[House Report 118-528]
[From the U.S. Government Publishing Office]


                                                 Union Calendar No. 439
                                                 
118th Congress }                                             {  Report
                        HOUSE OF REPRESENTATIVES
 2d Session    }                                             { 118-528

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



 
     MILITARY CONSTRUCTION, VETERANS AFFAIRS, AND RELATED AGENCIES 
                       APPROPRIATIONS BILL, 2025

                                _______
                                

  May 28, 2024.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

 Mr. Carter of Texas, from the Committee on Appropriations, submitted 
                             the following

                              R E P O R T

                             together with

                             MINORITY VIEWS

                        [To accompany H.R. 8580]

    The Committee on Appropriations submits the following 
report in explanation of the accompanying bill making 
appropriations for military construction, veterans affairs and 
related agencies for the fiscal year ending September 30, 2025.

                        INDEX TO BILL AND REPORT

                                                            Page Number

                                                            Bill Report
Purpose of the Bill........................................
                                                                      2
Summary of Committee Recommendation........................
                                                                      2
Title I--Department of Defense
        Military Construction..............................     2
                                                                      3
        NATO Security Investment Program...................     9
                                                                     15
        Department of Defense Base Closure Account.........    10
                                                                     16
        Family Housing Construction and Operation and 
            Maintenance....................................    10
                                                                     16
        Department of Defense Family Housing Improvement 
            Fund...........................................    12
                                                                     18
        Department of Defense Military Unaccompanied 
            Housing Improvement Fund.......................    12
                                                                     18
        Administrative Provisions..........................    12
                                                                     18
Title II--Department of Veterans Affairs
        Veterans Benefits Administration...................    27
                                                                     22
        Veterans Health Administration.....................    31
                                                                     29
        National Cemetery Administration...................    36
                                                                     58
        Departmental Administration........................    36
                                                                     58
        Administrative Provisions..........................    45
                                                                     65
Title III--Related Agencies
        American Battle Monuments Commission...............    80
                                                                     70
        U.S. Court of Appeals for Veterans Claims..........    81
                                                                     71
        Cemeterial Expenses, Army..........................    81
                                                                     72
        Armed Forces Retirement Home.......................    82
                                                                     72
        Administrative Provision...........................    83
                                                                     74
Title IV--General Provisions...............................    84
                                                                     74

                          Purpose of the Bill

    The Military Construction, Veterans Affairs, and Related 
Agencies Appropriations bill funds the Department of Defense's 
activities related to military construction; family housing 
construction, maintenance, and oversight; and environmental 
remediation at closed military bases. The bill also funds the 
Department of Veterans Affairs, including programs to assist 
veterans, such as disability and pension benefits, education, 
healthcare, and insurance and loan programs. The bill funds 
four related agencies that honor and respect the Nation's 
veterans including the American Battle Monuments Commission; 
Cemeterial Expenses, Army (including Arlington National 
Cemetery); the U.S. Court of Appeals for Veterans Claims; and 
the Armed Forces Retirement Home.

                  Summary of Committee Recommendation

    The Committee recommends $378,643,794,000 in total budget 
authority for the fiscal year 2025 programs and activities 
funded in the bill. This is an increase of $49,395,186,000 
above the fiscal year 2024 enacted level and $769,252,000 above 
the President's request.
    The bill includes $231,123,794,000 for mandatory programs 
and $147,526,000,000 for discretionary programs.
    The bill provides $17,957,000,000 for military construction 
and family housing. This is $718,000,000 below the fiscal year 
2024 enacted level and $411,321,000 above the budget request.
    The bill provides $337,501,444,000 for fiscal year 2025 for 
the Department of Veterans Affairs, which is an increase of 
$30,196,000,000 above the fiscal year 2024 enacted level. Of 
the total, $208,323,794,000 is provided for mandatory benefit 
programs and $129,177,646,000 is provided for discretionary 
programs.
    Of the total for fiscal year 2025, $112,582,000,000 for 
veterans' healthcare was advanced in the Consolidated 
Appropriations Act, 2024 (P.L. 118-42).
    For fiscal year 2026, the Committee recommendation includes 
$131,439,000,000 in advance appropriations for the four 
veterans' medical care accounts, and $22,800,000,000 for the 
Cost of War Toxic Exposures Fund. The Committee recommendation 
also includes $222,227,506,000 in advance appropriations for 
mandatory benefits programs.
    The Committee recommendation provides a total of 
$385,354,000, which is $85,956,000 below the fiscal year 2024 
enacted level and $500,000 above the budget request, for the 
four Related Agencies: The American Battle Monuments 
Commission, the U.S. Court of Appeals for Veterans Claims, Army 
Cemeterial Expenses (including Arlington National Cemetery), 
and the Armed Forces Retirement Home.
    Advertising Contracts for Small Business.--The Committee 
understands that, as the largest advertiser in the United 
States, the Federal government should work to ensure fair 
access to its advertising contracts for small disadvantaged 
businesses and businesses owned by minorities and women. The 
Committee directs each department and agency to include the 
following information in its fiscal year 2026 budget 
justification: Expenditures for fiscal year 2024 and expected 
expenditures for fiscal year 2026, respectively, for (1) all 
contracts for advertising services; and (2) contracts for the 
advertising services of (I) socially and economically 
disadvantaged small businesses concerns (as defined in section 
8(a)(4) of the Small Business Act (15 U.S.C. 637(a)(4)); and 
(II) women- and minority-owned businesses.

                                TITLE I


                         DEPARTMENT OF DEFENSE


                     Military Construction Overview


 
 
 
Appropriation, fiscal year 2024.......................   $18,675,000,000
Budget request, fiscal year 2025......................    17,545,679,000
Committee recommendation, fiscal year 2025............    17,957,000,000
    Change from enacted level.........................      -718,000,000
    Change from budget request........................      +411,321,000
 

    Military construction accounts provide funds for new 
construction, construction improvements, planning and design, 
and host nation support. Projects funded by these accounts 
include facilities for operations, training, readiness, 
maintenance, research and development, supply, medical care, 
and force protection as well as unaccompanied housing, 
military-owned family housing, utilities infrastructure, and 
land acquisition.

                          COMMITTEE DIRECTIVES

    In addition to the notification and reporting requirements 
for military construction programs contained in Title 10, 
United States Code, the Committee's recommendations include 
several provisions requiring the Department of Defense to 
report on various aspects of military construction programs and 
to provide notification to the Committee when certain actions 
are taken. The Committee also retains prior approval authority 
for any reprogramming of funds exceeding a specific threshold.
    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) that has been specifically reduced by 
Congress in acting on the budget request is considered to be a 
Congressional interest item and as such, prior approval is 
required. Accordingly, no reprogramming to an item specifically 
reduced below the threshold by Congress is permitted, except 
that the Department may seek reprogramming for appropriated 
increments.
    The reprogramming criteria that applies to military 
construction projects is 25 percent of the funded amount or 
$6,000,000 and includes new housing construction projects and 
improvements. To provide the Services the flexibility to 
proceed with construction contracts without disruption or 
delay, the costs associated with environmental hazard 
remediation such as asbestos removal, radon abatement, lead-
based paint removal or abatement, and any other legislated 
environmental hazard remediation may be excluded, if such 
remediation requirements could not be reasonably anticipated at 
the time of the budget submission. Reprogramming is a courtesy 
provided to the Department and can be taken away if the 
authority is abused. This exclusion applies to projects 
authorized in this budget year as well as projects authorized 
in prior years for which construction has not been completed. 
Planning and design costs associated with military construction 
and family housing projects may also be excluded from these 
guidelines. In instances where prior approval for a 
reprogramming request for a project or account has been 
received from the Committees on Appropriations of both Houses 
of Congress, the adjusted amount approved becomes the new base 
for any future increase or decrease via below-threshold 
reprogramming (provided that the project or account is not a 
Congressional interest item as defined above).
    In addition to these guidelines, the Services are directed 
to adhere to the guidance for military construction 
reprogramming actions and notifications, including the 
pertinent statutory authorities contained in DOD Financial 
Management Regulation 7000.14-R and relevant updates and policy 
memoranda. The Committee further encourages the Office of the 
Director of National Intelligence to use a format similar to 
that used by the Office of the Secretary of Defense to submit 
reprogramming requests.
    Facilities Sustainment, Restoration and Modernization 
(FSRM).--The Department is directed to continue describing on 
form 1390 the backlog of FSRM requirements at installations 
with future construction projects. For troop housing requests, 
form 1391 should describe any FSRM conducted in the past two 
years. Likewise, future requirements for unaccompanied housing 
at the corresponding installation should be included. 
Additionally, the forms should include English equivalent 
measurements for projects presented in metric measurement. 
Rules for funding repairs of facilities under the operation and 
maintenance accounts are described below:
          (1) components of the facility may be repaired by 
        replacement. Such replacement can be up to current 
        standards or codes;
          (2) interior arrangements and restorations may be 
        included as repair;
          (3) additions and new facilities, may be done 
        concurrently with repair projects as long as the final 
        conjunctively funded project is a complete and usable 
        facility; and (4) the appropriate Service Secretary 
        shall notify the appropriate committees 21 days prior 
        to carrying out any repair project with an estimated 
        cost in excess of $7,500,000.
    Quarterly Summary of Notifications.--The Committee directs 
the Services and the Office of the Secretary of Defense (on 
behalf of itself and defense agencies) to continue to submit a 
quarterly report listing all notifications that have been 
submitted to the Committees during the preceding three-month 
period.
    Work in Progress or Planned (WIP) Curve.--The Committee 
directs the Services and the Office of the Secretary of Defense 
(on behalf of itself and defense agencies) to submit a WIP 
curve for each project requested in a budget submission above 
$90,000,000 with the form 1391 justification to the 
congressional defense committees. The Committee also directs 
the Secretary of Defense to report to the congressional defense 
committees quarterly, beginning in the second quarter of fiscal 
year 2024 and each quarter thereafter, of projects that remain 
unawarded from the current and prior fiscal years and the 
reasons for delay.
    Transfer of Funds to and from the Foreign Currency 
Fluctuations, Construction, Defense Account.--Committee directs 
the Department of Defense to submit a quarterly report to the 
Committees on Appropriations of both Houses of Congress on the 
transfer of funds from military construction and family housing 
accounts to the Foreign Currency Fluctuations, Construction, 
Defense account. The report shall specify the amount 
transferred to the Foreign Currency account from each military 
construction and/or family housing account, and all other 
accounts for which an appropriation is provided in this Act, 
during the preceding fiscal quarter, and the amounts 
transferred from the Foreign Currency account to the above 
accounts during the same period. This report shall be submitted 
no later than 30 days after the close of each fiscal quarter. 
In addition, the Department shall notify the Committees on 
Appropriations of both Houses of Congress within 7 days of 
transferring any amount in excess of $10,000,000 to or from the 
Foreign Currency account.
    Bid Savings.--The Committee directs the Secretary of 
Defense to submit 1002 reports on military construction bid 
savings not later than 180 days after enactment of this Act, 
and biannually thereafter, to the Committees on Appropriations 
of both Houses of Congress.
    Incremental Funding of Projects.--In general, the Committee 
supports full funding for military construction projects if 
they are executable. However, it continues to be the practice 
of the Committee to provide incremental funding for certain 
large projects to enable the Services to more efficiently 
allocate military construction dollars among projects that can 
be executed in the year of appropriation.
    Unfunded Priority List (UPL) and Future Years Defense 
Program (FYDP).--The Committee directs the Department of 
Defense and Military Services, active and reserve components as 
well as Combatant Commanders, as required by law, to submit a 
UPL and FYDP to the congressional defense committees for 
military construction projects no later than 10 days and 5 
days, respectively, after the President's budget is submitted 
to Congress.

                           ITEMS OF INTEREST

    Advanced Manufacturing.--The Committee is encouraged by 
reports that three-dimensional (3D) construction could provide 
military civil engineers with a faster means of building 
facilities which could reduce supply lines and the number of 
personnel needed for construction and related activities. The 
Department of Defense is encouraged to study, develop, and 
utilize advanced manufacturing capabilities to the extent 
practicable.
    Barracks.--The Committee remains concerned about the 
inadequate conditions of DOD unaccompanied housing and 
continues to direct the Department to expeditiously address the 
findings of the Government Accountability Office (GAO) report 
entitled, ``Military Barracks: Poor Living Conditions Undermine 
Quality of Life and Readiness'' (GAO-23-105797).
    Building Materials.--The Committee supports the use by the 
Department of a diversity of building materials, and directs 
the Department to ensure selected building materials are 
mature, cost effective, and advance the performance, 
sustainability, reliability, and resiliency of DoD 
infrastructure. The Committee believes that Federal resources 
are best utilized when all materials can compete on their own 
merits, allowing for the best solutions to address our 
infrastructure challenges. The Committee further notes the need 
for building materials and heating systems to undergo rigorous 
testing, including in extreme temperature and conditions.
    Camp Bull Simons Child Development Center.--The Committee 
is concerned with the lack of affordable and accessible 
childcare for servicemembers stationed at Camp Bull Simons and 
Eglin Air Force Base. The Army and the Air Force stood up a 
task force to review, and propose, solutions to construct a 
child development center that would meet the needs of affected 
families. The Committee directs the Secretaries of the Army and 
the Air Force to provide a briefing within 30 days of filing 
this report and every 60 days thereafter on the status of the 
task force review and of the Departments' ongoing efforts to 
find a solution to the childcare deficiencies for 
servicemembers stationed at Camp Bull Simons and Eglin Air 
Force Base
    Demolition of Excess Infrastructure.--The bill includes 
$75,000,000 for unspecified minor military construction for 
demolition across the active and reserve components. The 
Committee is concerned about the amount of excess and obsolete 
infrastructure found on installations. While the Committee 
understands the need to balance demolition with other 
infrastructure needs, excess infrastructure can be costly to 
maintain and diverts resources away from current requirements.
    The Committee understands that recent technological 
advancements of non-nuclear soil and asphalt density gauges 
conform to American Society for Testing and Materials standards 
and encourages the Department of Defense to continue exploring 
the application of these innovative technologies in future 
military construction projects.
    Family Housing and CDC Heating and Air Conditioning.--The 
Committee recognizes the Services' efforts to improve energy 
efficiency through scheduled seasonal deactivation of air 
conditioning and heating systems at its facilities. Certain 
military installations, deactivate these systems in family 
housing units and child development centers (CDC). The 
Committee encourages the Department to examine its energy 
conservation programs, including where family housing units and 
CDCs may be excluded from air conditioning and heating 
restrictions.
    Infrastructure Needs to Support Alliance with the 
Philippines.--The Committee notes the importance of the 
recently reinvigorated alliance with the Philippines. To better 
understand the Department of Defense's needs to support the 
expanded alliance, the Committee directs the Secretary of 
Defense to provide a report, not later than 180 days after the 
date of the enactment of this Act, summarizing the plans for 
military construction and associated infrastructure needs to 
maximize the effectiveness of an enhanced posture in and 
alliance with the Philippines.
    Joint Civilian-Military Infrastructure in Alaska.--The 
Committee notes the potential benefit of infrastructure that is 
jointly used by both military and non-military users, 
especially in remote locations. The Committee directs the 
Assistant Secretary of Defense for Energy, Installations, and 
Environment to provide a report within 180 days of enactment of 
this Act detailing potential opportunities for joint-use 
infrastructure investments in Alaska, strategies for maximizing 
the utilization of existing infrastructure, and areas for 
potential future investment to achieve cost savings and 
operational efficiencies.
    Laboratory Infrastructure.--The Committee is concerned that 
aging laboratory infrastructure threatens the ability of 
Services to maintain the advanced technology necessary to keep 
ahead of U.S. adversaries across all domains. Accordingly, the 
Committee provides an additional $75,000,000 for planning and 
design for laboratory infrastructure projects. The Services are 
directed to provide a spend plan not later than 90 days after 
enactment of this Act regarding the use of these funds.
    Linear Power Generation.--The Committee understands that 
fuel agnostic linear generators can achieve over 50% net system 
efficiency, are compatible with more than 22 fuel types, and 
can house 2 megawatts of power in a standard 20-foot shipping 
container. These systems can shift between different fuel types 
in real-time without depleting fuel tanks or requiring hardware 
changes. The committee encourages the DoD to invest in 
scalable, fuel agnostic linear power generation as a means of 
improving grid resiliency at military installations.
    Mass Timber.--The Committee is aware that the use of cross 
laminated timber and other mass timber products as a building 
material has the potential to reduce costs, limit environmental 
impact, and increase functionality of various military 
structures. The Committee encourages the Department of Defense 
to continue exploring the application of these innovative 
technologies in future planning and design for military 
construction projects.
    Qatar.--Not later than 90 days after the date of the 
enactment of this Act, the Secretary of Defense shall submit to 
the Committee on Appropriations, a report detailing the burden 
sharing contributions by the State of Qatar to support the 
United States military presence at Al Udeid Air Base and 
elsewhere in Qatar, and joint operations between United States 
and Qatari military forces. Such report shall include all host 
country contributions, including facilities access, 
construction and maintenance, operating costs, logistics 
support, physical security, and any other financial or in-kind 
contributions.
    Resilient Military Installations.--The Committee supports 
the Department's continued efforts to build lasting and 
resilient military installations. These efforts include using 
methods that update hurricane-resistant building codes for 
bases, barracks, hospitals, and airfields and reviewing the 
effect of severe drought and desertification and how these two 
hazards affect installations and missions. The Committee 
encourages the Department to continue investing in innovative 
infrastructure projects to increase infrastructure resiliency 
and reduce costs.
    Remote Pacific Locations.--The Committee is aware of the 
strategic importance of geographic remote Pacific locations, 
yet the Department has failed to respond to direction included 
in House Report 117-391 requesting a classified briefing on 
military construction needs at Wake Island, Midway, Guam, 
Tinian, the Republic of Marshall Islands, the Federated States 
of Micronesia, the Republic of Palau, and other locations in 
the Pacific Islands. The Committee directs the Assistant 
Secretary of Defense for Sustainment, in conjunction with 
USINDOPACOM and Services to promptly provide this briefing due 
to the major infrastructure failures at Wake Island, unresolved 
Mawar damage on Guam, the significant funds requested for 
fiscal year 2025, and the significant planned investment for 
these locations across the Future Years Defense Plan.
    Transient Military Housing.--The Committee is concerned 
about the shortcomings in the administration of transient 
military housing within the Navy and Air Force. According to a 
2021 GAO study, while significant differences exist in how the 
services administer their respective programs, the Army's 
transient housing program, which is administered by the 
Assistant Secretary for Installations, Energy and Environment, 
uses accepted industry accounting methods, has improved the 
physical condition of Army lodging facilities at every Army 
installation in the U.S., generates annual budget savings, and 
has seen a dramatic increase in military traveler satisfaction. 
The Committee directs both the Navy and Air Force to provide a 
report, not later than 180 days after enactment of this Act, on 
how both Services can effectively adopt the best practices of 
the Army as they administer transient military housing. This 
report should include whether both services should consider 
transferring existing jurisdictions to most effectively 
administer these critical programs.

                      Military Construction, Army


 
 
 
Appropriation, fiscal year 2024.......................    $2,022,775,000
Budget request, fiscal year 2025......................     2,311,157,000
Committee recommendation, fiscal year 2025............     2,217,757,000
    Change from enacted level.........................      +194,982,000
    Change from budget request........................       -93,400,000
 

    The Committee recommends $2,217,757,000 for the Army in 
fiscal year 2025, of which $87,100,000 is for the following 
projects in the following amounts:

----------------------------------------------------------------------------------------------------------------
                 State                            Location                   Project                 Amount
----------------------------------------------------------------------------------------------------------------
FL.....................................  Naval Air Station Key      Joint Interagency Task           $70,000,000
                                          West.                      Force South Command and
                                                                     Control Facility.
NC.....................................  Fort Liberty.............  Automated Infantry                14,200,000
                                                                     Platoon Battle Course.
WA.....................................  Joint Base Lewis-McCord..  Airfield Fire & Rescue             2,900,000
                                                                     Station.
----------------------------------------------------------------------------------------------------------------

    Within the total for Military Construction, Army, the 
recommendation includes $334,738,000 for planning and design, 
which is $10,000,000 above the budget request; and $186,119,000 
for unspecified minor construction, which equal to the budget 
request.
    Further detail of the Committee's recommendation is 
provided in the State table at the end of this report.
    Engineer Research & Development Center (ERDC).--The 
Committee notes that U.S. Army Corp of Engineers' ERDC has 
limited and outdated testing infrastructure that impacts its 
mission to develop advanced airfield and pavement research 
requirements related to high heat resistance and 
sustainability. The Committee supports the development of the 
Jet Engine Thrust Simulator (JETS) facility to further this 
critical research and encourages the Army Futures Command and 
ERDC to take steps to advance this important project.
    Oahu Wildland Fire Center.--The Committee understands the 
critical role the Army's wildland firefighters in Hawaii play 
in preventing wildfires on Army training lands on Oahu and 
assisting non-military partners during emergencies elsewhere on 
the island. To better understand the condition of the Army's 
existing facilities on Oahu, the Committee directs the 
Assistant Secretary of the Army for Installations, Energy and 
Environment to provide a report, not later than 90 days after 
the date of the enactment of this Act, summarizing the 
infrastructure investment needs to support these efforts.
    Tobyhanna Army Depot.--The Committee views Tobyhanna Army 
Depot as an advantageous location for the build-out of physical 
space for future Army Materiel Command (AMC) manufacturing of 
microelectronics, including semi-conductors. As such, the 
Committee requests that the Army keep the Committee informed of 
AMC construction needs at Tobyhanna Army Depot.
    U.S. Indo-Pacific Command Pilot (USINDOPACOM).--The 
recommendation includes $66,000,000 to for the pilot program 
for minor military construction projects as established by the 
Fiscal Year 2024 National Defense Authorization Act.

              Military Construction, Navy and Marine Corps


 
 
 
Appropriation, fiscal year 2024.......................    $5,531,369,000
Budget request fiscal year 2025.......................     4,540,899,000
Committee recommendation, fiscal year 2025............     4,332,414,000
    Change from enacted level.........................    -1,198,955,000
    Change from budget request........................      -208,485,000
 

    The Committee recommends $4,332,414,000 or the Navy and 
Marine Corps in fiscal year 2025, of which $70,480,000 is for 
the following project in the following amount:

----------------------------------------------------------------------------------------------------------------
                 State                            Location                   Project                 Amount
----------------------------------------------------------------------------------------------------------------
FL.....................................  Marine Corps Support       Communications                    $4,300,000
                                          Facility Blount Island.    Infrastructure.
FL.....................................  Naval Air Station          Child Development Center.          6,900,000
                                          Jacksonville.
FL.....................................  Naval Air Station          Hurricane Consolidated            10,600,000
                                          Pensacola.                 (A) School Dorm.
FL.....................................  Naval Station Mayport....  Waterfront Emergency              13,700,000
                                                                     Power.
VA.....................................  Fort Story...............  Child Development Center.          2,000,000
VA.....................................  Naval Air Station OCEANA.  Unaccompanied Housing....         16,000,000
VA.....................................  Naval Air Station OCEANA.  Child Development Center.          2,000,000
GU.....................................  Guam.....................  Guam Defense Access Roads         14,980,000
----------------------------------------------------------------------------------------------------------------

    Within the total for Military Construction, Navy and Marine 
Corps, the recommendation includes $877,946,000 for planning 
and design, which is the same as the budget request; and 
$233,620,000 for unspecified minor construction, which is equal 
to the budget request.
    Further detail of the Committee's recommendation is 
provided in the State table at the end of this report.
    Battle Damage Requirements in Shipyard Infrastructure 
Optimization Program (SIOP).--As the Navy executes its 20-year, 
$21 billion SIOP, it will make infrastructure improvements that 
will last generations and support both peacetime and wartime 
requirements, to include responding to battle damage. The 
Committee directs the Naval Facilities Engineering Systems 
Command and Naval Sea Systems Command to provide a joint report 
within 180 days of the enactment of this Act (1) summarizing 
the ability of existing shipyard infrastructure to support 
wartime battle damage requirements, (2) how SIOP is 
incorporating any shortfalls in meeting battle damage 
requirements into its long-term infrastructure plan at the 
naval public shipyards, and (3) any possible benefits of 
coordinating these efforts with the U.S. Coast Guard's SIOP.
    Drydocks.--The Committee recognizes the critical strategic 
and logistics role public shipyards play in the security of the 
nation. The Committee strongly supports efforts to modernize 
and improve facilities at the Navy's four public shipyards, 
including for the multi-mission dry dock (M2D2), and to address 
the complex maintenance needs of the Navy's current and future 
active fleet. The current modernization plans for Pearl Harbor 
Naval Shipyard and Intermediate Maintenance Facility (IMF) 
include converting Dry Dock 4 to focus on depot-level 
maintenance for nuclear submarines. To better understand the 
Navy's options for a floating dry dock at Pearl Habor Naval 
Shipyard and IMF to address any infrastructure shortfalls, the 
Committee directs the Assistant Secretary of the Navy for 
Energy, Installations, and Environment to provide a report 
within 180 days of enactment of this Act (1) detailing 
potential locations for mooring a floating drydock, (2) a list 
of the individual major military construction projects needed 
to support a floating drydock, (3) the earliest a floating 
drydock could be brought into service given the timelines 
associated with the required military construction, and (4) how 
a floating drydock would be used to ensure extra capacity for 
potential crisis and conflict in the Indo-Pacific. The 
Committee recognizes the importance of fleet maintenance on the 
west coast to ensuring mission readiness in the Indo-Pacific 
region and is aware the Navy is already facing maintenance 
delays. The Committee encourages the Navy to avoid disruptions 
to aircraft carrier maintenance, including during west coast 
M2D2 construction.
    Ground-Based Midcourse Defense Planning and Design.--The 
Committee recognizes the need for an additional Ground-Based 
Midcourse Defense capability, both in total number of ballistic 
missile interceptors and sites from which those interceptors 
can engage ballistic missile threats. The Committee directs the 
Missile Defense Agency to bring planning and design of an 
additional East Coast based Ground-Based Midcourse Defense 
interceptor site to 35 percent complete.
    Infrastructure Needs at Naval Air Station Corpus Christi.--
The Committee recognizes the unique importance of the Naval 
Aviation Training Enterprise and is alarmed at the number of 
the poor and failing facilities that the Navy identified in its 
November 9, 2023 report to Congress, particularly at Naval Air 
Station Corpus Christi. The Committee urges the Navy to address 
the needs at Naval Air Station Corpus Christi, particularly as 
related to construction and other improvements for 
unaccompanied and family housing, child and youth development 
centers, and quality of life projects for servicemembers and 
their families.
    Joint Base Pearl Harbor-Hickam Drinking and Wastewater 
Infrastructure.--The Committee is concerned about wastewater 
discharges from Joint Base Pearl Harbor-Hickam's aging 
wastewater facility and the condition of the base's drinking 
water systems. To help the Committee fully understand the long-
term infrastructure needs at the base, the Committee directs 
the Assistant Secretary of the Navy for Energy, Installations, 
and Environment, to provide a report within 120 days after 
enactment of this Act summarizing: (1) any actions needed to 
bring Joint Base Pearl Harbor-Hickam Infrastructure's 
Installation Development Plan into compliance with Navy 
regulations, (2) staffing needs for planning these military 
construction projects, and (3) efforts to coordinate long-term 
infrastructure needs with major tenants across the joint base.
    Naval Aviation Training Enterprise.--The Committee notes 
the importance of the Naval Aviation Training Enterprise and 
encourages the Navy to prioritize infrastructure projects 
within the coastal Naval Aviation Training Enterprise, 
especially those that build, remodel, and restore unaccompanied 
and family housing, child and youth development centers, and 
quality of life projects for servicemembers and their families.
    P-8 Parking Aprons at Naval Air Station Jacksonville.--The 
Committee is concerned about the degradation of the P-8 
Poseidon parking aprons at Naval Air Station Jacksonville and 
its impact on the operational readiness of the aircraft. 
Therefore, the Committee directs the Assistant Secretary of the 
Navy for Energy, Installations, and Environment to provide a 
report within 60 days of enactment detailing the plan to 
recapitalize the P-8 parking apron infrastructure at Naval Air 
Station Jacksonville.
    Naval Air Station Pensacola B3260 Hangar.--Hurricane Sally 
in 2020 caused hundreds of millions of dollars in damage to 
numerous facilities at Naval Air Station Pensacola, forcing the 
Navy to condemn a hangar used by the world-famous Blue Angels 
flight demonstration squadron. The Committee directs the 
Secretary of the Navy to provide a report detailing the status 
of repairs to the hangar, as well as the necessary short- and 
long-term investments required to properly address the damage 
caused by Hurricane Sally, within 90 days of enactment of this 
Act.
    Port Improvements on Tinian Island.--The Committee notes 
that the Department of the Navy has previously acknowledged the 
critical nature of the Tinian Port Joint Area Development Plan 
in the Commonwealth of the Northern Mariana Islands. The 
Committee directs the Assistant Secretary of the Navy for 
Energy, Installations, and Environment to provide a report, not 
later than 180 days after the date of the enactment of this 
Act, summarizing (1) the major and minor military construction 
projects under consideration by the Department of the Navy to 
support port operations on the Island of Tinian, (2) design 
options to help maximize U.S. Marine Corps and U.S. Air Force 
training capabilities on the Island of Tinian, (3) efforts to 
coordinate the work and develop the requirements with the 
Commonwealth Ports Authority of the Commonwealth of the 
Northern Mariana Islands, and (4) actions the Navy can take to 
accelerate these projects.
    Unexploded Ordinance on Military Construction in Guam.--The 
Committee continues to recognize the significant environmental, 
planning, and construction activities on Guam and the impact 
unexploded ordinance removal has on these projects. The 
Committee directs the Assistant Secretary of the Navy for 
Installations, Energy, and Environment within 180 days of 
enactment to provide a report on efforts to address this issue 
and to help keep construction projects on-time and on-budget.
    United States Marine Corps Forces, Pacific Headquarters 
Needs Assessment.--The Committee is concerned about the 
condition of the infrastructure at Camp H. M. Smith, which was 
built in 1942 and whose planned major upgrades have been 
repeatedly delayed. The Committee directs the Deputy Commandant 
for Installations and Logistics to provide a report within 180 
days after enactment of this Act summarizing: (1) the Marine 
Corps' current assessment of the condition of Marine Corps 
Forces, Pacific Headquarters' infrastructure and (2) a plan for 
addressing failed or failing infrastructure, to include a 
detailed timeline, estimated cost, and specific projects that 
must be completed to meet Operational Plan requirements.

                    Military Construction, Air Force


 
 
 
Appropriation, fiscal year 2024.......................    $2,741,424,000
Budget request, fiscal year 2025......................     3,187,126,000
Committee recommendation, fiscal year 2025............     3,268,276,000
    Change from enacted level.........................      +526,852,000
    Change from budget request........................       +81,150,000
 

    The Committee recommends $3,268,276,000 for the Air Force 
in fiscal year 2025, of which $299,000,000 is for the following 
projects in the following amounts:

----------------------------------------------------------------------------------------------------------------
                 State                            Location                   Project                 Amount
----------------------------------------------------------------------------------------------------------------
AR.....................................  Ebbing Air National Guard  Academic Training Center.        $70,000,000
                                          Base.
CA.....................................  Beale Air Force Base.....  Multi-Doman Operations            53,000,000
                                                                     Complex.
FL.....................................  Tyndall Air Force Base...  Fire Crash/Rescue Station         46,000,000
LA.....................................  Barksdale Air Force Base.  ADAL Child Development            22,000,000
                                                                     Center.
NE.....................................  Offutt Air Force Base....  Survivable Airborne               10,000,000
                                                                     Operations Center.
UT.....................................  Hill Air Force Base......  F-35 T-7A East Campus             28,000,000
                                                                     Infrastructure.
TX.....................................  JBSA-Lackland Air Force    Military Training                 70,000,000
                                          Base.                      Classrooms/Dining
                                                                     Facility 4.
----------------------------------------------------------------------------------------------------------------

    Within the total for Military Construction, Air Force, the 
recommendation includes $459,926,000 for planning and design, 
which is $20,000,000 above the budget request; and $129,600,000 
for unspecified minor construction, which is equal to the 
request.
    Further detail of the Committee's recommendation is 
provided in the State table at the end of this report.
    Air Force Infrastructure Hardening.--The Committee remains 
concerned with the hardening of aircraft hangers and shelters 
on Pacific bases, as detailed in House Report 118-122, and 
directs the Air Force to report to the Committee not later than 
90 days after enactment of this Act on the use of funding 
provided in prior fiscal years and plans for the use of funds 
provided in this Act to this objective.
    Ground Based Strategic Deterrent (GBSD) Infrastructure.--
The Committee is encouraged by the Air Force's future years 
defense program expectations for military construction related 
to the GBSD. The Committee requests that the Air Force continue 
engaging with Congress on its infrastructure needs related to 
the GBSD.
    U.S. Space Forces Indo-Pacific Headquarters Study.--The 
Committee is concerned that significant infrastructure 
shortfalls on Joint Base Pearl Harbor-Hickam could negatively 
impact Space Force Indo-Pacific's ability to carry out its role 
as the Space Force Component to U.S. Indo-Pacific Command and 
as the Joint Force Space Component Commander. The Committee 
directs the Assistant Secretary of the Air Force for Energy, 
Installations and Environment to provide a report within 180 
days after enactment of this Act summarizing: (1) the 
Department's assessment of the current Space Forces Indo-
Pacific's headquarters (2) the plan for addressing short-term 
facility requirements in the next five years, to include a 
detailed timeline, estimated cost, and specific projects, and 
(3) the long-term plan for fully meeting operational capability 
facility requirements for Space Forces Indo-Pacific.
    Sentinel Workforce Lodging and Care.--The Committee remains 
concerned about the Sentinel program's ability to identify, 
hire and retain a skilled workforce. The Committee also notes 
that the Sentinel program's needs include secondary 
requirements associated with bringing in a large workforce for 
an extended period of time to communities that may lack the 
infrastructure to support such an influx, and encourages the 
Air Force to identify industry partners who have demonstrated 
experience in lodging and hospitality services for workforce in 
remote locations.

                  Military Construction, Defense-Wide


 
 
 
Appropriation, fiscal year 2024.......................    $3,161,782,000
Budget request, fiscal year 2025......................     3,733,763,000
Committee recommendation, fiscal year 2025............     3,500,083,000
    Change from enacted level.........................      +388,301,000
    Change from budget request........................      -233,680,000
 

    The Committee recommends $3,500,083,000 for Military 
Construction, Defense-Wide, in fiscal year 2025, of which 
$47,920,000 is for the following projects in the following 
amounts:

----------------------------------------------------------------------------------------------------------------
                 State                            Location                   Project                 Amount
----------------------------------------------------------------------------------------------------------------
AL.....................................  Anniston Army Depot......  Small Arms Warehouse.....        $14,500,000
AL.....................................  Anniston Army Depot......  General Purpose Warehouse          3,420,000
NC.....................................  Fort Liberty.............  SOF Mackall Company               30,000,000
                                                                     Operations Facilities.
----------------------------------------------------------------------------------------------------------------

    Within the total for Military Construction, Defense-Wide, 
the recommendation includes $395,131,000 for planning and 
design, which is $27,920,000 above the budget request; and 
$88,265,000 for unspecified minor construction, which is equal 
to the budget request.
    Further detail of the Committee's recommendation is 
provided in the State table at the end of this report.
    Energy Resilience and Conservation Investment Program 
(ERCIP).--The Committee provides $636,000,000 for ERCIP 
construction, the same as the budget request. The Committee 
supports the Department's efforts to improve energy resilience, 
contribute to mission assurance, save energy, and reduce energy 
costs through ERCIP. The Committee encourages the Department to 
continue using all available tools and authorities to ensure 
the timely execution of ERCIP projects. Additionally, as the 
Department works to achieve base energy independence, the 
Committee encourages the Department to leverage new energy 
technologies.
    Special Operations Command Pacific (SOCPAC) Headquarters 
Needs Assessment.--The Committee is aware that SOCPAC, has 
personnel spread across Hawaii due to facility space 
limitations at its primary headquarters at Camp H. M. Smith. To 
better assess possible military construction projects that 
could consolidate these locations, the Committee directs U.S. 
Special Operations Command to provide a report within 180 days 
after enactment of this Act summarizing: (1) the operational 
impacts of having personnel spread across Hawaii, (2) SOCPAC's 
total square foot and operational requirements for operations 
on Oahu, and (3) construction options for overcoming facility 
shortfalls.

               Military Construction, Army National Guard


 
 
 
Appropriation, fiscal year 2024.......................      $620,647,000
Budget request, fiscal year 2025......................       362,129,000
Committee recommendation, fiscal year 2025............       367,129,000
    Change from enacted level.........................      -253,518,000
    Change from budget request........................        +5,000,000
 

    The Committee recommends $367,129,000 for the Army National 
Guard in fiscal year 2025.
    Within the total for Military Construction, Army National 
Guard, the recommendation includes $30,529,000 for planning and 
design, which is $5,000,000 above the budget request; and 
$45,000,000 for unspecified minor construction, which is 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 National Guard


 
 
 
Appropriation, fiscal year 2024.......................      $295,526,000
Budget request, fiscal year 2025......................       190,792,000
Committee recommendation, fiscal year 2025............       195,792,000
    Change from enacted level.........................       -99,734,000
    Change from budget request........................        +5,000,000
 

    The Committee recommends $195,792,000 for the Air National 
Guard in fiscal year 2025, including $15,792,000 for planning 
and design, which is $5,000,000 above the budget request; and 
$40,200,000 for unspecified minor construction, which is equal 
to the budget request.
    Further detail of the Committee's recommendation is 
provided in the State table at the end of this report.
    Air National Guard Infrastructure.--The Committee 
recognizes that some Aviation Support Facilities are not 
configured to protect and maintain modern airframes and 
encourages the Air National Guard to upgrade these facilities 
using unspecified minor military construction funds, as 
appropriate, to ensure current facilities are upgraded to 
adequately support current airframes.

                  Military Construction, Army Reserve


 
 
 
Appropriation, fiscal year 2024.......................      $151,076,000
Budget request, fiscal year 2025......................       255,032,000
Committee recommendation, fiscal year 2025............       265,032,000
    Change from enacted level.........................      +113,956,000
    Change from budget request........................       +10,000,000
 

    The Committee recommends $265,032,000 for the Army Reserve 
in fiscal year 2025, of which $5,000,000 is for the following 
projects in the following amounts:

----------------------------------------------------------------------------------------------------------------
                 State                            Location                   Project                 Amount
----------------------------------------------------------------------------------------------------------------
KY.....................................  Fort Knox................  ARAC Support Facilities..          5,000,000
----------------------------------------------------------------------------------------------------------------

    Within the total for Military Construction, Army Reserve, 
the recommendation includes $41,508,000 for planning and 
design, which is $10,000,000 above the budget request; and 
$3,524,000 for unspecified minor construction, which is 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


 
 
 
Appropriation, fiscal year 2024.......................       $51,291,000
Budget request, fiscal year 2025......................        29,829,000
Committee recommendation, fiscal year 2025............        67,329,000
    Change from enacted level.........................       +16,038,000
    Change from budget request........................       +37,500,000
 

    The Committee recommends $50,499,000 for the Navy Reserve 
in fiscal year 2025, of which $37,500,000 is for the following 
projects in the following amounts:

----------------------------------------------------------------------------------------------------------------
                 State                            Location                   Project                 Amount
----------------------------------------------------------------------------------------------------------------
TX.....................................  Naval Air Station Fort     Maintenance Hanger.......        $37,500,000
                                          Worth.
----------------------------------------------------------------------------------------------------------------

    Within the total for Military Construction, Navy Reserve, 
the recommendation includes $3,219,000 for planning and design, 
which is 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


 
 
 
Appropriation, fiscal year 2024.......................      $331,572,000
Budget request, fiscal year 2025......................        69,263,000
Committee recommendation, fiscal year 2025............        50,499,000
    Change from enacted level.........................      -281,073,000
    Change from budget request........................       -18,764,000
 

    The Committee recommends $50,499,000 for the Air Force 
Reserve in fiscal year 2025, which includes $3,798,000 for 
planning and design, which is the $3,236,000 above the budget 
request; and $701,000 for unspecified minor construction, which 
is equal to the 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


 
 
 
Appropriation, fiscal year 2024.......................      $293,434,000
Budget request, fiscal year 2025......................       433,864,000
Committee recommendation, fiscal year 2025............       433,864,000
    Change from enacted level.........................      +140,430,000
    Change from budget request........................             - - -
 

    The North Atlantic Treaty Organization Security Investment 
Program (NSIP) consists of annual contributions by North 
Atlantic Treaty Organization (NATO) member countries to finance 
the costs of construction needed to support the roles of the 
major NATO commands.
    The United States occasionally has been forced to 
temporarily delay the authorization of projects due to 
shortfalls in United States obligation authority. The Committee 
directs the Secretary of Defense to notify the Committee within 
14 days of the United States taking action to delay the 
authorization of projects temporarily, or to temporarily 
withhold funds from previously authorized projects, due to 
shortfalls in U.S. obligation authority.

               Department of Defense Base Closure Account


 
 
 
Appropriation, fiscal year 2024.......................      $489,174,000
Budget request, fiscal year 2025......................       447,961,000
Committee recommendation, fiscal year 2025............       547,961,000
    Change from enacted level.........................       +58,787,000
    Change from budget request........................      +100,000,000
 

    The Committee recommends $547,961,000 for the Base Closure 
account, which is $100,000,000 above the budget request. The 
Committee continues to be concerned about the extent of per- 
and polyfluoroalkyl substance (PFAS) contamination at closed 
U.S. military installations and the Environmental Protection 
Agency's announcement in April establishing PFAS drinking water 
standards further highlights the urgency of this issue. 
Therefore, the agreement includes an additional $50,000,000 
above the budget request to increase the pace of cleanup at the 
military installations affected by PFAS. The Committee 
continues to recognize the Navy's efforts towards the 
demolition and removal of non-historically designated buildings 
and structures under Navy control where the sampling or 
remediation of radiologically contaminated materials have been 
the subject of substantiated allegations of fraud.

                        Family Housing Overview


 
 
 
Appropriation, fiscal year 2024.......................    $1,970,751,000
Budget request, fiscal year 2025......................     1,983,864,000
Committee recommendation, fiscal year 2025............     2,013,864,000
    Change from enacted level.........................       +43,113,000
    Change from budget request........................       +30,000,000
 

    Family housing construction accounts provide funds for new 
construction, construction improvements, the Federal 
government's costs for family housing privatization projects, 
and planning and design. The operation and maintenance accounts 
provide funds to pay for maintenance and repair, furnishings, 
management, services, utilities, leasing, interest, mortgage 
insurance, and miscellaneous expenses.
    Housing Oversight.--The Committee continues to be concerned 
that Military Housing Privatization Initiative (MHPI) companies 
are neglecting their responsibilities outlined in their 
partnership agreements with the Services to provide adequate 
and livable housing for servicemembers and their families. 
Additionally, an April 2023 GAO report found significant 
deficiencies in the Department's oversight of privatized 
housing. Adequate and safe housing is paramount to military 
readiness, recruitment, and retention, and as such the 
Committee remains concerned about the unacceptable conditions 
of some privatized military housing, including mold, lead 
paint, poor water quality, and other health and safety issues. 
The Committee provides an additional $30,000,000 above the 
budget request to expand oversight of the entire housing 
portfolio, including government-owned and controlled family 
housing and privatized family and unaccompanied housing. The 
Committee requests an expenditure plan detailing the planned 
use of these funds within 30 days of enactment of this Act, 
including the specific, additional oversight activities these 
funds above the budget request will support.
    The Committee is concerned that Servicemembers and their 
families have developed respiratory diseases, lead poisoning, 
and other health conditions as a result of these poor living 
conditions. Not later than 120 days after enactment of this 
Act, the Committee directs each Service to update its report to 
the Committees on Appropriations of both Houses of Congress 
detailing steps taken to improve the conditions of all MHPI 
housing, including the current backlog of maintenance requests; 
a summary of all MHPI tenant complaints; and an updated 
performance review of each MHPI management company.
    The Committee further directs the Services to provide a 
briefing no later than 120 days after enactment of this Act 
detailing steps being taken to improve the conditions of each 
Service's privatized housing portfolio and to expeditiously 
implement the recommendations issued in GAO's report, ``DOD Can 
Further Strengthen Oversight of Its Privatized Housing 
Program'' (GAO-23-105377). The Committee encourages the 
Services to look at the feasibility and reasonability of 
utilizing advanced technology to more quickly and accurately 
improve housing inspections, such as utilizing aerial imagery 
and probable weather analysis.

                   Family Housing Construction, Army


 
 
 
Appropriation, fiscal year 2024.......................      $304,895,000
Budget request, fiscal year 2025......................       276,647,000
Committee recommendation, fiscal year 2025............       276,647,000
    Change from enacted level.........................       -28,248,000
    Change from budget request........................             - - -
 

             Family Housing Operation And Maintenance, Army


 
 
 
Appropriation, fiscal year 2024.......................      $395,485,000
Budget request, fiscal year 2025......................       475,611,000
Committee recommendation, fiscal year 2025............       485,611,000
    Change from enacted level.........................       +90,126,000
    Change from budget request........................       +10,000,000
 

           Family Housing Construction, Navy and Marine Corps


 
 
 
Appropriation, fiscal year 2024.......................      $277,142,000
Budget request, fiscal year 2025......................       245,742,000
Committee recommendation, fiscal year 2025............       245,742,000
    Change from enacted level.........................       -31,400,000
    Change from budget request........................             - - -
 

    Family Housing Operation And Maintenance, Navy and Marine Corps


 
 
 
Appropriation, fiscal year 2024.......................      $373,854,000
Budget request, fiscal year 2025......................       377,217,000
Committee recommendation, fiscal year 2025............       387,217,000
    Change from enacted level.........................       +13,363,000
    Change from budget request........................       +10,000,000
 

                 Family Housing Construction, Air Force


 
 
 
Appropriation, fiscal year 2024.......................      $237,097,000
Budget request, fiscal year 2025......................       221,549,000
Committee recommendation, fiscal year 2025............       221,549,000
    Change from enacted level.........................       -15,548,000
    Change from budget request........................             - - -
 

          Family Housing Operation and Maintenance, Air Force


 
 
 
Appropriation, fiscal year 2024.......................      $324,386,000
Budget request, fiscal year 2025......................       326,250,000
Committee recommendation, fiscal year 2025............       336,250,000
    Change from enacted level.........................       +11,864,000
    Change from budget request........................       +10,000,000
 

         Family Housing Operation and Maintenance, Defense-Wide


 
 
 
Appropriation, fiscal year 2024.......................       $50,785,000
Budget request, fiscal year 2025......................        52,156,000
Committee recommendation, fiscal year 2025............        52,156,000
    Change from enacted level.........................        +1,371,000
    Change from budget request........................             - - -
 

         Department of Defense Family Housing Improvement Fund


 
 
 
Appropriation, fiscal year 2024.......................        $6,611,000
Budget request, fiscal year 2025......................         8,195,000
Committee recommendation, fiscal year 2025............         8,195,000
    Change from enacted level.........................        +1,584,000
    Change from budget request........................             - - -
 

 Department of Defense Military Unaccompanied Housing Improvement Fund


 
 
 
Appropriation, fiscal year 2024.......................          $496,000
Budget request, fiscal year 2025......................           497,000
Committee recommendation, fiscal year 2025............           497,000
    Change from enacted level.........................            +1,000
    Change from budget request........................             - - -
 

                       Administrative Provisions

    The bill includes a total of 33 administrative provisions, 
33 of which were effective in fiscal year 2024.
    The bill includes section 101 prohibiting the use of funds 
for payments under a cost-plus-a-fixed-fee contract for 
construction where cost estimates exceed $25,000. An exception 
for Alaska is provided.
    The bill includes section 102 permitting the use of 
construction funds for the hire of passenger motor vehicles.
    The bill includes section 103 permitting funds to be 
expended on the construction of defense access roads under 
certain circumstances.
    The bill includes section 104 prohibiting construction of 
new bases in the United States without a specific 
appropriation.
    The bill includes section 105 limiting the use of funds for 
the purchase of land or land easements that exceed 100 percent 
of value except under certain conditions.
    The bill includes section 106 prohibiting the use of funds 
to acquire land, prepare sites, or install utilities for family 
housing except housing for which funds have been appropriated.
    The bill includes section 107 limiting the use of minor 
construction funds to relocate any activity from one 
installation to another without prior notification.
    The bill includes section 108 prohibiting the procurement 
of steel unless American producers, fabricators, and 
manufacturers have been allowed to compete.
    The bill includes section 109 prohibiting the use of funds 
to pay real property taxes in foreign nations.
    The bill includes section 110 prohibiting the use of funds 
to initiate a new installation overseas without prior 
notification.
    The bill includes section 111 establishing a preference for 
United States architectural and engineering services where the 
services are in Japan, NATO member countries, or countries 
bordering the Arabian Sea.
    The bill includes section 112 establishing a preference for 
United States contractors for military construction in the 
United States territories and possessions in the Pacific and on 
Kwajalein Atoll, or countries bordering the Arabian Gulf, 
except bids by Marshallese contractors for military 
construction on Kwajalein Atoll.
    The bill includes section 113 requiring the Secretary of 
Defense to give prior notice to Congress of military exercises 
where construction costs exceed $100,000.
    The bill includes section 114 allowing funds appropriated 
in prior years to be used for new projects authorized during 
the current session of Congress.
    The bill includes section 115 allowing the use of expired 
or lapsed funds to pay the cost of associated supervision, 
inspection, overhead, engineering and design on those projects 
and on subsequent claims.
    The bill includes section 116 providing that funds for 
military construction projects are available until the end of 
the fourth fiscal year following the fiscal year in which funds 
are appropriated, subject to certain conditions.

                     (INCLUDING TRANSFER OF FUNDS)

    The bill includes section 117 allowing for the transfer of 
funds from Family Housing Construction accounts to the 
Department of Defense Family Housing Improvement Fund and funds 
from Military Construction accounts to the Department of 
Defense Military Unaccompanied Housing Improvement Fund.

                     (INCLUDING TRANSFER OF FUNDS)

    The bill includes section 118 providing transfer authority 
to the Homeowners Assistance Program.
    The bill includes section 119 requiring that funds in this 
title be the sole source of all operation and maintenance for 
flag and general officer quarter houses and limits the repair 
on these quarters to $20,000 per unit annually without 
notification.
    The bill includes section 120 making funds in the Ford 
Island Improvement Fund available until expended.

                     (INCLUDING TRANSFER OF FUNDS)

    The bill includes section 121 allowing the transfer of 
expired funds to the ``Foreign Currency Fluctuations, 
Construction, Defense'' account.
    The bill includes section 122 allowing the transfer of 
funds in accordance with reprogramming guidelines.
    The bill includes section 123 prohibiting the use of funds 
for projects at Arlington National Cemetery.
    The bill includes section 124 providing funds for certain 
projects identified in the respective military department's 
unfunded priority and cost to complete list for fiscal year 
2025.
    The bill includes section 125 directing all amounts 
appropriated to Military Construction (all accounts) be 
immediately available and allotted for the full scope of the 
authorized project.
    The bill includes section 126 extending the eligibility of 
unobligated funding for fiscal year 2018, 2019, and 2020 
projects that have not lapsed.
    The bill includes section 127 defining the congressional 
defense committees.
    The bill includes section 128 providing additional funds 
for planning and design for construction improvements to 
laboratory facilities.
    The bill includes section 129 providing additional funds 
for the Air Force for expenses incurred as a result of natural 
disasters.
    The bill includes section 130 providing funds for planning 
and design for child development centers.
    The bill includes section 131 providing funds for planning 
and design for barracks.
    The bill includes section 132 providing funds for 
unspecified minor construction for demolition.
    The bill includes section 133 prohibiting funds from being 
used to carry out the closure or realignment of Naval Station 
Guantanamo Bay.

                                TITLE II


                     DEPARTMENT OF VETERANS AFFAIRS


 
 
 
Appropriation, fiscal year 2024\1\...................   $307,305,393,000
Budget request, fiscal year 2025\1\..................    337,425,926,000
Committee recommendation, fiscal year 2025\1\........    337,501,440,000
    Change from enacted level........................    +30,196,047,000
    Change from budget request.......................        +75,517,000
 
Fiscal year 2026 advance budget request..............    376,466,506,000
Fiscal year 2026 Committee recommendation in the bill    376,466,506,000
    Change from budget request.......................              - - -
 
\1\All funding cited excludes amounts in the Medical Care Collections
  Fund.

    The Department of Veterans Affairs (VA) provides health 
care for 9,000,000 veteran enrollees; disability compensation 
benefits to an estimated 6,094,440 veterans and 562,448 
survivors; pension benefits for an estimated 136,678 veterans 
and 112,179 survivors; life insurance for more than 5,600,000 
veterans, servicemembers and their families; educational 
assistance for nearly 820,000 students; and interment of more 
than 140,000 veterans and eligible family members in national 
cemeteries. To serve adequately the nation's veterans, VA 
employs more than 450,000 staff, making it one of the largest 
Federal agencies in terms of employment.
    Congressional Oversight of VA's Actions on Abortion.--The 
bill prohibits funding to implement, administer, or otherwise 
carry out the Department's illegal actions in the interim final 
rule published September 9, 2022. The interim final rule 
clearly violated Section 106 of the Veterans Health Care Act of 
1992 (P.L. 102-585; Title 38 U.S.C. 1710 note). The Committee 
directs the Department to provide a report within 30 days of 
enactment, and every 180 days thereafter, to the Committee on 
Appropriations of the United States House of Representatives 
and the Committee on Appropriations of the United States Senate 
containing the following information, disaggregated by State: 
(1) the number of abortions the Department has provided in VA 
facilities since September 9, 2022; (2) the number of abortions 
performed elsewhere and funded by the Department since 
September 9, 2022; (3) under which exception each abortion 
provided or funded by the Department has qualified; (4) the 
total amount expended on each abortion; and (5) the criteria 
used and documentation required by the Department to determine 
when an exception allowing for an abortion applies.
    Veterans First Contracting Program.--The Committee 
recognizes the tremendous value of the Veterans First 
Contracting Program in assisting in the expansion and growth of 
service-disabled veteran and veteran-owned small businesses. 
Therefore, the Committee encourages VA to continue to expand 
and make mandatory the training of contracting officers in the 
requirements of the Veterans First Contracting Program, with 
particular attention being paid to conducting the market 
research necessary to ensure that service-disabled veteran and 
veteran-owned small businesses, particularly women and minority 
veteran-led small businesses, are awarded VA contracts when 
appropriate.
    Veterans in the Pacific.--The Committee directs the 
Department to continue efforts to improve and expand access to 
benefits, mental health, preventative and wellness programs, 
and telehealth, among other programs. The Committee requests a 
report not later than 90 days after enactment of this Act on 
the progress made in the prior fiscal year on improving access 
to such benefits and services.
    Sexual Harassment and Sexual Assault Protections for VA 
Beneficiaries and Employees.--The Committee directs the 
Secretary to implement the recommendations laid out in GAO 
Report 20-387.

                    VETERANS BENEFITS ADMINISTRATION

                       COMPENSATION AND PENSIONS

                     (INCLUDING TRANSFER OF FUNDS)

 
 
 
Fiscal year 2024 enacted level.......................   $161,850,524,000
Fiscal year 2025 enacted level.......................    182,310,515,000
Fiscal year 2025 budget year request.................      9,820,699,000
Committee 2025 budget year recommendation............      9,820,699,000
 
Fiscal year 2026 advance appropriation request.......    204,481,753,000
Committee 2026 advance appropriation recommendation..    204,481,753,000
Comparison with:
    Fiscal year 2025 enacted level...................   +22,171,238,0000
    Fiscal year 2026 advance budget request..........              - - -
 

    This appropriation provides funds for service-connected 
compensation payments to an estimated 6,094,446 veterans and 
562,448 survivors in fiscal year 2025. In addition, pension 
payments will be funded for an estimated 150,678 veterans and 
112,179 survivors. The average payment per compensation case 
for veterans in fiscal year 2025 is estimated to be $24,307 and 
pension payments are projected to be $14,063.
    The appropriation includes authority to transfer funding 
not to exceed $22,816,000 in fiscal year 2026 to General 
Operating Expenses, Veterans Benefits Administration (VBA) and 
Information Technology Systems. These funds are for the 
administrative expenses of implementing cost-saving provisions 
required by the Omnibus Budget Reconciliation Act of 1990 (P.L. 
101-508), the Veterans' Benefits Act of 1992 (P.L. 102-568), 
and the Veterans' Benefits Improvements Act of 1994 (P.L. 103-
446). The bill also continues to include language permitting 
this appropriation to reimburse such sums as may be earned to 
the Medical Care Collections Fund to help defray the operating 
expenses of individual medical facilities for nursing home care 
provided to pensioners.
    The Committee recommendation includes $9,820,699,000 in 
additional funding for fiscal year 2025 for a total of 
$192,131,214,000 for the fiscal year, which includes the 
advance appropriation provided in the prior fiscal year. For 
fiscal year 2026, the Committee recommendation includes an 
advance appropriation of $204,482,000,000.
    Signing of Veteran Death Certificates.--The Committee is 
concerned that the Veterans Administration is not signing death 
certificates of all veterans who die of natural causes and who 
have as their primary doctor a VA physician in a timely 
fashion. The Committee directs the VA to work in consultation 
with stakeholders to prepare a report within 45 days of passage 
of FY25 Appropriations bill on the average time the VA takes to 
sign a death certificate for a veterans family upon notice of 
their passing, the average number of delays lasting longer than 
72-hours over the last 5 years, the total number of refusals by 
the VA to sign death certificates and the reasoning behind any 
denial over the last 5 years, and solutions to ensure that a 
speedy signature is done and received by the family of our 
passed veterans. The agency should also transmit separate 
copies of this report to the House and Senate Appropriations 
Committees.
    Ensuring VBA Access for Veterans.--The Committee is 
concerned about closure of VBA offices in rural areas during 
the pandemic. Physical VBA offices are crucial in rural areas 
as veterans have more limited broadband access and 
transportation options. Accordingly, the Committee directs VA 
to report VBA offices at risk of closure 180 days prior to VBA 
realignment, including analysis used as justification of 
closure, necessary resources needed to prevent closure and the 
projected realignment of VBA staffers to nearby facilities to 
impacted congressional districts, as well as VA's corresponding 
efforts to ensure continued services for impacted veterans in 
the area.

                         READJUSTMENT BENEFITS

 
 
 
Fiscal year 2024 enacted level.......................     $8,827,352,000
Fiscal year 2025 enacted level.......................     13,399,805,000
Fiscal year 2025 budget year request.................      2,657,656,000
Committee 2025 budget year recommendation............      2,657,656,000
 
Fiscal year 2026 advance appropriation request.......     17,614,235,000
Committee 2026 advance appropriation recommendation..     17,614,235,000
Comparison with:
    Fiscal year 2025 enacted level...................     +4,214,430,000
    Fiscal year 2026 advance budget request..........              - - -
 

    This appropriation finances the education and training of 
veterans and servicemembers through the Post-9/11 GI Bill and 
the All-Volunteer Force Educational Assistance Program. In 
addition, certain disabled veterans are provided with 
vocational rehabilitation, specially adapted housing grants, 
and grants for automobiles with approved adaptive equipment. 
This account also finances educational assistance allowances 
for eligible dependents of veterans who died from service-
connected causes or have a total and permanent service-
connected disability, as well as dependents of servicemembers 
who were captured or are missing in action.
    The Committee recommendation includes an advance 
appropriation of $17,614,235,000 for fiscal year 2026.
    GI Bill Comparison Tool.--The Committee emphasizes the 
importance of providing veterans with the necessary information 
to make informed decisions when selecting institutions of 
higher education. The Committee urges the Department to 
continue to monitor and assess the effectiveness of the GI 
comparison tool, including usage metrics, the frequency that 
caution flags are checked and updated, and technical 
performance.
    GI Bill Apprenticeships and On-the-Job-Training.--The 
Committee directs VA to take additional actions to promote 
awareness and increased utilization of apprenticeships and on-
the-job training [OJT] programs, including continued 
coordination and support to State Approving Agencies [SAAs] and 
programs which may incentivize increased participation by 
employers. The Committee directs additional support and 
resources be provided to SAAs for the purpose of establishing 
partnerships between industry and institutes of higher 
education. The Department is encouraged to explore options to 
expand the program in the future, while ensuring proper 
oversight of SAA contracts.
    Post 9/11 GI Bill Books & Supplies Stipend.--The Committee 
acknowledges the increasing need for technology for education 
as coursework and class materials continue to shift from 
physical to virtual. Additionally, the Committee recognizes 
that the books and supply stipend has not been adjusted for 
inflation in 15 years. The Committee directs the Secretary to 
evaluate the need to increase the books and supplies stipend 
from the current rate of $1,000 per year to a higher inflation 
adjusted level.
    Skills and Certifications.--The Committee recognizes the 
importance of expanding job opportunities for veterans after 
their discharge and encourages VA to work with other Federal 
agencies and State licensing bureaus, as appropriate, to 
evaluate the transferability of DoD skills and certifications, 
including mechanical skills and certifications, to state 
certifications to aid in transition to civilian employment. The 
Committee directs the Secretary to partner with the appropriate 
agencies outreach effort and use this information to inform VA 
transition programs and advise the Secretary of Defense of any 
changes needed to DoD Credentialing Programs to aid in smooth 
transition to civilian employment within 90 days of enactment 
of this act.
    Technology for Student Veterans.--The Committee understands 
during the pandemic the importance of remote learning 
technologies, such as computers and routers for internet 
access, were widely used so students could continue their 
studies. House Report 118-122 directed a report within 180 days 
of enactment of this Act, on the cost, feasibility, and 
advisability of ensuring student veterans have access to the 
technologies needed to be successful in school. The Committee 
is looking forward to receiving this report.
    Transition Coordination.--The Committee encourages VA, in 
consultation with the Departments of Defense and Labor, to 
coordinate efforts and resources to ensure veterans have a 
successful transition to civilian life. This includes sharing 
information on community resources, including nonprofits and 
Veterans Service Organizations, that are available to veterans 
and their families. The Committee also urges VA to explore 
options for veterans to access hands-on job placement services 
that connect them directly with employers, including those 
offered through successful state and local programs. A report 
shall be submitted to the Appropriations Committees on these 
efforts within 60 days of enactment of the Act.
    VET TEC Pilot Program.--The Committee expects the 
Department to fund the program, if authorized, at $45,000,000 
for fiscal year 2025, and encourages it to take steps to expand 
access by including additional providers, particularly in areas 
of the country where the initiative is not currently available 
or only allowing access to online courses, as well as to help 
train and employ women veterans and veterans with disabilities.
    Veteran Transition Assistance Grant Program (VTAG).--The 
Committee continues to support VTAG and is looking forward to 
examining the program's success.
    Biomanufacturing Training.--The Committee directs the 
Department to engage with an institution of higher education 
with expertise in and simulated Current Good Manufacturing 
Practice facilities for the provision of biomanufacturing 
training to consider the establishment of a pilot program to 
provide targeted, hands-on, industrial biomanufacturing 
training for veterans, transitioning service members, and 
military spouses.
    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. 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.

                   VETERANS INSURANCE AND INDEMNITIES

 
 
 
Fiscal year 2024 enacted level........................      $133,827,000
Fiscal year 2024 enacted level........................       135,119,000
Fiscal year 2025 budget year request..................                 0
Committee 2025 budget year recommendation.............                 0
 
Fiscal year 2026 advance appropriation request........       131,518,000
Committee 2026 advance appropriation recommendation...       131,518,000
Comparison with:......................................
    Fiscal year 2025 enacted level....................             - - -
    Fiscal year 2026 advance budget request...........             - - -
 

    The Veterans Insurance and Indemnities appropriation is 
made up of the former appropriations for military and naval 
insurance, applicable to World War I veterans; national service 
life insurance (NSLI), applicable to certain World War II 
veterans; servicemember's indemnities, applicable to Korean 
Conflict veterans; and veterans mortgage life insurance, 
applicable to individuals who have received a grant for 
specially adapted housing.
    For fiscal year 2026, the Committee recommendation includes 
an advance appropriation of $131,518,000.

         VETERANS HOUSING BENEFIT PROGRAM FUND PROGRAM ACCOUNT

----------------------------------------------------------------------------------------------------------------
                                                                              Limitation on
                                                                             direct loans for    Administrative
                                                           Program Account  specially adapted       Expenses
                                                                              housing loans
----------------------------------------------------------------------------------------------------------------
Appropriation, fiscal year 2024..........................            - - -         ($500,000)       $316,742,419
Budget request est., fiscal year 2025....................            - - -          (500,000)        319,596,460
Committee recommendation, fiscal year 2025...............            - - -          (500,000)        319,596,460
    Change from enacted level............................            - - -              - - -        +2,854,2041
    Change from budget request...........................            - - -              - - -              - - -
----------------------------------------------------------------------------------------------------------------

    The purpose of the home loan guaranty program is to 
facilitate the extension of mortgage credit on favorable terms 
by private lenders to eligible veterans. This appropriation 
provides for all costs, with the exception of the Native 
American Veterans Housing Loan Program, of the Department's 
direct and guaranteed loans programs.
    The Committee recommendation includes $319,596,460 for 
fiscal year 2025 for administrative expenses to carry out the 
Veterans Housing Loan Program.
    VA Home Loan Program.--The Committee has been made aware of 
a pending settlement that would prohibit listing brokers from 
making offers of compensation to buyer brokers on a Multiple 
Listing Service, and could potentially disadvantage veterans 
utilizing the home loan under current rules. The Committee 
directs VA to study its current policy of prohibiting borrowers 
from paying fees or commissions to a real estate agent and 
determine whether this policy negatively impacts veterans when 
buying a home. The Department is directed to report these 
findings to the committee within 120 days of enactment.
    Home Loan Income Verification.--The Committee understands 
that as directed by House Report 116-63, VA has clarified that 
nothing in VA statutes or regulations specifically prohibits a 
veteran whose income is derived from state-legalized cannabis 
activities from obtaining a certificate of eligibility for VA 
home loan benefits. The Committee understands that VA is 
working to improve communication with eligible lending 
institutions to reduce confusion among lenders and borrowers on 
this matter.

            VOCATIONAL REHABILITATION LOANS PROGRAM ACCOUNT

----------------------------------------------------------------------------------------------------------------
                                                                              Limitation on      Administrative
                                                           Program Account     direct loans         Expenses
----------------------------------------------------------------------------------------------------------------
Appropriation, fiscal year 2024..........................          $78,337       ($2,026,000)           $460,698
Budget request, fiscal year 2025.........................           64,431        (1,563,660)            493,868
Committee recommendation, fiscal year 2024...............           64,431        (1,563,660)            493,898
    Change from enacted level............................          -13,906         (-462,340)            +33,170
    Change from budget request...........................            - - -              - - -              - - -
----------------------------------------------------------------------------------------------------------------

    This appropriation covers the subsidy cost of direct loans 
for vocational rehabilitation of eligible veterans and includes 
administrative expenses necessary to carry out the direct loan 
program. Loans of up to $1,530 (based on indexed chapter 31 
subsistence allowance rate) are available to service-connected 
disabled veterans enrolled in vocational rehabilitation 
programs when the veteran is temporarily in need of additional 
assistance.
    The Committee recommendation includes $64,431 for fiscal 
year 2025 for administrative expenses to carry out the 
Vocational Rehabilitation Direct Loan program. It is estimated 
that the Department will make 1,559 loans in fiscal year 2025.

          NATIVE AMERICAN VETERAN HOUSING LOAN PROGRAM ACCOUNT

 
 
 
Administrative expenses:
Appropriation, fiscal year 2024.......................        $2,718,546
Budget request, fiscal year 2025......................         5,845,241
Committee recommendation, fiscal year 2025............         5,845,241
    Change from enacted level.........................        +3,126,695
    Change from budget request........................             - - -
 

    The Native American Veteran Housing Loan Program, as 
authorized by title 38 United States Code, chapter 37, 
subchapter V, provides the Secretary authority to make direct 
housing loans to Native American veterans for the purpose of 
purchasing, constructing, or improving dwellings on trust 
lands, including Hawaiian Home Lands. These loans are available 
to purchase, construct, or improve homes to be occupied as 
veterans' residences.
    The Committee recommendation includes $5,845,241 for fiscal 
year 2025 for administrative expenses for the Native American 
Veteran Housing Loan Program, and $75,000,000, to remain 
available until expended, for the principal amount of direct 
loans pursuant to subchapter V of chapter 37 of title 38, 
United States Code, to remain available until expended.

      GENERAL OPERATING EXPENSES, VETERANS BENEFITS ADMINISTRATION

 
 
 
Appropriation, fiscal year 2024.......................    $3,899,000,000
Budget request, fiscal year 2025......................     4,035,000,000
Committee recommendation, fiscal year 2025............     4,035,000,000
    Change from enacted level.........................      +136,000,000
    Change from budget request........................             - - -
 

    The General Operating Expenses, Veterans Benefits 
Administration (VBA) account provides funding for VBA to 
administer entitlement programs such as service-connected 
disability compensation, education benefits, and vocational 
rehabilitation services.
    The Committee recommendation includes $4,899,000,000 for 
fiscal year 2025 for General Operating Expenses, VBA. These 
resources will fully fund VA's request for fiscal year 2025 and 
improve VBA's ability to address compensation and benefit 
claims. The bill makes available through September 30, 2026, up 
to ten percent of these funds.
    Benefits Usage.--The Committee encourages VA to include 
veteran benefit usage into its annual suicide prevention 
report, including usage of disability compensation, education 
and employment, home loan and foreclosure assistance benefits, 
as well as participation in housing and food security programs. 
Additional data may enable a better understanding of the 
correlation between benefit use and suicide and allow for more 
effective programs to assist veterans.
    Compensation and Pension Exams.--The Committee understands 
the important role of contractors in providing medical 
disability exams. These exams are necessary for Veterans to 
receive the benefits that they have earned. Therefore, the 
Committee directs VA to apply standard timeliness and quality 
performance metrics across contract providers and VHA providers 
to ensure quality exams for all Veterans. Further, VA is 
directed to report to the Committee on the impact on VHA 
healthcare wait times before committing additional VHA 
providers to the delivery of medical disability exams.
    Digitizing Veteran Records.--The Committee commends the 
efforts of VBA, in partnership with the National Archives and 
Records Administration, to address the backlog of veterans' 
records requests by creating digital copies of records that 
currently exist only in hardcopy form at the National Personnel 
Records Center (NPRC). The Committee strongly encourages VBA to 
continue its efforts to create digital copies of veterans' 
records housed at NPRC. The Committee requests VA update the 
analyses required by House Report 117-391 on resources needed 
to digitize all hard copy-only veteran records at NPRC not 
later than 90 days after enactment of this Act.
    Equitable Relief.--The Committee understands VA is working 
to implement new systems and protocols to eliminate instances 
of administrative error. However, as VA enacts system-wide 
reforms, ending equitable relief for veterans who were deemed 
eligible for benefits in error would place an unfair burden on 
veterans and their families. The Secretary is directed to 
continue to grant or extend equitable relief to eligible 
veterans initially deemed eligible in instances of 
administrative error. Not later than April 1, 2025, the 
Secretary is directed to submit to the Committees on 
Appropriations of both Houses of Congress a report containing a 
statement as to the disposition of each case recommended to the 
Secretary for equitable relief under section 503 of title 38, 
United States Code during the preceding calendar year.
    Information for Toxic-Exposed Veterans.--The Committee 
encourages VA to ensure resources and materials provided by VA 
to toxic-exposed veterans be made available in the most 
commonly spoken languages in the United States, as required by 
the Veterans and Family Information Act (P.L. 117-62).
    Military Sexual Trauma (MST).--The Committee is frustrated 
by the findings of the August 2021 OIG Report titled 
``Improvements Still Needed in Processing Military Sexual 
Trauma Claims'' which found VBA has failed to ensure all claims 
processors handling MST-related claims have received 
specialized MST training. The Committee urges VBA to prioritize 
specialized MST training for claims processors, and to continue 
to involve MST survivors in the development of specialized 
training. The Committee additionally remains concerned that 
veterans suffering from a mental health disorder as a result of 
sexual trauma during service have different standards of 
evidence based on their diagnosis. The Committee recognizes 
that evidence in personnel files is rare, no matter the 
resulting condition following MST, and therefore, the Committee 
urges VA to support the extension of the relaxed evidentiary 
standard to all those suffering from mental health disorders as 
a result of MST. The Committee requests that the Secretary 
submit a report to the Committees on Appropriations of both 
Houses of Congress, no later than 180 days after enactment of 
this Act, outlining the status of MST backlogs. Further, the 
Committee urges VA to continue to report to Congress on 
information relating to claims for disabilities incurred or 
aggravated by MST, as provided by section 113 of the Jeff 
Miller and Richard Blumenthal Veterans Health Care and Benefits 
Improvement Act of 2016 (P.L. 114-315).
    Toxic Exposure Claims.--The Committee recognizes that an 
increase in claims and associated workload increases is 
continued to be expected as a result of enactment of the 
Honoring our Promise to Address Comprehensive Toxics Act (PACT 
Act) and encourages the Department to implement thorough and 
special training protocols to ensure accuracy and efficiency in 
the claims adjudication process.
    Mileage Reimbursements Kiosks.--The Committee is concerned 
with the removal of mileage reimbursement kiosks and requests 
the Department to report to the Committee on Appropriations on 
the recent removal of mileage reimbursement kiosks from several 
VA facilities, which have been replaced by the online 
Beneficiary Travel Self Service System. The report shall 
include the circumstances leading to the removal of kiosks as 
well as the effects on veterans who rely on them. Additionally, 
any future plans for travel reimbursement will be detailed.
    Over-The-Counter-Hearing Aids.--The Committee notes that 
over 2.7 million veterans are compensated for hearing loss and 
tinnitus, and noise exposure during military service being a 
major factor. The Committee encourages VA to reassess its 
current model for hearing aids. The lower cost of over-the-
counter (OTC) hearing aids has the potential to reduce 
financial strain on VA's budget, freeing up resources to invest 
in other critical areas of veteran care and support. The 
Committee requests a report within 180 days of the bill's 
passage on VA hearing service access and cost savings from 
implementing OTC hearing aids for veterans receiving audiology 
treatment. OTC hearing aids present a cost-effective 
alternative, potentially enhancing access and alleviating 
financial pressure on the VA healthcare system.

                  Veterans Health Administration (VHA)

    The Department operates the largest integrated medical care 
delivery system in the United States, providing care at nearly 
1,300 health care facilities, including 171 medical centers and 
more than 1,100 outpatient sites to more than 9,000,000 
veterans enrolled in the VA health care program.
    Funding for veterans' health care, VA research, and the 
Veterans Health Administration is provided through five 
discretionary accounts and the mandatory Cost of War Toxic 
Exposures Fund. The discretionary accounts are Medical 
Services, Medical Community Care, Medical Support and 
Compliance, Medical Facilities, and Medical and Prosthetic 
Research.
    For fiscal year 2025, the President's Budget requested a 
total of $134,037,000,000 for veterans' medical care, including 
funding for medical care for the treatment of conditions 
related to toxic exposures.
    In fiscal year 2025, VA will collect an estimated 
$4,389,678,000 in the Medical Care Collections Fund.
    The Committee provides $923,514,000 for Medical and 
Prosthetic Research for fiscal year 2025, $55,514,000 above the 
requested level.
    The Committee provides $131,439,000,000, the total amount 
requested, in advance for fiscal year 2026. This request of 
discretionary advance appropriations is in conjunction with the 
Toxic Exposures Fund advance appropriations request of 
$22,800,000,000 billion in 2026.
    Air Ambulance Services.--The Committee remains concerned 
that changes to the reimbursement rates for ground and air 
ambulance services may negatively impact the ability of 
veterans to access emergency medical services, particularly in 
rural and underserved areas, and commends the Department for 
delaying the implementation of its final rule Change in Rates 
that VA Pays for Special Modes of Transportation, 88 Fed. Reg. 
10032, until February 16, 2025. The Committee directs the 
Department to delay implementation of the final rule until at 
minimum September 30, 2025, and urges the Department not to 
expend funds for any change in rates for travel by ground 
ambulance or for rotor wing and fixed wing air ambulance 
emergency or non-emergency transport without first engaging 
with industry stakeholders, to identify both an appropriate 
level of reimbursement and an effective contracting process for 
emergency air and ground services that does not jeopardize 
access to ambulance services for veteran beneficiaries. The 
Committee also requests that the Department submit a report 
within 180 days to the Committee detailing its discussions and 
efforts to ensure continued access for veterans to emergency 
health care transportation, and to report back to the Committee 
with its findings.
    Beneficiary Travel.--The Committee continues to hear from 
veterans frustrated with the system and the inability of VA 
staff to assist them. The Department is directed to ensure the 
new system is user-friendly and staff are trained and available 
to provide the required assistance.
    Community Care Expansion.--The Committee continues to 
strongly support the Department's efforts to expand veterans' 
access to timely, high-quality health care in their communities 
through the Veterans Community Care Program (VCCP) authorized 
under the MISSION Act. The Committee is pleased that the budget 
request includes robust funding for community care and urges 
the Department to continue increasing veterans' usage of 
community providers to supplement VA direct care as needed. The 
Committee remains concerned by reports of excessive wait times 
for care at many VA facilities, as exemplified by the recent 
issues at the Atlanta VA Medical Center that led to a 
leadership change. It is unacceptable that veterans continue to 
face delays and barriers to receiving the care they have 
earned. The Committee believes that leveraging community 
partnerships is essential to addressing these access challenges 
and that care delivery decisions should be based on clinical 
need and veteran preference, not simply defaulting to VA 
facilities. The Committee directs the Department to submit a 
report no later than 90 days after enactment of this Act 
detailing efforts to reduce wait times by expanding community 
care utilization in areas with access challenges, in accordance 
with the MISSION Act, and towards ensuring the MISSION Act is 
fully implemented as intended.
    Dispute Resolution.--The Committee urges VA to ensure that 
veterans are advised of their rights to contest VA billing 
charges and determinations and of the step-by-step process for 
disputes. VA should ensure this information is available online 
and in publicly accessible areas at each VA medical center, and 
that it is made available in English, Spanish, and the eight 
other most commonly spoken languages in the United States.
    Equitable Care for Veterans.--As the VHA considers policies 
that would remove anesthesiologists from the surgical care 
team, the Committee requests a report detailing how the VHA 
intends to ensure that Veterans, particularly PACT Act 
Veterans, will not receive a lower standard of care than non-
Veterans in the same state or jurisdiction.
    Essential Medical Devices.--The United States' 
manufacturing capacity for essential medical devices is at 
serious risk due to organized efforts by Chinese manufacturers 
to enter the U.S. market in response to inflationary pressures 
faced by U.S.-based manufacturers, distributors, and providers. 
The current shift toward purchasing Chinese-made medical 
devices is drastic and occurring at a pace that will leave U.S. 
hospitals dependent on Chinese supplied devices. The Committee 
urges VA to purchase essential medical devices, like needles 
and syringes, from U.S. manufacturers or allied trading 
partners. The Committee directs VA to submit a report to the 
Committee on Appropriations no later than 90 days after 
enactment of this Act on the percentage of Chinese made devices 
for the 96 device medical countermeasures published by the Food 
and Drug Administration in 2020. The report should also include 
specific recommendations on how the VA can reduce its 
dependency on Chinese medical devices, increase the domestic 
supply chain, while safeguarding against shortages.
    Native Hawaiian, Pacific Islander and United States-
Affiliated Pacific Islander (NHPIUSAPI) Veterans Health.--The 
Committee continues to support the VA Center for NHPIUSAPIs. 
The Committee encourages VA to partner with universities in the 
Pacific region focusing on issues unique to the NHPISAPI 
community.
    Timeliness of Care at VA Facilities.--The Committee 
recognizes the critical need for quality and timely health care 
for veterans. To ensure this is provided, the Committee directs 
the Secretary to submit a detailed report to Congress within 
180 days of the enactment of this legislation regarding the 
average waiting periods experienced by veterans seeking health 
care services through VA hospitals. This report should 
encompass data collected from various VA healthcare facilities 
nationwide, including to the extent possible non-VHA operated 
clinics, analyzing both the duration veterans wait from initial 
contact to their first appointment and any subsequent waits for 
further medical treatments. The data presented in this report 
should be broken out by state to facilitate a clear 
understanding of regional disparities and target improvements 
effectively. The directive aims to ensure transparency and 
accountability in the administration of veteran healthcare 
services, and to facilitate legislative or administrative 
measures to enhance the efficiency and effectiveness of the VA 
health system.

                            MEDICAL SERVICES

 
 
 
Fiscal year 2024 enacted level......................     $70,969,795,000
Fiscal year 2025 enacted level......................      71,000,000,000
Fiscal year 2025 budget year request................      71,000,000,000
Committee 2025 budget year recommendation...........                   0
 
Fiscal year 2026 advance appropriation request......      75,039,000,000
Committee 2026 advance appropriation recommendation.      75,039,000,000
Comparison with:
    Fiscal year 2025 enacted level..................      +4,039,000,000
    Fiscal year 2026 advanced budget request........               - - -
 

    The bill includes $75,039,000,000 for advance fiscal year 
2026 funding for Medical Services. The Committee has included 
bill language to make $2,000,000,000 of the Medical Services 
advance appropriation for fiscal year 2026 available through 
September 30, 2027.
    Allocation of Health Funding.--The Committee continues to 
request a report each year, no later than 30 days after VA 
allocates the medical services appropriation to the VISNs, that 
identifies: (1) the amount of general purpose funding that is 
allocated to each VISN; (2) the amount of funding that is 
retained by central headquarters for specific purposes, with 
amounts identified for each purpose; and (3) the amount of 
funding that is retained by each VISN before allocating it to 
the medical centers, identifying separately the amounts 
retained for purposes such as network operations, network 
initiatives, and emergencies.
    Changes in Funding Requirements Due to Modeling.--The 
Committee expects VA to continue to include in the sufficiency 
letter required by section 117(d) of title 38, United States 
Code, which is due to the Congress on July 31 of each year, a 
description of any changes exceeding $250,000,000 in funding 
requirements for the Medical Services account resulting from 
the spring recalculation of the Enrollee Healthcare Projection 
Model.
    Support for FAS Veterans.--Since the passage of the 
Consolidated Appropriations Act, 2024 (Public Law 118-42), VA 
is no longer restricted from providing services to veterans 
residing in the Freely Associated States (FAS), including 
direct care from VA providers, telehealth, and care through 
contracts with community providers; shipping medications to the 
FAS; and reimbursing veterans for travel from their home 
countries to the United States. To determine how VA implements 
these new authorities, the Committee directs VA within 60 days 
of enactment of this Act to provide the Committee with the 
estimated cost and the plan for implementing this law in fiscal 
year 2025.

                        CANCER AND RARE DISEASES

    Cancer Screening at Veterans Affairs Medical Centers.--The 
Department is encouraged to ensure its healthcare providers 
screen for the numerous types of cancers that veterans 
experience so they can receive the best possible care.
    Creutzfeldt-Jakob Disease (CJD) Monitoring.--The Committee 
continues to urge VA to utilize reference data from existing 
medical records of veterans to determine the percentage of 
veterans who have more frequent or unexplained symptoms 
associated with CJD compared to the civilian population. This 
data could be helpful in clarifying the extent and specifics of 
the medical issues suffered by veterans from exposure to CJD.
    Dermatological Care for Veterans.--The Committee is 
concerned by recent research studies, including those by the 
National Institutes of Health and the Journal of American 
Academy of Dermatology, regarding the increased risk of skin 
cancers in Veterans. Servicemembers' increased UV radiation 
exposure, lack of sun protective measures, and over two decades 
of deployments to regions in close equatorial proximity have 
placed veterans at higher risk for melanoma and other skin 
cancers. Veterans are also more likely to be diagnosed with 
advanced-stage skin cancers than the civilian population due to 
less frequent skin checks and access to specialized care. The 
Committee directs VA to submit a report to the Committee no 
later than 180 days after the enactment of this Act on 
veterans' access to dermatology screening, dermatologic 
preventative care, and trained Mohs micrographic surgeons.
    Lung Precision Oncology Program.--The Committee commends VA 
for launching the Lung Precision Oncology Program and its 
effort to expand access to lung cancer screening for veterans 
and accelerate the science on lung cancer prevention, 
detection, and treatment. The Committee is interested in the 
program's success since being launched and directs the 
Department to report to the Committee within 180 days of 
enactment of this Act regarding the program's efficacy.
    Expanding Lung Cancer Screening for Veterans.--The 
Committee recognizes the importance of early detection and 
timely diagnosis of cancers and directs the Department to 
review and update its approach to lung cancer screening to 
optimize veterans access to screenings given the unique risk 
factors and evolving demographics for this patient population. 
As part of this update, the Committee encourages the Department 
to issue a request for information and corresponding public 
docket to receive information and recommendations regarding the 
latest lung cancer research, data, and clinical best practices 
to inform the updates to the Department's lung cancer screening 
guidelines and update lung cancer screening guidelines to 
address those exposed to toxic hazards. The Department is 
directed to provide a report to the Committee on Appropriations 
within 120 days of enactment of this Act regarding the steps it 
is taking to optimize lung cancer screening for veterans.
    Digital Pathology.--The Committee recognizes the Veterans 
Affairs (VA) healthcare system for its efforts to modernize and 
enhance diagnostic capabilities using digital pathology. The 
utilization of digital pathology technology represents a 
transformative approach to pathology services that will improve 
efficiency and advance the quality of care provided to our 
nation's veterans. Digitization provides high-resolution 
imaging, aiding pathologists in achieving more accurate and 
timely diagnoses, crucial for effective treatment. Notably, the 
use of digital pathology fosters the required VA collaborative 
environment that allows for expert consultations across VA 
facilities, even in the most remote settings, ensuring veterans 
receive the best possible care regardless of location. The 
transition to digital pathology streamlines laboratory 
workflows, reducing turnaround times for pathology reports and 
enhancing overall operational efficiency within VA medical 
facilities, and eliminates the need for physical transportation 
of glass slides, reducing the risk of loss or damage and 
optimizing resource utilization within the VA healthcare 
system. The cycle of cancer care for our Nation's Veterans 
begins with diagnosis and staging from a pathologist. By moving 
our VA pathology labs to a digital format, it expedites this 
care cycle which is critical when it comes to a cancer 
diagnosis.
    Molecular Diagnostics and Precision Oncology.--The 
Committee recommendation includes $215,433,000 for Precision 
Oncology, and $55,090,000 for molecular diagnostics which are 
equal to budget request. VA is encouraged to continue to 
provide information to clinicians on the value of using 
molecular diagnostics for cancer patients and on how to 
contribute tissue specimens to a repository started among the 
Department, Department of Defense, and the National Institute 
of Health. Over 60 forms of cancer disproportionately impact 
military service members and most are rare, defined as fewer 
than six new cases per 100,000 Americans per year.
    The Committee requests an update, no later than 60 days 
after the enactment of this Act, describing how these funds 
will be used to enhance the use of molecular diagnostics, 
including information on the use of specific types of molecular 
diagnostics, such as microarray, whole exome, whole genome, and 
RNA-Seq which the Department is providing to cancer patients 
and their frequency of use, as well as detailed policy for 
data-sharing practices for cancer cell lines and models with 
the external research community.
    Metabolic Disease.--The Committee recommends that to ensure 
access to advanced care for all veterans, the VA Innovation 
Ecosystem (IE) include in its fiscal year 2025 portfolio 
activities expanding the VA healthcare system's infrastructural 
reach to enrolled veterans residing in geographically 
underserved areas, including rural and highly rural. The 
Committee would like IE to engage industry with community 
stakeholders to co-develop transformative, highly deployable, 
mobile, and scalable advanced MRI-based solutions to identify, 
stratify, and manage the highly prevalent metabolic disease 
burden in the VA population.

                       CAREGIVER SUPPORT PROGRAM

    Caregivers Program.--The Committee provides $2,913,000,000, 
as requested, for the caregivers program. The Committee 
continues to require quarterly reporting on obligations for 
this program.
    Caregiver Assistance Eligibility.--The Committee recognizes 
the important role of family caregivers in supporting the 
health and wellness of veterans. The Committee directs VA to 
report to the Committee on Appropriations within 180 days of 
enactment of this Act on the feasibility, including cost 
estimates, of expanding eligibility for the Program of 
Comprehensive Assistance for Family Caregivers and the Program 
of General Caregiver Support Services to include veterans with 
lower continuous care needs and disability ratings.

                         CENTERS OF EXCELLENCE

    Epilepsy Center of Excellence.--The Committee encourages 
the Department to ensure that all veterans with epilepsy are 
comprehensively evaluated at a VHA Epilepsy Center of 
Excellence to identify drug-resistant epilepsy patients who may 
be candidates for FDA-approved non-drug therapies.
    Neurology Centers of Excellence.--The Committee recognizes 
the increasing number of veterans affected by neurologic 
conditions, including but not limited to: epilepsy, headache, 
multiple sclerosis, and Parkinson's disease, and therefore 
provides $76,800,000 for the Neurology Centers of Excellence. 
This includes $26,800,000 for the Epilepsy Centers, $28,000,000 
for the Headache Centers, $6,000,000 for the Multiple Sclerosis 
Centers, and $16,000,000 for the Parkinson's Disease, Research, 
Education and Clinical Centers.
    The Neurology Centers of Excellence provide essential 
innovative clinical care, education, and research efforts 
focused on these conditions. The Committee applauds the 
Department for recent investments into the headache, multiple 
sclerosis, and Parkinson's disease centers and acknowledges the 
advancement and expansion the Centers have begun. The Committee 
encourages further investment and collaboration of the Centers 
across disciplines and directs the Department to allocate 
robust funding for the Neurology Centers of Excellence for 
maintenance and expansion. The Committee also directs the 
Department to provide a report to the Committees on 
Appropriations of both Houses of Congress on the use and 
allocation of funds for each Center within 120 days of 
enactment of this Act. Additionally, the Department should 
provide a report to the Committees on Appropriations of both 
Houses of Congress no later than 180 days of enactment of this 
Act detailing associations between neurological disorders and 
military exposures, including open burn pits.

                    COLLABORATIONS AND PARTNERSHIPS

    Academic Collaborations at Community Based Outpatient 
Clinics (CBOC).--The Committee encourages VA to expand academic 
collaborations with CBOCs, as they provide valuable patient 
care and access to services that can be strengthened by 
collaboration with educational institutions. Through clinical 
traineeships and research fellowships, emerging health 
professionals can gain a better understanding of veterans' 
specific healthcare needs, improve patient outcomes, advance 
specialized research, and increase the talented workforce 
pipeline. VA is encouraged to consider including public 
academic medical centers in CBOC collaborations.
    Whole Family Care Partnerships.--The Committee is aware of 
the efforts of private organizations to support veterans and 
their families and recognizes that they can sometimes provide 
services, such as counseling and wellness programs, for the 
families of veterans that the Department cannot. Recognizing 
that Congress, the Department, and private organizations share 
the same goal of supporting veterans, the Committee directs the 
Department to build upon its existing partnerships and seek 
opportunities to establish new ones. The Committee is 
particularly interested partnerships related to mental health, 
including the mental health of veterans' families, and provides 
up to $2,500,000 to increase outreach to this in-need 
underserved population.

                              DENTAL CARE

    Dental Care.--The recommendation includes $2,975,647,000, 
as requested, to provide dental care for veterans. The 
Committee requests that the fiscal year 2026 budget 
justification include information on the role, resources, and 
staffing required for the Assistant Under Secretary of Health 
for Dentistry and the Office of Dentistry.
    Dental Care Report.--House Report 118-122 directed the 
Department to submit a report within 180 days of enactment to 
assess the state of VA's oral health care program and its 
ability to meet the needs of current and future veterans. The 
Committee is looking forward to receiving this report.
    Veterans Oral Health.--The Committee understands that 
veterans may experience a large oral disease burden, and 
therefore an integrated and whole-person approach is needed to 
prevent and manage oral disease in this population, which may 
also enable cost savings in VA Health Care at large. The 
Committee looks forward to receiving the report on the 
Department's assessment of its oral healthcare program and its 
ability to meet current and future needs as required by House 
Report 118-122.

                             DIABETES CARE

    Improving Standards of Care for Diabetic Foot Ulcers.--One 
in four veterans in the United States suffers from diabetes. 
The VA health system treats about 115,000 diabetic foot ulcers 
(DFUs) per year, and about 40 percent of patients afflicted 
with the condition die within five years. DFUs are frequently 
recurrent and require specialized wound care technology to 
achieve optimal outcomes. To provide effective DFU care to the 
VA population, the Department is encouraged to examine 
alternatives to current standards of care for DFU treatment. 
The Committee requests a report, no later than 180 days after 
enactment of this Act, on tissue-based products proven in 
clinical trials to treat hard-to-heal wounds, specifically 
those with proven efficacy in tissue regeneration and anti-
inflammatory and anti-bacterial properties. This report should 
review each product's shelf life, storage requirements, source 
materials, and sizing options.
    Reducing Type 2 Diabetes in Veterans.--The Committee 
commends the Department for actively engaging with industry 
partners in a pilot study using telehealth to provide 
individualized ketogenic nutrition programs and medical support 
to reduce the incidence of diabetes in VA patients. The 
Committee applauds the effectiveness of the study at reducing 
patient dependence on diabetes medication and the clinical 
improvements achieved by Veterans engaged individualized 
ketogenic nutrition programs. The Committee is aware of 
existing plans within the Department to expand ketogenic 
diabetes telehealth services beyond the pilot study to address 
the healthcare needs of veterans living with Type 2 diabetes. 
The Committee encourages the Department to sustain and expand 
industry partnerships and programs focused on ketogenic 
diabetes telehealth services to support the health and quality 
of life of our Nation's veterans.

                 EMERGING AND NOTABLE HEALTHCARE ISSUES

    Dialysis.--Over 18,000 veterans receive dialysis through 
the National Dialysis Services Contract. The Committee 
appreciates the Department's commitment to ensure care is not 
disrupted or diminished for the veterans who receive treatment. 
The Committee looks forward to working with the Department to 
utilize a value-based dialysis payment model.
    Needle Stick Injuries.--The Committee remains interested in 
the Department's efforts to reduce or eliminate needlestick 
injury among caregivers and staff at VA facilities. The 
Committee encourages VA to use the most-up-to-date needle 
destruction technology.
    Nuclear Medicine Quality Improvements.--The Committee notes 
that the Nuclear Regulatory Commission (NRC) has confirmed 
nuclear medicine extravasations can result in radiation-safety-
significant doses to patients and is engaged in rulemaking to 
require medical event reporting of extravasations. The 
Committee encourages VA nuclear medicine facilities to monitor 
injection quality, image extravasations, conduct dosimetry, and 
notify patients when large extravasations occur.
    Pressure Injuries.--The Committee recognizes the 
Department's efforts to reduce pressure injuries among veterans 
and its willingness to enhance the existing standard of care. 
Further understanding of the VA Approved Enterprise Standard 
(VAAES) Skin Template, and its interplay with pressure injury 
statistics, notably within the spinal cord trauma population, 
is of interest to the Committee. As such, the Committee 
requests a briefing from VA on this issue within 120 days of 
enactment of this Act aimed at advancing a comprehensive 
understanding and effective implementation of improvements to 
pressure injury care across VA and includes outside stakeholder 
input and participation from clinicians and researchers.
    Rideshare Program.--The Committee recognizes the success of 
VA's temporary rideshare authority and is interested in 
expanding transportation services for veterans. The Committee 
is looking forward to the report as requested in House Report 
118-122.
    Veterans Transportation.--The Committee supports the 
Department's programs that provide veterans with transportation 
to VA medical facilities and make it easier for veterans to 
receive medical care and encourages VA to explore options to 
strengthen and sustain the Volunteer Transportation Network, 
such as increased funding to recruit and retain drivers and 
provide vehicle maintenance.

                        HEALTHCARE TECHNOLOGIES

    Bioelectronic Medicine for Veterans.--The Committee 
recognizes that Bioelectronic Medicine has the potential to 
harness the body's electrical signaling to advance treatments 
that save lives and lower medical expenditures. Accelerating 
studies, additional data collection, and the development and 
adoption of novel applications for Bioelectronic Medicine 
combined with machine learning and artificial intelligence (AI) 
can address challenging and expensive diseases by personalizing 
treatments and improving therapy delivery. The Committee 
encourages the Department to ensure that combined Bioelectronic 
Medicine and AI technologies are available to veterans.
    Medical Image Exchange.--The Committee applauds VA 
facilities in 17 of 18 VISNs that have deployed a modern 
software platform that supports bi-directional exchange of 
medical images, diagnostic reports, and other clinical data 
between VA facilities, community providers, and federal 
partners. VA is directed to expand this software's connections 
to Indian and tribal health clinics and work with the 
Department of Defense to expedite connections with military 
treatment facilities.
    Migraine Prevention and Treatment.--The Committee 
recognizes approximately one in three servicemembers experience 
severe headaches and migraines and encourages the Department to 
ensure neuromodulation devices with FDA-indication for migraine 
prevention and treatment are available to veterans and to 
educate clinicians and veterans on such devices.
    Respiratory Illness.--The Committee is aware of emerging 
technology that uses existing x-ray imaging equipment to derive 
four-dimensional models of lung function, which helps to 
identify respiratory illnesses and accompanying loss of lung 
function earlier than was previously feasible. The Committee is 
looking forward to learning about the program's efficacy in the 
required report as requested in House Report 118-122.

                      HOMELESS ASSISTANCE PROGRAMS

    The Committee provides $3,210,276,000 for VA homeless 
assistance programs, an increase of $96,746,000 above the 
fiscal year 2024 enacted level and equal to the budget request. 
An estimated $12,007,323,000 is provided for homeless veterans 
treatment costs, an increase of $820,715,000 above the fiscal 
year 2024 level.
    Programs to assist homeless veterans include the Homeless 
Providers Grant and Per Diem (GPD), Health Care for Homeless 
Veterans (HCHV), the Domiciliary Care for Homeless Veterans, 
the Supportive Services for Low Income Veterans and Families 
(SSVF), Veterans Justice Outreach Homeless Prevention (VJO), 
Compensated Work Therapy, and the Department of Housing and 
Urban Development-Department of Veterans Affairs Supported 
Housing (HUD-VASH) programs.
    Healthcare for Homeless Veterans.--The Committee notes the 
benefits of the Homeless Patient Aligned Care Team (HPACT) 
program and encourages VA to expand this program to additional 
sites, including rural areas, and to consider additional 
services to improve the program. The Committee directs the 
Department to explore options to expand this program to 
additional sites, including cost estimates, with its fiscal 
year 2026 budget request.
    HUD-VASH Case Management.--The Committee recognizes the 
value and impact of the HUD-VA Supportive Housing (VASH) 
program, which serves veterans experiencing homelessness and 
pairs each HUD affordable housing voucher designated for 
veterans with intensive case management from VA to assist with 
benefits and income, mental healthcare, recovery services, and 
permanent housing stability. Case management services are 
critically important to the function of the program, and public 
housing authorities rely on VA Medical Centers' referrals to 
house veterans. Existing requirements mandate that a veteran 
must receive VA case management services to receive a HUD-VASH 
voucher. The inadequacy of staff for case management has 
contributed to the ongoing underutilization of HUD-VASH 
vouchers. Therefore, the Committee directs an increase in 
staffing for case management services to continue to improve 
the rate of lease referrals and to account for increased 
staffing costs and recent expansions in eligibility.
    Recovery-Oriented Care.--The Committee notes the National 
Center for Homelessness Among Veterans' development of housing 
models that promote recovery-oriented care for veterans 
experiencing or at risk of homelessness. The Committee is 
looking forward to receiving the report on the program's 
effectiveness as requested in House Report 118-122.
    Veterans Councils.--The Committee is aware of the 
importance of Veterans Councils and their mission to assist 
homeless prevention actions, and their assistance to at-risk, 
impoverished, and veterans of all ages and terms of service.
    Supportive Housing for Veterans with Serious Mental 
Illness.--The Committee encourages VA to build upon the 
tangible achievements of the HUD-VASH program and explore 
whether a new model of vouchers could provide housing 
opportunities for low-income veterans experiencing serious 
mental illness who seek healthcare services from VA.
    Legal Assistance for the Supportive Services for Veteran 
Families Program.--The Committee continues to encourage the 
Supportive Services for Veteran Families [SSVF] program to work 
with grantees to expand their legal service offerings, 
particularly in rural areas where access to private legal 
assistance can be limited. Within funds provided, the 
Department is further encouraged to pilot projects to partner 
SSVF grantees with university law schools in rural areas or 
within underserved populations to enhance legal assistance to 
veterans.
    Cost of Care for Veterans' Homes.--The Committee is 
concerned with the current reimbursement rate for state and 
non-profit run Veterans Homes. The Committee recognizes that 
the costs associated with Veterans Homes are substantial due to 
the high acuity level of the veteran population served, and 
that current VHA rates are inconsistent with the current cost 
of care. The Committee requests a report, no later than 90 days 
following enactment of this Act, outlining how current 
reimbursement rates are calculated, how VHA makes locality 
adjustments, how VHA works to reduce the cost of prescription 
drugs for veterans in homes, and recommended legislative 
changes for Congress to consider.
    Tiny Homes.--The Committee notes the success of the tiny 
home village model by multiple veterans service organizations 
(VSOs) and encourages VA, in coordination with the Department 
of Housing and Urban Development to support this work and 
facilitate the creation of additional villages of tiny homes 
villages within the VA's existing Grant and Per-Diem (GPD) 
program.
    Veterans At-Risk of Homelessness Data.--The Committee notes 
that homelessness data may currently undercount women veterans 
with children. The Committee directs VA to work with the 
Department of Housing and Urban Development's Continuums of 
Care to include data on veterans at-risk of homelessness within 
Section 5: Veterans Experiencing Homelessness of the Annual 
Homelessness Assessment Report (AHAR) to Congress. The 
Committee commends the progress made by the Supportive Services 
for Veteran Families Program but encourages data collection on 
women veterans with children who may not meet the VA's 
definition of homelessness but are homeless for parts of the 
year and remain at-risk.

              INTIMATE PARTNER VIOLENCE ASSISTANCE PROGRAM

    Intimate Partner Violence Program (IPV).--The Committee 
continues to support VA's efforts to expand its IPV program, 
which provides a holistic approach that involves understanding, 
recognizing and responding to the effects of all types of 
trauma, with the ultimate goals to end violence, prevent 
further violence, and promote healthy relationships

                         MENTAL HEALTH PROGRAMS

    The Committee provides $16,380,187,000 for mental health 
programs. Of the total, $3,161,426,000 is for suicide 
prevention and treatment programs, including $582,554,000 for 
suicide prevention outreach and $306,683,000 for the Veterans 
Crisis Line.
    The Committee continues to direct the Department to focus 
on efforts to address parking lot suicides and connect veterans 
to care.
    The Department is directed to provide a report to the 
Committee, no later than 90 days after enactment of this Act, 
identifying a detailed expenditure plan for all suicide 
outreach and treatment programs and how VA is meeting the 
Committee's directives.
    AANHPI Veterans.--The Committee understands that Asian 
American, Native Hawaiian, and Pacific Islander (AANHPI) 
veterans have a lower use of VA and non-VA mental health 
services and requests a report Committee not later 180 days 
after enactment of this Act on reasons for such lower 
utilization and ways improve access of AANHPI veterans to 
mental health care and increase outreach to such veterans, 
especially for those in harder-to-reach populations, including 
rural communities and English-as-a-second-language households.
    Faith Based Digital Applications Impact on Mental Health.--
The Committee understands that recent data has shown that the 
use of digital, faith-based applications can have a measurable 
impact on mental health and wellness. The Committee directs VA 
to conduct a study on the effectiveness of such applications 
and requests a report on findings within 180 days of enactment 
of this Act.
    Agritherapy.--The Committee supports efforts to train 
veterans in agricultural vocations, while also tending to 
behavioral and mental health needs with behavioral healthcare 
services and treatments from licensed providers. The Department 
is urged to consider including agritherapy as a Complementary 
and Alternative Medicine therapy.
    Improving Depression Treatment with Precision Medicine.--
The Committee recognizes that depression is one of the most 
common conditions associated with military service and combat 
service. Further, the risk of suicide increases with this 
diagnosis each time a veteran tries and fails a medication. The 
Committee is encouraged by ongoing VA-sponsored genetic testing 
research to aid in depression treatment selection; however, 
veterans still have less access than Medicare beneficiaries to 
precision medicine tools. The Committee directs VHA to ensure 
the procurement of pharmacogenomic tests for use in the 
treatment of depression if they have been shown to improve 
health outcomes of veterans in clinical trials.
    Military Sexual Assault.--The Committee recommends that all 
veterans seeking treatment services are screened for sexual 
assault using an evidence-based screening tool in order to 
successfully treat those who have experienced assault.
    Modeling and Simulation Treatment of PTSD.--The committee 
commends the Department of Veterans Affairs for its innovative 
implementation of immersive technology to improve Veterans' 
health care experiences. The Committee is aware that modeling 
and simulation technology has enabled the development of 
innovative and immersive therapies, which can extend trauma 
management therapy protocol. The Committee requests that VA to 
provide a report with 90 days of enactment of this Act 
regarding the results of the study. Immersive technology is 
currently being used in VA Medical Centers and Facilities 
across all 50 states American Samoa, Guam, and Puerto Rico. 
Immersive technologies have proven effective in treating 
Veterans with difficult-to-treat post-traumatic stress 
disorder, depression, stress, and anxiety.
    Veterans Crisis Line (VCL).--The Committee provides funding 
to support the VCL, as requested, and continues to monitor the 
VCL to ensure veterans are receiving appropriate clinical care. 
To support this critical care, the Committee encourages VA to 
utilize funds provided by the bill to ensure appropriate 
staffing for call centers and back-up centers, provide 
necessary training for VCL staff, and ensure that staff are 
able to appropriately and effectively respond to the needs of 
veterans. The Committee maintains bill language requiring the 
VCL to: (1) provide to individuals who contact the hotline 
immediate assistance from a trained professional; and (2) to 
adhere to all requirements of the American Association of 
Suicidology.

                MILITARY TOXIC EXPOSURE RESEARCH PROGRAM

    The bill includes $59,000,000, as requested, for research 
on military environmental exposures. The Committee supports 
efforts to improve diagnosis and treatment of conditions 
resulting from toxic exposures and appreciates the work of the 
Health Outcomes Military Exposures (HOME) program, the Office 
of Research and Development, and other VA program offices to 
increase attention to this issue.
    The Committee encourages the Department to continue 
research on the effects of and treatments for veterans exposed 
to toxins, such as Agent Orange, open burn pits, PFAS, 
radiation, and asbestos, during the course of their active-duty 
service. The Committee also urges the Department to utilize 
reference data from existing medical records to determine how 
veterans who served in areas where toxins were dispersed may 
have more frequent or unexplained diseases compared to the 
civilian population.
    Airborne Hazards and Burn Pits Center of Excellence.--The 
Committee provides $15,165,000 and continues to support the 
Airborne Hazards and Burn Pits Center of Excellence on 
diagnoses, mitigation, and treatment of conditions related to 
airborne hazards and burn pits.
    Colorectal Cancer Screening.--The Committee recognizes that 
early detection with screening is the most effective tool 
available to help prevent thousands of cancer deaths and that 
catching cancers in earlier stages when they are most treatable 
saves lives as well as provides a cost savings for the patient 
and the system. The Committee urges the Department of Veterans 
Affairs to review its policy related to colorectal cancer 
screening and take action to align it with the nationally 
recognized guideline recommendations from the United States 
Preventive Services Task Force (USPSTF), National Comprehensive 
Care Network, and the American Cancer Society. Furthermore, the 
Committee requests a briefing by the Department of Veteran 
Affairs no later than 6 months after enactment of this act to 
receive an update on the alignment of the colorectal screening 
options available to veterans.
    Service-Connected Colorectal Cancer.-- Colorectal cancer is 
the fourth most common cancer diagnosis among our nation's 
veterans. More information is needed to determine why 
colorectal cancer is so prevalent among the veteran population, 
and if their service, including exposure to burn pits, played a 
role. The Committee requests the Department to report to the 
Committee, no later than 180 days after enactment of the Act, 
on the prevalence of colorectal cancer among veterans and the 
potential effect of exposures to burn pits and other 
environmental hazards during military service.

                OPIOID PREVENTION AND TREATMENT PROGRAM

    The bill includes $713,049,000 for opioid treatment and 
prevention efforts, which is $2,316,000 below the fiscal year 
2024 enacted level. Of the total, $254,487,000 is provided for 
activities authorized by the Comprehensive Addiction and 
Recovery Act of 2016 (P.L. 114-198).
    Fentanyl Abuse Education.--The Committee recognizes the 
alarming rise in fentanyl overdoses as part of the opioid 
epidemic that is impacting our service members. The Committee 
urges the VA to prioritize comprehensive education and 
awareness initiatives for veterans on fentanyl abuse, alongside 
support programs aimed at reducing substance use. The Committee 
directs VA provide a report within 180 days of enactment on 
effectiveness of the ongoing initiatives.
    Nonaddictive Opioid Alternatives.--The Committee remains 
concerned about the continued use of opioids in the veteran 
population. The Committee requests that the Department to 
provide a report to the Committee no later than 60 days after 
enactment of this act on veterans' access to non-opioid pain 
relief medications. The report should include: (1) steps the 
Department will take to ensure that coverage, cost-sharing, and 
access are not an impediment to veterans receiving these 
medications; (2) what actions need to be taken to ensure 
Tricare beneficiaries have access to prescriptions for 
nonaddictive opioid alternatives for both acute and chronic 
pain; and (3) how the Department will support continued and 
expanded education to providers on nonaddictive opioid 
alternatives.
    Improvements to Opioid Management in the Military Health 
System.--The Committee is concerned that the Department of 
Veterans Affairs (VA) Pharmacy Benefits Management (PBM) 
Services has not conducted a class review of the opioid 
analgesics therapeutic class since 2017 and has not undertaken 
such a review following the Department of Defense and 
Department of Veterans Affairs' joint publication of the 
guideline titled ``VA/DoD Clinical Practice Guideline for the 
Use of Opioids in the Management of Chronic Pain, 2022''. The 
Committee encourages the VA PBM to evaluate the opioid 
analgesics therapeutic class annually, and in connection with 
that evaluation, consider the FDA-approved labels of 
therapeutics in this class as such labels may evolve from time 
to time, the value of consistent coverage positions across 
formularies that may be accessed by beneficiaries of the 
Veterans Health Administration, real-world evidence and health 
economics and outcomes research pertaining to therapeutics in 
this class, and the extent to which VA national formulary 
coverage aligns with, and enables, any applicable clinical and 
public health guidelines or reports.

                         PHARMACEUTICAL ISSUES

    Drug Pricing Report.--The Committee remains interested in 
information regarding VA drug pricing and appreciates VA 
providing a report as requested in previous fiscal years on 
VA's spending on prescription drugs. The Committee encourages 
VA to conduct this analysis annually and requests robust and 
routine updates to Congress, including updated information for 
fiscal year 2025 on prescription drug prices (net of rebates) 
paid by VA for the ten most frequently prescribed drugs and the 
ten highest-cost drugs for VA. In addition, the report should 
include total annual costs to VA for all prescription drugs. As 
VA has noted that country of origin information on drugs and 
active pharmaceutical ingredients is not yet available on a 
national level, the Committee urges the VA's National 
Acquisition Center to work with the Food and Drug 
Administration to track this data and establish a national 
database for such information.
    Medication Optimization for Veterans.--The Committee 
commends VA's work to implement a National Pharmacogenomics 
Program to ensure all eligible veterans have access to 
appropriate, evidenced-based pharmacogenomic testing, and that 
VA has a robust and highly trained healthcare professional 
workforce to help veterans who have undergone pharmacogenomic 
testing. The Committee provides $41,300,000, as requested, for 
this work.
    Prescription Drug Quality.--The availability of safe and 
effective prescription drugs has significant implications for 
the health of veterans, the workload of VHA personnel, and 
federal spending. The U.S. experiences over three drug recalls 
a day, and production of most drugs and active pharmaceutical 
ingredients (API) has shifted to China and India. VHA is one of 
the largest purchasers of pharmaceuticals in the U.S. but has 
no way to distinguish between higher- and lower-quality 
pharmaceutical manufacturers. Currently, the Uniformed Services 
University of the Health Sciences' (USUHS) Center for Health 
Services Research (CHSR) is piloting a system to evaluate the 
quality of drug products for essential medicines and develop a 
scoring tool for potential use in Department of Defense 
procurement. The Committee encourages the Department to explore 
a potential partnership with USUHS and work to develop a 
strategy for the use of drug quality scoring in VA procurement. 
The Committee directs the Department to report to the 
Committees on Appropriations of both Houses of Congress not 
later than 180 days after enactment of this Act and annually 
thereafter on the progress of this effort.
    Novel Program for Optimizing Pain Management.--The 
Committee recognizes the balance between supporting access to 
care for veterans with pain and the veteran's risk of 
developing dependency for prescription pain medication. The 
Committee supports the implementation of a process improvement 
initiative that will reduce the risk of tolerance, dependence, 
misuse, addiction, and diversion of prescription pain 
medication by establishing more precise and effective 
prescribing guidelines to ensure veterans receive appropriate 
care. The Committee expects VA to deploy an innovative clinical 
decision support tool to evaluate and interpret the acute and 
chronic pain management needs for military veterans, their 
dependents, and/or employees of VA. The Committee supports the 
use of a novel care model that is available to those receiving 
treatment through traditional VHA hospitals/clinics and those 
utilizing Care in the Community. Such model should enable 
better value, a better standard of care, and seek to 
significantly reduce VA spending on pharmacy and behavioral 
health services. The Committee requests VA to provide a report 
within 180 days on its plans for the model and how it intends 
to phase in its use across VHA over the next several years.
    Pharmaceutical On-dose Tracking and Tracing Technologies.--
The Committee is committed to providing veterans safe and 
reliable medication. Track and trace systems are increasingly 
being implemented as a technological solution to secure 
pharmaceutical supply chains. These systems offer the potential 
to minimize reimbursement fraud, facilitate fast market 
recalls, and help identify medicine shortages. The Committee 
looks forward to receiving the report requested in House Report 
117-391, especially regarding solutions to prevent counterfeit 
medicines from entering the VA supply chain.
    Weight Loss and Weight Management Tools.--According to the 
Centers for Disease Control and Prevention, nearly 35 percent 
of American adults are obese. VA estimates that 78 percent of 
veterans are overweight or obese. The Committee continues to 
encourage the Department to ensure veterans have access to 
evidence-based weight management interventions, including 
prescription medications.
    Pain.--The Committee recognizes the balance between 
supporting access to care for veterans with pain and the 
veteran's risk of developing dependency for prescription pain 
medication. The Committee supports the implementation of a 
process improvement initiative that will reduce the risk of 
tolerance, dependence, misuse, addiction, and diversion of 
prescription pain medication by establishing more precise and 
effective prescribing guidelines to ensure veterans receive 
appropriate care and provides up to $5,000,000 for this 
purpose. The Committee expects VA to deploy an innovative 
clinical decision support tool to evaluate and interpret the 
acute and chronic pain management needs for military veterans, 
their dependents, and/or employees of VA. The Committee 
supports the use of a novel care model that is available to 
those receiving treatment through traditional VHA hospitals/
clinics and those utilizing Care in the Community. Such model 
should enable better value, a better standard of care, and seek 
to significantly reduce VA spending on pharmacy and behavioral 
health services. The Committee requests the Department to 
provide a report within 180 days on its plans for the model and 
how it intends to phase in its use across VHA over the next 
several years.

                  POST-TRAUMATIC STRESS DISORDER CARE

    National Center for Post-traumatic Stress Disorder.--
Recognizing the importance of VA's National Center for PTSD in 
promoting better prevention, diagnoses and treatment of PTSD, 
the Committee provides $42,000,000 for the Center, as 
requested.
    Service Dogs for Veterans' Mental Health.--The Committee 
recognizes the positive role that service, guide, and hearing 
dogs have played in mitigating veterans' disabilities and 
providing assistance and rehabilitation. In House Report 118-
122, the Committee encouraged VA to expand the number of pilot 
sites to include medical centers that primarily serve veterans 
in rural areas and in states with few VA medical facilities. 
Within 180 days of enactment of this Act, the Department is 
directed to report on ongoing efforts to expand the number of 
pilot sites and recommendations to help alleviate financial 
burdens on non-profits to implement the program, including 
potential partnerships with Department of Defense medical 
schools.
    Women Veteran PTSD Research and Treatment.--The Committee 
recognizes the effects of PTSD may manifest differently between 
men and women. The Committee also notes that more women are 
using the VA system than ever before and over 30% of new VHA 
users are women. The Committee encourages the Department to 
continue and expand its research on the effects of PTSD and to 
ensure specific research on women veterans is included in these 
efforts. The Committee also encourages that commensurate number 
of women veterans relative to the total women veteran 
population are utilized in research studies pertaining to PTSD.
    New Treatments for PTSD.--The Committee is aware of 
privately funded research regarding potential new treatments 
for PTSD and encourages the Department to monitor these efforts 
and review the results of existing and future clinical trials.
    Women Veterans Network.--The Committee continues to support 
the role of Women Veterans Network (WoVeN), a national peer 
support network for women veterans managed by the National 
Center for PTSD-Women's Health Sciences Division, and provides 
up to $3,000,000 for peer support programs for women veterans.

                              RURAL HEALTH

    Office of Rural Health (ORH).--The bill includes 
$337,455,000 for rural health, which is equal to the budget 
request, to improve access and quality of care for the more 
than 3,000,000 enrolled veterans residing in rural and highly 
rural areas.
    Rural Veterans Transportation Program.--The Committee 
encourages the Office of Rural Health to use $10,000,000 for 
the continued partnership between the Veterans Transportation 
Program an the Office of Rural Health to continue to provide 
transportation to VA appointments for veterans who live in 
rural areas. Further, the Committee directs the Secretary to 
submit a report with the President's Budget Request for FY2026 
that assesses the transportation challenges faced by rural 
veterans.
    Office of Rural Health Operating Plan.--The Committee 
directs the Office of Rural Health to submit no later than 30 
days after enactment of this Act an operating plan for fiscal 
year 2025 funding, as well as for the fiscal year 2026 funding 
provided in advance by this Act.
    Rural Access Network for Growth Enhancement (RANGE).--The 
RANGE Program provides case management and treatment services 
to mentally ill veterans in rural areas. The bill includes 
sufficient funding to maintain three new centers of the RANGE 
Program, as authorized by the Sgt. Ketchum Rural Veterans 
Mental Health Act of 2021 (P.L. 117-21).
    Transportation Challenges.--The Committee recognizes the 
transportation challenges and barriers to care that rural and 
remote veterans face and directs the Office of Rural Health to 
increase efforts to improve transportation mobility for 
veterans, to allocate funding to enhance rural access and 
transportation services, and continue to consider utilizing 
accessible autonomous electric vehicles to overcome these 
challenges.

                      SUBSTANCE-USE DISORDER CARE

    The bill includes $263,881,000 for Substance-Use Disorder 
(SUD) efforts to ensure veterans can receive timely SUD 
specialty services.
    Jason Simcakoski Memorial and PROMISE Act Implementation.--
The Committee supports the continued implementation of the 
Jason Simcakoski Memorial and Promise Act, Title IX of the 
Comprehensive Addiction and Recovery Act of 2016 (P.L. 114-
198), including updating therapy and pain management 
guidelines, strengthening provider education and training, and 
improving patient advocacy.
    Medication-Assisted Treatments.--The Committee encourages 
VA to increase education among its primary care practitioners, 
and on the diagnosis and treatment of alcohol use disorders 
with FDA-approved medication-assisted treatments and 
counseling, as clinically indicated.
    Tobacco Harm Reduction.--The Committee is concerned that 
smoking rates among U.S. military veterans is significantly 
higher than among the civilian population, finding that 27% of 
Iraq and Afghanistan combat veterans use tobacco products daily 
versus 11.5% of their civilian counterparts. The Committee is 
aware of the Department's smoking cessation program but is 
concerned that there is no publicly available information 
regarding the success of the program. The Committee is also 
aware that if the success rate of the tobacco cessation program 
reflects that of the civilian population, then over 90% of 
veteran participants are likely to continue use of combustible 
cigarettes. The Committee directs the Department to coordinate 
with the Food and Drug Administration (FDA) to incorporate into 
the Department's smoking cessation program, information about 
FDA-authorized tobacco products that have been determined to be 
less harmful than continued cigarette smoking, such as heated 
tobacco products, to help reduce cigarette use amongst the 
veteran community.

                           SUICIDE PREVENTION

    Lethal Means Safety Collaboration.--The Committee notes 
that VA has been called to partner with the Departments of 
Defense, Health and Human Services, Homeland Security, Justice, 
and the Office of Emergency Medical Services within the 
Department of Transportation to create and implement a 
coordinated approach for improving lethal means safety. The 
Committee looks forward to the report required by House Report 
117-391 on this coordinated approach and VA's plans to 
incorporate the coordinated approach into the Department's 
existing lethal means safety initiatives.
    Lethal Means Safety Training.--To ensure that every 
employee who regularly interacts with veterans is prepared to 
have a conversation that could save a veteran's life, the 
Committee continues to urge VA to implement mandatory lethal 
means safety trainings for all VA employees who regularly 
interact with veterans in their work, compensation and pension 
examiners, employees of Veterans Centers and vocational 
rehabilitation facilities, community care providers, and family 
caregivers to the extent practicable.
    Firearm Lockbox Program.--The Committee supports VA's 
efforts to address veteran suicide prevention, and the firearm 
lockbox program is a critical element. As VA implements this 
program, the Committee is concerned that funding limitations 
may impact the scope and reach of this initiative within the 
broader National Strategy for Preventing Veteran Suicide. The 
Committee provides $3,000,000 above the request to expand the 
firearms safety elements of the lockbox program to increase 
awareness and enable greater distribution of firearms safe 
storage devices. The Committee encourages VA to ensure that 
access to firearms storage resources for Veterans is included 
in training for employees of the Veterans Crisis Line.
    Predictive Modeling and Analytics for Veterans Suicide 
Prevention.--The Committee continues to be concerned by the 
alarming number of veterans dying by suicide each day. The 
Committee encourages the Department to utilize its Recovery 
Engagement and Coordination for Health--Veterans Enhanced 
Treatment (REACH VET) program, for predictive modeling and 
analytics to support early detection of suicidal ideations, and 
continue to utilize improved technologies to expand its 
efforts.
    Suicide Prevention Coordinators.--The Committee recognizes 
the importance of Suicide Prevention Coordinators, who follow 
up with and coordinate care for veterans who have been directly 
referred to them by responders at the Veterans Crisis Line, and 
directs VA to fully staff suicide prevention coordinator 
positions. To better support coordinators, the Committee 
encourages the Department to incorporate enterprise-wide and 
interactive technology. The Committee directs the Secretary to 
outline in the next budget request how VA medical facilities 
are using this technology, total program cost, and schedule to 
implement an enterprise-wide solution.
    Zero Suicide Initiative.--The Committee expects the 
Department to prioritize efforts to combat veteran suicide and 
looks forward to receiving the report requested in House Report 
118-122.
    Suicide Prevention Reporting.--The Committee directs VA to 
incorporate full veteran benefit usage in its annual suicide 
prevention report to demonstrate the relationship between VA 
benefits and veterans who die by suicide. The report shall 
contain detailed usage of benefits the same way VA reports on 
veteran interactions with VHA. Additionally, the Committee 
directs VA to provide annual utilization reports on community 
grants for suicide prevention.
    Veteran Resiliency, Suicide Prevention and Response.--The 
Committee notes that death by suicide in our veteran population 
remains an alarming crisis. Tragically, 18 to 24 Veterans die 
by suicide daily. The Department's data demonstrates that 
veterans suicide rates have increased over the last 20 years. 
The Committee encourages VA to modernize current suicide 
prevention models to better ensure they are reaching at risk 
veterans.

                     TELEHEALTH AND CONNECTED CARE

    The bill includes $6,398,020,000 for teleheath and 
connected care, which includes home telehealth, home telehealth 
prosthetics, and clinic-based telehealth.
    VA is encouraged to leverage newly gained telehealth 
capacity to address backlogs for disability exams and 
healthcare appointments when appropriate. The Committee further 
directs VA to continue to implement plans to improve veteran 
and provider satisfaction, increase awareness of the telehealth 
program, and enhance adoption of telehealth by veterans and 
providers.
    VA Telehealth Benefits.--VA Telehealth Services are 
transforming how Veteran's access high-quality VA care by 
making it easier for veterans to connect with health 
specialists from across the country. Not later than 180 days 
after the enactment of this Act, the Secretary of Veterans 
Affairs shall submit a report to the Committees on 
Appropriations of both Houses of Congress a report on the wait 
times for VA telehealth services and the active public-private 
partnerships that enable and enhance telehealth access to 
Veterans. The report shall include an update on obligations of 
public-private partnerships (P3s) included in the VA Mission 
Act of 2018.

                              WHOLE HEALTH

    The Committee recommendation includes $119,289,000 Whole 
Health, as requested, which is $11,441,000 above the fiscal 
year 2024 enacted level. The Committee supports the Whole 
Health model of care and the expansion of Whole Health to all 
VA facilities.
    Continued Support and Expansion of Whole Health.--Since FY 
2021, the Committee has consistently praised the Veterans 
Administration (VA) Whole Health System, citing its ability to 
provide efficient and effective patient-centered, integrative 
care to veterans, especially those who are struggling with 
opioid use disorder and chronic pain. In light of independent 
evaluations from the National Academy of Sciences and VA, which 
have demonstrated both dramatic increases in program 
participation and decreases in total healthcare costs among 
enrolled Veterans, the Committee has provided $34,300,000 in 
additional funding since FY 2022 to help expand Whole Health to 
all VA health facilities nationwide. In response to ``VA's 
Report to Congress on Continued Support and Expansion for Whole 
Health'' submitted in March 2023, the Committee includes 
$119,300,000 which is $11,400,000 above the FY 24 enacted level 
to support the continued expansion of Whole Health. Further, 
the Committee requests a report from the VA no later than 90 
days following enactment of the Act regarding the status of the 
program's expansion efforts to date and, if applicable, an 
increased cost estimate.
    Adaptive Sports.--As requested, the bill provides 
$30,542,000, for National Veterans Sports Programs, including 
$16,500,000 for adaptive sports programs and up to $5,000,000 
equine therapy.
    Creative Arts Therapies.--The Committee continues to 
acknowledge the effective use of creative arts therapies and 
arts and humanities partnerships in treating veterans with 
traumatic brain injuries and psychological health conditions 
and provides up to $5,000,000 to do so.
    Equine Assisted Therapy Services.--The Department should 
utilize funding provided for equine therapy to conduct a 
comprehensive program evaluation to ensure the continued 
effectiveness of equine assisted therapy and services 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. The Committee directs the 
Department to provide a report to the Committees on the 
feasibility and cost associated with expanding access to 
recreational therapy options, such as equine assisted therapy 
and services, to all veterans enrolled in VA care within 180 
days of enactment of this Act.
    Creative Arts Therapies.--The Committee continues to 
acknowledge the effective use of creative arts therapies and 
arts and humanities partnerships in treating veterans with 
traumatic brain injuries and psychological health conditions 
and provides up to $5,000,000 to do so.
    Produce Prescription.--Studies have shown veterans 
experience obesity and chronic diet-related comorbidities at 
higher levels compared to the U.S. population. VHA has the 
potential to play an important role in alleviating diet-related 
disease through produce prescriptions. The Committee provides 
up to $2,000,000 for VA facilities to partner directly with 
organizations to develop and implement local VA produce 
prescription programs and pursue strategies for patient 
education and outreach. The Committee looks forward to the 
report requested in House Report 118-122 on this issue.
    Medically Tailored Meals.--The Committee recognizes the 
ability for VA to provide food to veterans in both inpatient 
and non-inpatient settings under existing statutory authority. 
The Committee requests that medically tailored meals and food 
be provided, when VA providers deem it to be appropriate, in 
order to support a healthy food-as-medicine component and as 
part of a comprehensive care plan for veterans with at least 
one chronic health condition.
    Food Service Guidelines.--The Committee encourages VA to 
explore goals supports the goal set forth in the National 
Strategy on Hunger, Nutrition, and Health to update and 
implement government-wide the Food Service Guidelines for 
Federal Facilities. The Committee provides $1,000,000 to the 
Veterans Health Administration to implement the Food Service 
Guidelines across its food service facilities within one year 
or sooner of the date of enactment of this Act. The Committee 
requests within two years or sooner of the date of enactment of 
this Act a report that includes a baseline and final assessment 
of how the Veterans Health Administration's food purchasing and 
food service practices align with the Food Service Guidelines; 
an evaluation of the implementation strategy including 
associated costs and customer feedback; and recommendations for 
changes to procurement or other laws that would facilitate 
ongoing implementation of the Food Service Guidelines.

                       WOMEN VETERANS HEALTH CARE

    The recommendation includes a total of $1,323,444,000, as 
requested, to support care for women, the Office of Women's 
Health and programmatic efforts, including the childcare 
initiative. Within this amount, VA is encouraged to continue 
hiring women primary care providers and increase the number of 
peer support specialists for women veterans.
    Care for Women.--The Committee recognizes that women are 
the fastest growing cohort within the veteran community. The 
number of women veterans using VHA services has more than 
tripled since 2001, growing from 159,810 in 2001 to more than 
600,000 today. The increased number of women using VHA services 
necessitates a greater investment of resources to provide and 
expand VA's services to women veterans and ensure women 
veterans' health needs, which often differ from men, are met.
    Breast Cancer Screening Guidelines.--The Committee commends 
VA's decision to offer breast cancer screening and mammography 
to eligible women veterans beginning at age 40. However, the 
Department should be prepared to offer screening to eligible 
younger women veterans, especially women at higher risk for 
breast cancer, should a physician determine medical necessity, 
or risk factors warrant, screening before age 40. The Committee 
supports this effort to ensure that women veterans have access 
to and receive adequate and timely care and requests an update 
on the departments implementation of this policy no later than 
60 days after enactment of this Act.
    Maternal and Infant Health Outcomes for Women Veterans.--
The Committee directs the Department to provide a report within 
180 days of enactment of this Act regarding the incidence of 
birth defects, miscarriage, stillbirth, and maternal morbidity 
and mortality that can be related to military service and 
provide recommendations to raise awareness and improve maternal 
and infant health outcomes.
    Maternity Healthcare and Coordination Programs.--The 
Committee is pleased that to coordinate prenatal and postpartum 
care provided in the community, the Department has established 
maternity healthcare and coordination programs, which have been 
successful in ensuring that veterans can receive high-quality, 
appropriate care and robust support during and after pregnancy. 
The Committee supports these programs and encourages VA to 
continue to ensure veterans have access to high-quality, well-
coordinated care, and robust services and directs VA to 
continue to implement the Protecting Moms Who Served Act (P.L. 
117-69).
    Women's Veteran Initiative.--The Committee supports 
continued efforts to identify and address unique issues 
experienced by women veterans.
    Women's Health Research and Innovation.--The Committee is 
aware of a new joint collaborative to improve women's health 
research for service members and veterans that will develop a 
roadmap to close pressing research gaps specific to women who 
served in the military. Of the areas of research that will 
benefit women veterans, the Committee notes that 80 percent of 
patients diagnosed with an autoimmune disease are women. The 
Committee encourages VA to engage with experts who are 
researching autoimmune diseases in women veterans, including 
myalgic encephalomyelitis/chronic fatigue syndrome and Gulf War 
Illness, to better understand sex-based differences in disease 
diagnosis and treatment. The Committee requests a detailed 
report within 180 days of filing this report of how the 
Department will execute the Executive Order, what research gaps 
will be prioritized, and how it will engage with nationally 
recognized experts on diseases that impact women veterans.

                     WORKFORCE AND STAFFING ISSUES

    Expanding Recruitment.--The Committee recognizes the 
challenge VA has in the recruitment and retention of 
clinicians. To help VA better keep pace with other providers 
and continue to train its workforce to improve their service to 
veterans, the Committee urges VA to explore potential options 
to enhance recruitment and retention, such as expanding 
benefits to relocate to underserved VA medical facilities and 
expanding reimbursement to clinicians for Continuing 
Professional Education, regardless of individual specialty or 
board certification.
    Expedited Hiring Authority.--The Committee strongly 
encourages the Department to focus hiring efforts on converting 
clinical trainees to full VA employment immediately upon 
completion of their residencies through the utilization of the 
expedited hiring authority granted to the VA by Title 38.
    Homeless Veterans Caseworkers.--The Committee requests that 
the Department evaluate staffing needs for caseworkers for 
homeless veterans and veterans at risk of homelessness and 
evaluate the potential benefits and effectiveness of 
contracting for caseworkers in the annual Staffing Report.
    Respiratory Therapists.--The Committee remains concerned 
with gaps in coverage of respiratory therapists at VA, 
particularly as additional veterans become eligible under the 
PACT Act. The Committee encourages VA to evaluate staffing 
needs for respiratory therapists using a validated data system, 
and to report to the Committee within 180 days of enactment of 
this Act on gaps in staffing for respiratory therapists.
    Staffing Report.--The Committee looks forward to the annual 
comprehensive report required by the Joint Explanatory 
Statement accompanying the Consolidated Appropriations Act, 
2022 (P.L. 117-103) on the Department's plan to address 
critical workforce issues.
    VA/HHS Collaboration on Health Workforce Shortages.--The 
Committee continues to encourage VA to work with the Department 
of Health and Human Services (HHS) to explore ways the agencies 
can work together, such as by creating a taskforce, to increase 
the availability of providers, including in the behavioral 
health workforce and among physicians specializing in cancer, 
spinal cord, and neuropsychiatric conditions. This 
collaboration is urged to examine VA's recruitment challenges, 
review programs that could enhance recruitment and retention, 
and to think creatively on how other Federal agencies like HHS 
can identify and address provider shortages. VA also is 
encouraged to consult with the Department of Defense to explore 
recruiting those who have left military service.
    VA Physician Pay.--The Committee understands that one of 
the biggest hurdles in retaining health care professionals 
within VA health care system is the agency's ability to compete 
with market pay rates. The Committee encourages VA to explore 
opportunities in which VA can better compete with market pay 
rates and increase pay opportunities for physicians and other 
identified health care professionals.
    Staffing at Richard A. Pittman Community-Based Outpatient 
Clinic.--The Committee celebrates the recent opening of the 
Richard A. Pittman Community-Based Outpatient Clinic in San 
Joaquin County, California. The Committee recognizes the 
crucial role this clinic has in expanding primary care and 
specialty health care services to veterans across California's 
Central Valley. The Committee recommends the Department work 
with all relevant partners to ensure full-staffing requirements 
at all levels are met and sustained within the first six months 
of seeing patients.

                         MEDICAL COMMUNITY CARE

 
 
 
Fiscal year 2024 enacted level.......................    $30,342,023,000
Fiscal year 2025 enacted level.......................     20,382,000,000
Fiscal year 2025 budget year request.................              - - -
Committee 2025 budget year recommendation............              - - -
 
Fiscal year 2026 advance appropriation request.......     34,000,000,000
Committee 2026 advance appropriation recommendation..     34,000,000,000
Comparison with:
    Fiscal year 2025 enacted level...................    +13,618,000,000
    Fiscal year 2025 advance budget request..........              - - -
 

    The Committee recommendation includes an advance 
appropriation of $34,000,000,000 for fiscal year 2026 for 
Medical Community Care, of which $2,000,000,000 is available 
until September 30, 2027.
    Dystonia.--The Committee continues to note the connection 
between traumatic brain injury (TBI) and dystonia. The 
Committee requests a report within 90 days of enactment of this 
Act on efforts to pursue collaborative opportunities with the 
dystonia stakeholder community and related federal agencies.
    Third-Party Payments and Reimbursements.--The Committee 
continues to direct VA to provide comprehensive reports on a 
quarterly basis detailing the amount owed to outside providers 
for every state, outstanding payments over six months, the 
corrective actions being implemented to address these 
outstanding balances, and the average time for repayment.
    Community Pharmacies.--In the previous fiscal year, the 
Committee requested a report on the feasibility and 
advisability of expanding the use of community pharmacies, 
including an assessment of cost, veteran access, and effect on 
rural delivery. The Committee looks forward to receiving this 
report and working with VA to expand healthcare access to 
veterans.
    Ground Ambulance Providers.--The Committee is concerned 
that the Department is inadvertently disadvantaging veterans in 
connection to reimbursement for ground ambulance services. 
Specifically, under the Community Care Program, ground 
ambulance providers are required to notify VA and seek approval 
for payment within 72-hours. By contrast, veterans have a 30-
day window to notify VA of their receipt of emergency treatment 
in a non-VA facility. This results in ground ambulance provider 
claims being denied and the burden falls upon the veterans to 
seek reimbursement. The Committee directs the Department to 
provide a briefing within 90 days of enactment of this Act 
regarding how the Department and its respective VISNs could 
reduce the financial burden on veterans by reducing the number 
of ground ambulance service claims that are denied for failure 
to meet the 72-hour notification requirement but ultimately 
comply with the VA's coverage rules.
    Long-Term Care for Veterans with Severe Traumatic Brain 
Injury (TBI).--The Committee continues to note the increasing 
prevalence of deployment-related traumatic brain injuries. This 
increase continues to demonstrate the longstanding need for 
providing adequate long-term specialty care for Veterans 
suffering from severe TBIs. The Committee is encouraged by the 
Department's progress in using agreements with non-VA providers 
to ensure all Veterans receive such long-term specialty care in 
their communities and directs the Department to continue 
entering into such agreements, to educate case managers on all 
tools available to provide veterans with long-term specialty 
care outside the VA system, and to provide quarterly updates to 
Congress on the Department's progress on providing access to 
long-term care to veterans with severe TBIs.

                     MEDICAL SUPPORT AND COMPLIANCE

 
 
 
Fiscal year 2024 enacted level........................   $10,750,000,000
Fiscal year 2025 enacted level........................    11,800,000,000
Fiscal year 2025 budget year request..................                 0
Committee 2025 budget year recommendation.............                 0
 
Fiscal year 2026 advance appropriation request........    12,700,000,000
Committee 2026 advance appropriation recommendation...    12,700,000,000
Comparison with:
    Fiscal year 2025 enacted level....................          +900,000
    Fiscal year 2026 advance budget request...........             - - -
 

    The Committee recommendation includes an advance 
appropriation of $12,700,000,000 for fiscal year 2026 for 
Medical Support and Compliance, of which $350,000,000 shall 
remain available through September 30, 2027.

                           MEDICAL FACILITIES

 
 
 
Fiscal year 2024 enacted level........................    $8,949,485,000
Fiscal year 2025 enacted leve.........................     9,400,000,000
Fiscal year 2025 budget year request..................                 0
Committee 2025 budget year recommendation,............                 0
 
Fiscal year 2026 advance appropriation request........     9,700,000,000
Committee 2026 advance appropriation recommendation...     9,700,000,000
Comparison with:
    Fiscal year 2025 enacted level....................      +300,000,000
    Fiscal year 2026 advance budget request...........             - - -
 

    The Committee recommendation includes an advance 
appropriation of $9,700,000,000, for fiscal year 2026 for 
Medical Facilities, of which $500,000,000 shall remain 
available until September 30, 2027.
    Community-Based Outpatient Clinic in Bakersfield, 
California.--The Committee remains disappointed that the new 
Bakersfield CBOC remains unbuilt more than a decade after 
Congress authorized this facility in fiscal year 2010 through 
Public Law 111-82. The Committee directs the Secretary to 
expeditiously execute Lease No. 36C10F20L0008 and, unless 
prevented by an order issued by a federal or state court, 
commence construction of the CBOC by no later than September 
30, 2025, as provided in the lease. Furthermore, the Committee 
directs the Secretary to provide monthly reports to the 
Committees on Appropriations of both Houses of Congress on the 
CBOC 's progress until completion and activation.
    Medical Center Services.--The Committee reminds the 
Department to ensure it consults with a wide variety of 
stakeholders regarding any changes to services, hours, and 
staffing prior to making changes and to ensure veterans are not 
negatively affected.
    Spend Plan.--The Committee expects VA to provide, no later 
than 30 days after enactment of this Act, an expenditure plan 
detailing the planned use of the funds provided. The Committee 
understands that some of the projects planned for fiscal year 
2025 may not be ready within that timeframe, requiring an 
adjustment to the spending plan. The Committee requests a 
quarterly update of the plan if the funding for any single 
project changes by more than $3,000,000 during that time 
period.
    Use of Autonomous Robots.--In House Report 118-122 the 
Committee encouraged VA to consider autonomous robots during 
the planning for new construction or modernization of VA 
hospitals and requested the VA report to the Committee not 
later than 180 days after the enactment of the Act on the use 
of robots at VA hospitals, including current use and potential 
benefits from expanded use in the future. The Committee looks 
forward to receiving this report.
    Viruses and Bacteria.--The Committee encourages VA to 
explore initiating a pilot program that would evaluate how 
commercial, off-the-shelf, sensor-integrated autonomous UV 
technologies can reduce the transmission of viruses and 
bacteria in VA facilities. The Committee requests a report from 
VA on its efforts within 90 days of an enactment of this Act.
    VA--Water Conservation at Medical Centers and Clinics.--The 
Committee is aware that hospital laboratories account for 
approximately 15% of the total hospital water usage. There have 
been advancements in laboratory equipment which operate with 
zero water input or connection to the municipal water systems. 
The Committee encourages the Assistant Under Secretary for 
Health for Support (AUSH-S) to consider water efficiency and 
zero water systems where feasible for VA Medical Centers and 
Community Based Outpatient Clinics when modernizing VA 
facilities and medical equipment. In addition, the Committee 
requests the AUSH-S to provide a report to the Committee within 
180 days of enactment on the plans to implement laboratory 
systems that have no to little impact on the water suppl in the 
communities they reside.
    Veterans Integrated Service Network Distribution.--The 
Committee is interested in learning how the Veterans Integrated 
Services Network (VISN) (1) determines patient service 
catchment areas (2) assesses where to build new VA medical 
centers, and (3) plans the distribution of VA medical centers 
and outpatient clinics compared to the number of veterans in 
each area. The Committee requests the Department to provide a 
report within 180 days of enactment, that details the criteria 
used to determine how various types of medical facilities 
including VAMCs and CBOCs are distributed, and the distribution 
of VA medical facilities given the number of veterans in each 
location. Further, the report should include information on how 
many communities nationwide exist where veterans utilize a VAMC 
not within their home state.
    Women Veterans Healthcare Facilities.--The Committee 
recognizes that some women veterans who routinely use VA 
primary care and women's health services have experienced 
childhood or military sexual trauma which makes them 
uncomfortable with male healthcare providers. The Committee 
also acknowledges the Department's efforts to revise care 
standards to align with women veterans' preferences for care, 
including women-only care environments. The Committee requests 
a report within 120 days of enactment of this Act on the needs, 
utilization patterns, and preferences of women veterans, and 
any planned steps, including recommendations on facility 
modifications, to meet those needs.
    Food Pantry Program.--The Committee recognizes the success 
of the VA food pantry program in easing veteran access to 
quality food and reducing stigma around veteran food 
insecurity. The Committee understands that VA collaborates with 
nonprofit organizations to identify potential VA medical 
centers with the need and capacity for enrolling this program 
and encourages VA to ensure that at least one VA medical center 
in a dense urban area offers food on-site. The Committee 
directs VA to identify the additional funds necessary to scale 
up the food pantry program.

                    MEDICAL AND PROSTHETIC RESEARCH

 
 
 
Appropriation, fiscal year 2024.......................      $943,000,000
Budget request, fiscal year 2025......................       868,000,000
Committee recommendation, fiscal year 2025............       923,514,000
    Change from enacted level.........................       -19,486,000
    Change from budget request........................       +55,514,000
 

    The Committee recommendation includes $923,514,000 for 
Medical and Prosthetic Research, available through September 
30, 2026, which is $19,486,000 below the fiscal year 2024 
level. The Committee appreciates the Department's plans to 
focus on critical research areas that include environmental 
exposures, traumatic brain injury, cancer and precision 
oncology, and mental health.
    In addition to this appropriation, resources from other 
sources, including appropriations from the medical care 
accounts, reimbursements from DOD, grants from the National 
Institutes of Health, private sources, and voluntary 
organizations, support the Department's researchers. The total 
amount estimated available for fiscal year 2025 is 
$1,437,400,000.
    Limb Loss.--The Committee commends the Department's work 
with veterans living with limb loss, particularly its support 
of programs that engage amputees to become certified peer 
visitors for other veterans. Over the past year, this program 
has trained veterans to become certified peer visitors and re-
certified many to continue to provide peer support. In 
addition, veterans with amputations have been able to benefit 
from over 250 registered support groups nationwide. While these 
programs have touched the lives of veterans across the country 
in the last year, there are still many veterans who have not 
benefited from these and other support programs because they 
have not grown to keep pace with the number of veteran amputees 
across the country. The Committee encourages the Department to 
consider expanding its certified peer visitor program in fiscal 
year 2025 to meet the needs of all veterans. In addition, the 
Committee requests a report no later than 90 days after 
enactment of this act on the feasibility, advisability, and 
cost estimate of expanding amputee services and educational 
opportunities for individuals who have received 
osseointegration surgery and are using osseointegration 
prosthetic technology.
    Advanced Platform Technology (APT) Center.--The Committee 
applauds the Department for progress being made to provide 
veterans with new assistive and restorative technologies that 
address sensory, motor, or cognitive deficits, as well as limb 
loss. The APT Center has effectively utilized a partnership 
model to leverage local and national research expertise to 
drive progress in diverse areas including artificial lung 
development, wound healing, and neural connected sensory 
prosthesis. The Committee continues to support the APT Center's 
efforts.
    Endometriosis.--The Committee directs the Department to 
ensure its research program adequately addresses the unique 
needs and concerns of veterans with endometriosis. The 
Committee further directs VA to prioritize endometriosis 
research to expand basic, clinical, and translational research 
into the mechanics of endometriosis, identify early diagnostic 
markets, and develop new treatment methods.
    Metastatic Cancer Research.--The Committee supports the 
Department's work to achieve therapeutic advances and extend 
the life of metastatic cancer survivors, including through 
clinical trials that treat patients with diverse types of 
cancer, demographics, and genetics, and recognizes more studies 
are required to develop a comprehensive understanding of this 
complex process. The 2018 Department of Defense report to 
Congress on the Metastatic Cancer Task Force noted there are 
few active duty servicemembers with metastatic cancer because 
they are medically retired prior to metastasis. However, the 
Department's FY25 budget justification notes that there were 
more than 51,000 new cases among veterans in 2017. The 
Committee directs the Department to assess the likelihood that 
service in the military, including types of service, affect 
veterans' likelihood of a metastatic cancer diagnosis and 
continue to increase veterans participation in clinical trials. 
The Committee requests that the FY26 budget justification 
include an update on its progress on this issue.
    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 Department is 
encouraged to make the findings of all research conducted by or 
for the Executive Branch publicly available as soon as possible 
and continue to publish disease-specific mortality data related 
specifically to Persian Gulf War veterans. The Committee 
continues to encourage the Department to utilize the term 
``Gulf War Illness,'' as recommended by the Institute of 
Medicine. The Committee appreciates the Department's work to 
strengthen the training of primary, specialty, and mental 
healthcare providers on effective assessment, diagnosis, and 
clinical management of Gulf War Illness.
    Herbicide-Related Toxic Exposure Research.--To understand 
the residual effects of Agent Orange, dioxins, and other 
herbicide-related toxic exposures, the Committee urges the 
Department to utilize reference data from existing medical 
records of veterans who served in Vietnam, Thailand, Guam, the 
Northern Mariana Islands, America Samoa, and other geographic 
areas where these toxic substances were dispersed to determine 
the percentage who have frequent or unexplained diseases 
compared to the civilian population.
    National Intrepid Center of Excellence (NICoE).--The 
Committee recognizes the high-quality mental health care and 
neurological research being conducted at the NICoE and directs 
the Department to expand its work with NICoE to strengthen VA's 
research capacity. The Committee continues to encourage the 
Department to pursue new collaborative initiatives with NICoE, 
consider public academic medical centers as partners in such 
efforts, and assist DOD-wide efforts to optimize research to 
implement solutions and deliver better health outcomes for 
veterans.
    Research Using Animals.--The Department is directed to 
include in any report to Congress describing animal research 
approved under section 247 in division A of the Consolidated 
Appropriations Act, 2024 (P.L. 118-42), submitted after the 
date of filing of this report, details on the specific 
alternatives to animals that were considered, why those 
alternatives were not chosen, and an explanation for why these 
animal subjects were the only viable option for this research. 
The Committee looks forward to the Department fully 
implementing its plan to eliminate the research conducted using 
canines, felines, or non-human primates by 2026, as directed in 
Public Law 118-42 and directs the Department to not approve any 
new animal research that would not be complete before 2026.
    Kidney Disease.--The Committee applauds VA's focus on 
ensuring that veterans with kidney disease are provided access 
to the best medical care available. The value of testing for 
APOL1 in kidney disease patients is well documented and the 
Committee encourages VA to continue screening for kidney 
diseases for veterans, including rare and genetic, and 
encourages VA to prioritize funding for staffing for genetic 
kidney disease clinical trials at qualified VA sites. Further, 
the Committee urges the Department to focus resources on 
clinical trials for kidney disease in high-risk populations. 
The Department is directed to provide a report to the Committee 
no later than 90 days after enactment of this act on its 
efforts in this area. The report should include: (1) current 
funding levels for clinical trials related to APOL1; (2) 
details on ongoing trials, including the number of veterans in 
each trial and the trial location; and (3) funding for APOL1 
research over the past 3 years.
    PFAS Registry.--The Committee directs the Secretary of 
Veterans Affairs to (1) establish and maintain a registry for 
eligible individuals who may have been exposed to per- and 
polyfluoroalkyl substances due to the environmental release of 
aqueous film-forming foam on military installations to meet the 
requirements of military specification MIL-F-24385F; (2) 
develop a public information campaign to inform eligible 
individuals about the registry, including how to register and 
the benefits of registering; and (3) periodically notify 
eligible individuals of significant developments in the study 
and treatment of conditions associated with exposure to PFAS.
    Wearable Monitoring Devices.--The Committee urges the 
Department to initiate a research program focused on the 
application of platform agnostic wearable medical devices 
wearables in transitioning veterans from inpatient to 
outpatient care. This program will study the efficacy of 
wearable hardware in continuous health monitoring, aiming to 
enhance patient outcomes and optimize care as veterans 
reintegrate into daily life outside the hospital. The research 
will explore the adaptability of these devices in varied living 
environments, ensuring veterans receive the same level of care 
they would within the hospital setting. The Committee urges the 
Department to deliver a comprehensive research report detailing 
the feasibility of utilizing such devices, findings, potential 
improvements in healthcare delivery, and recommendations for 
wide scale implementation, within 180 days of enactment of this 
Act.
    Wound Dressings.--The Committee is interested in effective 
advanced treatments for wound care, including fentonite. The 
Committee understands advanced methods can be used for various 
wounds such as diabetic ulcers, venous ulcers, burns, and 
pressure wounds and can lead to improved outcomes while 
reducing long-term costs. The Committee requests that VA to 
provide a report within 90 days of enactment of this Act on its 
findings.

                     Medical Care Collections Fund

    The Department of Veterans Affairs Medical Care Collections 
Fund (MCCF) was established by the Balanced Budget Act of 1997 
(P.L. 105-33). The Department deposits first-party and pharmacy 
co-payments, third-party insurance payments and enhanced-use 
collections, long-term care co-payments, Compensated Work 
Therapy Program collections, Compensation and Pension Living 
Expenses Program collections, and Parking Program fees into the 
MCCF. The Department uses these funds for medical care and 
services to veterans. The estimate of fees that will be 
collected in fiscal year 2025 is $4,400,000,000.

                    National Cemetery Administration


 
 
 
Appropriation, fiscal year 2024.......................      $480,000,000
Budget request, fiscal year 2025......................       495,000,000
Committee recommendation, fiscal year 2025............       495,000,000
    Change from enacted level.........................       +15,000,000
    Change from budget request........................             - - -
 

    The Committee recommends $495,000,000 for fiscal year 2025, 
which is $15,000,000 above the fiscal year 2024 enacted level. 
NCA should prioritize maintaining the current level of services 
at existing cemeteries and activating new cemeteries to 
increase burial access. In addition, the bill includes language 
making ten percent of the total available until September 30, 
2026.
    Medallions on Headstones.--The Committee is concerned with 
the decision to remove medallions from headstones honoring the 
First Special Service Forces (FSSF). The Committee requests a 
report on its decision to remove medallions from headstones in 
cemeteries honoring members of the FSSF. This report should 
include a justification of the National Cemetery 
Administration's directive leading to the removal as well as a 
plan for apologies to the families of FSSF soldiers affected.

                      Departmental Administration


                         GENERAL ADMINISTRATION

                     (INCLUDING TRANSFER OF FUNDS)

 
 
 
Appropriation, fiscal year 2024.......................      $475,000,000
Budget request, fiscal year 2025......................       457,000,000
Committee recommendation, fiscal year 2024............       457,000,000
    Change from enacted level.........................       -18,000,000
    Change from budget request........................             - - -
 

    The General Administration account provides funds for the 
Office of the Secretary, the General Counsel, six Assistant 
Secretaries, and two Department-level staff offices.
    The Committee recommendation includes $457,000,000 for 
General Administration, a decrease of $18,000,000 below the 
fiscal year 2024 enacted level.
    The Committee has included bill language to make available 
through September 30, 2026, up to ten percent of these funds 
and to permit the transfer of funds in this account to the 
General Operating Expenses, Veterans Benefits Administration 
account.
    Additional Budgetary Information.--The Committee continues 
its request that items described in previous House reports 
continue to be included in the budget justifications submitted 
each year. Further, the Committee directs VA to include in its 
budget justification materials a table for each account that 
shows a five-year funding history for requested and enacted 
levels.
    Data Governance Analytics.--The Committee continues to 
support the work carried out by VA's Office of Enterprise 
Integration for the continuous improvement of veterans' access 
and outcomes throughout their lifetimes, as outlined in VA Data 
Strategy. VA, as a learning enterprise, should manage, 
integrate, and consolidate its various data sources to ensure 
its data of highest quality and is used to support operational 
decision making. As such, the Committee encourages OEI to 
further coordinate enterprise-wide efforts to manage VA data as 
a strategic asset, in order to enhance veterans' insights and 
to strengthen VA's delivery of services and benefits to 
veterans, their families, survivors, and caregivers. Of the 
funds provided, $3,250,000 shall be for the Office of 
Enterprise Integration to further coordinate enterprise-wide 
efforts of managing VA data as a strategic asset, in order to 
enhance veterans' insights and to strengthen VA's delivery of 
services and benefits to veterans, their families, survivors, 
and caregivers.
    Data on Women and Minority Veterans.--The Committee 
continues to recommend that, when applicable, the Secretary of 
Veterans Affairs display information in the annual report(s) 
submitted to Congress separately or women veterans and minority 
veterans.
    Federal Bureau of Investigation's National Instant Criminal 
Background Check System.--The Committee directs the Department 
to provide a report on the impact and implementation status of 
section 413 of division A of the Consolidated Appropriations 
Act, 2024 (Public Law 118-42), which prohibits the Department 
from submitting a veteran or beneficiary's name to the FBI's 
National Instant Criminal Background Check System (NICS) list 
without a judge's consent.
    Office of Resolution Management, Diversity, and Inclusion 
(ORMDI).--The Committee recommendation does not include any 
funds for diversity, equity, and inclusion programs, projects, 
or activities for ORMDI.
    Quarterly Financial Information Reports.--The bill includes 
an administrative provision that extends the requirement for 
submission of the quarterly financial information required in 
the fiscal year 2017 bill and conference report.
    COVID-19 Vaccine Requirements.--The Committee is concerned 
about remaining COVID-19 vaccine requirements for VA employees. 
The Department shall produce a report on any remaining 
requirements for VA employees to receive the COVID-19 
vaccination to continue employment. The report should 
prioritize scientific justification from peer reviewed research 
published in the last calendar year from the date of enactment.
    Staff Relocations Within VA.--The bill continues the 
administrative provision requiring written notification 15 days 
prior to organizational changes that result in the transfer of 
25 or more full-time equivalent staff from one organizational 
unit of the Department to another.
    Supporting Minority and Disadvantaged Contractors.--The 
Committee reiterates the reporting requirement included in 
House Report 117-81 on this topic and looks forward to 
receiving the requested report.
    Transparency and Accountability in Disciplinary Actions.--
The Committee is aware that the House Veterans Affairs 
Committee has been alerted to allegations of sexual harassment 
and other misconduct by credible whistleblowers who have not 
trusted the VA's internal investigations process. From 2014 to 
2016, the House Veterans Affairs Committee reviewed more than 
200 settlements. In 96% of these settlements, the disciplinary 
action proposed or taken against the employee did not appear on 
their permanent record form. The Committee is concerned that 
this practice has weakened accountability within the VA. The 
Committee encourages the VA to complete its investigations 
against employees credibly accused of misconduct. Further, it 
encourages the VA to notate any investigation and its findings 
in resigning or retiring employees.
    Delays With Board of Veterans Appeals.--The Committee is 
concerned about ongoing delays veterans and their families 
experience before the Board of Veterans Appeals, often causing 
years-long wait times for final adjudication and resolution of 
claims. Within the funds provided, the Committee urges VA to 
prioritize hiring the staff necessary to allow the efficient 
processing of the Board's current inventory of cases.

                       BOARD OF VETERANS APPEALS

 
 
 
Appropriation, fiscal year 2024.......................      $287,000,000
Budget request, fiscal year 2025......................       267,000,000
Committee recommendation, fiscal year 2025............       267,000,000
    Change from enacted level.........................       -20,000,000
    Change from budget level..........................             - - -
 

    The Committee recommendation includes $267,000,000 for the 
Board of Veterans Appeals, which is $20,000,000 below fiscal 
year 2024 enacted level. Ten percent of this funding is 
available through September 30, 2026.
    VA Board of Appeals Backlog.--Congress has provided 
significant funding increases to enable VA to hire the staff, 
acquire the technology, and change work processes necessary to 
significantly reduce the appeals backlog. The Committee is 
concerned that despite these investments, the Board of 
Veterans' Appeals has not adequately addressed the backlog of 
veterans waiting for a decision and that the inventory of 
pending appeals cannot be depleted with the Board of Veterans' 
Appeals' current policies and procedures. The Committee directs 
the Secretary to prioritize the processing of appeals and to 
submit a plan no later than 90 days after the enactment of this 
legislation detailing a strategy to clear the backlog of cases 
within 36 months.

                     INFORMATION TECHNOLOGY SYSTEMS

                     (INCLUDING TRANSFER OF FUNDS)

 
 
 
Appropriation, fiscal year 2024.......................    $6,401,000,000
Budget request, fiscal year 2025......................     6,231,680,000
Committee recommendation, fiscal year 2025............     6,231,680,000
    Change from enacted level.........................      -169,320,000
    Change from budget request........................             - - -
 

    The Committee recommendation includes $6,231,680,000 for 
Information Technology Systems, which is $169,320,000 below the 
fiscal year 2024 enacted amount. Within the account total, the 
Committee allocates $1,686,245,270 for pay and associated 
costs; $4,544,475,000 for operations and maintenance; and 
$118,900,000 for activations.
    The bill makes available three percent of pay and 
associated costs and five percent of operations and maintenance 
funds until September 30, 2026. All development funds are 
available until September 30, 2026.
    The Committee continues bill language permitting the 
transfer of funding among the three subaccounts upon approval 
of the Committees on Appropriations of both Houses of Congress.
    The bill also continues language allowing for the 
reprogramming of funds among development projects upon approval 
by the Committees on Appropriations of both Houses of Congress.
    The Committee continues to include bill language limiting 
the funds available for information technology systems 
development to the projects and in the amounts specified in the 
report. The bill limits the amount of funds that can be 
transferred into the IT account to ten percent of the total of 
either the source or destination account. The bill contains 
language that permits the reprogramming of funds among 
development projects upon prior notification to, and approval 
by, the Committees on Appropriations of both Houses of 
Congress.
    The Committee expects the Office of Information and 
Technology (OIT) to continue to provide an IT expenditure 
report to the Committees on Appropriations of both Houses of 
Congress on a monthly basis. This report should include a 
comparison to the project costs included in the development 
funding chart above and provide an explanation for any 
differences in excess of $3,000,000.
    Small Business IT Security Partners.--The Committee urges 
the Office of Information Technology to increase utilization of 
small businesses in implementing IT security programs, 
including in the areas of secure storage and encryption.

                   VETERANS ELECTRONIC HEALTH RECORD

 
 
 
Appropriation, fiscal year 2024.......................    $1,334,142,000
Budget request, fiscal year 2025......................       894,000,000
Committee recommendation, fiscal year 2025............       894,000,000
    Change from enacted level.........................      -440,142,000
    Change from budget request........................             - - -
 

    The bill includes $894,000,000, as requested, for Veterans 
Electronic Health Record, which is $440,142,000 below the 
enacted level. This reduction reflects deferred deployments and 
focus on current site optimization, sustaining infrastructure, 
and supporting 6 live sites. It also assumes costs for 
activities related to the development and rollout of VA's 
Electronic Health Record Modernization (EHRM) initiative, the 
associated contractual costs, and the salaries and expenses of 
employees hired under titles 5 and 38, United States Code. 
Within the total, the bill includes $375,000,000 for the 
electronic health record contract; $191,009,000 for 
infrastructure readiness; and $327,890,000 for program 
management. Funding is made available for three fiscal years.
    This account is intended to be the single source of funding 
within VA for the electronic health record effort. No authority 
is provided for funds from other VA accounts to be transferred 
into this account nor for funds from this account to be 
transferred out to other accounts.
    The Committee continues to direct the Department to manage 
this initiative in the Office of the Deputy Secretary and 
provide monthly briefings on program implementation, including 
updates on progress resolving outstanding issues, and to 
provide quarterly updates to review timelines, performance 
milestones, implementation, and change management progress. The 
Government Accountability Office is directed to continue 
quarterly performance reviews of EHRM deployment and to report 
to the Committees on each quarter.
    Future Deployments.--The Committee has been encouraged by 
EHRM's rollout at Captain James A. Lovell Federal Health 
Community Center. However, the Committee is concerned that the 
Department did not include funding for future deployments in 
this year's request. The Committee requests a report that 
outlines the Department's plan to schedule deployments, 
potential shortcomings that could hinder deployments, and 
actions VA will take to execute a schedule within 90 days of 
enactment of this Act.
    Contractor Accountability.--The Committee expects the 
Department to hold its contractors accountable. The Department 
is expected to work closely with Oracle Cerner to resolve 
usability problems and dramatically improve training to ensure 
that when deployments restart the new system can be adopted 
easily by clinicians and healthcare staff.
    Life-Cycle Cost Estimate.--The Committee continues to 
require that at least annually the Department provide a report 
to the Committee on Appropriation that compares current 
estimated costs to the revised Life Cycle Cost Estimate to the 
estimate provided by the Institute for Defense Analyses.

                      OFFICE OF INSPECTOR GENERAL

 
 
 
Appropriation, fiscal year 2025.......................      $296,000,000
Budget request, fiscal year 2026......................       296,000,000
Committee recommendation, fiscal year 2026............       296,000,000
    Change from enacted level.........................             - - -
    Change from budget request........................             - - -
 

    The Committee recommendation includes $296,000,000 for 
fiscal year 2025 for the Office of the Inspector General, which 
is equal to the budget request. The bill makes up to ten 
percent of this funding available until September 30, 2026.
    The Committee continues to request robust oversight of the 
Electronic Health Record Modernization initiative and medical 
community care claims.
    VA Claims Backlog.--OIG is encouraged to continue to review 
VA's work to address the claims backlog and report to the 
Committee about such efforts. This report should analyze how 
VA's partnership with the National Archives and Records 
Administration to digitally scan all paper-based military 
personnel files has helped address and resolve the backlog as 
well as any changes in wait times and size of the claims 
backlog.

                      CONSTRUCTION, MAJOR PROJECTS

 
 
 
Appropriation, fiscal year 2024.......................      $961,218,560
Budget request, fiscal year 2025......................     2,069,000,000
Committee recommendation, fiscal year 2025............     2,069,000,000
    Change from enacted level.........................    +1,107,781,000
    Change from budget request........................             - - -
 

    The Committee recommendation includes $2,069,000,000 for 
Construction, Major Projects for fiscal year 2025, of which 
$1,265,300,000 shall remain available until September 30, 2029, 
and of which $803,700,000 shall remain available until 
expended. In addition, the Committee supports the Department's 
plan to allocate $1,403,110,000 to support major construction 
projects in West Los Angeles, CA, Dallas, TX, and Denver, CO.
    As required by language that is in permanent law, all major 
construction projects costing more than $100,000,000 must be 
managed by a non-VA government entity, such as the Army Corps 
of Engineers. While the Committee no longer duplicates this 
language, the Committee intends to continue its oversight of 
the quality of the outside entity management and expects to 
receive quarterly briefings on each of the large construction 
projects.
    Construction Reports.--The Committee continues to request 
that VA provide quarterly briefings on the progress and cost of 
each facility managed by an outside entity. Several additional 
bill language provisions are included to enhance the 
Committee's capacity to conduct oversight of VA's facility 
construction efforts including: (1) no funding greater than 
$7,000,000 may be reprogrammed between construction projects 
unless approved by the Committees on Appropriations of both 
Houses of Congress; (2) any change to the scope of a 
construction project is prohibited without the approval of the 
Committees; and (3) VA must report any bid savings of 
$5,000,000 or more on projects as soon as they are identified.
    The Committee does not provide transfer authority between 
twelve VA appropriations and for funds to be transferred to 
major or minor construction to be made available for five 
years.
    The chart below reflects the Committee's recommendation for 
Major Construction projects.

                      CONSTRUCTION, MAJOR PROJECTS
                        [In thousands of dollars]
------------------------------------------------------------------------
                       Project                               Amount
------------------------------------------------------------------------
Veterans Health Administration (VHA)
West Los Angeles, CA--Build New Critical Care Center           1,344,810
 Central Utility Plant, Demolition and Renovations to
 Building 500
Dallas, TX--Clinical Expansion for Mental Health,                 13,300
 Expansion of Parking Facilities and Land Acquisition
Advanced Planning and Design--Various Stations.......            278,409
Asbestos.............................................              1,000
Claims Analysis--Various Stations....................                500
Construction & Facilities Management Staff--Various              213,000
 Stations............................................
Hazardous Waste--....................................              1,000
Non-Departmental Federal Entity Project Management               134,481
 Support--Various Stations...........................
    Total, VHA.......................................          1,986,500
National Cemetery Administration (NCA)
Denver, CO--Fort Logan National Cemetery--Gravesite               45,000
 Expansion...........................................             30,000
    Total, NCA.......................................             75,000
General Administration/Staff Offices
Department Advance Planning and Design Fund for Major              7,500
 Construction........................................
    Total, Major Construction........................          2,069,000
------------------------------------------------------------------------

    To enhance the Committee's capacity to conduct oversight on 
VA's facility construction efforts, several administrative 
provisions are continued in the bill: (1) No funding amount 
greater than $7,000,000 may be reprogrammed between 
construction projects unless approved by the Committees on 
Appropriations of both Houses of Congress; (2) any change to 
the scope of a construction project is not permitted without 
the approval of the Committees; and (3) VA must report any bid 
savings of $5,000,000 or more on projects as soon as they are 
identified.

                      CONSTRUCTION, MINOR PROJECTS

 
 
 
Appropriation, fiscal year 2024.......................      $692,000,000
Budget request, fiscal year 2025......................       380,453,000
Committee recommendation, fiscal year 2025............       380,453,000
    Change from enacted level.........................      -311,547,000
    Change from budget request........................             - - -
 

    The Committee recommendation includes $380,453,000 for 
Construction, Minor Project for fiscal year 2025, of which 
$342,408,000 shall remain available until September 30, 2029, 
and $38,045,000 shall remain available until expended.
    In addition, the Committee supports the Department's plan 
to allocate $307,000,000 from the Recurring Expenses 
Transformational Fund.
    Greater Los Angeles Healthcare System's Master Plan.--The 
Committee continues to encourage the VA to engage with the 
Principal Developer Team responsible for the Greater Los Angles 
Health Care System's Master Plan and support the 
operationalization of the Master Plan, as appropriate.

       GRANTS FOR CONSTRUCTION OF STATE EXTENDED CARE FACILITIES

 
 
 
Appropriation, fiscal year 2024.......................      $171,000,000
Budget request, fiscal year 2025......................       141,000,000
Committee recommendation, fiscal year 2025............       156,000,000
    Change from enacted level.........................       -15,000,000
    Change from budget request........................             - - -
 

    The Committee recommendation includes $156,000,000 for 
fiscal year 2025 for Grants for Construction of State Extended 
Care Facilities, which is $15,000,000 below the fiscal year 
2024 level. A grant may not exceed 65 percent of the total cost 
of the project. The bill makes this funding available until 
expended.
    State Veterans Home Construction Grant Program.--The 
Committee remains concerned about compliance with State 
Veterans Home Construction Grant Program (SHCGP) projects that 
are subject to Build America, Buy America Act (BABAA) 
requirements. The Committee is aware that three USDVA State 
Veterans Home Construction Grant Program projects in Idaho. The 
Committee urges the Secretary to ensure it consults with the 
affected stakeholders to ensure veterans are not negatively 
affected.

             GRANTS FOR CONSTRUCTION OF VETERANS CEMETERIES

 
 
 
Appropriation, fiscal year 2024.......................       $60,000,000
Budget request, fiscal year 2025......................        60,000,000
Committee recommendation, fiscal year 2025............        60,000,000
    Change from enacted level.........................             - - -
    Change from budget request........................             - - -
 

    The Committee recommendation includes $60,000,000 for 
Grants for Construction of Veterans Cemeteries, which is equal 
to the budget request. The bill makes this funding available 
until expended.
    Grants For Construction of Veterans Cemeteries.--The 
Committee applauds the Department's efforts to improve Veterans 
Cemeteries through the Grants for Construction of Veterans 
Cemeteries. Within 60 days of the enactment of this Act, the 
Committee requires a report on the impact of the grants from 
January 1, 2021, to include information on all outstanding 
projects and statistics on state usage of the grants program.

                    COST OF WAR TOXIC EXPOSURES FUND

 
 
 
Fiscal year 2024 enacted level........................             - - -
Fiscal year 2025 enacted level........................             - - -
Fiscal year 2025 budget year request..................             - - -
Committee 2025 budget year recommendation.............             - - -
Fiscal year 2025 advance appropriation request........    22,800,000,000
Committee 2026 advance appropriation recommendation...    22,800,000,000
Comparison with:
    Fiscal year 2024 enacted level....................             - - -
    Fiscal year 2025 advance budget request...........   +22,800,000,000
 

    The bill provides $22,800,000,000 for the Cost of War Toxic 
Exposures Fund (TEF) for advance funding for fiscal year 2026 
for veterans medical care related to toxic exposures.
    Section 103 Expansion.--The Committee requests a briefing 
on how many new enrollments the Department has taken in since 
section 103 expanded, metrics on staffing and work flow 
efficiency, and any new findings that may impact future budget 
requests.

                       Administrative Provisions

    The bill includes 61 administrative provisions, of which 57 
were in effect in fiscal year 2024 and 4 are new. The 
administrative provisions included in the bill are as follows:

                     (INCLUDING TRANSFER OF FUNDS)

    The bill includes section 201 allowing for the transfer of 
funds among three mandatory appropriations. The Administration 
proposal to modify this provision is not adopted.

                     (INCLUDING TRANSFER OF FUNDS)

    The bill includes section 202 allowing the Department to 
transfer funding among the four medical appropriations accounts 
in fiscal year 2025. The Administration proposal to modify this 
provision is not adopted.
    The bill includes section 203 allowing for salaries and 
expenses funds to be used for hire of passenger vehicles, lease 
of facilities or land, and purchase of uniforms.
    The bill includes section 204 providing that only funding 
in ``Construction, Major Projects'' and ``Construction, Minor 
Projects'' can be used for the purchase of any site for any new 
hospital or home or to construct any new hospital or home.
    The bill includes section 205 requiring the Department to 
be reimbursed for medical services it provides to any person 
not defined as a beneficiary to ensure the Department is 
receiving payment for all medical services provided.
    The bill includes section 206 allowing for the use of funds 
appropriated in fiscal year 2025 for ``Compensation and 
Pensions'', ``Readjustment Benefits'', and ``Veterans Insurance 
and Indemnities'' for payment of accrued obligations recorded 
in the last quarter of fiscal year 2024.
    The bill includes section 207 allowing for the use of 
fiscal year 2025 funds to pay prior year obligations resulting 
from implementation of sections 3328(a), 3334, and 3712(a) of 
title 31, United States Code.

                     (INCLUDING TRANSFER OF FUNDS)

    The bill includes section 208 allowing the Department to 
use surplus earnings from the national service life insurance, 
U.S. Government life insurance, and veterans' special life 
insurance program to administer these programs.
    The bill includes section 209 allowing enhanced-use lease 
proceeds deducted for administrative expenses that were 
incurred in a prior fiscal year to be available until expended.

                     (INCLUDING TRANSFER OF FUNDS)

    The bill includes section 210 limiting the amount of 
reimbursement the Office of Resolution Management, Diversity 
and Inclusion, the Office of Employment Discrimination 
Complaint Adjudication, and the Alternative Dispute Resolution 
function within the Office of Human Resources and 
Administration can charge other offices and accounts of the 
Department for services provided.
    The bill includes section 211 requiring the Department to 
collect current and accurate third-party reimbursement 
information for the purposes of third-party insurance 
collections. If persons receiving care or medical services do 
not disclose this information, the Department is allowed to 
bill them reasonable charges for services provided.

                     (INCLUDING TRANSFER OF FUNDS)

    The bill includes section 212 allowing the Department to 
use enhanced-use lease funds for construction and alteration of 
medical facilities.
    The bill includes section 213 allowing the Department to 
use the Medical Services appropriation for expenses related to 
the broader mission of medical care to veterans.

                     (INCLUDING TRANSFER OF FUNDS)

    The bill includes section 214 allowing the Department to 
transfer Medical Care Collections to the ``Medical Services'' 
and ``Medical Community Care'' accounts to be used for veterans 
medical care and makes those funds available until expended.
    The bill includes section 215 allowing veterans who reside 
in Alaska to obtain medical services from medical facilities 
supported by the Indian Health Service or tribal organizations, 
and provides for reimbursement for those services from VA.

                     (INCLUDING TRANSFER OF FUNDS)

    The bill includes section 216 allowing the Department to 
transfer the proceeds received from the transfer of real 
property deposited into the VA Capital Asset Fund to the Major 
and Minor Construction appropriations accounts and makes those 
funds available until expended.
    The bill includes section 217 requiring the Secretary to 
submit quarterly reports to the Committees on Appropriations of 
both Houses of Congress on the financial status of the 
Department of Veterans Affairs.

                     (INCLUDING TRANSFER OF FUNDS)

    The bill includes section 218 prohibiting the Department 
from increasing total resources of the Information Technology 
appropriation by more than ten percent by transferring funding 
from the other VA accounts and requires the Department to 
receive approval from the Committees on Appropriations of both 
Houses of Congress before such transfer. The Administration 
proposal to modify this provision is not adopted.

                     (INCLUDING TRANSFER OF FUNDS)

    The bill includes section 219 providing up to $594,828,000 
of fiscal year 2025 funds for transfer to the Joint DOD-VA 
Medical Facility Demonstration Fund. Additional funding may be 
transferred from these accounts upon written notification to 
the Committees on Appropriations of both Houses of Congress.

                     (INCLUDING TRANSFER OF FUNDS)

    The bill includes section 220 permitting the transfer of 
$664,625,000 of fiscal year 2025 funding appropriated for 
medical accounts to the Joint DOD-VA Medical Facility 
Demonstration Fund for the operation of facilities designated 
as combined Federal medical facilities.

                     (INCLUDING TRANSFER OF FUNDS)

    The bill includes section 221 permitting the transfer of 
funds deposited in the Medical Care Collections Fund to the 
Joint DOD-VA Medical Facility Demonstration Fund for facilities 
designated as combined Federal medical facilities.

                     (INCLUDING TRANSFER OF FUNDS)

    The bill includes section 222 directing that a minimum of 
$15,000,000 shall be transferred from the four medical care 
appropriations to the Department of Defense/Department of 
Veterans Affairs Health Care Sharing Incentive Fund, to be 
available until expended.
    The bill includes section 223 requiring the Secretary to 
notify the Committees on Appropriations of both Houses of 
Congress of all bid savings when identified in Major 
Construction projects that total at least $5,000,000 or five 
percent of the programmed amount of the project. The 
Administration proposal to delete this provision is not 
adopted.
    The bill includes section 224 prohibiting the original 
scope of work for a Major Construction project from being 
increased above the scope specified for that project in the 
original justification data provided to Congress unless 
approved by the Committees on Appropriations of both Houses of 
Congress. The Administration proposal to delete this provision 
is not adopted.
    The bill includes section 225 requiring a quarterly report 
from each VBA regional office on pending disability claims, 
both initial and supplemental; error rates; the number of 
claims processing personnel; corrective actions taken; training 
programs; and review team audit results. In addition, the bill 
requires quarterly reporting on pending appeals at VBA, as well 
as BVA. The Administration proposal to delete this provision is 
not adopted.
    The bill includes section 226 requiring advance written 
notification to the Committees on Appropriations of both Houses 
of Congress 15 days prior to organizational changes which 
result in the transfer of 25 or more full-time equivalent staff 
from one organizational unit to another. The Administration 
proposal to delete this provision is not adopted.
    The bill includes section 227 requiring the Secretary to 
provide, on a quarterly basis to the Committees on 
Appropriations of both Houses of Congress, notification of any 
single national outreach and awareness marketing campaign in 
which obligations exceed $1,000,000. The Administration 
proposal to delete this provision is not adopted.

                     (INCLUDING TRANSFER OF FUNDS)

    The bill includes section 228 permitting the transfer to 
``Medical Services'' from any discretionary program except 
``General Operating Expenses, Veterans Benefits 
Administration'' upon approval of the Committees on 
Appropriations of both Houses of Congress. This provision is 
intended to give VA flexibility as it administers the changes 
to its traditional healthcare program and the MISSION Act. The 
Administration proposal to modify this provision is not 
adopted.

                     (INCLUDING TRANSFER OF FUNDS)

    The bill includes section 229 permitting the transfer of 
funds between the ``Board of Veterans Appeals'' and ``General 
Operating Expenses, Veterans Benefits Administration'' upon 
approval of the Appropriations Committees on Appropriations of 
both Houses of Congress. The Administration proposal to modify 
this provision is not adopted.
    The bill includes section 230 prohibiting the reprogramming 
of funds exceeding $7,000,000 among the Major Construction 
projects unless the Committees on Appropriations of both Houses 
of Congress approve the request. The Administration proposal to 
modify this provision is not adopted.
    The bill includes section 231 requiring the Secretary to 
ensure that the toll-free suicide hotline provides immediate 
assistance from a trained professional and adheres to all 
requirements of the American Association of Suicidology. The 
Administration request to delete this provision is not adopted.
    The bill includes section 232 requiring VA to use the 
mammography screening guidelines announced by the Secretary on 
May 10, 2017, through January 1, 2024. The Administration 
request to delete this provision is not adopted.
    The bill includes section 233 allowing the use of Medical 
Services funding for assisted reproductive technology treatment 
and adoption reimbursement for veterans and their spouses.
    The bill includes section 234 prohibiting any funds from 
being used in a manner that is inconsistent with statutory 
limitations on outsourcing.
    The bill includes section 235 pertaining to exceptions for 
Indian- or Native Hawaiian-owned businesses contracting with 
VA.
    The bill includes section 236 directing the elimination 
over a series of years of the use of Social Security numbers in 
VA programs.
    The bill includes section 237 referencing the provision in 
the Continuing Appropriations and Military Construction, 
Veterans Affairs, and Related Agencies Appropriations Act, 
2017, and Zika Response and Preparedness Act (P.L. 114-223) 
pertaining to certification of marriage and family therapists. 
The Administration request to delete this provision is not 
adopted.
    The bill includes section 238 which prohibits funds from 
being used to transfer funding from the Filipino Veterans 
Equity Compensation Fund to any other VA account. The 
Administration request to delete this provision is not adopted.
    The bill includes section 239 permitting funding to be used 
in fiscal years 2025 and 2026 to carry out and expand the 
childcare pilot program authorized by section 205 of the 
Caregivers and Veterans Omnibus Health Services Act of 2010 
(P.L. 111-163).
    The bill includes section 240 prohibiting VA from using 
funds to enter into an agreement to resolve a dispute or claim 
with an individual that would restrict the individual from 
speaking to Members of Congress or their staff on any topic, 
except those required to be kept secret in the interest of 
national defense or the conduct of foreign affairs. The 
Administration request to delete this provision is not adopted.
    The bill includes section 241 referencing language in the 
Continuing Appropriations and Military Construction, Veterans 
Affairs, and Related Agencies Appropriations Act, 2017, and 
Zika Response and Preparedness Act (P.L. 114-223) requiring 
certain data to be included in budget justifications for major 
construction projects. The Administration request to delete 
this provision is not adopted.
    The bill includes section 242 prohibiting the use of funds 
to deny the Inspector General timely access to information 
unless a provision of law expressly refers to the Inspector 
General and expressly limits such access.
    The bill includes section 243 prohibiting funding from 
being used in a manner that would increase wait times for 
veterans at medical facilities. The Administration request to 
delete this provision is not adopted.
    The bill includes section 244 prohibiting the use of funds 
in fiscal year 2025 to convert any program that received 
specific purpose funds in fiscal year 2024 to a general 
purpose-funded program without the approval of the Committees 
on Appropriations of both Houses of Congress at least 30 days 
prior to any such action. The Administration request to delete 
this provision is not adopted.
    The bill includes section 245 regarding verification of 
service for coastwise merchant seamen.
    The bill includes section 246 regarding the use of canines, 
felines, and non-human primates in VA research.
    The bill includes section 247 regarding staffing ratios.
    The bill includes section 248 to allow fiscal year 2025 and 
2026 ``Medical Community Care'' funds to be used to cover 
obligations that would have otherwise been paid by the Veterans 
Choice Fund.
    The bill includes section 249 allowing obligations and 
expenditures applicable to the ``Medical Services'' account in 
fiscal years 2017 through 2019 for aid to state homes to remain 
in the ``Medical Community Care'' account for such fiscal 
years.
    This bill includes section 250 specifying an amount from 
the four medical care accounts for gender-specific care for 
women. The administration request to delete this provision is 
not adopted.
    The bill includes section 251 regarding a community-based 
outpatient clinic in Bakersfield, California.
    The bill includes section 252 requiring quarterly reports 
on the status of the ``Veterans Medical Care and Health Fund,'' 
established to execute section 8002 of the American Rescue Plan 
(P.L. 117-2).
    The bill includes section 253 establishing a timeline for 
construction in accordance with a lease.
    The bill includes section 254 regarding the use of 
unobligated balances to support construction projects in the 
CHIP-IN program.
    The bill includes section 255 prohibiting federal funding 
for abortions except in cases of incest, rape, or life of the 
mother and prohibiting federal funding to implement the 
Department of Veterans Affairs' Interim Final Rule on abortion.
    The bill includes section 256 prohibiting federal funding 
for hormone therapies or surgeries for gender-affirming care.
    The bill includes section 257 permitting certain flags to 
be flown over VA facilities.
    The bill includes section 258 prohibiting federal funding 
for administering, implementing, or enforcing the final rule 
issued by the Secretary of Veterans Affairs related to special 
modes of transportation (88 Fed. Reg. 10032).
    This bill includes section 259 prohibiting federal funds 
for carrying out the Coronavirus Disease 2019 Vaccination for 
Veterans Health Administration Health Care Personnel (VHA 
Directive 11903).
    This bill includes section 260 prohibiting federal funds 
for providing services to individuals who are unlawfully 
present in the United States and are not eligible for health 
care under laws administered by the Secretary of Veterans 
Affairs.
    This bill includes section 261 prohibiting the Secretary of 
Veterans Affairs to use federal funding to report a person who 
is deemed mentally incapacitated, mentally incompetent, or to 
be experiencing an extended loss of consciousness who has been 
adjudicated as a mental defective, without the order or finding 
a judge, magistrate, or other judicial authority that a person 
is in danger to himself or herself or others.

                               TITLE III


                            RELATED AGENCIES


                  American Battle Monuments Commission


                         SALARIES AND EXPENSES

 
 
 
Appropriation, fiscal year 2024.......................      $158,630,000
Budget request, fiscal year 2025......................        89,520,000
Committee recommendation, fiscal year 2025............        90,020,000
    Change from enacted level.........................       -68,610,000
    Change from budget request........................          +500,000
 

    The recommendation includes $90,020,000 for Salaries and 
Expenses of the American Battle Monuments Commission (ABMC).
    Identifying Improperly Buried Servicemembers.--The 
Committee recommendation includes an additional $500,000 for 
ABMC to award a contract for the purpose of researching and 
identifying American-Jewish servicemembers buried at American 
military cemeteries who were buried under markers incorrectly 
representing their religion and heritage. The research should 
also include identifying surviving next of kin of these 
servicemembers. The ABMC should prioritize making an award to 
an organization with a demonstrated capability and expertise in 
conducting such research and identification activities. The 
Committee requests a report within 180 days of enactment of 
this Act on progress towards identifying incorrect markers for 
American-Jewish servicemembers, timeline for completion, and 
expected future funding requirements.
    ABMC Mission.--The Committee requests that ABMC submit to 
the Committee on Appropriations a report not later than 90 days 
after enactment of the Act on the role of remembrance 
activities including facilitating flower orders for families of 
the fallen in its mission and the reason for any changes to 
that role and in its mission over time.
    National Memorial Day Parade.--The National Memorial Day 
Parade is the largest Memorial Day event in the nation. The 
Committee encourages American Battle Monuments Commission to 
partner with relevant stakeholders, including the National 
Parks Service, the city of Washington D.C., and non-profit 
stakeholders to support a sustainable path forward for this 
important American tradition.

                 FOREIGN CURRENCY FLUCTUATIONS ACCOUNT

    The recommendation includes such sums as necessary for the 
Foreign Currency Fluctuations Account (FCFA). The Foreign 
Currency Fluctuations account addresses exchange rate 
imbalances between the U.S. Dollar, the European Euro, and 
other foreign currencies. If exchange rates change at time of 
expenditure, funds from FCFA are transferred to Salaries and 
Expenses.

                            CAPITAL PROGRAM

 
 
 
Appropriation, fiscal year 2024.......................       $44,000,000
Budget request, fiscal year 2025......................             - - -
Committee recommendation, fiscal year 2025............             - - -
    Change from enacted level.........................             - - -
    Change from budget request........................             - - -
 

    The recommendation includes no funds as requested for the 
Capital Program Account.

           United States Court of Appeals for Veterans Claims


                         SALARIES AND EXPENSES

 
 
 
Appropriation, fiscal year 2024.......................       $47,200,000
Budget request, fiscal year 2025......................        47,300,000
Committee recommendation, fiscal year 2025............        47,300,000
    Change from enacted level.........................          +100,000
    Change from budget request........................             - - -
 

    The recommendation includes $47,300,000 for Salaries and 
Expenses for the United States Court of Appeals for Veterans 
Claims.

                      Department of Defense--Civil


                       Cemeterial Expenses, Army


                         SALARIES AND EXPENSES

 
 
 
Appropriation, fiscal year 2024.......................       $98,800,000
Budget request, fiscal year 2025......................       105,514,000
Committee recommendation, fiscal year 2025............       105,514,000
    Change from enacted level.........................        +5,634,000
    Change from budget request........................             - - -
 

    The recommendation includes $105,514,000 for Salaries and 
Expenses for Arlington National Cemetery, which is equal to the 
fiscal year 2025 budget request.
    Virtual Tours.--The Committee appreciates the efforts to 
improve the interactive tools available to Arlington National 
Cemetery (ANC) visitors and understands that the ANC is 
currently working to supplement the visitor experience through 
the creation of a three-dimensional virtual tour utilizing 
ground level, interactive, 360-degree perspective, with key 
interactive information about every internment. The Committee 
encourages the ANC to continue engaging with stakeholders to 
explore virtual tour technologies for potential use in the 
future.

                              CONSTRUCTION

 
 
 
Appropriation, fiscal year 2024.......................       $88,600,000
Budget request, fiscal year 2025......................        42,000,000
Committee recommendation, fiscal year 2026............        42,000,000
    Change from enacted level.........................       -46,600,000
    Change from budget request........................             - - -
 

    The recommendation includes $42,000,000 to complete the 
Southern Expansion, to remain available until expended. The 
Committee reminds the Army to include status updates in its 
required quarterly reports on funds obligated, including 
previously appropriated funds, and funds remaining for the 
Southern Expansion project, as well as any remaining unfunded 
needs to complete the project.

                      Armed Forces Retirement Home


                               TRUST FUND

    The recommendation includes a total of $69,520,000 for the 
Armed Forces Retirement Home (AFRH) Trust Fund, including 
$1,000,000 for capital projects and $25,000,000 from the 
general fund of the Treasury.
    Redevelopment of AFRH Washington, DC Campus.--The Committee 
notes that the Armed Forces Retirement Home (AFRH) announced 
its decision to terminate the RFP from 2018 for the mixed-use 
development project of 80 acres of the Home's Washington, DC 
campus in October, 2023. To date, AFRH has not provided 
congressional stakeholders or other affected parties with 
support for its explanation of the decision to terminate the 
redevelopment initiative, which is a central element of the 
AFRH Master Plan and a critical step toward providing a 
dedicated source of revenue to support the long-term 
sustainability of the AFRH, including the Washington, DC 
campus. The Committee has historically expressed concern about 
the use of the General Fund to support the AFRH and has 
directed the AFRH to increase revenues and stabilize the Trust 
Fund for the long term. The decision by the AFRH to terminate 
the project without consultation or communication with the 
Committee is concerning and undermines the long-term viability 
of the Washington, DC campus and, more importantly, the well-
being of the resident veterans in its care. The Committee 
directs the Department to conduct and provide to the Committee, 
within 90 days of enactment of this Act, a detailed evaluation 
of the AFRH decision and justification to terminate the mixed-
use redevelopment project at the AFRH Washington, DC campus. 
Such report shall address the following: (1) terms of the 
negotiated agreement AFRH claims could not be finalized, (2) 
the economic analysis upon with AFRH relied for its termination 
decision, and (3) the specific ``significant changes in 
economic conditions'' cited by AFRH for its termination 
decision in the fiscal year 2025 budget submission. The 
Committee further directs AFRH to provide the Committee its 
plan for achieving in a timely fashion a dedicated source of 
revenue to support AFRH operations, including specific 
milestones and costs associated with such plan.
    General Fund.--The Committee continues to be concerned 
about the use of the General Fund to support the AFRH and 
directs it to make progress to increase revenues and stabilize 
the Trust Fund for the long term.
    Land Redevelopment.--The Committee reminds AFRH of the 
direction in the joint explanatory statement accompanying the 
Consolidated Appropriations Act, 2024 (Public Law 118-42) to 
provide a briefing on the options for and timelines associated 
with the future use of the 80-acre master planned parcel.

                       OPERATION AND MAINTENANCE

 
 
 
Appropriation, fiscal year 2024.......................       $43,060,000
Budget request, fiscal year 2025......................        43,520,000
Committee recommendation, fiscal year 2025............        43,520,000
    Change from enacted level.........................          +460,000
    Change from budget request........................             - - -
 

    The Committee makes these operation and maintenance funds 
available until September 30, 2026, as requested, to provide 
AFRH greater ability to respond to emergency situations and 
ensure stable operations.

                            CAPITAL PROGRAM

 
 
 
Appropriation, fiscal year 2024.......................        $8,940,000
Budget request, fiscal year 2025......................         1,000,000
Committee recommendation, fiscal year 2025............         1,000,000
    Change from enacted level.........................        -7,940,000
    Change from budget request........................             - - -
 

    Capital Maintenance Spending Plan.--The Committee directs 
AFRH to provide, no later than 30 days after enactment of this 
Act, an expenditure plan detailing the planned use of the funds 
provided for construction and renovation. The Committee 
continues to direct AFRH to prioritize completing projects that 
are currently underway.

                           MAJOR CONSTRUCTION

 
 
 
Appropriation, fiscal year 2024.......................              $- -
Budget request, fiscal year 2025......................        31,000,000
Committee recommendation, fiscal year 2025............        31,000,000
    Change from enacted level.........................       +31,000,000
    Change from budget request........................             - - -
 

    The Committee reminds AFRH to provide quarterly reports on 
the status of this construction project, including obligations 
of funds, anticipated timelines, and any changes to the overall 
cost of the project.

                        Administrative Provision

    The bill includes section 301 permitting funds from 
concessions at Army National Military Cemeteries to be used to 
support activities at the Cemeteries.

                                TITLE IV


                           GENERAL PROVISIONS

    The bill includes a total of 22 provisions; 12 were in 
effect in fiscal year 2024 and 10 are new:
    The bill includes section 401 prohibiting the obligation of 
funds beyond the current fiscal year unless expressly so 
provided.
    The bill includes section 402 prohibiting the use of funds 
for programs, projects, or activities not in compliance with 
Federal law relating to risk assessment, the protection of 
private property rights, or unfunded mandates.
    The bill includes section 403 encouraging all departments 
and agencies funded in this Act to expand the use of ``E-
Commerce'' technologies and procedures.
    The bill includes section 404 specifying the Congressional 
committees that are to receive all reports and notifications.
    The bill includes section 405 prohibiting the transfer of 
funds to any instrumentality of the United States Government 
without authority from an appropriations Act.
    The bill includes section 406 prohibiting any funds in this 
Act to be used for a project or program named for an individual 
serving as a Member, Delegate, or Resident Commissioner of the 
United States House of Representatives.
    The bill includes section 407 requiring all reports 
submitted to Congress to be posted on official websites of the 
submitting agency.
    The bill includes section 408 prohibiting the use of funds 
to establish or maintain a computer network unless such network 
blocks the viewing, downloading, and exchanging of pornography, 
except for law enforcement investigation, prosecution, or 
adjudication activities.
    The bill includes section 409 prohibiting the use of funds 
for payment of first-class travel by an employee of the 
executive branch.
    The bill includes section 410 prohibiting the use of funds 
in this Act for any contract where the contractor has not 
complied with E-Verify requirements.
    The bill includes section 411 prohibiting the use of funds 
in this Act to construct facilities on military installations 
that do not meet resiliency standards.
    The bill includes section 412 prohibiting the use of funds 
in this Act for the renovation, expansion, or construction of 
any facility in the continental United States for the purposes 
of housing any individual who has been detained at the United 
States Naval Station, Guantanamo Bay, Cuba.
    The bill includes section 413 prohibiting the use of funds 
to support or defeat legislation pending before Congress.
    The bill includes section 414 prohibiting the use of funds 
to implement Executive Order 13985, Executive Order 14035, 
Executive Order 14091 regarding diversity, equity, and 
inclusion activities.
    The bill includes section 415 prohibiting the use of funds 
to promote or advance Critical Race Theory or any concept 
associated with Critical Race Theory.
    The bill includes section 416 prohibiting discrimination 
based on religious beliefs related to marriage.
    The bill includes section 417 prohibiting federal funding 
for Diversity, Equity, and Inclusion training or 
implementation.
    The bill includes section 418 prohibiting federal funding 
for enforcing COVID-19 mask mandates.
    This bill includes section 419 prohibiting federal funding 
for administering, implementing, or enforcing Executive Order 
No. 14057 of December 8, 2021.
    The bill includes section 420 prohibiting federal funding 
for implementing Executive Order No. 13990, Executive Order No. 
14408, Section 6 of Executive Order No. 14013, Executive Order 
No. 14030, Executive No. 14082, and Executive No. 14096 
regarding climate initiatives.
    The bill includes section 421 prohibiting the Department of 
Veterans Affairs from purchasing computers, printers, software, 
or hardware needed for an office environment from the People's 
Republic of China or entities that contribute to the defense 
industry of the Chinese Communist Party.
    The bill includes section 422 establishing a ``Spending 
Reduction Account'' in the bill.

            House of Representatives Reporting Requirements

    The following items are included in accordance with various 
requirements of the Rules of the House of Representatives:

         STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

    Pursuant to clause 3(c)(4) of rule XIII of the Rules of the 
House of Representatives, the following is a statement of 
general performance goals and objectives for which this measure 
authorizes funding:
    The Committee on Appropriations considers program 
performance, including a program's success in developing and 
attaining outcome-related goals and objectives, in developing 
funding recommendations.

                          RESCISSION OF FUNDS

    Pursuant to clause 3(f)(2) of rule XIII of the Rules of the 
House of Representatives, the following statements are 
submitted describing the rescissions in the accompanying bill:
    The bill does not contain any rescission of funds from 
amounts appropriated by prior Acts.

                           TRANSFER OF FUNDS

    Pursuant to clause 3(f)(2) of rule XIII of the Rules of the 
House of Representatives, the following statements are 
submitted describing the transfer of funds provided in the 
accompanying bill.
    Language is included under Title I to allow for the 
transfer of funds from Family Housing, Construction accounts to 
the Department of Defense Family Housing Improvement Fund and 
funds from Military Construction accounts to the Department of 
Defense Military Unaccompanied Housing Improvement Fund.
    Language is included under Title I to provide transfer 
authority from the BRAC account to the Homeowners Assistance 
Program.
    Language is included under Title I to allow the transfer of 
expired funds to the ``Foreign Currency Fluctuations, 
Construction, Defense'' account.
    Language is included under Title II to transfer not to 
exceed $22,816,224 in fiscal year 2026 from Compensation and 
Pensions to General Operating Expenses, Veterans Benefits 
Administration and Information Technology Systems. These funds 
are for the administrative costs of implementing cost-savings 
proposals required by the Omnibus Budget Reconciliation Act of 
1990 and the Veterans' Benefits Act of 1992. Language is also 
included transferring funds to the Medical Care Collections 
Fund to augment funding of medical facilities for nursing home 
care provided to pensioners.
    Language is included under Title II to permit the transfer 
of funds from General Administration to General Operating 
Expenses, Veterans Benefits Administration.
    Language is included under Title II to permit the transfer 
of funds between Information Technology Systems development 
projects and among the three sub-accounts identified in bill 
language subject to the approval of the Committee.
    Language is included under Title II to provide authority 
for the Department of Veterans Affairs for any funds 
appropriated in 2025 for Compensation and Pensions, 
Readjustment Benefits, and Veterans Insurance and Indemnities 
to be transferred among those three accounts.
    Language is included under Title II to transfer funds among 
the Medical Services, Medical Community Care, Medical Support 
and Compliance, and Medical Facilities accounts, subject to 
approval by the Committee.
    Language is included under Title II to permit the funds 
from three life insurance funds to be transferred to General 
Operating Expenses, Veterans Benefits Administration and 
Information Technology Systems for the costs of administering 
such programs.
    Language is included under Title II to permit funding up to 
$150,655,581 to be transferred to General Administration and 
Information Technology Systems from any funds appropriated in 
fiscal year 2025 to reimburse three headquarters offices for 
services provided.
    Language is included under Title II to transfer certain 
funds derived from enhanced-use leasing activities to the 
Construction, Major Projects and Construction, Minor Projects 
accounts.
    Language is included under Title II to allow the transfer 
of funds from the Medical Care Collections Fund to the Medical 
Services and Medical Community Care accounts.
    Language is included under Title II to allow the transfer 
of funds from the Capital Asset Fund to the Construction, Major 
Projects and Construction, Minor Projects accounts.
    Language is included under Title II to allow the transfer 
of funds from various accounts to the Information Technology 
Systems account in an aggregate amount not to exceed ten 
percent of the account appropriation, subject to approval by 
the Committee.
    Language is included under Title II to allow the transfer 
of funds provided for the Department of Veterans Affairs in 
fiscal year 2025 to the Joint Department of Defense-Department 
of Veterans Affairs Medical Facility Demonstration Fund.
    Language is included under Title II allowing fiscal year 
2026 medical care funding to be transferred to the Joint 
Department of Defense-Department of Veterans Affairs Medical 
Facility Demonstration fund.
    Language is included under Title II permitting funds 
deposited to the Medical Care Collections Fund for healthcare 
provided at a combined Federal medical facility to be 
transferred to the Joint Department of Defense-Department of 
Veterans Affairs Medical Facility Demonstration Fund.
    Language is included under Title II to the Department of 
Veterans Affairs that would transfer no less than $15,000,000 
for the DOD-VA Health Care Sharing Incentive Fund as authorized 
by section 8111(d) of title 38, United States Code.
    Language is included under Title II that permits the 
transfer from all discretionary accounts except General 
Operating Expenses, Veterans Benefits Administration, to 
Medical Services, subject to approval by the Committee.
    Language is included under Title II that permits transfer 
of funds between General Operating Expenses, Veterans Benefits 
Administration and the Board of Veterans Appeals, subject to 
approval by the Committee.

   DISCLOSURE OF EARMARKS AND CONGRESSIONALLY DIRECTED SPENDING ITEMS

    The following table is submitted in compliance with clause 
9 of rule XXI, and lists the congressional earmarks (as defined 
in paragraph (e) of clause 9) contained in the bill or in this 
report. Neither the bill nor the report contain any limited tax 
benefits or limited tariff benefits as defined in paragraphs 
(f) or (g) of clause 9 of rule XXI.


          COMPLIANCE WITH RULE XIII, CL. 3(E) (RAMSEYER RULE)

    In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italics, existing law in which no change 
is proposed is shown in roman):
    In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, the Committee notes that the 
accompanying bill does not propose to repeal or amend a statute 
or part thereof.

               CHANGES IN THE APPLICATION OF EXISTING LAW

    Pursuant to clause 3(f)(1)(A) of rule XIII of the Rules of 
the House of Representatives, the following statements are 
submitted describing the effect of provisions in the 
accompanying bill that directly or indirectly change the 
application of existing law.
    Pursuant to clause 3(f)(1)(A) of rule XIII of the Rules of 
the House of Representatives, the following statements are 
submitted describing the effect of provisions in the 
accompanying bill that directly or indirectly change the 
application of existing law.
    Language is included in various parts of the bill to 
continue ongoing activities that require annual authorization 
or additional legislation, which to date have not been enacted.
    Language is included in various parts of the bill to place 
limitations on the use of funds in the bill or change existing 
limitations and which might, under some circumstances, be 
construed as changing the application of existing law.
    Language is included in various parts of the bill to allow 
the Secretary of Defense to exceed certain limitations upon 
notification to the Committee.
    Language is included in various parts of the bill to allow 
funding to be used for official reception and representation 
expenses.
    Language is included in various parts of the bill to enable 
various appropriations to remain available for more than one 
year for some programs for which the basic authority 
legislation does not presently authorize such extended 
availability.
    Language is included in various parts of the bill to permit 
the transfer of funds to other accounts.
    Language is included under Title I to prohibit payments for 
cost plus-a-fixed-fee contracts under certain circumstances.
    Language is included in various parts of the bill to allow 
funds to be used for the hire of passenger motor vehicles.
    Language is included under Title I to allow advances to the 
Federal Highway Administration, Department of Transportation 
under certain circumstances. Language is included under Title I 
to prohibit the use of funds to begin construction of new bases 
without specific appropriations.
    Language is included under Title I to prohibit the use of 
funds for purchase of land or land easements under certain 
circumstances.
    Language is included under Title I to prohibit the use of 
funds for land acquisition, site preparation, and utility 
installation for family housing unless funds have been made 
available in annual appropriations Acts.
    Language is included under Title I to prohibit the use of 
minor construction funds to transfer an activity between 
installations without prior notification.
    Language is included under Title I to prohibit the use of 
funds for the procurement of steel for any activity if American 
steel producers have been denied the opportunity to compete for 
such steel procurements.
    Language is included under Title I to prohibit the use of 
funds to pay real property taxes in any foreign nation.
    Language is included under Title I to prohibit the use of 
funds to initiate a new installation overseas without prior 
notification.
    Language is included under Title I to limit the use of 
funds for architect and engineer contracts under certain 
circumstances.
    Language is included under Title I to limit the use of 
funds for awarding contracts to foreign contractors under 
certain circumstances.
    Language is included under Title I to require the 
Department of Defense to notify the appropriate committees of 
Congress of any proposed military exercises under certain 
circumstances.
    Language is included under Title I to allow prior year 
construction funding to be available for currently authorized 
projects.
    Language is included under Title I to allow payment for the 
cost associated with supervision, inspection, overhead, 
engineering and design on family housing or military 
construction projects that are being completed with expired or 
lapsed funds.
    Language is included under Title I to allow funds to be 
expended on military construction projects for four fiscal 
years after enactment under certain circumstances.
    Language is included under Title I to allow construction 
funds to be transferred to Housing Improvement Funds.
    Language is included under Title I to allow for the 
transfer of BRAC funds to the Homeowners Assistance Program.
    Language is included under Title I to limit funds for the 
operation and maintenance of family housing to those provided 
in this appropriation and to limit amounts expended on repairs 
of general and flag officer quarters under certain 
circumstances.
    Language is included under Title I to allow funds in the 
Ford Island Improvement Account to be available until expended 
for certain purposes.
    Language is included under Title I to allow for the 
transfer of expired funding to the Foreign Currency Fluctuation 
Account under certain circumstances.
    Language is included under Title I to prohibit funds from 
being used for projects at Arlington Cemetery.
    Language is included under Title I directing all amounts 
appropriated to Military Construction (all accounts) be 
immediately available and allotted for the full scope of the 
authorized project.
    Language is included under Title I providing funds for 
unfunded requirements requested by the Services and Combatant 
Commanders.
    Language is included under Title I allowing unobligated 
funds from prior appropriations acts for fiscal years 2018, 
2019, and 2020 to be obligated under certain circumstances.
    Language is included under Title I defining the 
congressional defense committees.
    Language is included under Title I providing funds for 
military laboratory facilities.
    Language is included under Title I providing funds for 
natural disasters.
    Language is included under Title I providing funds for 
child development centers planning and design.
    Language is included under Title I providing funds for 
barracks planning and design.
    Language is included under Title I providing funds for 
demolition.
    Language is included under Title I prohibiting funds to 
close Naval Station Guantanamo Bay, Cuba.
    Language is included under Title II providing for the 
reimbursement to the Department of Defense for the costs of 
verseas employee mail.
    Language is included under Title II to require that the 
Secretary of Veterans Affairs establish a priority for 
treatment of Veterans who are service-connected disabled, lower 
income, or have special needs.
    Language is included under Title II to require that the 
Secretary of Veterans Affairs give priority funding of basic 
medical benefits to priority groups 1 through 6.
    Language is included under Title II to allow the Secretary 
of Veterans Affairs to dispense prescription drugs from VHA 
facilities to enrolled Veterans with privately written 
prescriptions at no additional cost to the Department.
    Language is included under Title II requiring the Secretary 
to ensure sufficient funding is available for the acquisition 
of prosthetics designed for women Veterans.
    Language is included under Title II requiring sufficient 
funding is available for prosthetic research specifically for 
female Veterans and for toxic exposure research.
    Language is included under Title II to require approval of 
a transfer between development projects in the Information 
Technology Systems account.
    Language is included under Title II prohibiting funding in 
the Veterans Electronic Health Record account from being 
obligated in a manner inconsistent with deployment schedules.
    Language is included under Title II establishing time 
limitations and reporting requirements concerning the 
obligation of Major Construction funds, limiting the use of 
funds, allowing the use of funds for program costs, and 
allowing for the reimbursement to the ``General 
Administration'' account for the salaries and expenses of the 
Office of Construction and Facilities Management employees.
    Language is included under Title II to allow Minor 
Construction funds to be used to repair non-medical facilities 
damaged by natural disaster or catastrophe.
    Language is included under Title II permitting transfers 
between mandatory and discretionary accounts, limiting and 
providing for the use of certain funds, funding administrative 
expenses associated with life insurance programs from excess 
program revenues, allowing reimbursement from enhanced-use 
leases and for certain services, requiring notification of 
construction bid savings, limiting reprogramming amount of 
major construction projects, restricting changes in the scope 
of major construction projects, requiring disclosure of 
insurance and income information, allowing a recovery audit 
collection program, allowing Veterans in the State of Alaska to 
use Indian Health Service facilities under certain conditions, 
requiring quarterly reports on the Department's financial 
status, performance measures, and data, allowing medical 
services funds for recreational and funeral expenses, and 
requiring notification of organizational changes that transfer 
25 or more employees rom one VA organizational unit to another.
    Language is included under Title II requiring notification 
of any single national outreach and awareness marketing 
campaign in which obligations exceed $1,000,000.
    Language is included under Title II requiring the Secretary 
to maintain certain requirements in operating the toll-free 
suicide hotline.
    Language is included under Title II prohibiting funds from 
being used in contravention of certain breast cancer screening 
guidance.
    Language is included under Title II to allow covered 
veterans and their spouses or partners, under certain 
conditions, to receive assisted reproductive technology 
services and adoption reimbursement.
    Language is included under Title II pertaining to 
exceptions for Indian-or Native Hawaiian-owned businesses 
contracting with the Department.
    Language is included under Title II directing the 
elimination of using Social Security account numbers to 
identify individuals in all information systems of the 
Department.
    Language is included under Title II pertaining to 
certification of marriage and family therapists.
    Language is included under Title II prohibiting funds from 
being used to transfer funding from the Filipino Veterans 
Equity Compensation Fund to any other VA account.
    Language is included under Title II permitting funds to 
carry out and expand the childcare program.
    Language is included under Title II prohibiting funds to 
enter into an agreement to resolve a dispute or claim with an 
individual that would restrict the individual from speaking to 
Members of Congress or their staff.
    Language is included under Title II requiring certain data 
to be included in budget justifications for major construction 
projects.
    Language is included under Title II prohibiting the 
Inspector General from being denied timely access to 
information.
    Language is included under Title II prohibiting funding to 
be used in a manner that would increase wait times for Veterans 
who seek medical care.
    Language is included under Title II prohibiting the use of 
funds in fiscal year 2024 to convert any program that received 
specific purpose funding in fiscal year 2023 to a general 
purpose-funded program.
    Language is included under Title II prohibiting the use of 
dogs or cats as part of the conduct of any study.
    Language is included under Title II allowing for funds 
within the Medical Community Care account to be used for 
expenses that would have otherwise been payable from the 
Veterans Choice Fund.
    Language is included under Title II allowing for 
obligations and expenditures applicable to the Medical Services 
account in fiscal years 2017 through 2019 for aid to state 
homes to remain in the Medical Community Care account for such 
fiscal years.
    Language is included under Title II providing for a certain 
amount within the medical care accounts to be made available 
for gender-specific care and programmatic efforts to deliver 
care for women veterans.
    Language is included under Title II rescinding unobligated 
balances in the ``Recurring Expenses Transformational Fund.''
    Language is included under Title II requiring quarterly 
reports on the status of the Veterans Medical Care and Health 
Fund.
    Language is included under Title II allowing the use of 
unobligated balances for CHIP-In construction projects. 
Language is included under Title II to require an expenditure 
plan for funds made available in the Fiscal Responsibility Act 
of 2023 (P.L. 118-5).
    Language is included under Title II prohibiting federal 
funding for abortions except in cases of incest, rape, or life 
of the mother and prohibiting federal funding for implementing 
the Department of Veterans Affairs Interim Final Rule on 
abortion.
    Language is included under Title II regarding funding for 
hormone therapies or surgeries for gender-affirming care.
    Language is included under Title II permitting certain 
flags to be flown at VA facilities. Language is included under 
Title II prohibiting the use of funds to implement 88. Fed. 
Reg. 10032.
    Language is included under Title II prohibiting the use of 
funds to carry out VHA Directive 1193.01.
    Language is included prohibiting the use of to provide any 
services to any individual unlawfully present in the United 
States who is not eligible for health care under the laws 
administered by the Secretary of Veterans Affairs.
    Language is included under Title II prohibiting the 
Secretary of Veterans Affairs from reporting who is deemed 
mentally incapacitated, mentally incompetent, or experiencing 
an extended loss of consciousness as mental defective under 18 
U.S.C (d)(4) or (g)(4).
    Language is included under Title III, United States Court 
of Appeals for Veterans Claims, Salaries and Expenses, to 
permit the use of funds for a pro bono program.
    Language is included under Title III, Cemeterial Expenses, 
Army, Salaries and xpenses, to permit the use of funds for 
parking maintenance and repairs.
    Language is included under Title III, Armed Forces 
Retirement Home to permit payment from the general fund of the 
Treasury to the Trust Fund.
    Language is included under Title III to allow for the use 
of concession fees.
    Language is included under Title IV prohibiting funding 
beyond the current fiscal year unless expressly so provided.
    Language is included under Title IV to limit the use of 
funds for Federal entities when they are not in compliance with 
Federal law relating to risk assessment, the protection of 
private property rights, or unfunded mandates.
    Language is included under Title IV providing funding to 
expand the use of ``E Commerce'' technologies and procedures.
    Language is included under Title IV specifying the 
Congressional committees that are to receive all reports and 
notifications.
    Language is included under Title IV prohibiting the 
transfer of funds to any instrumentality of the United States 
Government without authority from an appropriations Act.
    Language is included under Title IV prohibiting the use of 
funds for a project or program named for an individual serving 
as a Member, Delegate, or Resident Commissioner of the United 
States House of Representatives.
    Language is included under Title IV requiring all reports 
submitted to the Congress to be posted on the official public 
website of that agency.
    Language is included under Title IV prohibiting funds from 
being used to maintain or establish a computer network unless 
such network blocks the viewing, downloading, and exchanging of 
pornography.
    Language is included under Title IV prohibiting funds from 
being used to pay for first-class travel in violation of 
Federal regulations.
    Language is included under Title IV prohibiting funds from 
being used to execute a contract for goods or services where a 
contractor has not complied with Executive Order 12989.
    Language is included under Title IV prohibiting the use of 
funds in this Act to construct facilities on military 
installations that do not meet resiliency standards.
    Language is included under Title IV prohibiting funds to 
build or house detainees at Naval Station Guantanamo Bay, Cuba.
    Language is included under Title IV prohibiting funds for 
executive orders related to diversity, equity, and inclusion.
    Language is included under Title IV prohibiting use of 
funds to directly or indirectly influence an appropriation 
mattered pending before Congress, other than to communicated 
with Members of Congress as described in 18 U.S.C 1913.
    Language is included under Title IV prohibiting use of 
funds to carry Executive Order 13985, Executive Order 14035, or 
Executive Order 14091.
    Language is included under Title IV prohibiting funds to 
teach or promote Critical Race Theory.
    Language is included under Title IV prohibiting 
discrimination based on religious beliefs related to marriage.
    Language is included under Title IV prohibiting Diversity, 
Equity, and Inclusion training or implementation.
    Language is included under Title IV prohibiting use of 
funds to enforce COVID-19 mask mandates.
    Language is included under Title IV prohibiting use of 
funds to administer, implement, or enforce Executive Order 
14057.
    Language is included under Title IV prohibiting use of 
funds to implement Executive Order 13990, Executive Order 
14008, Executive Order 14013, Executive Order 14030, Executive 
Order 14057, Executive Order 14082, and Executive Order 14096.
    Language is included under Title IV prohibiting use of 
funds to purchases various IT related equipment from China.
    Language is included under Title IV regarding a Spending 
Reduction Account.

                  APPROPRIATIONS NOT AUTHORIZED BY LAW

    Pursuant to clause 3(f)(1)(B) of rule XIII of the Rules of 
the House of Representatives, the following table lists the 
appropriations in the accompanying bill which are not 
authorized by law for the period concerned:

                                             [dollars in thousands]
----------------------------------------------------------------------------------------------------------------
                                                                                  Appropriations
                                                   Last year of    Authorization   in  last year  Appropriations
                 Agency/program                    authorization       level            of          in this bill
                                                                                   authorization
----------------------------------------------------------------------------------------------------------------
Military Construction, Army.....................            2024       1,912,289       2,022,775       2,217,757
Military Construction, Navy and Marine Corps....            2024       5,310,740       5,531,369       4,332,414
Military Construction, Air Force................            2024       3,151,314       2,741,424       3,268,276
Military Construction, Defense-Wide.............            2024       3,198,571       3,161,782       3,500,083
Military Construction, Army National Guard......            2024         732,078         620,647         367,129
Military Construction, Air National Guard.......            2024         361,265         295,526               0
Military Construction, Army Reserve.............            2024         234,076         151,076         265,032
Military Construction, Navy Reserve.............            2024          66,291          51,291          67,329
Military Construction, Air Force Reserve........            2024         346,572         331,572          50,499
North Atlantic Treaty Organization Security                 2024         343,434         293,434         433,864
 Investment Program.............................
Family Housing Construction, Army...............            2024         316,284         304,895         276,647
Family Housing Operation and Maintenance, Army..            2024         385,485         395,485         485,611
Family Housing Construction, Navy and Marine                2024         277,142         277,142         245,742
 Corps..........................................
Family Housing Operation and Maintenance, Navy              2024         363,854         373,854         387,217
 and Marine Corps...............................
Family Housing Construction, Air Force..........            2024         264,097         237,097         221,549
Family Housing Operation and Maintenance, Air               2024         314,386         324,386         336,250
 Force..........................................
Family Housing Operation and Maintenance,                   2024          50,785          50,785          52,156
 Defense-Wide...................................
Department of Defense Family Housing Improvement            2024           6,611           6,611           8,195
 Fund...........................................
Department of Defense Military Unaccompanied                2024             496             496             497
 Housing Improvement Fund.......................
Base Realignment and Closure Account............            2024         539,174         489,174         539,174
Dept. of Veterans Affairs, Major Construction...    done each yr  ..............         961,219       2,069,000
Armed Forces Retirement Home....................            2024          77,000          77,000         100,520
----------------------------------------------------------------------------------------------------------------

                          PROGRAM DUPLICATION

    Pursuant to clause 3(c)(5) of rule XIII of the Rules of the 
House of Representatives, no provision of this bill establishes 
or reauthorizes a program of the Federal Government known to be 
duplicative of another Federal program, a program that was 
included in any report from the Government Accountability 
Office to Congress pursuant to section 21 of Public Law 111-
139, or a program related to a program identified in the most 
recent Catalog of Federal Domestic Assistance.

                 COMPARISON WITH THE BUDGET RESOLUTION

    Pursuant to clause 3(c)(2) of rule XIII of the Rules of the 
House of Representatives and Section 308(a)(1)(A) of the 
Congressional Budget Act of 1974 (P.L. 93-344), as amended, the 
following table compares the levels of new budget authority 
provided in the bill with the appropriate allocations under 
section 302(b) of the Budget Act:

                                            [In millions of dollars]
----------------------------------------------------------------------------------------------------------------
                                                         302(b) Allocation                   This Bill
                                                 ---------------------------------------------------------------
                                                      Budget                          Budget
                                                     Authority        Outlays        Authority        Outlays
----------------------------------------------------------------------------------------------------------------
Comparison of amounts in the bill with Committee
 allocations to its subcommittees: Subcommittee
 on Military Construction, Veterans Affairs, and
 Related Agencies
    Discretionary...............................         147,520  ..............         147,520      \1\144,158
    Mandatory...................................  ..............  ..............         221,926      \1\218,333
----------------------------------------------------------------------------------------------------------------
\1\Includes outlays from prior-year budget authority.

                      FIVE-YEAR OUTLAY PROJECTIONS

    Pursuant to clause 3(c)(2) of rule XIII and section 
308(a)(1)(B) of the Congressional Budget Act of 1974 (P.L. 93-
344), as amended, the following table contains five-year 
projections associated with the budget authority provided in 
the accompanying bill as provided to the Committee by the 
Congressional Budget Office.

                        [In millions of dollars]
------------------------------------------------------------------------
                                                               Outlays
------------------------------------------------------------------------
Projection of outlays associated with the recommendation:
    2025...................................................   \1\212,745
    2026...................................................      123,898
    2027...................................................       18,224
    2028...................................................        5,790
    2029 and future years..................................       5,530
------------------------------------------------------------------------
\1\Excludes outlays from prior-year budget authority.

               ASSISTANCE TO STATE AND LOCAL GOVERNMENTS

    Pursuant to clause 3(c)(2) of rule XIII and section 
308(a)(1)(C) of the Congressional Budget Act of 1974 (P.L. 93-
344), as amended, the Congressional Budget Office has provided 
the following estimates of new budget authority and outlays 
provided by the accompanying bill for financial assistance to 
State and local governments.

                        [In millions of dollars]
------------------------------------------------------------------------
                                     Budget Authority       Outlays
------------------------------------------------------------------------
Financial assistance to State and                 276            \1\269
 local governments for 2025.......
------------------------------------------------------------------------
\1\Excludes outlays from prior-year budget authority.



                           COMMITTEE HEARINGS

    Pursuant to clause 3(c)(6) of rule XIII of the Rules of the 
House of Representatives, the following hearings were used to 
develop or consider the Military Construction, Department of 
Veterans Affairs, and Related Agencies Appropriations Act, 
[2025]:
    The Subcommittee on Military Construction, Department of 
Veterans Affairs, and Related Agencies held a hearing on March 
20, 2024, entitled ``Oversight Hearing--Quality of Life in the 
Military''. The Subcommittee received testimony from:
          Sergeant Major Michael A. Weimer, U.S. Army
          Master Chief Petty Officer James A. Honea, U.S. Navy
          Sergeant Major Carlos A. Ruiz, U.S. Marine Corps
          Chief Master Sergeant David A. Flossi, U.S. Air Force
          Chief Master Sergeant John F. Bentivegna, U.S. Space 
        Force
    The Subcommittee on Military Construction, Department of 
Veterans Affairs, and Related Agencies held a hearing on May 1, 
2024, entitled ``Budget Hearing--Fiscal Year 2025 Request for 
Army Military Construction and Family Housing''. The 
Subcommittee received testimony from:
          The Honorable Rachel Jacobson, Assistant Secretary of 
        the Army, Installations, Energy, and Environment 
        Department of Veterans Affairs
          Lieutenant General Kevin Vereen, Deputy Chief of 
        Staff G9, Installation Management Command
          The Subcommittee on Military Construction, Department 
        of Veterans Affairs, and Related Agencies held a 
        hearing on April 16, 2024, entitled ``Budget Hearing--
        Fiscal Year 2024 Request for the Department of Veterans 
        Affairs''. The Subcommittee received testimony from:
          The Honorable Denis McDonough, Secretary, Department 
        of Veterans Affairs
    The Subcommittee on Military Construction, Department of 
Veterans Affairs, and Related Agencies held a hearing on April 
11, 2024, entitled ``Budget Hearing--Fiscal Year 2025 Request 
for Navy and Marine Corps Military Construction and Family 
Housing''. The Subcommittee received testimony from:
          The Honorable Meredith Berger, Assistant Secretary of 
        the Navy, Energy, Installations, and Environment
          Vice Admiral Jeffrey T. Jablon, Deputy Chief of Naval 
        Operations, Fleet Readiness, and Logistics, N4, Office 
        of the Chief of Naval Operations
          Lieutenant General Edward D. Banta, Deputy 
        Commandant, Installations and Logistics, United States 
        Marine Corps
    The Subcommittee on Military Construction, Department of 
Veterans Affairs, and Related Agencies held a hearing on April 
17, 2023, entitled ``Budget Hearing--Fiscal Year 2025 Request 
for Air Force and Space Force Military Construction and Family 
Housing''. The Subcommittee received testimony from:
          Dr. Ravi I. Chaudhary, Assistant Secretary of the Air 
        Force, Energy, Installations, and Environment, 
        Department of the Air Force
          Mr. Bruce Hollywood, Associate Chief Operations 
        Officer, Office of the Chief Operations Officer, United 
        States Space Force
          Brigadier General Brian S. Hartless, Air Force 
        Director of Civil Engineers, Deputy Chief of Staff for 
        Logistics, Engineering and Force Protection, United 
        States Air Force

      COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY

    The following table provides a detailed summary, for each 
Department and agency, comparing the amounts recommended in the 
bill with amounts enacted for fiscal year 2024 and budget 
estimates presented for fiscal year 2025.



                             MINORITY VIEWS

    The fiscal year 2025 Military Construction, Veterans 
Affairs, and Related Agencies (MilCon-VA) bill funds critical 
military construction, family housing, and quality of life 
improvements and enhancements for our brave men and women in 
uniform and their families. The bill also funds a wide variety 
of assistance programs for veterans, including disability and 
pension benefits, healthcare services, educational assistance, 
and home loan and insurance programs they have earned through 
their service to our country. It also funds the American Battle 
Monuments Commission, Armed Forces Retirement Home, Arlington 
National Cemetery, and the Court of Appeals for Veterans 
Claims.
    The fiscal year 2025 MilCon-VA bill, together with funds 
provided in the fiscal year 2024 bill through advance 
appropriations and the Fiscal Responsibility Act of 2023 (FRA), 
provides $380.3 billion for fiscal year 2025, an increase of 
$33.5 billion above current funding levels. Of this amount, 
discretionary funding for programs such as veterans' health 
care and military construction totals $147.5 billion, a 
decrease of $6.4 billion below current funding levels. The bill 
also provides advance funding of $376.5 billion for fiscal year 
2026, including $23 billion through the Cost of War Toxic 
Exposures Fund (TEF) for veterans medical care.
    We thank Chairman Carter and his staff for their work in 
keeping a professional process in place and engaging in 
respectful debate on difficult issues, in spite of clear policy 
differences. While we appreciate the efforts made to 
accommodate Democratic priorities, the funding levels and 
significant policy riders in the MilCon-VA bill are not 
workable or sustainable.

                         MILITARY CONSTRUCTION

    The bill funds military construction at $18 billion, which 
is $718 million below the fiscal year 2024 enacted level. Since 
2021, this committee has built on the progress from the 
previous year and continued to increase investments in military 
construction. This bill backtracks on that progress. In a time 
when we have a recruitment and retention issue, the condition 
of military facilities has a direct impact on the quality of 
life of our servicemembers and their families. We need to be 
strongly investing in infrastructure that supports quality of 
life--including child development centers, gyms, barracks, 
family housing, among others, to better the lives of our 
servicemembers and their families.
    We are pleased that the bill includes Ranking Member 
Wasserman Schultz's request to provide $30 million in dedicated 
funding to expand the oversight of the housing portfolio at the 
Department of Defense, including government-owned and 
controlled family housing and privatized family and 
unaccompanied housing. We appreciate Chairman Carter's shared 
commitment to this oversight and ensuring privatized housing 
providers are held accountable. The wellbeing of servicemembers 
and their families is of utmost importance, and we continue to 
hear unacceptable reports of poor housing conditions, slow 
response times, and indifference towards requests for 
assistance.
    Additionally, we are pleased to see $50 million in 
dedicated funding for PFAS remediation and cleanup. The 
Environmental Protection Agency announced its final rule in 
April 2024 for certain PFAS under the Safe Drinking Water Act 
that sets limits on PFOS and PFOA at 4 parts per trillion, 
which will have a significant impact on DOD's PFAS remediation 
efforts within the Base Closure Account. However, the bill does 
not include additional, dedicated funding for military 
installation climate change and resilience projects, which is a 
cut of $30 million from the current level. It also includes 
$100 million for natural disasters, and while we appreciate 
Chairman Carter including this funding in the bill, it is a cut 
of $50 million from the enacted level. Providing funding for 
resiliency to harden military construction on the front end 
will save taxpayer dollars on the back end to build back after 
natural disasters, and we hope we can work together on these 
issues moving forward.

                     DEPARTMENT OF VETERANS AFFAIRS

    The current version of the bill funds the Department of 
Veterans Affairs at $337.5 billion in total mandatory and 
discretionary resources, which is $30 billion above the enacted 
level and $75.5 million above the budget request. The bill 
provides $112.5 billion for the four medical care accounts, 
equal to the budget request. Combined with the $24.5 billion 
provided for medical care through the TEF in the Fiscal 
Responsibility Act, a total of $137 billion is available for 
medical care in 2025. The bill further provides $131 billion in 
discretionary advance appropriations for medical care. Combined 
with the $22.8 billion provided in advance appropriations for 
medical care through the TEF, the bill provides $154 billion in 
total advance appropriations for 2026 for medical care, equal 
to the request.
    The bill would have been improved if the amendments offered 
by Ranking Member Wasserman Schultz and Congresswoman Lee were 
adopted to strike the partisan riders included in the bill that 
prohibit VA from implementing its rule on abortion; prohibit VA 
from submitting a beneficiary's name to the National Instant 
Criminal Background Check System based on VA's appointment of a 
fiduciary, preventing VA from protecting veterans and those 
around them; prohibit VA from flying Pride flags at its 
facilities; prohibit VA from providing hormone therapy or 
surgical treatment for gender affirming care; create a license 
to discriminate against LGBTQI+ people under the guise of 
religious liberty; prohibit the enforcement of any covid-19 
mask mandate or the vaccine requirement for health care 
personnel; prohibit the implementation of clean energy or 
climate change executive orders; prohibit VA from providing 
financial services to Immigration and Customs Enforcement; 
prohibit the influencing of congressional action aimed to 
prevent VA from providing technical assistance; prohibit funds 
related to Guantanamo Bay that are not germane to the bill; and 
prohibit VA from implementing Diversity, Equity, and Inclusion 
(DEI) executive orders, any DEI programs or training, or any 
concept related to Critical Race Theory. These riders only 
further politicize this bill, and take away from the focus of 
veterans, servicemembers, and their families.
    This subcommittee has a long-standing tradition of 
bipartisanship, and we will work in good faith with our 
colleagues as we proceed through the appropriations process 
with the hope of restoring bipartisan priorities in this bill. 
By working together, we can best address the needs of our 
Nation's military and its veterans and reach an agreement on 
the Military Construction, Veterans Affairs, and Related 
Agencies bill for FY 2025.

                                   Rosa DeLauro.
                                   Debbie Wasserman Schultz.