the amendment and of the statute or part thereof
proposed to be amended, showing by stricken-through type and
italics, parallel columns, or other appropriate typographical
devices the omissions and insertions which would be made by the
bill or joint resolution if enacted in the form recommended by
the committee.''
In compliance with this rule, changes in existing law
proposed to be made by the bill are shown as follows: existing
law to be omitted is enclosed in black brackets; new matter is
printed in italic; and existing law in which no change is
proposed is shown in roman.
CONSOLIDATED APPROPRIATIONS ACT, 2018,
PUBLIC LAW 115-141
DIVISION J--MILITARY CONSTRUCTION, VETERANS AFFAIRS, AND RELATED
AGENCIES APPROPRIATIONS ACT, 2018
* * * * * * *
TITLE II
DEPARTMENT OF VETERANS AFFAIRS
Administrative Provisions
* * * * * * *
[(INCLUDING TRANSFER OF FUNDS)
Sec. 220. Of the amounts appropriated to the Department of
Veterans Affairs which become available on October 1, 2018, for
``Medical Services'', ``Medical Community Care'', ``Medical
Support and Compliance'', and ``Medical Facilities'', up to
$306,378,000, 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.]
Repealed.
BUDGETARY IMPACT OF BILL
PREPARED IN CONSULTATION WITH THE CONGRESSIONAL BUDGET OFFICE PURSUANT TO SEC. 308(a), PUBLIC LAW 93-344, AS
AMENDED
[In millions of dollars]
----------------------------------------------------------------------------------------------------------------
Budget authority Outlays
-------------------------------------------------------
Committee Amount in Committee Amount in
allocation bill allocation bill
----------------------------------------------------------------------------------------------------------------
Comparison of amounts in the bill with the subcommittee
allocation for 2019: Subcommittee on Military
Construction and Veterans Affairs, and Related
Agencies:
Mandatory........................................... 109,472 109,472 109,086 \1\109,086
Discretionary....................................... 97,086 98,007 90,261 \1\90,261
Security........................................ 10,319 11,240 NA NA
Nonsecurity..................................... 86,767 86,767 NA NA
Projections of outlays associated with the
recommendation:
2019................................................ ............ ............ ............ \2\114,799
2020................................................ ............ ............ ............ 5,486
2021................................................ ............ ............ ............ 5,216
2022................................................ ............ ............ ............ 3,202
2023 and future years............................... ............ ............ ............ 3,590
Financial assistance to State and local governments forP NA 277 NA \2\59
2019...................................................
----------------------------------------------------------------------------------------------------------------
\1\Includes outlays from prior-year budget authority.
\2\Excludes outlays from prior-year budget authority.
NA: Not applicable.
NOTE.--Consistent with the funding recommended in the bill for overseas contingency operations and in accordance
with subparagraph (A)(ii) of section 251(b)(2) of the BBEDCA of 1985, the Committee anticipates that the
Budget Committee will provide, at the appropriate time, a 302(a) allocation for the Committee on
Appropriations reflecting an upward adjustment of $921,000,000 in budget authority plus the associated
outlays.
MILITARY CONSTRUCTION PROJECT LISTING BY LOCATION
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Committee
recommendation
Installation and project Budget Committee compared to
estimate recommendation budget
estimate
----------------------------------------------------------------------------------------------------------------
ALABAMA
ARMY:
ANNISTON ARMY DEPOT:
WEAPON MAINTENANCE SHOP................................. 5,200 5,200 ..............
-----------------------------------------------
TOTAL, ALABAMA........................................ 5,200 5,200 ..............
ALASKA
AIR FORCE:
EIELSON AFB:
F-35 AIRCRAFT MAINTENANCE UNIT ADMIN FACILITY........... 6,800 6,800 ..............
F-35 CONVENTIONAL MUNITIONS MAINTENANCE FACILITY........ 15,500 15,500 ..............
F-35A CATM RANGE........................................ 19,000 19,000 ..............
F-35A SCHOOL AGE FACILITY............................... 22,500 22,500 ..............
DEFENSE-WIDE:
CLEAR AFS:
LONG RANGE DISCRIM RADAR SYS COMPLEX PHASE 2............ 174,000 174,000 ..............
FORT GREELY:
MISSILE FIELD #1 EXPANSION.............................. 8,000 8,000 ..............
JOINT BASE ELMENDORF-RICHARDSON:
OPERATIONS FACILITY REPLACEMENT......................... 14,000 14,000 ..............
ARMY NATIONAL GUARD:
JOINT BASE ELMENDORF-RICHARDSON:
UNITED STATES PROPERTY & FISCAL OFFICE.................. 27,000 27,000 ..............
-----------------------------------------------
TOTAL, ALASKA......................................... 286,800 286,800 ..............
ARIZONA
AIR FORCE:
LUKE AFB:
F-35A AIRCRAFT MAINTENANCE UNIT FACILITY................ 23,000 23,000 ..............
F-35A SQUAD OPS #6...................................... 17,000 17,000 ..............
-----------------------------------------------
TOTAL, ARIZONA........................................ 40,000 40,000 ..............
ARKANSAS
DEFENSE-WIDE:
LITTLE ROCK AFB:
HYDRANT FUEL SYSTEM ALTERATIONS......................... 14,000 14,000 ..............
-----------------------------------------------
TOTAL, ARKANSAS....................................... 14,000 14,000 ..............
CALIFORNIA
ARMY:
FORT IRWIN:
MULTIPURPOSE RANGE COMPLEX.............................. 29,000 29,000 ..............
NAVY
CAMP PENDLETON:
AAV-ACV MAINTENANCE & WAREHOUSE FACILITY................ 49,410 49,410 ..............
ELECTRICAL UPGRADES..................................... 4,020 4,020 ..............
FULL MOTION TRAINER FACILITY............................ 10,670 10,670 ..............
POTABLE WATER DISTRIBUTION IMPROVEMENTS................. 47,230 47,230 ..............
CORONADO:
CMV-22B AIRFIELD IMPROVEMENTS........................... 77,780 77,780 ..............
LEMOORE:
F-35 MAINTENANCE HANGAR................................. 112,690 112,690 ..............
MIRAMAR:
AIRFIELD SECURITY IMPROVEMENTS.......................... 11,500 11,500 ..............
F-35 VERTICAL LANDING PADS AND TAXIWAY.................. 20,480 20,480 ..............
POINT MUGU:
DIRECTED ENERGY SYSTEMS INTERGRATION LAB................ 22,150 22,150 ..............
SAN DIEGO:
HARBOR DRIVE SWITCHING STATION.......................... 48,440 48,440 ..............
PIER 8 REPLACEMENT...................................... 108,100 108,100 ..............
SAN NICOLAS ISLAND:
MISSILE ASSEMBLY BUILD & HIGH EXPLOSIVE MAGAZINE........ 31,010 31,010 ..............
SEAL BEACH:
CAUSEWAY, BOAT CHANNEL & TURNING BASIN.................. 117,830 60,000 -57,830
DEFENSE-WIDE:
CAMP PENDLETON:
SOF EOD FACILITY--WEST.................................. 3,547 3,547 ..............
SOF HUMAN PERFORMANCE TRAINING CENTER-WEST.............. 9,049 9,049 ..............
CORONADO:
SOF ATC APPLIED INSTRUCTION FACILITY.................... 14,819 14,819 ..............
SOF ATC TRAINING FACILITY............................... 18,329 18,329 ..............
SOF CLOSE QUARTERS COMBAT FACILITY...................... 12,768 12,768 ..............
SOF NSWG-1 OPERATIONS SUPPORT FACILITY.................. 25,172 25,172 ..............
DEFENSE DISTRIBUTION DEPOT-TRACY
MAIN ACCESS CONTROL POINT UPGRADES...................... 18,800 18,800 ..............
AIR NATIONAL GUARD:
CHANNEL ISLANDS ANGS:
CONSTRUCT C-130J FLIGHT SIMULATOR FACILITY.............. 8,000 8,000 ..............
ARMY RESERVE:
BARSTOW:
ECS MODIFIED TEMF / WAREHOUSE........................... 34,000 34,000 ..............
NAVY RESERVE:
SEAL BEACH:
RESERVE TRAINING CENTER................................. 21,740 21,740 ..............
-----------------------------------------------
TOTAL, CALIFORNIA..................................... 856,534 798,704 -57,830
COLORADO
ARMY:
FORT CARSON:
VEHICLE MAINTENANCE SHOP................................ 77,000 77,000 ..............
DEFENSE-WIDE:
FORT CARSON:
SOF HUMAN PERFORMANCE TRAINING CENTER................... 15,297 15,297 ..............
SOF MOUNTAINEERING FACILITY............................. 9,000 9,000 ..............
-----------------------------------------------
TOTAL, COLORADO....................................... 101,297 101,297 ..............
DISTRICT OF COLUMBIA
NAVY:
NAVAL OBSERVATORY:
MASTER TIME CLOCKS & OPERATIONS FACILITY................ 115,600 40,000 -75,600
-----------------------------------------------
TOTAL, DISTRICT OF COLUMBIA........................... 115,600 40,000 -75,600
FLORIDA
NAVY:
MAYPORT:
LCS OPERATIONAL TRAINING FACILITY ADDITION.............. 29,110 29,110 ..............
LCS SUPPORT FACILITY.................................... 82,350 82,350 ..............
AIR FORCE:
EGLIN AFB:
F-35A INTEGRATED TRNG CENTER ACADEMICS BLDG............. 34,863 34,863 ..............
F-35A STUDENT DORMITORY II.............................. 28,000 28,000 ..............
MACDILL AFB:
KC135 BEDDOWN ADD FLIGHT SIMULATOR TRAINING............. 3,100 3,100 ..............
-----------------------------------------------
TOTAL, FLORIDA................................ 177,423 177,423 ..............
GEORGIA
ARMY:
FORT GORDON:
CYBER INSTRUCTIONAL FAC AND NETWORK CTR................. 99,000 99,000 ..............
NAVY RESERVE:
BENNING:
RESERVE TRAINING CENTER................................. 13,630 13,630 ..............
-----------------------------------------------
TOTAL, GEORGIA........................................ 112,630 112,630 ..............
HAWAII
ARMY:
FORT SHAFTER:
COMMAND AND CONTROL FACILITY, INCR 4.................... 105,000 105,000 ..............
NAVY:
JOINT BASE PEARL HARBOR-HICKAM:
DRYDOCK WATERFRONT FACILITY............................. 45,000 45,000 ..............
KANEOHE BAY:
CORROSION CONTROL HANGAR................................ 66,100 66,100 ..............
PEARL CITY:
WATER TRANSMISSION LINE:........................ 78,320 78,320 ..............
AIR NATIONAL GUARD:
JOINT BASE PEARL HARBOR-HICKAM:
CONSTRUCT ADDITION TO F-22 LO/CRF B3408................. 17,000 17,000 ..............
-----------------------------------------------
TOTAL, HAWAII......................................... 311,420 311,420 ..............
ILLINOIS
ARMY NATIONAL GUARD:
MARSEILLES:
AUTOMATED RECORD FIRE RANGE............................. 5,000 5,000 ..............
AIR NATIONAL GUARD:
GREATER PEORIA REGIONAL AIRPORT:
CONSTRUCT NEW FIRE CRASH/RESCUE STATION................. 9,000 9,000 ..............
-----------------------------------------------
TOTAL, ILLINOIS....................................... 14,000 14,000 ..............
INDIANA
ARMY:
CRANE ARMY AMMUNITION PLANT:
RAILCAR HOLDING AREA.................................... 16,000 16,000 ..............
AIR FORCE RESERVE:
GRISSOM ARB:
ADD/ALTER AIRCRAFT MAINTENANCE HANGAR................... 12,100 12,100 ..............
-----------------------------------------------
TOTAL, INDIANA........................................ 28,100 28,100 ..............
KENTUCKY
ARMY:
FORT CAMPBELL:
VEHICLE MAINTENANCE SHOP................................ 32,000 32,000 ..............
FORT KNOX:
DIGITAL AIR/GROUND INTEGRATION RANGE.................... 26,000 26,000 ..............
DEFENSE-WIDE:
FORT CAMPBELL:
FT CAMPBELL MIDDLE SCHOOL............................... 62,634 62,634 ..............
SOF AIR/GROUND INTEG. URBAN LIVE FIRE RANGE............. 9,091 9,091 ..............
SOF LOGISTICS SUPPORT OPERATIONS FACILITY............... 5,435 5,435 ..............
SOF MULTI-USE HELICOPTER TRAINING FACILITY.............. 5,138 5,138 ..............
-----------------------------------------------
TOTAL, KENTUCKY....................................... 140,298 140,298 ..............
LOUISIANA
AIR NATIONAL GUARD:
NEW ORLEANS:
NORTHCOM--CONSTRUCT ALERT APRON......................... 15,000 15,000 ..............
-----------------------------------------------
TOTAL, LOUISIANA...................................... 15,000 15,000 ..............
MAINE
NAVY:
KITTERY:
DRY DOCK #1 SUPERFLOOD BASIN............................ 109,960 109,960 ..............
EXTEND PORTAL CRANE RAIL................................ 39,725 39,725 ..............
DEFENSE-WIDE:
KITTERY:
CONSOLIDATED WAREHOUSE REPLACEMENT...................... 11,600 11,600 ..............
-----------------------------------------------
TOTAL, MAINE.......................................... 161,285 161,285 ..............
MARYLAND
AIR FORCE:
JOINT BASE ANDREWS:
PAR RELOCATE HAZ CARGO PAD AND EOD RANGE................ 37,000 37,000 ..............
PRESIDENTIAL AIRCRAFT RECAP COMPLEX, INC. 2............. 154,000 129,116 -24,884
DEFENSE-WIDE:
FORT MEADE:
MISSION SUPPORT OPERATIONS WAREHOUSE FACILITY........... 30,000 30,000 ..............
NSAW RECAPITALIZE BUILDING #2 INC 4..................... 218,000 218,000 ..............
NSAW RECAPITALIZE BUILDING #3 INC 1..................... 99,000 99,000 ..............
-----------------------------------------------
TOTAL, MARYLAND....................................... 538,000 513,116 -24,884
MASSACHUSETTS
AIR FORCE:
HANSCOM AFB:
MIT-LINCOLN LABORATORY (WEST LAB CSL/MIF)............... 225,000 90,000 -135,000
-----------------------------------------------
TOTAL, MASSACHUSETTS.................................. 225,000 90,000 -135,000
MINNESOTA
AIR FORCE RESERVE:
MINNEAPOLIS-ST PAUL IAP:
SMALL ARMS RANGE........................................ 9,000 9,000 ..............
-----------------------------------------------
TOTAL, MINNESOTA...................................... 9,000 9,000 ..............
MISSISSIPPI
AIR FORCE RESERVE:
KEESLER AFB:
AEROMEDICAL STAGING SQUADRON FACILITY................... 4,550 4,550 ..............
-----------------------------------------------
TOTAL, MISSISSIPPI.................................... 4,550 4,550 ..............
MISSOURI
DEFENSE-WIDE:
ST LOUIS:
NEXT NGA WEST (N2W) COMPLEX PHASE 1 INC. 2.............. 213,600 181,600 -32,000
NEXT NGA WEST (N2W) COMPLEX PHASE 2 INC. 1.............. 110,000 110,000 ..............
-----------------------------------------------
TOTAL, MISSOURI....................................... 323,600 291,600 -32,000
MONTANA
ARMY NATIONAL GUARD:
MALTA:
NATIONAL GUARD READINESS CENTER......................... 15,000 15,000 ..............
-----------------------------------------------
TOTAL, MONTANA........................................ 15,000 15,000 ..............
NEBRASKA
AIR FORCE:
OFFUTT AFB:
PARKING LOT, USSTRATCOM................................. 9,500 9,500 ..............
-----------------------------------------------
TOTAL, NEBRASKA....................................... 9,500 9,500 ..............
NEVADA
AIR FORCE:
CREECH AFB:
MQ-9 CPIP GCS OPERATIONS FACILITY....................... 28,000 28,000 ..............
MQ-9 CPIP OPERATIONS & COMMAND CENTER FAC............... 31,000 31,000 ..............
NELLIS AFB:
CRH SIMULATOR........................................... 5,900 5,900 ..............
ARMY NATIONAL GUARD:
NORTH LAS VEGAS:
NATIONAL GUARD READINESS CENTER......................... 32,000 32,000 ..............
-----------------------------------------------
TOTAL, NEVADA......................................... 96,900 96,900 ..............
NEW HAMPSHIRE
ARMY NATIONAL GUARD:
PEMBROKE:
NATIONAL GUARD READINESS CENTER......................... 12,000 12,000 ..............
-----------------------------------------------
TOTAL, NEW HAMPSHIRE.................................. 12,000 12,000 ..............
NEW JERSEY
ARMY:
PICATINNY ARSENAL:
MUNITIONS DISASSEMBLY COMPLEX........................... 41,000 41,000 ..............
DEFENSE-WIDE:
JOINT BASE MCGUIRE-DIX-LAKEHURST:
HOT CARGO HYDRANT SYSTEM REPLACEMENT.................... 10,200 10,200 ..............
-----------------------------------------------
TOTAL, NEW JERSEY..................................... 51,200 51,200 ..............
NEW MEXICO
ARMY:
WHITE SANDS:
INFORMATION SYSTEMS FACILITY............................ 40,000 40,000 ..............
AIR FORCE:
HOLLOMAN AFB:
MQ-9 FTU OPS FACILITY................................... 85,000 85,000 ..............
-----------------------------------------------
TOTAL, NEW MEXICO..................................... 125,000 125,000 ..............
NEW YORK
ARMY:
U.S. MILITARY ACADEMY:
ENGINEERING CENTER...................................... 95,000 95,000 ..............
PARKING STRUCTURE....................................... 65,000 65,000 ..............
AIR NATIONAL GUARD:
FRANCIS S. GABRESKI AIRPORT:
SECURITY FORCES/COMM.TRAINING FACILITY.................. 20,000 20,000 ..............
AIR FORCE RESERVE:
NIAGARA FALLS IAP:
PHYSICAL FITNESS CENTER................................. 14,000 14,000 ..............
-----------------------------------------------
TOTAL, NEW YORK....................................... 194,000 194,000 ..............
NORTH CAROLINA
ARMY:
FORT BRAGG:
DINING FACILITY......................................... 10,000 10,000 ..............
NAVY:
CHERRY POINT MARINE CORPS AIR STATION:
AIRCRAFT MAINTENANCE HANGAR............................. 133,970 60,000 -73,970
FLIGHTLINE UTILITY MODERNIZATION........................ 106,860 106,860 ..............
DEFENSE-WIDE:
FORT BRAGG:
SOF REPLACE TRAINING MAZE AND TOWER..................... 12,109 12,109 ..............
SOF SERE RESISTANCE TRAINING LAB. COMPLEX............... 20,257 20,257 ..............
NEW RIVER:
AMB CARE CENTER/DENTAL CLINIC REPLACEMENT............... 32,580 32,580 ..............
-----------------------------------------------
TOTAL, NORTH CAROLINA................................. 315,776 241,806 -73,970
NORTH DAKOTA
AIR FORCE:
MINOT AFB:
CONSOLIDATED HELO/TRF OPS/AMU AND ALERT FACILITY........ 66,000 66,000 ..............
ARMY NATIONAL GUARD:
FARGO:
NATIONAL GUARD READINESS CENTER......................... 32,000 32,000 ..............
-----------------------------------------------
TOTAL, NORTH DAKOTA................................... 98,000 98,000 ..............
OHIO
AIR FORCE:
WRIGHT-PATTERSON AFB:
ADAL INTELLIGENCE PRODUCTION COMPLEX (NASIC)............ 116,100 116,100 ..............
ARMY NATIONAL GUARD:
CAMP RAVENNA:
AUTOMATED MULTIPURPOSE MACHINE GUN RANGE................ 7,400 7,400 ..............
-----------------------------------------------
TOTAL, OHIO........................................... 123,500 123,500 ..............
OKLAHOMA
AIR FORCE:
ALTUS AFB:
KC-46A FTU/FTC SIMULATOR FACILITY PHASE 3............... 12,000 12,000 ..............
TINKER AFB:
KC-46A DEPOT FUEL MAINTENANCE HANGAR.................... 85,000 85,000 ..............
KC-46A DEPOT MAINTENANCE HANGAR......................... 81,000 81,000 ..............
DEFENSE-WIDE:
MCALESTER:
BULK DIESEL SYSTEM REPLACEMENT.......................... 7,000 7,000 ..............
-----------------------------------------------
TOTAL, OKLAHOMA....................................... 185,000 185,000 ..............
PENNSYLVANIA
NAVY:
PHILADELPHIA:
SUBMARINE PROPULSOR MANUFACTURING SUPPORT FACILITY...... 71,050 71,050 ..............
AIR NATIONAL GUARD:
FORT INDIANTOWN GAP:
REPLACE OPERATIONS TRAINING/DINING HALL................. 8,000 8,000 ..............
NAVY RESERVE:
PITTSBURGH:
RESERVE TRAINING CENTER--PITTSBURGH, PA................. .............. .............. ..............
-----------------------------------------------
TOTAL, PENNSYLVANIA................................... 79,050 79,050 ..............
SOUTH CAROLINA
ARMY:
FORT JACKSON:
TRAINEE BARRACKS COMPLEX 3, PHASE 2..................... 52,000 52,000 ..............
NAVY:
BEAUFORT:
RECYCLING/HAZARDOUS WASTE FACILITY...................... 9,517 9,517 ..............
PARRIS ISLAND:
RANGE IMPROVEMENTS & MODERNIZATION, PHASE 2............. 35,190 35,190 ..............
AIR FORCE:
SHAW AFB:
CPIP MQ-9 MCE GROUP..................................... 53,000 53,000 ..............
-----------------------------------------------
TOTAL, SOUTH CAROLINA................................. 149,707 149,707 ..............
SOUTH DAKOTA
ARMY NATIONAL GUARD:
RAPID CITY:
NATIONAL GUARD READINESS CENTER......................... 15,000 15,000 ..............
-----------------------------------------------
TOTAL, SOUTH DAKOTA................................... 15,000 15,000 ..............
TEXAS
ARMY:
FORT BLISS:
SUPPLY SUPPORT ACTIVITY................................. 24,000 24,000 ..............
AIR FORCE:
JOINT BASE SAN ANTONIO:
BMT RECRUIT DORMITORY 6................................. 25,000 25,000 ..............
DEFENSE-WIDE:
JOINT BASE SAN ANTONIO:
ENERGY AEROSPACE OPERATIONS FACILITY.................... 10,200 10,200 ..............
RED RIVER ARMY DEPOT:
GENERAL PURPOSE WAREHOUSE............................... 71,500 71,500 ..............
AIR FORCE RESERVE:
FORT WORTH:
MUNITIONS TRAINING/ADMIN FACILITY....................... 3,100 3,100 ..............
-----------------------------------------------
TOTAL, TEXAS.......................................... 133,800 133,800 ..............
UTAH
NAVY:
HILL AFB:
D5 MISSILE MOTOR RECEIPT/STORAGE FACILITY............... 105,520 105,520 ..............
-----------------------------------------------
TOTAL, UTAH........................................... 105,520 105,520 ..............
VIRGINIA
NAVY:
PORTSMOUTH:
SHIPS MAINTENANCE FACILITY.............................. 26,120 26,120 ..............
QUANTICO:
TBS FIRE STATION........................................ 21,980 .............. -21,980
DEFENSE-WIDE:
DAM NECK:
SOF MAGAZINES........................................... 8,959 8,959 ..............
FORT A.P. HILL:
TRAINING CAMPUS......................................... 11,734 11,734 ..............
FORT BELVOIR:
HUMAN PERFORMANCE TRAINING CENTER....................... 6,127 6,127 ..............
HUMPHREYS ENGINEER CENTER:
MAINTENANCE AND SUPPLY FACILITY......................... 20,257 20,257 ..............
JOINT BASE LANGLEY-EUSTIS:
FUEL FACILITIES REPLACEMENT............................. 6,900 6,900 ..............
GROUND VEHICLE FUELING FACILITY REPLACEMENT............. 5,800 5,800 ..............
PENTAGON:
EXTERIOR INFRASTRUC. & SECURITY IMPROVEMENTS............ 23,650 23,650 ..............
NORTH VILLAGE VACP & FENCING............................ 12,200 12,200 ..............
AIR NATIONAL GUARD:
JOINT BASE LANGLEY-EUSTIS:
CONSTRUCT CYBER OPS FACILITY............................ 10,000 10,000 ..............
-----------------------------------------------
TOTAL, VIRGINIA....................................... 153,727 131,747 -21,980
WASHINGTON
NAVY:
BANGOR:
PIER AND MAINTENANCE FACILITY........................... 88,960 88,960 ..............
WHIDBEY ISLAND:
FLEET SUPPORT FACILITY.................................. 19,450 19,450 ..............
NEXT GENERATION JAMMER FACILITY......................... 7,930 7,930 ..............
DEFENSE-WIDE:
JOINT BASE LEWIS-MCCHORD:
REFUELING FACILITY...................................... 26,200 26,200 ..............
-----------------------------------------------
TOTAL, WASHINGTON..................................... 142,540 142,540 ..............
WISCONSIN
ARMY RESERVE:
FORT MCCOY:
TRANSIENT TRAINING BARRACKS............................. 23,000 23,000 ..............
-----------------------------------------------
TOTAL, WISCONSIN...................................... 23,000 23,000 ..............
BAHAMAS
NAVY:
ANDROS ISLAND:
AUTEC AUSTERE QUARTERS.................................. 31,050 31,050 ..............
-----------------------------------------------
TOTAL, BAHAMAS........................................ 31,050 31,050 ..............
BAHRAIN ISLAND
NAVY:
SW ASIA:
FLEET MAINTENANCE FACILITY & TOC........................ 26,340 26,340 ..............
-----------------------------------------------
TOTAL, BAHRAIN ISLAND................................. 26,340 26,340 ..............
BELGIUM
DEFENSE-WIDE:
CHIEVRES AB:
EUROPE WEST DISTRICT SUPERINTENDENT'S OFFICE............ 14,305 14,305 ..............
-----------------------------------------------
TOTAL, BELGIUM........................................ 14,305 14,305 ..............
CONUS CLASSIFIED
DEFENSE-WIDE:
CLASSIFIED LOCATION:
BATTALION COMPLEX, PHASE 2.............................. 49,222 49,222 ..............
-----------------------------------------------
TOTAL, CONUS CLASSIFIED............................... 49,222 49,222 ..............
GERMANY
ARMY:
EAST CAMP GRAFENWOEHR:
MISSION TRAINING COMPLEX................................ 31,000 31,000 ..............
NAVY:
PANZER KASERNE:
MARFOREUR HQ MODERNIZATION AND EXPANSION................ 43,950 43,950 ..............
DEFENSE-WIDE:
BAUMHOLDER:
SOF JOINT PARACHUTE RIGGING FACILITY.................... 11,504 11,504 ..............
KAISERLAUTERN AB:
KAISERSLAUTERN MIDDLE SCHOOL............................ 99,955 99,955 ..............
RHINE ORDNANCE BARRACKS:
MEDICAL CENTER REPLACEMENT INC. 8....................... 319,589 319,589 ..............
WIESBADEN:
CLAY KASERNE ELEMENTARY SCHOOL.......................... 56,048 56,048 ..............
-----------------------------------------------
TOTAL, GERMANY................................ 562,046 562,046 ..............
GUAM
NAVY:
JOINT REGION MARIANAS:
ACE GYM & DINING........................................ 27,910 27,910 ..............
EARTH COVERED MAGAZINES................................. 52,270 52,270 ..............
MACHINE GUN RANGE....................................... 141,287 50,000 -91,287
ORDNANCE OPS............................................ 22,020 22,020 ..............
UNACCOMPANIED ENLISTED HOUSING.......................... 36,170 36,170 ..............
AIR FORCE:
JOINT REGION MARIANAS:
HAYMAN MUNITIONS STORAGE IGLOOS MSA 2................... 9,800 9,800 ..............
-----------------------------------------------
TOTAL, GUAM........................................... 289,457 198,170 -91,287
GUANTANAMO BAY, CUBA
NAVY:
GUANTANAMO BAY:
SOLID WASTE MANAGEMENT FACILITY......................... 85,000 85,000 ..............
DEFENSE-WIDE:
GUANTANAMO BAY:
WORKING DOG TREATMENT FACILITY REPLACEMENT.............. 9,080 9,080 ..............
-----------------------------------------------
TOTAL, GUANTANAMO BAY, CUBA........................... 94,080 94,080 ..............
HONDURAS
ARMY:
SOTO CANO AB:
BARRACKS................................................ 21,000 21,000 ..............
-----------------------------------------------
TOTAL, HONDURAS....................................... 21,000 21,000 ..............
JAPAN
NAVY:
KADENA AB:
TACTICAL OPERATIONS CENTER.............................. 9,049 9,049 ..............
DEFENSE-WIDE:
CAMP MCTUREOUS:
BECHTEL ELEMENTARY SCHOOL............................... 94,851 94,851 ..............
IWAKUNI:
FUEL PIER............................................... 33,200 33,200 ..............
KADENA AB:
TRUCK UNLOAD FACILITIES................................. 21,400 21,400 ..............
YOKOSUKA:
KINNICK HIGH SCHOOL..................................... 170,386 60,000 -110,386
-----------------------------------------------
TOTAL, JAPAN.................................. 328,886 218,500 -110,386
KOREA
ARMY:
CAMP TANGO:
COMMAND AND CONTROL FACILITY............................ 17,500 17,500 ..............
-----------------------------------------------
TOTAL, KOREA.......................................... 17,500 17,500 ..............
KUWAIT
ARMY:
CAMP ARIFJAN:
VEHICLE MAINTENANCE SHOP................................ 44,000 44,000 ..............
-----------------------------------------------
TOTAL, KUWAIT......................................... 44,000 44,000 ..............
MARIANA ISLANDS
AIR FORCE:
TINIAN:
APR--CARGO PAD WITH TAXIWAY EXTENSION................... 46,000 46,000 ..............
APR--MAINTENANCE SUPPORT FACILITY....................... 4,700 4,700 ..............
-----------------------------------------------
TOTAL, MARIANA ISLANDS................................ 50,700 50,700 ..............
QATAR
AIR FORCE:
AL UDEID:
FLIGHTLINE SUPPORT FACILITIES........................... 30,400 .............. -30,400
PERSONNEL DEPLOYMENT PROCESSING FACILITY................ 40,000 .............. -40,000
-----------------------------------------------
TOTAL, QATAR.......................................... 70,400 .............. -70,400
UNITED KINGDOM
AIR FORCE:
ROYAL AIR FORCE LAKENHEATH:
F-35A 6 BAY HANGAR...................................... 39,036 39,036 ..............
F-35A ADAL CONVENTIONAL MUNITIONS MX.................... 9,204 9,204 ..............
F-35A ADAL PARTS STORE.................................. 13,926 13,926 ..............
F-35A AGE FACILITY...................................... 12,449 12,449 ..............
F-35A DORM.............................................. 29,541 29,541 ..............
F-35A FUEL SYSTEM MAINTENANCE DOCK 2 BAY................ 16,880 16,880 ..............
F-35A PARKING APRON..................................... 27,431 27,431 ..............
DEFENSE-WIDE:
CROUGHTON RAF:
AMBULATORY CARE CENTER ADDITION/ALTERATION.............. 10,000 .............. -10,000
-----------------------------------------------
TOTAL, UNITED KINGDOM................................. 158,467 148,467 -10,000
WORLDWIDE CLASSIFIED
AIR FORCE:
CLASSIFIED LOCATION:
TACMOR--UTILITIES AND INFRASTRUCTURE SUPPORT............ 18,000 18,000 ..............
-----------------------------------------------
TOTAL, WORLDWIDE CLASSIFIED........................... 18,000 18,000 ..............
NATO SECURITY INVESTMENT PROGRAM........................ 171,064 171,064 ..............
WORLDWIDE UNSPECIFIED
ARMY:
HOST NATION SUPPORT......................................... 34,000 34,000 ..............
MINOR CONSTRUCTION.......................................... 72,000 82,000 +10,000
PLANNING AND DESIGN......................................... 71,068 71,068 ..............
PLANNING AND DESIGN......................................... 5,000 5,000 ..............
NAVY:
PLANNING AND DESIGN......................................... 185,542 185,542 ..............
MINOR CONSTRUCTION.......................................... 28,579 28,579 ..............
AIR FORCE:
PLANNING AND DESIGN......................................... 206,577 206,577 ..............
MINOR CONSTRUCTION.......................................... 38,500 38,500 ..............
DEFENSE-WIDE:
CONTINGENCY CONSTRUCTION.................................... 10,000 .............. -10,000
ENERGY CONSERVATION INVESTMENT PROGRAM...................... 150,000 195,000 +45,000
PLANNING AND DESIGN:
DEFENSE WIDE............................................ 24,300 24,300 ..............
DEFENSE HEALTH AGENCY................................... 55,699 55,699 ..............
DEFENSE INFORMATION SYSTEMS AGENCY...................... 496 496 ..............
DEFENSE LOGISTICS AGENCY................................ 42,705 42,705 ..............
MISSILE DEFENSE AGENCY.................................. 14,184 14,184 ..............
SPECIAL OPERATIONS COMMAND.............................. 55,925 55,925 ..............
WASHINGTON HEADQUARTERS SERVICE......................... 2,036 2,036 ..............
-----------------------------------------------
SUBTOTAL, PLANNING AND DESIGN......................... 195,345 195,345 ..............
UNSPECIFIED MINOR CONSTRUCTION:
DEFENSE WIDE............................................ 3,000 3,000 ..............
DEFENSE HEALTH AGENCY................................... 5,000 5,000 ..............
DEFENSE LOGISTICS AGENCY................................ 17,366 17,366 ..............
MISSILE DEFENSE AGENCY.................................. 10,000 10,000 ..............
SPECIAL OPERATIONS COMMAND.............................. 13,642 13,642 ..............
THE JOINT STAFF......................................... 12,479 12,479 ..............
-----------------------------------------------
SUBTOTAL, UNSPECIFIED MINOR CONSTRUCTION.................. 61,487 61,487 ..............
ARMY NATIONAL GUARD:
PLANNING AND DESIGN......................................... 16,622 16,622 ..............
MINOR CONSTRUCTION.......................................... 18,100 28,100 +10,000
AIR NATIONAL GUARD:
PLANNING AND DESIGN......................................... 18,500 18,500 ..............
MINOR CONSTRUCTION.......................................... 23,626 33,626 +10,000
ARMY RESERVE:
PLANNING AND DESIGN......................................... 5,855 5,855 ..............
MINOR CONSTRUCTION.......................................... 2,064 2,064 ..............
NAVY RESERVE:
PLANNING AND DESIGN......................................... 4,695 4,695 ..............
MINOR CONSTRUCTION.......................................... 3,000 3,000 ..............
AIR FORCE RESERVE:
PLANNING AND DESIGN......................................... 4,055 4,055 ..............
MINOR CONSTRUCTION.......................................... 3,358 3,358 ..............
FAMILY HOUSING, ARMY
WISCONSIN:
FORT MCCOY:
FAMILY HOUSING NEW CONSTRUCTION (7 units)............... 6,200 6,200 ..............
PUERTO RICO:
FORT BUCHANAN:
FAMILY HOUSING NEW CONSTRUCITON (26 UNITS).............. 26,000 26,000 ..............
KOREA:
CAMP WALKER--DAEGU:
FAMILY HOUSING REPLACEMENT CONSTRUCTION (90 UNITS)...... 68,000 68,000 ..............
CAMP HUMPHRIES:
FAMILY HOUSING NEW CONSTRUCTION......................... 85,000 85,000 ..............
ITALY:
VICENZA:
FAMILY HOUSING NEW CONSTRUCTION (111 UNITS)............. 95,134 95,134 ..............
GERMANY:
BAUMHOLDER:
CONSTRUCTION IMPROVEMENTS (72 UNITS).................... 32,000 32,000 ..............
PLANNING AND DESIGN..................................... 18,326 18,326 ..............
-----------------------------------------------
SUBTOTAL, CONSTRUCTION.................................... 330,660 330,660 ..............
OPERATION AND MAINTENANCE:
UTILITIES ACCOUNT....................................... 57,872 57,872 ..............
SERVICES ACCOUNT........................................ 10,502 10,502 ..............
MANAGEMENT ACCOUNT...................................... 36,302 36,302 ..............
MISCELLANEOUS ACCOUNT................................... 408 408 ..............
FURNISHINGS ACCOUNT..................................... 15,842 15,842 ..............
LEASING................................................. 161,252 161,252 ..............
MAINTENANCE OF REAL PROPERTY............................ 75,530 75,530 ..............
PRIVATIZATION SUPPORT COSTS......................... 18,801 18,801 ..............
-----------------------------------------------
SUBTOTAL, OPERATION AND MAINTENANCE....................... 376,509 376,509 ..............
FAMILY HOUSING, NAVY AND MARINE CORPS
GUAM:
NSA ANDERSON:
REPLACEMENT HOUSING PHASE III........................... 83,441 83,441 ..............
JAPAN:
IWAKUNI:
CONSTRUCTION IMPROVEMENTS (44 UNITS).................... 16,638 16,638 ..............
PLANNING AND DESIGN..................................... 4,502 4,502 ..............
-----------------------------------------------
SUBTOTAL, CONSTRUCTION.................................... 104,581 104,581 ..............
OPERATION AND MAINTENANCE:
UTILITIES ACCOUNT........................................... 60,252 60,252 ..............
SERVICES ACCOUNT............................................ 16,261 16,261 ..............
MANAGEMENT ACCOUNT.......................................... 50,870 50,870 ..............
MISCELLANEOUS ACCOUNT....................................... 148 148 ..............
FURNISHINGS ACCOUNT......................................... 16,395 16,395 ..............
LEASING..................................................... 62,515 62,515 ..............
MAINTENANCE OF REAL PROPERTY................................ 86,328 86,328 ..............
PRIVATIZATION SUPPORT COSTS................................. 21,767 21,767 ..............
-----------------------------------------------
SUBTOTAL, OPERATION AND MAINTENANCE....................... 314,536 314,536 ..............
FAMILY HOUSING, AIR FORCE
JAPAN:
KADENA:
CONSTRUCTION IMPROVEMENTS (130 UNITS)................... 72,129 72,129 ..............
UNITED KINGDOM:
RAF LAKENHEATH:
CONSTRUCTION IMPROVEMENTS............................... 3,118 3,118 ..............
LANNING AND DESIGN.............................................. 3,199 3,199 ..............
-----------------------------------------------
SUBTOTAL, CONSTRUCTION.................................... 78,446 78,446 ..............
OPERATION AND MAINTENANCE:
UTILITIES ACCOUNT........................................... 48,566 48,566 ..............
MANAGEMENT ACCOUNT.......................................... 54,423 54,423 ..............
SERVICES ACCOUNT............................................ 13,669 13,669 ..............
FURNISHINGS ACCOUNT......................................... 30,645 30,645 ..............
MISCELLANEOUS ACCOUNT....................................... 2,171 2,171 ..............
LEASING..................................................... 15,832 15,832 ..............
MAINTENANCE................................................. 129,763 129,763 ..............
PRIVATIZATION SUPPORT COSTS................................. 22,205 22,205 ..............
-----------------------------------------------
SUBTOTAL, OPERATION AND MAINTENANCE....................... 317,274 317,274 ..............
FAMILY HOUSING, DEFENSE-WIDE
OPERATION AND MAINTENANCE:
NATIONAL SECURITY AGENCY:
UTILITIES............................................... 106 106 ..............
FURNISHING.............................................. 416 416 ..............
LEASING................................................. 13,046 13,046 ..............
MAINTENANCE OF REAL PROPERTY............................ 121 121 ..............
DEFENSE INTELLIGENCE AGENCY:
UTILITIES................................................... 4,100 4,100 ..............
FURNISHINGS............................................. 643 643 ..............
LEASING................................................. 38,232 38,232 ..............
DEFENSE LOGISTICS AGENCY:
UTILITIES............................................... 9 9 ..............
FURNISHINGS............................................. 1 1 ..............
SERVICES................................................ 2 2 ..............
MANAGEMENT.............................................. 155 155 ..............
MAINTENANCE OF REAL PROPERTY............................ 1,542 1,542 ..............
-----------------------------------------------
SUBTOTAL, OPERATION AND MAINTENANCE................... 58,373 58,373 ..............
DOD MILITARY UNACCOMPANIED HOUSING IMPROVEMENT FUND............. 600 600 ..............
DOD FAMILY HOUSING IMPROVEMENT FUND............................. 1,653 1,653 ..............
BASE REALIGNMENT AND CLOSURE:
BASE REALIGNMENT AND CLOSURE ACCOUNT........................ 267,538 277,538 +10,000
ADMINISTRATIVE PROVISIONS
MILITARY CONSTRUCTION, ARMY..................................... .............. 77,600 +77,600
MILITARY CONSTRUCTION, NAVY AND MARINE CORPS.................... .............. 244,400 +244,400
MILITARY CONSTRUCTION, AIR FORCE................................ .............. 118,516 +118,516
MILITARY CONSTRUCTION, ARMY NATIONAL GUARD...................... .............. 22,000 +22,000
MILITARY CONSTRUCTION, AIR NATIONAL GUARD....................... .............. 11,100 +11,100
MILITARY CONSTRUCTION, ARMY RESERVE............................. .............. 10,000 +10,000
MILITARY CONSTRUCTION, AIR FORCE RESERVE........................ .............. 14,400 +14,400
MILITARY CONSTRUCTION--ENHANCING FORCE PROTECTION AND SAFETY ON .............. .............. ..............
MILITARY INSTALLATIONS (SEC. 131)..............................
DEFENSE ACCESS ROADS PROGRAM (SEC. 129)......................... .............. 30,000 +30,000
RESCISSIONS FROM PRIOR YEAR UNOBLIGATED BALANCES
AIR FORCE (RESCISSION).......................................... .............. -31,158 -31,158
ARMY NATIONAL GUARD (RESCISSION)................................ .............. -10,000 -10,000
42 USC 3374 (SEC. 135) (RESCISSION)............................. .............. .............. ..............
NATO SECURITY INVESTMENT PROGRAM (RESCISSION)................... .............. .............. ..............
FAMILY HOUSING, NAVY AND MARINE CORPS (RESCISSION).............. .............. -2,138 -2,138
RECAP
ARMY............................................................ 1,011,768 1,021,768 +10,000
RESCISSION.................................................. .............. .............. ..............
NAVY AND MARINE CORPS........................................... 2,543,189 2,222,522 -320,667
RESCISSION.................................................. .............. .............. ..............
AIR FORCE....................................................... 1,725,707 1,495,423 -230,284
RESCISSION.................................................. .............. -31,158 -31,158
DEFENSE-WIDE.................................................... 2,693,324 2,575,938 -117,386
RESCISSION.................................................. .............. .............. ..............
ARMY NATIONAL GUARD............................................. 180,122 190,122 +10,000
RESCISSION.................................................. .............. -10,000 -10,000
AIR NATIONAL GUARD.............................................. 129,126 139,126 +10,000
RESCISSION.................................................. .............. .............. ..............
ARMY RESERVE.................................................... 64,919 64,919 ..............
RESCISSION.................................................. .............. .............. ..............
NAVY RESERVE.................................................... 43,065 43,065 ..............
RESCISSION.................................................. .............. .............. ..............
AIR FORCE RESERVE............................................... 50,163 50,163 ..............
RESCISSION.................................................. .............. .............. ..............
NATO............................................................ 171,064 171,064 ..............
RESCISSION.................................................. .............. .............. ..............
CHEMICAL DEMILITARIZATION CONSTRUCTION, DEFENSE-WIDE............ .............. .............. ..............
RESCISSION.................................................. .............. .............. ..............
DOD UNACCOMPANIED HOUSING IMPROVEMENT FUND...................... 600 600 ..............
RESCISSION.................................................. .............. .............. ..............
DOD FAMILY HOUSING IMPROVEMENT FUND............................. 1,653 1,653 ..............
RESCISSION.................................................. .............. .............. ..............
HOMEOWNERS ASSISTANCE PROGRAM................................... .............. .............. ..............
RESCISSION.................................................. .............. .............. ..............
FAMILY HOUSING, ARMY............................................ 707,169 707,169 ..............
CONSTRUCTION................................................ (330,660) (330,660) ..............
OPERATION AND MAINTENANCE................................... (376,509) (376,509) ..............
RESCISSION.............................................. .............. .............. ..............
FAMILY HOUSING, NAVY AND MARINE CORP............................ 419,117 419,117 ..............
CONSTRUCTION................................................ (104,581) (104,581) ..............
OPERATION AND MAINTENANCE................................... (314,536) (314,536) ..............
RESCISSION.............................................. .............. -2,138 -2,138
FAMILY HOUSING, AIR FORCE....................................... 395,720 395,720 ..............
CONSTRUCTION................................................ (78,446) (78,446) ..............
OPERATION AND MAINTENANCE................................... (317,274) (317,274) ..............
RESCISSION.............................................. .............. .............. ..............
FAMILY HOUSING, DEFENSE-WIDE.................................... 58,373 58,373 ..............
CONSTRUCTION................................................ .............. .............. ..............
OPERATION AND MAINTENANCE................................... (58,373) (58,373) ..............
RESCISSION.............................................. .............. .............. ..............
BRAC............................................................ 267,538 277,538 +10,000
RESCISSION.............................................. .............. .............. ..............
42 USC 3374 (SEC. 135).......................................... .............. .............. ..............
RESCISSION.............................................. .............. .............. ..............
ADMINISTRATIVE PROVISIONS........................... .............. 528,016 +528,016
RESCISSION.............................................. .............. .............. ..............
===============================================
GRAND TOTAL............................................... 10,462,617 10,319,000 -143,617
----------------------------------------------------------------------------------------------------------------
OVERSEAS CONTINGENCY OPERATIONS
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Committee
recommendation
Budget Committee compared to
estimate recommendation budget
estimate
----------------------------------------------------------------------------------------------------------------
BULGARIA
ARMY:
NEVO SELO FOS:
EDI: AMMUNITION HOLDING AREA............................ 5,200 5,200 ..............
GERMANY
AIR FORCE:
RAMSTEIN AB:
EDI: KMC DABS-FEV/RH STORAGE WAREHOUSES................. 119,000 119,000 ..............
GREECE
NAVY:
SOUDA BAY:
EDI: JOINT MOBILITY PROCESSING CENTER................... 41,650 41,650 ..............
EDI: MARATHI LOGISTICS SUPPORT CENTER................... 6,200 6,200 ..............
GUANTANAMO BAY, CUBA
ARMY:
GUANTANAMO BAY:
OCO: HIGH VALUE DETENTION FACILITY...................... 69,000 .............. -69,000
ITALY
NAVY:
SIGONELLA:
EDI: P-8A TAXIWAY....................................... 66,050 66,050 ..............
NORWAY
AIR FORCE:
RYGGE:
EDI: CONSTRUCT TAXIWAY.................................. 13,800 13,800 ..............
POLAND
ARMY:
POWIDZ AB:
EDI: AMMUNITION STORAGE FACILITY........................ 52,000 52,000 ..............
EDI: BULK FUEL STORAGE.................................. 21,000 21,000 ..............
EDI: RAIL EXTENSION & RAILHEAD.......................... 14,000 14,000 ..............
ZAGAN
EDI: RAIL EXTENSION AND RAILHEAD........................ 6,400 6,400 ..............
EDI: STAGING AREA....................................... 51,000 .............. -51,000
EDI: STAGING AREA....................................... .............. 34,000 +34,000
DRAWSKO POMORSKI:
EDI: STAGING AREA....................................... .............. 17,000 +17,000
QATAR
AIR FORCE:
AL UDEID
OCO: FLIGHTLINE SUPPORT FACILITIES...................... .............. 29,000 +29,000
OCO: PERSONNEL DEPLOYMENT PROCESSING FCILITY............ .............. 40,000 +40,000
DEFENSE-WIDE:
AL UDEID
OCO: TRANS-REGIONAL LOGISTICS COMPLEX................... 60,000 60,000 ..............
ROMANIA
ARMY:
MIHAIL KOGALNICEANU
EDI: EXPLOSIVES & AMMO LOAD/UNLOAD APRON................ 21,651 21,651 ..............
SLOVAKIA
AIR FORCE:
MALACKY:
EDI: REGIONAL MUNITIONS STORAGE AREA.................... 59,000 59,000 ..............
SPAIN
NAVY:
ROTA:
EDI: PORT OPERATIONS FACILITIES......................... 21,590 21,590 ..............
UNITED KINGDOM
NAVY:
LOSSIEMOUTH:
EDI: P-8 BASE IMPROVEMENTS.............................. 79,130 79,130 ..............
AIR FORCE:
RAF FAIRFORD:
EDI: CONSTRUCT DABS-FEV STORAGE......................... 87,000 87,000 ..............
EDI: MUNITIONS HOLDING AREA............................. 19,000 19,000 ..............
ESTONIA
DEFENSE-WIDE:
UNSPECIFIED LOCATIONS:
EDI: SOF OPERATIONS FACILITY............................ 6,100 6,100 ..............
EDI: SOF TRAINING FACILITY.............................. 9,600 9,600 ..............
WORLDWIDE UNSPECIFIED
ARMY:
EDI: PLANNING AND DESIGN................................ 20,999 20,999 ..............
NAVY:
EDI: PLANNING AND DESIGN................................ 12,700 12,700 ..............
AIR FORCE:
EDI: PLANNING & DESIGN FUNDS............................ 48,000 48,000 ..............
DEFENSE-WIDE
EDI: PLANNING AND DESIGN................................ 7,100 7,100 ..............
EDI: PLANNING AND DESIGN................................ 4,250 4,250 ..............
RECAP
ARMY............................................................ 261,250 192,250 -69,000
RESCISSION.................................................. .............. .............. ..............
NAVY AND MARINE CORPS........................................... 227,320 227,320 ..............
RESCISSION.................................................. .............. .............. ..............
AIR FORCE....................................................... 345,800 414,800 +69,000
RESCISSION.................................................. .............. .............. ..............
DEFENSE-WIDE.................................................... 87,050 87,050 ..............
RESCISSION.................................................. .............. .............. ..............
===============================================
GRAND TOTAL............................................... 921,420 921,420 ..............
----------------------------------------------------------------------------------------------------------------
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2018 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL FOR FISCAL
YEAR 2019
[In thousands of dollars]
--------------------------------------------------------------------------------------------------------------------------------------------------------
Senate Committee recommendation
compared with (+ or -)
Item 2018 Budget estimate Committee ---------------------------------
appropriation recommendation 2018
appropriation Budget estimate
--------------------------------------------------------------------------------------------------------------------------------------------------------
TITLE I--DEPARTMENT OF DEFENSE
Military Construction, Army........................................ 923,994 1,011,768 1,021,768 +97,774 +10,000
Military Construction, Navy and Marine Corps....................... 1,553,275 2,543,189 2,222,522 +669,247 -320,667
Military Construction, Air Force................................... 1,543,558 1,725,707 1,495,423 -48,135 -230,284
Military Construction, Defense-Wide................................ 2,811,513 2,693,324 2,575,938 -235,575 -117,386
------------------------------------------------------------------------------------
Total, Active components..................................... 6,832,340 7,973,988 7,315,651 +483,311 -658,337
====================================================================================
Military Construction, Army National Guard......................... 220,652 180,122 190,122 -30,530 +10,000
Military Construction, Air National Guard.......................... 171,491 129,126 139,126 -32,365 +10,000
Military Construction, Army Reserve................................ 83,712 64,919 64,919 -18,793 ...............
Military Construction, Navy Reserve................................ 95,271 43,065 43,065 -52,206 ...............
Military Construction, Air Force Reserve........................... 73,535 50,163 50,163 -23,372 ...............
------------------------------------------------------------------------------------
Total, Reserve components.................................... 644,661 467,395 487,395 -157,266 +20,000
====================================================================================
North Atlantic Treaty Organization Security Investment Program 177,932 171,064 171,064 -6,868 ...............
Chemical demilitarization construction, Defense-Wide........... ............... ............... ............... ............... ...............
Department of Defense Base Closure Account..................... 310,000 267,538 277,538 -32,462 +10,000
------------------------------------------------------------------------------------
Total, Military Construction................................. 7,964,933 8,879,985 8,251,648 +286,715 -628,337
====================================================================================
Family Housing Construction, Army.................................. 182,662 330,660 330,660 +147,998 ...............
Family Housing Operation and Maintenance, Army..................... 348,907 376,509 376,509 +27,602 ...............
Family Housing Construction, Navy and Marine Corps................. 83,682 104,581 104,581 +20,899 ...............
Family Housing Operation and Maintenance, Navy and Marine Corps.... 328,282 314,536 314,536 -13,746 ...............
Family Housing Construction, Air Force............................. 85,062 78,446 78,446 -6,616 ...............
Family Housing Operation and Maintenance, Air Force................ 318,324 317,274 317,274 -1,050 ...............
Family Housing Operation and Maintenance, Defense-Wide............. 59,169 58,373 58,373 -796 ...............
Department of Defense Family Housing Improvement Fund.............. 2,726 1,653 1,653 -1,073 ...............
DoD Military Unaccompanied Housing Improvement Fund................ 623 600 600 -23 ...............
------------------------------------------------------------------------------------
Total, Family Housing........................................ 1,409,437 1,582,632 1,582,632 +173,195 ...............
====================================================================================
ADMINISTRATIVE PROVISIONS
Defense Access Roads (Sec. 132).................................... ............... ............... ............... ............... ...............
Military Construction, Air Force (Sec. 125) (rescission)........... ............... ............... -31,158 -31,158 -31,158
Military Construction, Army (Sec. 124)............................. 93,800 ............... 77,600 -16,200 +77,600
Military Construction, Navy and Marine Corps (Sec. 124)............ 202,130 ............... 244,400 +42,270 +244,400
Military Construction, Air National Guard (Sec. 124)............... 52,000 ............... 11,100 -40,900 +11,100
Military Construction, Army National Guard (Sec. 124).............. 113,500 ............... 22,000 -91,500 +22,000
Military Construction, Army National Guard (Sec. 125) (rescission). ............... ............... -10,000 -10,000 -10,000
Military Construction, Army Reserve (Sec. 124)..................... 76,000 ............... 10,000 -66,000 +10,000
NATO Security Investment Program (Sec. 125) (rescission)........... -25,000 ............... ............... +25,000 ...............
42 USC 3374 (Sec. 125)............................................. ............... ............... ............... ............... ...............
Military Construction, Air Force (Sec. 124)........................ 138,100 ............... 118,516 -19,584 +118,516
Military Construction, Air Force Reserve (Sec. 124)................ 64,100 ............... 14,400 -49,700 +14,400
Family Housing Construction, Army (Sec. 126)....................... -18,000 ............... ............... +18,000 ...............
Family Housing Construction, Navy and Marine Corps (Sec. 125)...... ............... ............... -2,138 -2,138 -2,138
Family Housing Construction, Air Force (Sec. 126).................. ............... ............... ............... ............... ...............
Defense Access Roads Program (Sec. 129)............................ 20,000 ............... 30,000 +10,000 +30,000
------------------------------------------------------------------------------------
Total, Administrative Provisions............................. 716,630 ............... 484,720 -231,910 +484,720
Appropriations........................................... (759,630) ............... (528,016) (-231,614) (+528,016)
Rescissions.............................................. (-43,000) ............... (-43,296) (-296) (-43,296)
====================================================================================
Total, title I, Department of Defense........................ 10,091,000 10,462,617 10,319,000 +228,000 -143,617
Appropriations........................................... (10,134,000) (10,462,617) (10,362,296) (+228,296) (-100,321)
Rescissions.............................................. (-43,000) ............... (-43,296) (-296) (-43,296)
====================================================================================
TITLE II--DEPARTMENT OF VETERANS AFFAIRS
Veterans Benefits Administration
Compensation and pensions:
Advance from prior year........................................ (90,119,449) (95,768,462) (95,768,462) (+5,649,013) ...............
Current year request........................................... ............... 1,410,332 1,410,332 +1,410,332 ...............
------------------------------------------------------------------------------------
Subtotal, current year................................... 90,119,449 97,178,794 97,178,794 +7,059,345 ...............
Advance appropriation, fiscal year 2020........................ 95,768,462 107,119,807 107,119,807 +11,351,345 ...............
Readjustment benefits:
Advance from prior year........................................ (13,708,648) (11,832,175) (11,832,175) (-1,876,473) ...............
------------------------------------------------------------------------------------
Subtotal................................................. 13,708,648 11,832,175 11,832,175 -1,876,473 ...............
Advance appropriation, fiscal year 2020........................ 11,832,175 14,065,282 14,065,282 +2,233,107 ...............
Veterans insurance and indemnities:
Advance from prior year........................................ (107,899) (109,090) (109,090) (+1,191) ...............
Current year request........................................... 12,439 ............... ............... -12,439 ...............
------------------------------------------------------------------------------------
Subtotal................................................. 120,338 109,090 109,090 -11,248 ...............
Advance appropriation, fiscal year 2020........................ 109,090 111,340 111,340 +2,250 ...............
Veterans housing benefit program fund:
(Limitation on direct loans)................................... (500) (500) (500) ............... ...............
Administrative expenses........................................ 178,626 200,612 200,612 +21,986 ...............
Vocational rehabilitation loans program account.................... 30 39 39 +9 ...............
(Limitation on direct loans)................................... (2,356) (2,037) (2,037) (-319) ...............
Administrative expenses........................................ 395 396 396 +1 ...............
Native American veteran housing loan program account............... 1,163 1,149 1,163 ............... +14
General operating expenses, VBA.................................... 2,910,000 2,868,909 2,956,316 +46,316 +87,407
------------------------------------------------------------------------------------
Total, Veterans Benefits Administration...................... 110,812,380 125,777,866 125,865,287 +15,052,907 +87,421
Appropriations............................................. (3,102,653) (4,481,437) (4,568,858) (+1,466,205) (+87,421)
Advance appropriations, fiscal year 2020................... (107,709,727) (121,296,429) (121,296,429) (+13,586,702) ...............
Advances from prior year appropriations.................... (103,935,996) (107,709,727) (107,709,727) (+3,773,731) ...............
====================================================================================
Veterans Health Administration:
Medical services:
Advance from prior year........................................ (44,886,554) (49,161,165) (49,161,165) (+4,274,611) ...............
Current year request\1\........................................ 1,962,984 ............... 750,000 -1,212,984 +750,000
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Subtotal................................................. 46,849,538 49,161,165 49,911,165 +3,061,627 +750,000
Advance appropriation, fiscal year 2020........................ 49,161,165 48,747,988 51,411,165 +2,250,000 +2,663,177
Medical community care:
Advance from prior year........................................ (9,409,118) (8,384,704) (8,384,704) (-1,024,414) ...............
Current year request........................................... 419,176 ............... ............... -419,176 ...............
4/13/2018 Budget Amendment..................................... ............... 500,000 1,000,000 +1,000,000 +500,000
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Subtotal................................................. 9,828,294 8,884,704 9,384,704 -443,590 +500,000
Advance appropriation, fiscal year 2020........................ 8,384,704 14,419,786 10,758,399 +2,373,695 -3,661,387
Choice Fund.................................................... ............... 1,900,000 ............... ............... -1,900,000
Medical support and compliance:
Advance from prior year........................................ (6,654,480) (7,239,156) (7,239,156) (+584,676) ...............
Current year request........................................... 100,000 ............... ............... -100,000 ...............
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Subtotal................................................. 6,754,480 7,239,156 7,239,156 +484,676 ...............
Advance appropriation, fiscal year 2020........................ 7,239,156 7,106,150 7,239,156 ............... +133,006
Medical facilities:
Advance from prior year........................................ (5,434,880) (5,914,288) (5,914,288) (+479,408) ...............
Current year request........................................... 707,000 ............... 211,000 -496,000 +211,000
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Subtotal................................................. 6,141,880 5,914,288 6,125,288 -16,592 +211,000
Advance appropriation, fiscal year 2020........................ 5,914,288 5,276,676 6,141,880 +227,592 +865,204
Medical and prosthetic research................................ 722,262 727,369 779,000 +56,738 +51,631
Medical care cost recovery collections:
Offsetting collections......................................... -2,507,000 -3,590,000 -3,590,000 -1,083,000 ...............
Appropriations (indefinite).................................... 2,507,000 3,590,000 3,590,000 +1,083,000 ...............
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Subtotal................................................. ............... ............... ............... ............... ...............
DoD-VA Joint Medical Funds (by transfer)........................... (297,137) (301,578) (301,578) (+4,441) ...............
DoD-VA Health Care Sharing Incentive Fund (by transfer) (15,000) (15,000) (15,000) ............... ...............
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Total, Veterans Health Administration........................ 74,610,735 78,677,969 78,290,600 +3,679,865 -387,369
Appropriations........................................... (3,911,422) (3,127,369) (2,740,000) (-1,171,422) (-387,369)
(By transfer)............................................ (312,137) (316,578) (316,578) (+4,441) ...............
Advance appropriations, fiscal year 2020....................... (70,699,313) (75,550,600) (75,550,600) (+4,851,287) ...............
Advances from prior year appropriations........................ (66,385,032) (70,699,313) (70,699,313) (+4,314,281) ...............
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National Cemetery Administration
National Cemetery Administration................................... 306,193 315,836 315,836 +9,643 ...............
Departmental Administration
General administration............................................. 335,891 367,629 365,976 +30,085 -1,653
Board of Veterans Appeals.......................................... 161,048 174,748 174,748 +13,700 ...............
Information technology systems..................................... 4,055,500 4,184,571 4,184,571 +129,071 ...............
Veterans Electronic Health Record.................................. 782,000 1,207,000 800,000 +18,000 -407,000
Office of Inspector General........................................ 164,000 172,054 192,000 +28,000 +19,946
Construction, major projects....................................... 512,430 1,127,486 1,127,486 +615,056 ...............
Construction, minor projects....................................... 342,570 706,889 706,889 +364,319 ...............
Grants for construction of State extended care facilities.......... 110,000 150,000 150,000 +40,000 ...............
Grants for the construction of veterans cemeteries................. 45,000 45,000 45,000 ............... ...............
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Total, Departmental Administration........................... 6,508,439 8,135,377 7,746,670 +1,238,231 -388,707
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Administrative Provisions
Mandatory disability exams language (Sec. 256)..................... 25,000 ............... ............... -25,000 ...............
Medical Support and Compliance (Sec. 236) (rescission)............. ............... ............... -211,000 -211,000 -211,000
Medical services (Sec. 237) (rescission)........................... -751,000 ............... ............... +751,000 ...............
VA deferred maintenance (Sec. 248)................................. 2,000,000 ............... 2,000,000 ............... +2,000,000
Construction, major projects:
Sec. 243(a) rescission......................................... -10,000 ............... ............... +10,000 ...............
Sec. 243(b) reappropriation.................................... 10,000 ............... ............... -10,000 ...............
Sec. 243(c) rescission......................................... -410,000 ............... ............... +410,000 ...............
Sec. 243(d) reappropriation.................................... 410,000 ............... ............... -410,000 ...............
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Total Administrative Provisions.............................. 1,274,000 ............... 1,789,000 +515,000 +1,789,000
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Total, title II.............................................. 193,511,747 212,907,048 214,007,393 +20,495,646 +1,100,345
Appropriations........................................... (15,853,707) (16,060,019) (17,371,364) (+1,517,657) (+1,311,345)
Reappropriations......................................... (420,000) ............... ............... (-420,000) ...............
Emergency appropriations................................. ............... ............... ............... ............... ...............
Rescissions.............................................. (-1,171,000) ............... (-211,000) (+960,000) (-211,000)
(By transfer)............................................ (312,137) (316,578) (316,578) (+4,441) ...............
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TITLE III--RELATED AGENCIES
American Battle Monuments Commission
Salaries and expenses.............................................. 79,000 75,100 81,000 +2,000 +5,900
Foreign currency fluctuations account.............................. ............... ............... ............... ............... ...............
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Total, American Battle Monuments Commission.................. 79,000 75,100 81,000 +2,000 +5,900
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U.S. Court of Appeals for Veterans Claims
Salaries and expenses.............................................. 33,600 107,455 34,955 +1,355 -72,500
(Transfer out)................................................. ............... (-72,500) ............... ............... (+72,500)
Department of Defense--Civil
Cemeterial Expenses, Army
Salaries and expenses.............................................. 80,800 70,800 80,800 ............... +10,000
Construction....................................................... 167,000 ............... 56,600 -110,400 +56,600
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Total, Cemeterial Expenses, Army............................. 247,800 70,800 137,400 -110,400 +66,600
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Armed Forces Retirement Home--Trust Fund
Operation and maintenance.......................................... 41,300 41,300 41,300 ............... ...............
Capital program.................................................... 1,000 1,000 1,000 ............... ...............
Payment from General Fund.......................................... 22,000 22,000 22,000 ............... ...............
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Total, Armed Forces Retirement Home.......................... 64,300 64,300 64,300 ............... ...............
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Total, title III............................................. 424,700 317,655 317,655 -107,045 ...............
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TITLE IV--OVERSEAS CONTINGENCY OPERATIONS
Overseas Contingency Operations
Army............................................................... 130,400 69,000 ............... -130,400 -69,000
Navy............................................................... 13,390 ............... ............... -13,390 ...............
Air Force.......................................................... 275,522 ............... 69,000 -206,522 +69,000
Defense-Wide....................................................... 22,400 60,000 60,000 +37,600 ...............
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Subtotal..................................................... 441,712 129,000 129,000 -312,712 ...............
European Deterrence/Reassurance Initiative
Army............................................................... 15,700 192,250 192,250 +176,550 ...............
Navy............................................................... 19,858 227,320 227,320 +207,462 ...............
Air Force.......................................................... 270,830 345,800 345,800 +74,970 ...............
Defense-Wide....................................................... 1,900 27,050 27,050 +25,150 ...............
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Subtotal..................................................... 308,288 792,420 792,420 +484,132 ...............
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Total, title IV.............................................. 750,000 921,420 921,420 +171,420 ...............
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OTHER APPROPRIATIONS
DEPARTMENT OF DEFENSE
Hurricane Supplemental (Public Law 115-123) (emergency)............ 201,636 ............... ............... -201,636 ...............
Additional Funds (Public Law 115-96) (emergency)................... 200,000 ............... ............... -200,000 ...............
Hurricane Supplemental (Public Law 115-123) (emergency)............ 519,345 ............... ............... -519,345 ...............
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Total, Military Construction................................. 920,981 ............... ............... -920,981 ...............
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DEPARTMENT OF VETERANS AFFAIRS
Veterans Health Administration
Hurricane Supplemental (Public Law 115-123) (emergency)............ 11,075 ............... ............... -11,075 ...............
Hurricane Supplemental (Public Law 115-123) (emergency)............ 4,088 ............... ............... -4,088 ...............
Hurricane Supplemental (Public Law 115-123) (emergency)............ 3,209 ............... ............... -3,209 ...............
Hurricane Supplemental (Public Law 115-123) (emergency)............ 75,108 ............... ............... -75,108 ...............
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Total, Veterans Health Administration........................ 93,480 ............... ............... -93,480 ...............
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Total, Further Additional Supplemental Appropriations for 1,014,461 ............... ............... -1,014,461 ...............
Disaster Relief Requirements Act, 2018......................
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Grand total.................................................. 205,791,908 224,608,740 225,565,468 +19,773,560 +956,728
Appropriations........................................... (26,412,407) (26,840,291) (28,051,315) (+1,638,908) (+1,211,024)
Reappropriations......................................... (420,000) ............... ............... (-420,000) ...............
Rescissions.............................................. (-1,214,000) ............... (-254,296) (+959,704) (-254,296)
Advance appropriations, fiscal year 2020................. (178,409,040) (196,847,029) (196,847,029) (+18,437,989) ...............
Overseas contingency operations.......................... (750,000) (921,420) (921,420) (+171,420) ...............
Emergency appropriations................................. (1,014,461) ............... ............... (-1,014,461) ...............
Advances from prior year appropriations...................... (170,321,028) (178,409,040) (178,409,040) (+8,088,012) ...............
(By transfer)................................................ (312,137) (316,578) (316,578) (+4,441) ...............
(Limitation on direct loans)................................. (2,856) (2,537) (2,537) (-319) ...............
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\1\$2.1 billion in emergency funding for Medical: Services purposes was appropriated in H. J. Res. 124 in addition to these funds.
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