House Appropriations Committee Issues Report on Military Construction, VA, Related Agencies Appropriations Bill, 2018 (Part 2 of 5)
TITLE II
Fiscal year 2017 enacted level1...................
Fiscal year 2018 budget request1.................. 182,661,467,000
Committee recommendation in the bill1............. 182,277,635,000
Comparison with:
Fiscal year 2017 enacted........................
Fiscal year 2018 budget request................. (383,832,000)
Fiscal year 2019 advance budget request1.......... 178,409,040,000
Fiscal year 2019 Committee recommendation in the 178,409,040,000
bill1............................................ 1All funding cited excludes amounts in the
The
COMPENSATION AND PENSIONS
(INCLUDING TRANSFER OF FUNDS)
Fiscal year 2018 enacted level........................
Fiscal year 2019 advance budget request............... 95,768,462,000
Fiscal year 2019 Committee recommendation in the bill. 95,768,462,000
Comparison with:
Fiscal year 2018 enacted level.................... 5,649,013,000
Fiscal year 2019 budget request................... - - -
This appropriation will provide funds for service-connected compensation payments to an estimated 5,020,000 veterans, survivors, and dependents in 2018. In addition, pension payments will be funded for 493,000 veterans and their survivors. The average cost per compensation case for veterans in 2018 is estimated at
The appropriation includes authority to transfer funding not to exceed
READJUSTMENT BENEFITS
Fiscal year 2018 enacted level........................
Fiscal year 2019 advance budget request............... 11,832,175,000
Fiscal year 2019 Committee recommendation in the bill. 11,832,175,000
Comparison with:
Fiscal year 2018 enacted level.................... (1,876,473)
Fiscal year 2019 budget request................... - - -
This appropriation finances the education and training of veterans and servicemembers through the Post 9-11 GI Bill and the
VETERANS INSURANCE AND INDEMNITIES
Fiscal year 2018 enacted level........................
Fiscal year 2018 additional request................... 12,439,000
Fiscal year 2018 recommendation in the bill........... 12,439,000
Fiscal year 2019 advance budget request............... 109,090,000
Fiscal year 2019 Committee recommendation in the bill. 109,090,000
Comparison with:
Fiscal year 2018 enacted level.................... 1,191,000
Fiscal year 2019 budget request................... - - -
The amount provided will enable the Department to transfer funding to the service-disabled veterans insurance fund and transfer additional amounts for payments for policies under the veterans mortgage life insurance program. These policies are identified under the
VETERANS HOUSING BENEFIT PROGRAM FUND PROGRAM ACCOUNT
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The purpose of the home loan guaranty program is to facilitate the extension of mortgage credit on favorable terms by private lenders to eligible veterans. This appropriation provides for all costs, with the exception of the Native American veterans housing loan program, of the Department's direct and guaranteed loans programs. The Federal Credit Reform Act of 1990 requires budgetary resources to be available prior to incurring a direct loan obligation or a loan guaranty commitment. In addition, the bill requires all administrative expenses of a direct or guaranteed loan program to be funded through a program account. Loan guaranties are made to servicemembers, veterans, reservists, and single surviving spouses for the purchase of homes, condominiums, and manufactured homes and for refinancing loans. The Department guarantees part of the total loan, permitting the purchaser to obtain a mortgage with a competitive interest rate, even without a down payment if the lender agrees. The Department requires that a down payment be made for a manufactured home. With a Department guaranty, the lender is protected against loss, up to the amount of the guaranty, if the borrower fails to repay the loan.
Access problems.--The Committee is concerned with the ability of veterans to benefit from the
VOCATIONAL REHABILITATION LOANS PROGRAM ACCOUNT
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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
It is estimated that the Department will make 2,402 loans in fiscal year 2018, with an average amount of
NATIVE AMERICAN VETERAN HOUSING LOAN PROGRAM
Administrative expenses: Fiscal year 2017 enacted level........................
Fiscal year 2018 budget request....................... 1,163,000
Committee recommendation in the bill.................. 1,163,000
Comparison with:
Fiscal year 2017 enacted level.................... ---
Fiscal year 2018 budget request................... ---
The Native American Veteran Housing Loan Program, as authorized by title 38 United States Code, chapter 37, subchapter V, provides the Secretary with authority to make direct housing loans to Native American veterans for the purpose of purchasing, constructing, or improving dwellings on trust lands, including Hawaiian Home Lands. Native Hawaiians, Alaska Natives and
GENERAL OPERATING EXPENSES,
Fiscal year 2017 enacted level........................
Fiscal year 2018 budget request....................... 2,844,000,000
Committee recommendation in the bill.................. 2,894,000,000
Comparison with:
Fiscal year 2017 enacted level.................... 37,840,000
Fiscal year 2018 budget request................... 50,000,000
The General Operating Expenses,
The bill makes available through
The Committee provides
Addressing backlogs.--The Committee is pleased that
Performance reporting.--The bill includes language directing
Reforms to expedite
Equitable relief.--The Committee understands that
Military sexual trauma (MST) claims.--The Committee understands VBA is developing and implementing new training initiatives and procedures for posttraumatic stress disorder (PTSD) claims related to MST. The Committee is pleased with the increased focus on this area and encourages
Transition assistance.--The Committee encourages
Veterans service data.--The Committee notes the enduring interest in minimizing the barriers to veteran employment. Often, businesses seeking to hire veterans and take advantage of the Work Opportunity Tax Credit are faced with difficulty in verifying veterans' disabilities and service data. While the Committee recognizes the multiple means for veterans to obtain access to their DD-214 and medical records, the Committee recognizes the benefits of making these documents available to prospective employers electronically in controlled settings if privacy and confidentiality issues can be addressed. The Committee encourages the Secretary to work with the Secretary of Defense and State governors to create mechanisms to share this data to help support the employment of veterans.
State and county veteran service officers receiving access to
Therapeutic benefits of farming.--Currently, 40 percent of the nation's farms are operated and owned by farmers over the age of 65, and over the next 15 years there will be a demand for one million new farmers. In addition, over 800,000 servicemembers will transition out of the military over the next decade. Veterans face obstacles accessing mental health services in rural and highly rural areas and filling the shortfall of working farmers could provide therapeutic benefits for veterans and transitioning servicemembers. Therefore, the Committee encourages the Department to coordinate with the Departments of Defense and Agriculture in identifying and promoting vocational programs that provide the following: educational or vocational training in agriculture-related fields, behavioral health services on-site through licensed providers, if possible, and a pathway to employment in agriculture-related fields.
Minority outreach.--The Committee is concerned that current outreach efforts to educate minority veterans about benefits to which they are entitled may not be adequate. The Committee requests that, within 180 days of enactment of this Act, VBA submit a report, in coordination with the
Vision assistive technology.--Recent innovation in vision assistive technology provides an opportunity for
Service dogs.--The Committee recognizes that more than 20,000 service members have been wounded in action in Operation Iraqi Freedom, Operation Enduring Freedom, Operation Inherent Resolve, and Operation Freedom's Sentinel. Many of these men and women have suffered severe injuries such as spinal cord injuries, amputations, traumatic brain injuries, and visual and hearing impairments. For many of those most severely injured warriors, service, guide and hearing dogs provide crucial tasks to mitigate a veteran's disabilities, as well as provide therapy, assistance, and rehabilitation. Currently, there is a waiting list of veterans and active military personnel who seek the support of assistance dogs. Given the growing need for service dogs and the positive impact these dogs will have on the lives of wounded service members, the Committee believes that
The Department operates the largest Federal medical care delivery system in the country, with 145 hospitals, 115 domiciliary residential rehabilitation treatment programs, 136 nursing homes, 300 Vet Centers, 80 mobile Vet Centers, and 1,252 outpatient clinics which include independent, satellite, community-based, and rural outreach clinics. More than 7,000,000 patients will be treated in 2018.
The
Fiscal year 2017 enacted level........................
Fiscal year 2018 enacted level........................ 44,886,554,000
Fiscal year 2018 additional request................... 1,031,808,000
Committee 2018 additional recommendation.............. 1,031,808,000
Fiscal year 2019 advance budget request............... 49,161,165,000
Committee 2019 recommendation in the bill............. 49,161,165,000
Comparison with:
Fiscal year 2018 enacted level.................... 4,274,611,000
Fiscal year 2019 budget request................... ---
This appropriation provides for medical services of eligible veterans and beneficiaries in Department medical centers, outpatient clinic facilities, contract hospitals, State homes, and outpatient programs on a fee basis.
The bill provides the request of
Funding identified in the bill does not include the
Changes in funding requirements due to modeling.--The Committee expects
Allocation of health funding.--The Committee continues to be concerned that the process
Mental health issues
The Committee provides the full fiscal year 2018 budget request of
Veterans crisis line (VCL).--According to the
The Committee has repeated bill language included in the fiscal year 2017 Act 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
Suicide prevention training.--
Clay Hunt SAV Act.--The Committee is pleased that
Suicide among female veterans.--Female veterans are six times more likely to commit suicide than women in the general population. This alarming trend must be addressed by the Department without delay. The Committee directs the
Community clinic mental health services.--The Committee understands that
Public-private partnerships.--The Committee continues to recommend that
PTSD service dogs.--The Committee is pleased that
Postpartum depression.--An estimated one out of seven new mothers experience postpartum depression. The Committee requests a report on what maternal mental health services are available to women veterans at each VISN through the VHA and the Choice program. The report should include mental health support services for women veterans who: have miscarried; had a still born baby; who have had challenges related to fertility; have or have had a high risk pregnancy; or have postpartum depression. The report should also specifically address if women veterans are screened for postpartum depression, as well as how many female mental health professionals are available in each
Law enforcement liaison.--The Committee is pleased that VHA is working with the
Veterans treatment courts.--The Committee is aware of the successful outcome-oriented support system developed by Veterans Treatment Courts that connects veterans with appropriate treatment and services that can reduce recidivism and break the cycle of crime, arrest and incarceration. Bringing together a team that usually includes a judge, prosecutor, defense counsel, law enforcement officer, probation officer, court coordinator, treatment provider and case manager, is similar to what a veteran experienced in the military and is conducive for them to confront and correct the underlying cause of their crime. The Committee urges the Department to continue to make treatment services a priority in the treatment court system as more jurisdictions implement Veterans Treatment Courts.
Independent review of mental health care.--The Committee is aware of occasional reports of gross negligence in
Mental health services training for community providers.-- Community providers play an essential role in ensuring our Nation's veterans receive the support they have earned. The Committee supports providing care to veterans within the community because while many veterans seek mental health care at
Discrimination in PTSD claims.--The Committee is concerned that veterans of color may be disproportionately denied claims for post-traumatic stress disorder. Therefore, the Committee requests a report not later than 90 days after enactment of this Act detailing the number of claims from each of the years 2015, 2016, and 2017 related to PSTD that were filed, the number granted, and the number that were appealed. These numbers should be broken down by racial and ethnic group.
Hepatitis C
The bill provides
Homeless assistance
The Committee provides the full fiscal year 2018 budget request of
Enhanced use lease (EUL) authority.--The Committee believes that enhanced use lease authority, with which
Related needs of homeless veterans.--While
HUD-VASH program.--The Committee recognizes the important contributions the HUD-VASH program has made in reducing the number of homeless veterans and commends
Female homeless veterans.--The Committee remains committed to helping homeless veterans and commends
Homeless veterans in rural areas.--The Committee continues to be concerned about
Construction of housing for rural homeless veterans.--The Department has made great efforts to find housing for homeless veterans and their families. However, to date,
Staffing issues
Hiring delays.-- The Committee is concerned about whether the
Medical staff retention.--The Committee expects
Position vacancies.--The Committee is concerned about the large number of vacancies among senior positions at
Nurse training programs.--The Committee encourages
Nursing locality pay systems.--Recognizing the importance of recruitment and retention of qualified nurses, the Committee requests
Leveraging military expertise.--The Committee recognizes that civilian medical personnel may have a difficult time communicating with military veterans due to the distinct nature of military language and culture. The Committee urges the Secretary to conduct a feasibility study regarding the expansion of existing programs that allow guard and reserve members to maintain clinical competencies by conducting a portion of their contractual reserve time at
Psychology internships.--The Committee understands that VHA each year uses the services of the
Recruitment incentives.--The Committee is concerned with the shortage of medical providers at
Residency positions.--In the Veterans Access, Choice, and Accountability Act of 2014,
Access for rural veterans
Operating plan.--The Committee directs ORH to submit to the Committee not later than 30 days after enactment of this Act an operating plan for fiscal year 2018 funding, as well as the fiscal year 2019 funding provided in advance by this Act.
Rural caregivers.--The report
Telemedicine.--The Committee encourages further development and implementation of telemedicine to help veterans in rural areas. Telemedicine is useful for a number of types of appointments, including helping veterans with mental health issues. The Committee requests
Improving access for rural veterans.--According to the most recent census data, usage of
Remote areas.--The Committee directs the Department to conduct a study of the feasibility of establishing health clinics in remote and underserved areas, such as the
Facility expansion.--The Committee encourages
Womens' issues
Women's access to medical services.--In 2010, in recognition of the increasing number of women veterans and the fact that they were not being served adequately at
Childbirth data.--The Committee requests a report not later than 90 days after enactment of this Act identifying the number of women veterans participating in the
Maternity care benefit, survey, and education campaign.-- The Committee requests a report on the following data related to
Womens' psychiatric needs.--The Committee encourages
Delivery of gender-specific care to female
Breast cancer screening guidelines.--The Committee commends the
Maternal mental health.--The Committee requests a report not later than 90 days after enactment of this Act identifying how many pregnant veterans were screened for depression in 2017, and, on average, at what points during pregnancy women were screened. The report should include how many times referrals were made based on the screening results, the number of pregnant veterans who utilized treatment based on the referral, and whether they accessed care at
Pharmacy issues
Pharmacy workflow.--The Committee requests
Vaccine procurement.--The Committee is pleased that
Continues with Part 3 of 5
House Appropriations Committee Issues Report on Military Construction, VA, Related Agencies Appropriations Bill, 2018 (Part 1 of 5)
AGING POPULATION, and Lack of MENTAL HEALTH SERVICES Spur Hospital Investments
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