26–165 PDF 

Calendar No. 173 

115TH CONGRESS REPORT " ! SENATE 1st Session 115–130 

MILITARY CONSTRUCTION, VETERANS AFFAIRS, AND 

RELATED AGENCIES APPROPRIATION BILL, 2018 

JULY 13, 2017.—Ordered to be printed 

Mr. MORAN, from the Committee on Appropriations, 

submitted the following 

R E P O R T 

[To accompany S. 1557] 

The Committee on Appropriation reports the bill (S. 1557) making appropriations for military construction, the Department of 

Veterans Affairs, and related agencies for the fiscal year ending 

September 30, 2018, and for other purposes, reports favorably 

thereon and recommends that the bill do pass. 

Amounts in new budget authority 

Total of bill as reported to the Senate ....................$200,887,098,000 

Amount of 2017 appropriations ............................... 189,862,366,000 

Amount of 2018 budget estimate ............................ 201,453,868,000 

Bill as recommended to Senate compared to— 

2017 appropriations .......................................... ∂11,024,732,000 

2018 budget estimate ........................................ ¥566,770,000 
(2) 

C O N T E N T S 

Page 

Background: 

Purpose of the Bill ............................................................................................ 4 

Committee Recommendation ........................................................................... 4 

Overview and Summary of Bill ....................................................................... 4 

Title I: 

Military Construction: 

Items of Special Interest: 

Hearings .............................................................................................. 6 

Summary of Committee Recommendations ..................................... 6 

Reprogramming Guidelines ............................................................... 6 

Real Property Maintenance ............................................................... 7 

Incremental Funding ......................................................................... 7 

Other Matters ..................................................................................... 7 

Military Construction Overview ............................................................... 15 

Military Construction, Army .................................................................... 15 

Military Construction, Navy and Marine Corps ..................................... 17 

Military Construction, Air Force .............................................................. 19 

Military Construction, Defense-Wide ...................................................... 20 

Military Construction, Army National Guard ......................................... 22 

Military Construction, Air National Guard ............................................. 22 

Military Construction, Army Reserve ...................................................... 23 

Military Construction, Navy Reserve ...................................................... 23 

Military Construction, Air Force Reserve ............................................... 23 

North Atlantic Treaty Organization Security Investment Program ..... 23 

Department of Defense Base Closure Account ....................................... 24 

Family Housing Overview ........................................................................ 24 

Family Housing Operation and Maintenance, Army ............................. 25 

Family Housing Operation and Maintenance, Navy and Marine 

Corps ....................................................................................................... 25 

Family Housing Operation and Maintenance, Air Force ....................... 25 

Family Housing Operation and Maintenance, Defense-Wide ................ 25 

Family Housing Construction, Army ....................................................... 25 

Family Housing Construction, Navy and Marine Corps ........................ 26 

Family Housing Construction, Air Force ................................................. 26 

Department of Defense Family Housing Improvement Fund ............... 26 

Department of Defense Military Unaccompanied Housing Improvement Fund .............................................................................................. 26 

Administrative Provisions ........................................................................ 27 

Title II: 

Department of Veterans Affairs: 

Items of Special Interest: 

Hearings .............................................................................................. 29 

Summary of Committee Recommendations ..................................... 29 

Department Overview ........................................................................ 29 

Veterans Benefits Administration ........................................................... 32 

Compensation and Pensions .............................................................. 33 

Readjustment Benefits ....................................................................... 34 

Veterans Insurance and Indemnities ............................................... 34 

Veterans Housing Benefit Program Fund ........................................ 35 

Vocational Rehabilitation Loans Program Account ......................... 35 

Native American Veteran Housing Loan Program Account ........... 36 

General Operating Expenses, Veteran Benefits Administration ... 37 

Veterans Health Administration .............................................................. 41 

Medical Services ................................................................................. 44 
Page

3 

Title II—Continued 

Department of Veterans Affairs—Continued 

Veterans Health Administration—Continued 

Medical Community Care .................................................................. 67 

Medical Support and Compliance ..................................................... 69 

Medical Facilities ............................................................................... 70 

Medical and Prosthetic Research ...................................................... 71 

Medical Care Cost Recovery Collections .......................................... 74 

National Cemetery Administration .......................................................... 75 

Departmental Administration .................................................................. 75 

General Administration ..................................................................... 76 

Board of Veterans Appeals ................................................................ 77 

Information Technology Systems ...................................................... 78 

Office of Inspector General ................................................................ 80 

Construction, Major Projects ............................................................. 80 

Construction, Minor Projects ............................................................. 82 

Grants for Construction of State Extended Care Facilities ............ 83 

Grants for Construction of Veterans Cemeteries ............................ 83 

Administrative Provisions ........................................................................ 84 

Title III: 

Related Agencies: 

American Battle Monuments Commission: 

Salaries and Expenses ....................................................................... 88 

Foreign Currency Fluctuations ......................................................... 88 

United States Court of Appeals for Veterans Claims: Salaries and 

Expenses ................................................................................................. 89 

Department of Defense—Civil: Cemeterial Expenses, Army: 

Salaries and Expenses ....................................................................... 89 

Armed Forces Retirement Home: Trust Fund ........................................ 90 

Administrative Provisions ........................................................................ 91 

Title IV: Overseas Contingency Operations .......................................................... 92 

Title V: General Provisions ..................................................................................... 93 

Program, Project, and Activity ............................................................................... 94 

Compliance With Paragraph 7, Rule XVI, of the Standing Rules of the 

Senate ................................................................................................................... 94 

Compliance With Paragraph 7(c), Rule XXVI of the Standing Rules of the 

Senate ................................................................................................................... 96 

Compliance With Paragraph 12, Rule XXVI of the Standing Rules of the 

Senate ................................................................................................................... 97 

Budgetary Impact of Bill ......................................................................................... 105 

Military Construction Project Listing by Location ................................................ 106 

Overseas Contingency Operations .......................................................................... 121 

Comparative Statement of Budget Authority ........................................................ 123 
(4) 

BACKGROUND 

PURPOSE OF THE BILL

The Military Construction, Veterans Affairs, and Related Agencies appropriations bill provides necessary funding for the planning, design, construction, alteration, and improvement of military 

facilities worldwide. It also finances the cost of military family 

housing and the U.S. share of the NATO Security Investment Program. In addition, the bill provides funding, including environmental remediation, for base closures and realignments authorized 

by law. The bill provides resources to the Department of Veterans 

Affairs for veterans benefits and healthcare and funding for U.S. 

cemeteries and battlefield monuments both in the United States 

and abroad, including the American Battle Monuments Commission and Arlington National Cemetery. Additionally, the bill funds 

the U.S. Court of Appeals for Veterans Claims and the Armed 

Forces Retirement Homes. 

COMMITTEE RECOMMENDATION

The Committee recommends new budget authority totaling $200,887,098,000 for fiscal year 2018 military construction, family 

housing, base closure, veterans healthcare and benefits, including 

fiscal year 2019 advance appropriations for veterans medical care 

and appropriated mandatories, and related agencies. This includes 

$107,723,000,000 in mandatory funding and $93,164,098,000 in 

discretionary funding. The table at the end of the report displays 

the Committee recommendation in comparison with the current fiscal year and the President’s fiscal year 2018 request. 

APPROPRIATIONS FOR FISCAL YEAR 2018 

Budget request Senate recommendation 

New budget authority ..................................................................................... $201,453,868,000 $200,887,098,000 

Previous advances provided for fiscal year 2018 for medical care .............. 66,385,032,000 66,385,032,000 

Previous advances provided for fiscal year 2018 for appropriated 

mandatories ................................................................................................ 103,935,996,000 103,935,996,000 

Less advances provided for fiscal year 2019 for medical care .................... ¥70,699,313,000 ¥70,700,000,000 

Less advances provided for fiscal year 2019 for appropriated mandatories ¥107,709,727,000 ¥107,710,000,000 

Total appropriations for fiscal year 2018 ......................................... 193,365,856,000 192,798,126,000 

OVERVIEW AND SUMMARY OF BILL

The Military Construction, Veterans Affairs, and Related Agencies appropriations bill funds an array of programs that are vital 

to America’s military personnel and their families, and to the Nations’ veterans. For U.S. military forces and their families worldwide, the bill funds critical infrastructure, ranging from mission es-
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sential operational and training facilities to key quality-of-life facilities, including barracks, family housing, child care centers, 

schools, and hospitals. 

For America’s 21.4 million veterans, the bill provides the necessary funding for veterans benefits and healthcare, from prescription drugs and clinical services to the construction of hospitals and 

other medical facilities throughout the Nation. 

The bill also funds veterans cemeteries in the United States and 

provides funding for four independent agencies—the American Battle Monuments Commission, the U.S. Court of Appeals for Veterans 

Claims, Arlington National Cemetery, and the Armed Forces Retirement Homes. 
(6) 

TITLE I 

MILITARY CONSTRUCTION 

ITEMS OF SPECIAL INTEREST

HEARINGS

The Subcommittee on Military Construction, Veterans Affairs, 

and Related Agencies held one hearing related to the fiscal year 

2018 military construction budget request. Witnesses included representatives of the Army, Navy, Marine Corps, Air Force, and the 

Office of the Secretary of Defense. 

SUMMARY OF COMMITTEE RECOMMENDATIONS

The fiscal year 2018 budget request for military construction and 

family housing totals $9,782,451,000. The Committee recommends 

$9,536,000,000, which is $246,451,000 below the President’s budget 

request. 

REPROGRAMMING GUIDELINES

The following reprogramming guidelines apply for all military 

construction and family housing projects. A project or account (including the sub-elements of an account) which has been specifically 

reduced by the Congress in acting on the budget request is considered to be a congressional interest item and as such, prior approval 

is required. Accordingly, no reprogrammings to an item specifically 

reduced below the threshold by the Congress are permitted. 

The reprogramming criteria that apply to military construction 

projects (25 percent of the funded amount or $2,000,000, whichever 

is less) continue to apply to new housing construction projects and 

to improvements over $2,000,000. To provide the services the flexibility to proceed with construction contracts without disruption or 

delay, the costs associated with environmental hazard remediation 

such as asbestos removal, radon abatement, lead-based paint removal or abatement, and any other legislated environmental hazard remediation may be excluded, provided that such remediation 

requirements could not be reasonably anticipated at the time of the 

budget submission. This exclusion applies to projects authorized in 

this budget year, as well as projects authorized in prior years for 

which construction has not been completed. 

Furthermore, in instances where prior approval of a reprogramming request for a project or account has been received from the 

Committee, the adjusted amount approved becomes the new base 

for any future increase or decrease via below-threshold 

reprogrammings (provided that the project or account is not a congressional interest item as defined above). 
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In addition to these guidelines, the services are directed to adhere to the guidance for military construction reprogrammings and 

notifications, including the pertinent statutory authorities contained in Department of Defense [DoD] Financial Management 

Regulation 7000.14–R and relevant updates and policy memoranda. 

REAL PROPERTY MAINTENANCE

The Committee recommends a continuation of the following general rules for repairing a facility under ‘‘Operation and Maintenance’’ account funding: 

—Components of the facility may be repaired by replacement, 

and such replacement may be up to current standards or code. 

—Interior arrangements and restorations may be included as repair, but additions, new facilities, and functional conversions 

must be performed as military construction projects. 

—Such projects may be done concurrent with repair projects, as 

long as the final conjunctively funded project is a complete and 

usable facility. 

—The appropriate Service Secretary shall submit a 21-day notification prior to carrying out any repair project with an estimated cost in excess of $7,500,000. 

The Department is directed to continue to report on the real 

property maintenance backlog at all installations for which there 

is a requested construction project in future budget requests. This 

information is to be provided on the form 1390. In addition, for all 

troop housing requests, the form 1391 is to continue to show all 

real property maintenance conducted in the past 2 years and all future requirements for unaccompanied housing at that installation. 

INCREMENTAL FUNDING

In general, the Committee supports full funding for military construction projects. However, it continues to be the practice of the 

Committee to provide incremental funding for certain large 

projects, despite administration policy to the contrary, to enable the 

services to more efficiently allocate military construction dollars 

among projects that can be executed in the year of appropriation. 

Therefore, the Committee recommends incremental funding for 

three projects. 

OTHER MATTERS

Naval Shipyard Modernization.—The Committee is concerned 

with likely impacts to Fleet readiness and operational availability 

of Navy ships and submarines in the absence of significant longterm improvements to public shipyard infrastructure and major dry 

dock capacity. In a 2013 report to Congress pursuant to the requirements in Section 2865 of the Fiscal Year 2012 National Defense Authorization Act (Public Law 112–81), the Navy identified 

a $3,450,000,000 maintenance backlog comprising more than 1,000 

facilities at the public shipyards. 

The Committee is aware that public shipyards involved in Navy 

ship maintenance face a number of challenges in completing maintenance on time, including unanticipated work requirements, workforce inexperience, workload fluctuations, and inadequate facilities. 
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These challenges are exacerbated by the failing conditions of facilities across all four public shipyards. For example, Norfolk Naval 

Shipyard has 130 facilities in failing condition, including 17 mission-critical facilities. These deteriorated facility conditions combined with an inefficient and outdated layout of functions at the 

yards have a direct, negative impact on the readiness of naval 

forces as well as the life, safety and health of sailors and the civilian workforce at the public shipyards. At the Portsmouth Naval 

Shipyard, increasing workload is making it difficult to schedule 

necessary maintenance on its three nuclear qualified dry docks. 

Within the next 5 years, the workload at Portsmouth will exceed 

the available capacity of the dry docks. Additionally, critical components will reach the end of their service life soon, placing great 

strain on the ability to support maintenance on Los Angeles- and 

Virginia-class submarines. Significant military construction is 

needed to expand and modernize Dry Dock 1 to meet the growing 

maintenance requirements of the submarine fleet. 

The Committee also notes that while the Navy has prioritized 

dry docks and piers over other failing facilities, it is nevertheless 

taking risks in its dry dock infrastructure. Without significant dry 

dock investments, the public shipyards will be unable to meet the 

Navy’s surface and subsurface maintenance and inactivation requirements through 2040. For example, at Pearl Harbor Naval 

Shipyard, the Navy has identified an urgent requirement to extend 

Dry Dock 3 and build a 500 foot-long concrete lock at the entrance 

of the dry dock. These improvements are essential to sustain Fleet 

readiness in the Pacific and provide maintenance for Virginia-class 

submarines but remain unprogrammed in the Navy’s Future Years 

Defense Plan budget for military construction. Similarly, at Puget 

Sound Naval Shipyard in Washington State, the Navy has been 

forced to develop mitigation strategies to maximize the use of Dry 

Dock 1 to accommodate Los Angeles-class submarine availabilities 

and inactivations, as well as availabilities on all Virginia-class submarines. 

Finally, the Committee notes that the Navy is investing in existing facilities that may not be ideally designed, placed, sized or configured to support the current work processes, leading to inefficiencies in ship repair functions. In order for resources to be expended 

prudently for maximum benefit for shipyard operations, the Navy 

must first review industrial processes, logistics streams and workload distribution to develop a facilities plan that optimizes ship repair processes. Therefore, the Committee directs the Secretary of 

the Navy to submit a report by February 1, 2018, providing an engineering master plan for the optimal placement of facilities and 

major equipment to support ship repair functions at each public 

shipyard, including an investment strategy to address the infrastructure requirements at each shipyard. The report shall include 

the following elements: 

—A review of current and projected workload requirements for 

ship repairs to assess efficiencies in the use of existing facilities including consideration of new ship characteristics, obsolescence of facilities, siting of facilities and equipment, and various constrained process flows; 
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—An analysis of life cycle costs to repair and modernize existing 

mission essential facilities versus the cost to consolidate functions into modern, right-sized waterfront facilities to meet current and programmed future mission requirements; 

—A review of the progress made in prioritizing and funding 

projects that facilitate implementation of the hub concept for 

ship repair in order to improve process efficiencies, and contribute to availability cost and schedule reductions; 

—A Master Plan for each shipyard incorporating the results of 

a review of industrial processes, logistics streams and workload 

distribution required to support ship repairs at each shipyard 

and the facilities requirements to support optimized processes; 

and 

—An updated investment strategy planned for each public shipyard, including timelines to complete the masterplan for each 

shipyard, a list of projects and brief scopes of work, and cost 

estimates necessary to complete projects for mission essential 

facilities. 

Informed by the results of this study, the Committee urges the 

Navy to prioritize infrastructure investment in its shipyards within 

the Department’s future years military construction budget planning. 

Federal, State and Local Intelligence Collaboration.—The Committee is aware that several States utilize National Guard facilities 

for intelligence fusion centers according to their respective State 

authorities. These centers allow Federal, State, local, and tribal 

law enforcement officials to collaborate and share intelligence and 

threat information, and co-locating them with National Guard facilities offers opportunities for cost savings. Therefore, the Committee urges the Department, the services, and the National Guard 

Bureau to prioritize needed workplace replacement projects, including Sensitive Compartmented Information Facility [SCIF] projects 

to conduct State and Federal intelligence analysis, in the fiscal 

year 2019 and future budget submissions. 

Historic Buildings.—The Committee recognizes the historical 

value of many of our Nation’s military installations, and the need 

for preserving these historic sites for posterity. However, the Committee is also aware of the challenges of maintaining historical 

buildings, particularly those that are still in use today. On certain 

military installations, these historical structures are still used for 

housing and other purposes, which can lead to a struggle to balance maintaining hospitable living and work environments with 

preserving the historical status of the building. The Committee requests that the Government Accountability Office conduct a review 

that assesses historical structures or sites on Department installations in the United States that may be utilized for housing and for 

other purposes. The review shall include qualitative analysis as it 

relates to State and Federal regulatory standards for habitation, 

and also provide recommendations concerning the Department’s 

processes and procedures for assessing whether certain structures 

or sites require renovation to meet State and Federal regulatory 

standards for habitation or other uses as warranted. 

DoD Installation Energy Policy.—Department of Defense [DoD] 

installation energy use accounts for nearly a quarter of all Federal 
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Government energy consumption. In fiscal year 2015, according to 

DoD’s Annual Energy Management Report, the Department spent 

$3,900,000 on installation energy. While DoD has made great 

strides in increasing installation energy efficiency and reducing 

overall energy consumption, more needs to be done to bring down 

the energy costs throughout the Department. DoD must also ramp 

up its efforts to enhance energy security on its installations 

through a range of actions, including investing in renewable energy 

and smart technology that can shield mission-critical operations 

from disruptions to the power grid. According to a January 2017 

report commissioned by the Pew Charitable Trusts (‘‘Power Begins 

at Home: Assured Energy for U.S. Military Bases’’), DoD could enhance energy security on installations and save hundreds of millions of dollars annually by investing in microgrids and renewable 

energy systems, and by increasing energy efficiency on military 

bases. The report found that microgrid power systems are more reliable than the stand-alone diesel generators typically used for 

backup power and could save $8,000,000 to $20,000,000 over a 20- 

year period. The report also found that DoD could save as much 

as $1,000,000,000 a year simply by increasing the use of commercially available energy efficiency measures in its facilities. The 

Committee notes that military installations in Hawaii are among 

those at the forefront of DoD’s efforts to increase energy efficiency 

and security, including projects to develop net-zero energy military 

housing and installation facilities, upgrade and retrofit systems to 

improve energy and water efficiency, and demonstrate microgrid 

technology. The Committee supports DoD’s investments in energy 

efficiency, renewable energy systems, and energy security, including through the Energy Resilience and Conservation Investment 

Program [ERCIP]. The fiscal year 2018 ERCIP request of 

$150,000,000 provides funding for 26 projects, including 7 energy 

resilience, 12 energy efficiency, 5 renewable energy, and 2 water 

conservation projects. The Committee recommends an increase of 

$15,000,000 above the request for ERCIP and encourages the Department to prioritize funding for energy-related projects, including 

renewable energy projects, to mitigate risk to mission-critical assets and promote energy security and efficiency at military installations. 

Major Range and Test Facility Base [MRTFB].—The Committee 

recognizes the strategic importance of the key Department of Defense [DoD] installations, ranges and facilities that comprise the 

Major Range and Test Facility Base [MTRFB]. These ranges, which 

include Army, Navy, Air Force and Defense Agency facilities in 

more than 20 locations, are designated by DoD as ‘‘national assets’’ 

because of their critical role in maintaining the Nation’s military 

technological advantage. However, the Committee is concerned 

about the lack of investment and sustainment of these facilities. 

For example, White Sands Missile Range in New Mexico, which is 

the Nation’s largest overland testing facility, has not received a 

military construction project in support of test and evaluation missions in over a decade. As a result, support for critical testing on 

missile systems such as the Standard Missile-2 [SM2], Patriot Missile system [PAC3], JASSM, CALCM, and others may be adversely 

impacted. The Barking Sands Tactical Underwater Range at the 
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Pacific Missile Range Facility in Hawaii exceeded its 20-year design service life in 2014. Key underwater cables have been repeatedly repaired in recent years, but the Navy has determined that future repairs of the seafloor cables are not feasible. The Air Force 

Development Test Center’s [AFDTC] overall mission is to plan conduct, and evaluate testing of U.S. and allied nonnuclear munitions, 

electronic combat, target acquisitions, weapon delivery, base intrusion protection, and supporting systems. AFDTC carries out this 

work at Eglin Air Force Base, FL, whose land test areas encompass 

463,000 acres, and water test areas cover 86,500 square miles in 

the Gulf of Mexico, the largest DoD test and training area in the 

world. 

In order to continue to conduct safe and robust testing of our 

military’s newest munitions and systems, deployed by our fastest 

and longest-range aircraft, surface, and subsurface vessels, test and 

training range infrastructure and instrumentation must be modernized. The lack of needed investment at MRTFB facilities jeopardizes future technology development and threaten the Nation’s 

ability to counter emerging threats. The Committee therefore directs the Secretary of Defense to submit a comprehensive MRTFB 

modernization plan within 180 days of enactment of this act outlining a timetable and specific actions for repair, replacement and 

renovation of infrastructure, equipment and instrumentation at 

mission-critical facilities. 

Infrastructure to Support Third Offset Capabilities.—The Committee notes that the Department of Defense is increasing investments in a number of technology areas to support the Third Offset 

strategy, an effort to offset declining technological superiority over 

near peer rivals using targeted investments in advanced technologies and through the development of new operational concepts 

using existing and next generation systems. This includes increased funding in undersea warfare, robotics, directed energy, 

hypersonics, and precision munitions, among other areas. The 

Committee is concerned that these investments are not being 

matched by coordinated funding of modern research and testing infrastructure that will ensure that these new systems and technologies are developed and tested as efficiently and quickly as possible, and are deployed to operational forces as soon as feasible. In 

testimony to the Subcommittee on Defense, Deputy Secretary of 

Defense Robert Work acknowledged the importance of investing in 

this type of research infrastructure, although the current Future 

Years Defense Plan includes very few military construction projects 

that support research or testing activities. The Committee directs 

the Secretary of Defense to develop a plan for investments in research and testing infrastructure, including through major military 

construction projects that support development of Third Offset capabilities. The strategy should make clear how the infrastructure 

investments will be timed so that they are coordinated with 

planned programs of record. The Committee directs that the plan 

be delivered to the congressional defense committees no later than 

1 year after the date of enactment of this act. 

Water Conservation on Military Installations.—The Senate Report accompanying H.R. 5325 (S. Rept. 114–237) included language 

highlighting the status of water use on military installations, the 
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vulnerability of installations to water scarcity, and water conservation potential at military installations based on both reduced water 

use and cost savings. The report directed the Secretary of Defense 

to report to the Committees on Appropriations of both Houses of 

Congress on the current status of water demand and potential 

water conservations opportunities across U.S. military installations, including water usage rates, water scarcity vulnerabilities, 

water conservation potential from reduced water usage, and potential cost savings from water conservation technologies. The Committee notes that the report is currently 90 days overdue and directs the Secretary to provide the report no later than October 1, 

2017. 

Sea Level Rise and Coastal Erosion.—The Committee is concerned about the increasingly harmful impact of sea level rise and 

flooding on facilities at DoD’s coastal military installations, both in 

the United States and overseas. A June 30, 2014, Government Accountability Office [GAO] report to Congress, (GAO–14–446, ‘‘Climate Change Adaptation: DoD Can Improve Infrastructure Planning and Processes to Better Account for Potential Impacts’’) assessed 15 sites at defense installations in the U.S. that are vulnerable to the effects of climate change and provided recommendations 

to improve readiness and reduce fiscal exposure for DoD. 

Among several compelling findings, GAO noted that DoD officials 

are concerned that the combination of thawing permafrost, decreasing sea ice, and rising sea levels on the Alaskan coast have increased coastal erosion at several Air Force radar early warning 

and communication installations. Further, Navy officials are concerned that if a storm surge occurs while a submarine is undergoing maintenance while sitting in a dry dock, substantial repair 

costs likely would be needed. Officials told GAO that if salt water 

floods the submarine’s systems, it could result in severe damage. 

In a July 23, 2015, report to Congress regarding the security implications of climate-related risks, the Department noted that it 

had directed a global screening level assessment to determine installation vulnerabilities to climate-related security risks with the 

goal of identifying serious vulnerabilities and developing necessary 

adaptation strategies. Senate Report 114–237 accompanying the 

fiscal year 2017 Military Construction, Veterans Affairs, and Related Agencies Appropriations Act included language directing the 

Secretary of Defense to report to the congressional defense committees not later than 120 days after the enactment of the act on the 

findings of that assessment. The Committee notes that the fiscal 

year 2017 Military Construction, Veterans Affairs, and Related 

Agencies Appropriations Act was signed into law on September 29, 

2016, and that the report is currently more than 90 days overdue. 

The Committee therefore directs the Secretary to comply with the 

directive not later than October 1, 2017. 

Understanding the costs associated with mitigation of climate 

vulnerabilities is essential to an accurate assessment of future DoD 

infrastructure costs. The Committee believes that DoD must be 

proactive in assessing the potential effects of projected climate 

change on the design, operation, maintenance, and repair of buildings; utility systems; and storm water management systems. DoD 

requires its components to manage the risks associated with these 
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effects, including changes—as appropriate—to design and construction standards. The GAO has noted that extreme weather events 

have caused tens of millions of dollars in damage to DoD infrastructure and that these types of extreme weather events are expected to become more frequent or severe with climate change. The 

Committee expects that DoD will implement an effective approach 

to analyzing and addressing the potential impacts of climate 

change on military construction projects during the design phase to 

mitigate the need for future costly repair or restoration requirements. 

Therefore, the Committee directs the Comptroller General to undertake a study of DoD’s progress in developing a means to account 

for potentially damaging weather in project design, and to report 

to the Committees on Appropriations of both Houses of Congress 

not later than 180 days after enactment of this act. At a minimum, 

the Comptroller General should answer the following questions: 

—What is known about the historical and projected costs for facilities maintenance and repair beyond expected repair costs of 

DoD infrastructure stemming from damage or degradation 

caused by weather effects associated with climate change? 

—What best practices has DoD adopted for incorporating climate 

change adaptation into the design of military construction or 

facilities sustainment, restoration, or modernization projects? 

—To what extent has DoD developed a systematic process for ensuring climate change or severe weather effects are accounted 

for in the design of military construction and facilities 

sustainment, modernization, or restoration projects? 

Local Hiring in Military Construction.—In March 2015 the Federal Highway Administration and the Federal Transit Administration implemented a Local Labor Hiring Pilot Project which aims to 

increase local, low income and veteran employment in construction 

projects funded by those agencies. The pilot project was recently extended through 2022. The Committee encourages the Department 

of Defense to consider implementing a similar pilot project with respect to military construction. The Secretary of Defense is directed 

to report to the Congressional defense committees within 6 months 

of the date of enactment of this act on the feasibility of implementing such a program. 

Remotely Piloted Aircraft and Joint Use Military/Civilian Airports.—The Committee is concerned that many existing Airport 

Joint Use Agreements [AJUA] were not written to accommodate 

the increasing use of remotely piloted aircraft [RPAs]. In some instances, a long term AJUA may need significant modifications to 

allow for the use of RPAs and to calculate the appropriate Federal 

compensation. Therefore, the Committee directs the Secretary of 

Defense to conduct a review of the authorities needed to update 

AJUAs and associated compensation for airfields impacted by a 

transition to RPA missions, and to report such findings to the congressional defense committees no later than March 30, 2018. 

Special Operations Command Training Opportunities.—Abandoned mine land and surface reclamation projects throughout the 

Nation can provide a unique environment for military training and 

range capabilities, to include mobility and irregular warfare opportunities for the Special Operations Command [SOCOM]. The Com-
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mittee urges SOCOM to work with the National Guard Bureau and 

the States on the development of such sites to meet its unique 

training requirements. 

Viability of Armed Forces Reserve Centers.—The Committee is 

aware of the proposed closure of certain recently constructed reserve centers due to a lack of usage. This raises concerns about the 

adequacy and accuracy of the personnel and unit forecasting that 

led to the construction of such facilities. The Committee directs the 

Department of Defense to submit a report on the status of all reserve centers constructed during the last 15 years, to include those 

facilities that were built as part of the 2005 BRAC round. The report should include a detailed assessment of individual facility 

usage rates, identify underutilized or unutilized facilities, include 

an assessment of the cause of any utilization shortfalls, and include 

a review of any personnel or units re-stationed away from recently 

constructed facilities. 

Accidental window fall prevention.—The Committee is concerned 

about the risks of unintentional falls from windows in military 

family housing. Deaths and injuries often occur when children push 

against window screens or climb onto furniture located near an 

open window. Therefore, not later than 180 days after the date of 

enactment of this act, the Committee directs the Department of Defense to update its Unified Facilities Criteria [UFC] for Family 

Housing (UFC 4–711–01) to require that all new and existing residential buildings have corrosion-resistant screens that meet the 

ANSI/SMA6001 specifications for at least Medium loads, or successor standard; or that windows shall be equipped with window 

fall prevention screens, guards, or other devices that comply with 

ASTM F2006 or ASTM F2090, or a successor standard. 

The Committee also directs the Department of Defense, in updating its UFC for family housing, to: (1) specify that military housing 

privatization partners shall be required to include window fall prevention screens, guards, or other devices for military housing and 

shall not be allowed to seek waivers or exemptions; (2) conduct an 

oversight program to ensure that all military housing be equipped 

with window fall prevention screens, guards, or other devices; and 

(3) establish an awareness campaign that educates families on window fall risks and window fall prevention measures. The Secretary 

of each military department shall brief the Committee within 1 

year of enactment of this act on the following: (a) the extent to 

which the Secretary is in compliance with the requirements of the 

updates to UFC 4–711–01; and (b) a plan for retrofitting existing 

military family housing units that are not in compliance with the 

revised UFC 4–711–01. 

Military Construction Funding Initiatives.—The bill includes 

funding for military construction initiatives to address important 

unfunded priorities included in the Department of Defense’s unfunded priority lists provided to Congress. The Committee notes 

that in recent years the military construction budget requests have 

been at historically low levels. Amounts budgeted for facility 

sustainment, restoration, and modernization are similarly low. The 

infrastructure initiatives in unfunded priority lists would ordinarily 

appear as part of the annual budget request, but were not included 

as the military construction budget remains severely constrained. 
15 

For this reason, the Committee includes an additional 

$68,800,000 for the Army, $110,100,000 for the Navy and Marine 

Corps, $127,300,000 for the Air Force, $83,500,000 for the Army 

National Guard, $24,000,000 for the Air National Guard, 

$30,000,000 for the Army Reserve, and $35,100,000 for the Air 

Force Reserve. All additional funding is reserved for projects that 

were included in the unfunded priority lists submitted to Congress. 

Rescissions.—The Committee recommends an administrative provision rescinding prior year unobligated funds due primarily to 

project bid savings and the slow execution of projects. 

MILITARY CONSTRUCTION OVERVIEW

Appropriations, 2017 ............................................................................. $7,726,000,000 

Budget estimate, 2018 ........................................................................... 9,782,451,000 

Committee recommendation ................................................................. 9,536,000,000 

MILITARY CONSTRUCTION ACCOUNTS—PROGRAM DESCRIPTION

The military construction appropriation provides for acquisition, 

construction, installation, and equipment of temporary or permanent public works, military installations, facilities, and real property for the Department of Defense. This appropriation also provides for facilities required as well as funds for infrastructure 

projects and programs required to support bases and installations 

around the world. 

MILITARY CONSTRUCTION, ARMY

Appropriations, 2017 ............................................................................. $513,459,000 

Budget estimate, 2018 ........................................................................... 920,394,000 

Committee recommendation ................................................................. 930,394,000 

COMMITTEE RECOMMENDATION

The Committee recommends $930,394,000 for the Army for fiscal 

year 2018. This amount is $416,935,000 above the fiscal year 2017 

enacted level and $10,000,000 above the budget request. Further 

detail of the Committee’s recommendation is provided in the State 

table at the end of this report. 

Defense Laboratory Enterprise Facilities and Infrastructure.—The 

Committee is concerned the unspecified minor military construction 

[UMMC] request is insufficient to support the Army Laboratories. 

Threats continue to emerge, construction costs continue to rise, and 

outdated laboratory facilities continue to age. Congress established 

a higher threshold for UMMC specifically for laboratories so that 

the services can keep up with threats that evolve faster than can 

be addressed through the normal military construction planning 

process. However, the Army has funded very few laboratory revitalization projects and the request for UMMC has remained flat. 

Therefore, an additional $10,000,000 is provided to supplement unspecified minor construction projects. 

Sunflower Army Ammunition Plant.—The Committee understands that the U.S. Army is currently managing the environmental remediation of the Sunflower Army Ammunition Plant 

[SFAAP] property in excess of 9,000 acres in DeSoto, Kansas, 

which was conveyed to Sunflower Redevelopment, LLC [SRL] 
16 

through the Army and the General Services Administration on August 3, 2005. Ten years after the conveyance, on October 29, 2015, 

the Army reinforced its responsibility in writing, ‘‘the Army is committed to programming the necessary resources to carry out a longterm clean-up and has, for execution in fiscal year 2016, awarded 

several services contracts for the short term requirements.’’ The 

Army further wrote it would ‘‘issue competitively sourced clean-up 

contracts, with Army oversight to ensure its Comprehensive Environmental Response, Compensation, and Liabilities Act [CERCLA] 

§ 120(h) obligation at Sunflower.’’ The Army confirmed its intention 

‘‘to conduct in-depth coordination with Sunflower Redevelopment, 

LLC [SRL] to ensure SRL’s redevelopment priorities are synchronized with the Army managed clean-up activities.’’ However, 

the Committee is disappointed to learn that the Army has neglected to communicate regularly with SRL and far less than the 

in-depth coordination commitment made by the Army. The Committee recently learned of ongoing risk assessments of contaminated portions of SFAAP and expects the Army will work in consultation and coordination with SRL to ensure transparency. The 

Committee further expects that the findings and recommendations 

of such assessment will receive approval from State and Federal 

regulators regarding allowable levels of contaminants including, 

but not limited to, pesticides, asbestos or other contaminants subject to remediation for commercial use of the property. The Committee directs the Secretary of the Army to deliver the assessment 

and brief the Committee on its findings and to provide a plan that 

ensures SRL’s redevelopment priorities are synchronized with 

Army managed cleanup activities. 

Military Construction at Depots and Arsenals.—The Committee is 

concerned about the need to maintain critical investment in Army 

depots and arsenals. Maintaining the physical infrastructure of depots and arsenals, which allows these installations to operate at 

peak efficiency, is essential to maintaining military readiness. 

However, the Future Years Defense Program [FYDP] for military 

construction at Army depots and arsenals does not reflect the need 

for investment in the infrastructure of these facilities, with only 

two depot or arsenal military construction projects included in the 

most recent FYDP, both in fiscal year 2020. For example, the Detroit Arsenal which hosts the Army’s Tank-automotive and Armaments Command [TACOM] Life Cycle Management Command and 

the U.S. Army Tank Automotive Research Development and Engineering Center, requires an electrical substation to meet electrical 

demand for existing missions at the installation. The Army, which 

included this project in its fiscal year 2018 list of unfunded priorities, noted that the Arsenal must currently rely on substations located outside its perimeter, presenting vulnerability and mission 

security issues. The Committee therefore urges the Army to 

prioritize and accelerate construction of the Detroit Arsenal substation and other critical arsenal and depot military construction 

and infrastructure maintenance investments within the fiscal year 

2019 FYDP. 

Badger Army Ammunition Plant.—In 2011, an Army Feasibility 

Study concluded that an offsite drinking water treatment system 

was needed as part of a comprehensive groundwater cleanup rem-
17 

edy for the former Badger Army Ammunition Plant [BAAP]. Accordingly, in 2015, the Town of Merrimac, Wisconsin, designed and 

approved a sanitation district required by the Army to support 

such a system, and as recently as May 2016, the Army noted in 

writing that ‘‘design of the municipal drinking water system has 

been initiated.’’ Recently, however, the Army reversed its plans to 

construct and operate the drinking water system. The Committee 

is concerned about this decision, its potential to delay the provision 

of clean drinking water to homes near the site, and the Army’s lack 

of public communication regarding the decision. 

Therefore, the Committee expects the Army to conduct required 

human health risk assessments expeditiously, and if needed, use 

expedited contracting authorities. Additionally, the Committee 

urges the Army to hold regular public meetings to update and engage with local stakeholders. The Committee expects the Army to 

integrate local priorities in its remediation plans. Furthermore, 

within 90 days of the date of enactment of this act, the Secretary 

of the Army shall submit to the Committee a report and provide 

a corresponding briefing regarding the Army’s rationale and process for approving plans to construct and operate a drinking water 

system and its subsequent decision to terminate such plans, as well 

as the Army’s completed and planned actions for environmental 

restoration at the site. 

MILITARY CONSTRUCTION, NAVY AND MARINE CORPS

Appropriations, 2017 ............................................................................. $1,021,580,000 

Budget estimate, 2018 ........................................................................... 1,616,665,000 

Committee recommendation ................................................................. 1,565,665,000 

COMMITTEE RECOMMENDATION

The Committee recommends $1,565,665,000 for Navy and Marine 

Corps military construction for fiscal year 2018. This amount is 

$544,085,000 above the fiscal year 2017 enacted level and 

$51,000,000 below the budget request. Further detail of the Committee’s recommendation is provided in the State table at the end 

of this report. 

Navy Strategic Laydown and Dispersal.—The Committee recognizes the inherent risk of natural and man-made hazards associated with the stationing of U.S. capital ships at major ports, and 

the Navy’s corresponding requirement for the strategic dispersal of 

its fleet in the Pacific and Atlantic to mitigate that risk. During the 

next Future Years Defense Program [FYDP], the Navy will begin 

to expand the fleet as it seeks to achieve its new force structure 

goal of having a 355-ship fleet. The Navy’s own internal guidance 

on making decisions regarding strategic basing requires that the 

Navy consider strategic dispersal strategies and that these strategies be factored into homeporting decisions to limit the risk associated with natural disasters or man-made catastrophe. The Committee believes that strategic dispersal should be a key consideration in expanding the fleet, and that, as a first step, the Navy 

should program military construction funding for necessary infrastructure to achieve strategic dispersal of its fleet, beginning with 

the budget request and FYDP for fiscal year 2019. 
18 

Innovative Ship Design & Technology Integration Collaboration 

Center.—The Navy has experienced numerous cost overruns on recent ship acquisition and development programs. As the Navy has 

been tasked by the Administration to reach a fleet size of 355 

ships, it is essential that early stage design efforts are comprehensive and detailed and account for flexibility and adaptability in 

ship designs that allow for rapid reconfiguration, technology and 

modular systems integration, as well as design allowances for likely upgrades. To accomplish this will require considerable time, effort and strain on the Navy’s ship design community. The Committee is concerned that the Navy has not established the infrastructure and associated facilities that allow for effective collaboration, productivity, and innovation in ship design and recommends 

that the Navy prioritize future military construction programs to 

include a facility for an Innovative Ship Design & Technology Integration Collaboration Center. Such a Collaboration Center would 

provide a Navy venue to bring together all relevant ship design 

personnel, technologists and stakeholders to ensure that all future 

ship, submarine and unmanned vehicle designs are developed in a 

comprehensive, efficient and collaborative manner to prevent extended ship construction timelines. The Committee directs the 

Navy to provide a report no later than March 30, 2018 detailing 

a plan to invest in infrastructure and facilities that will foster collaborative ship design. 

Advanced Electric Ship Testbed.—The Committee notes the 

Navy’s continued development of advanced ship electric power systems to support the integration of high power weapons and sensors. 

The Navy’s development of these technologies requires continued 

investment in its major testing ranges to ensure that these systems 

are compatible with the fleet, including new classes of ships. A 

cost-effective approach would be a land-based demonstration site 

representative of an integrated ship power system that includes 

power generation, energy storage, power distribution, and power 

loads, and that provides for testing of high power weapons and sensors. The Committee directs the Navy to assess the feasibility of 

developing a land-based advanced electric ship testbed to test and 

evaluate high power weapons and systems, identifying what technologies the Navy must still mature to build such a testbed and the 

factors that would influence the siting of a testbed, such as cost, 

security, integrated electric grid, ability to integrate a weapon system on site, minimal encroachment, access to the open ocean for 

eventual operationally relevant testing. The Committee directs the 

Department to submit this report no later than March 30, 2018. 

Navy Yard Land Acquisition.—The Committee does not recommend providing $60,000,000 as requested by the Navy to acquire four acres of land adjacent to the Navy Yard in Southeast 

Washington, D.C., to provide an anti-terrorism force protection 

[ATFP] buffer zone. Although the Committee supports enhancing 

ATFP measures at the Navy Yard, it is concerned by the high price 

of the land acquisition and by the budget justification explanation 

that the Navy’s recommended use of the land is for a Navy Museum. The Committee questions whether the Navy fully explored 

alternative options for the acquisition and use of the land, including consultation with other Federal agencies to evaluate the poten-
19 

tial use of this parcel to meet pending land acquisition requirements for other Federal agencies. The Committee also notes that 

the proposed land acquisition addresses only a portion of the Navy 

Yard’s ATFP deficiencies. The Secretary of the Navy is therefore directed to provide a report to the Committees on Appropriations of 

both Houses of Congress no later than 180 days after enactment 

of this act on a Government-wide assessment of the potential uses 

by other Federal agencies for the proposed Navy Yard land acquisition and a comprehensive ATFP Master Plan for the Navy Yard. 

MILITARY CONSTRUCTION, AIR FORCE

Appropriations, 2017 ............................................................................. $1,491,058,000 

Budget estimate, 2018 ........................................................................... 1,738,796,000 

Committee recommendation ................................................................. 1,569,296,000 

COMMITTEE RECOMMENDATION

The Committee recommends $1,569,296,000 for the Air Force in 

fiscal year 2018. This amount is $78,238,000 above the fiscal year 

2017 enacted level and $169,500,000 below the budget request. 

Further detail of the Committee’s recommendation is provided in 

the State table at the end of this report. 

Air Force Ballistic Missile Facilities.—The Committee is concerned with the deteriorating infrastructure of the ground-based 

intercontinental ballistic missile [ICBM] facilities at Malmstrom 

Air Force Base [AFB], Montana; Minot AFB, North Dakota; and 

F.E. Warren AFB, Wyoming. The Missile Alert Facilities [MAF] at 

these bases are in advanced states of disrepair. For example, the 

Committee is aware that the power lines providing electricity to 

these ICBM launch facilities were constructed in the 1960s in conjunction with the deployment of the original Minuteman ICBM. In 

order to ensure these launch facilities retain a reliable source of 

power through 2075, the expected lifespan of the Ground Based 

Strategic Deterrent [GBSD] program, these power lines eventually 

will require replacement. In April 2017, the Air Force provided the 

Committee with a study that highlighted the need to recapitalize 

the MAFs. The report also noted that while the Air Force is developing plans to recapitalize MAFs, the Air Force does not have a reliable estimate of military construction requirements at this time. 

Infrastructure is critically important to the nuclear mission, and 

the Committee urges the Secretary of the Air Force to finalize MAF 

recapitalization requirements; upon being finalized, the Secretary 

of the Air Force is directed to provide these MAF recapitalization 

requirements to the Committee. The report should include an assessment of the reliability of existing power lines, a review of Federal partnerships with local electrical cooperatives to build and 

maintain power lines, and an estimate of when investments in electrical power will be required. The Committee also directs the Secretary of the Air Force to provide an assessment of the lessons 

learned in fielding the prototype Weapons Storage Facility at F.E. 

Warren, and the timeline to replace Weapons Storage Facilities at 

Malmstrom and Minot. 

Presidential Aircraft Recapitalization Complex.—The Committee 

notes that the work in progress curve submitted with the budget 

request shows that the Air Force cannot execute the full request 
20 

of $254,000,000. Therefore, the Committee provides $100,000,000 

for the first increment of this project. 

KC–46 Main Operating Base 4.—The Committee notes that the 

budget request included a funding wedge for the KC–46 Main Operating Base 4. Shortly after the budget submission, the Secretary 

of the Air Force announced that the first aircraft would arrive at 

Joint Base McGuire-Dix-Lakehurst in fiscal year 2021 and the first 

aircraft will arrive at Travis Air Force Base in fiscal year 2023. Accordingly, the Committee provides funding for the specific KC–46 

Main Operating Base 4 projects at the designated locations rather 

than the unspecified wedge. Furthermore, as a result of the Secretary of the Air Force’s sequencing decision, the Committee defers 

funding on three associated projects at Travis Air Force Base pending further review, and directs the Air Force to promptly provide 

an updated schedule for these projects. 

Launch Support and Infrastructure Modernization.— The 

Launch and Test Range System [LTRS] located at the Eastern 

Range (Patrick AFB, Cape Canaveral AS and Kennedy SC, FL) and 

the Western Range (Vandenberg AFB, CA) consists of ground based 

surveillance, navigation, flight operations and analysis, command 

and control, communications and weather assets used to support 

space missions. The mission is to provide DOD, NASA and commercial customers a highly reliable, integrated system to support 

spacecraft launch, ballistic missile and aeronautical testing. The 

Committee is concerned with the current state of space launch support and infrastructure as launch schedules continue to increase in 

tempo. The Committee directs the Secretary of Defense to provide 

a report to the congressional defense committees not later than 120 

days after the enactment of this act on the plan for the implementation of launch support and infrastructure modernization program. The report shall include a description of plans and the resources needed to improve launch support infrastructure, utilities, 

support equipment, and range operations; a description of plans to 

streamline and normalize processes, systems, and products at the 

Eastern and Western ranges, to ensure consistency for range users; 

and recommendations for improving transparency, flexibility, and 

responsiveness in launch scheduling. 

MILITARY CONSTRUCTION, DEFENSE-WIDE

(INCLUDING TRANSFER OF FUNDS)

Appropriations, 2017 ............................................................................. $2,025,444,000 

Budget estimate, 2018 ........................................................................... 3,114,913,000 

Committee recommendation ................................................................. 2,612,583,000 

COMMITTEE RECOMMENDATION

The Committee recommends $2,612,583,000 for projects considered within the Defense-Wide account in fiscal year 2018. This 

amount is $587,139,000 above the fiscal year 2017 enacted level 

and $502,330,000 below the budget request. Further detail of the 

Committee’s recommendation is provided in the State table at the 

end of this report. 

Hydrant Fuel Systems in Support of Humanitarian Assistance 

and Disaster Relief Operations.—The Committee notes that the De-
21 

partment of Defense has a long history of successfully conducting 

urgently needed humanitarian assistance and disaster relief 

[HADR] missions. In recent years HADR missions have responded 

to major earthquakes, tsunamis, typhoons, hurricanes, floods, and 

the nuclear disaster in Fukushima, Japan. The Committee believes 

that hydrant fuel systems capable of supporting large scale fueling 

of heavy aircraft are an essential component of our HADR capability. The Committee encourages the services and the Defense Logistics Agency to prioritize construction and enhancement of these 

systems in locations that serve as staging bases for HADR operations. 

Fort Bliss Hospital Replacement.—The Committee is deeply concerned about the past performance of the Army Corps of Engineers 

[the Corps] in its management of major Defense Health Agency 

[DHA] construction projects. Recently, the Corps reached a 

$22,000,000 settlement with its contractors involved with the Irwin 

Army Community Hospital at Fort Riley, Kansas. The settlement 

resulted from ‘‘design deficiencies and associated delays.’’ Earlier 

this year, the Committee approved a $74,000,000 reprogramming 

request to cover cost overruns on the Fort Bliss Hospital replacement project. This additional funding was needed to cover ‘‘design 

errors, design omissions, and settlement of contractor requests for 

equitable adjustments.’’ These are two examples of a pattern of 

mismanagement and a lack of accountability from the Corps that 

raise questions about the cost estimates and the planned execution 

of major projects included in DHA’s fiscal year 2018 budget request, which represents an increase of more than $550,000,000 

from the fiscal year 2017 enacted level. Given that DHA already 

has 45 active construction projects underway worldwide totaling 

more than $5,000,000,000, the need for effective and efficient 

project management is clear. The Committee is not convinced that the $251,000,000 requested 

as the final increment for the Fort Bliss Hospital will, in fact, be 

the final increment. Continued delays and an extensive backlog of 

contractor claims against the Corps will likely result in another increment or another request to reprogram funds onto the project. 

This is a subject the Committee will conduct extensive oversight on 

in the coming months. As a result, the Committee provides 

$100,000,000 for Increment 8 of the Fort Bliss Hospital Replacement and directs the Secretary of the Army not later than 90 days 

after the enactment of this act to submit a report listing projects 

managed by the Army Corps of Engineers that resulted in a settlement with a contractor, to include settlement cost, dating back to 

2010. 

Fort Leonard Wood Hospital Replacement.—The Committee notes 

that the work in progress curve submitted by the Defense Health 

Agency shows it is unable to execute the full $250,000,000 request 

in fiscal year 2018. Therefore, the Committee provides 

$100,000,000 for the first increment of this project. 

National Geospatial Intelligence Agency West Campus.—The 

Committee is concerned that the Administration chose to request 

funding for this project in two phases, rather than incrementally. 

The Committee notes that similar large buildings designed for intelligence missions for the National Security Agency are incremen-
22 

tally funded. The work in progress curve submitted with the budget request shows that the NGA can only execute a fraction of the 

$381,000,000, and will not take possession of the required land 

until the 4th quarter of fiscal year 2018. The Committee believes 

this is a textbook example of a project that should be incrementally 

funded. Therefore, the Committee provides $175,000,000 for the 

first increment of this project. 

MILITARY CONSTRUCTION, ARMY NATIONAL GUARD

Appropriations, 2017 ............................................................................. $232,930,000 

Budget estimate, 2018 ........................................................................... 210,652,000 

Committee recommendation ................................................................. 210,652,000 

COMMITTEE RECOMMENDATION

The Committee recommends $210,652,000 for Military Construction, Army National Guard for fiscal year 2018. This amount is 

$22,278,000 below the fiscal year 2017 enacted level and equal to 

the budget request. Further detail of the Committee’s recommendation is provided in the State table at the end of this report. 

Army National Guard Readiness Center Transformation Plan.— 

The Committee remains concerned by the deteriorating condition of 

the Army National Guard Readiness Center national portfolio and 

the Army’s lack of an implementable investment plan to address it. 

In April 2017, the Army submitted a report on a plan to implement 

the National Guard’s ‘‘Affordable Readiness’’ Transformation Plan, 

as required by last year’s Committee report. However, the Army 

failed to include any meaningful investment strategy for closing the 

gap between the resources required by the ‘‘Affordable Readiness’’ 

scenario’s 15-year implementation timeline and the resources currently budgeted by the Department over the same period. Therefore, the Committee directs the Army to provide a report no later 

than March 30, 2018 on such an investment strategy, including detailed estimates of the annual resources, activities, and possible 

budgetary tradeoffs required to make progress toward the ‘‘Affordable Readiness’’ scenario. Further, the Committee encourages the 

Department to use the National Readiness Portfolio to prioritize investment in facilities with low readiness ratings, and to examine 

where efficiencies and cost-sharing can be achieved by co-locating 

Readiness Centers with other public facilities. 

MILITARY CONSTRUCTION, AIR NATIONAL GUARD

Appropriations, 2017 ............................................................................. $143,957,000 

Budget estimate, 2018 ........................................................................... 161,491,000 

Committee recommendation ................................................................. 161,491,000 

COMMITTEE RECOMMENDATION

The Committee recommends $161,491,000 for Military Construction, Air National Guard for fiscal year 2018. This amount is 

$17,534,000 above the fiscal year 2017 enacted level and equal to 

the budget request. Further detail of the Committee’s recommendation is provided in the State table at the end of this report. 
23 

MILITARY CONSTRUCTION, ARMY RESERVE

Appropriations, 2017 ............................................................................. $68,230,000 

Budget estimate, 2018 ........................................................................... 73,712,000 

Committee recommendation ................................................................. 73,712,000 

COMMITTEE RECOMMENDATION

The Committee recommends $73,712,000 for Military Construction, Army Reserve for fiscal year 2018. This amount is $5,482,000 

above the fiscal year 2017 enacted level and equal to the budget 

request. Further detail of the Committee’s recommendation is provided in the State table at the end of this report. 

MILITARY CONSTRUCTION, NAVY RESERVE

Appropriations, 2017 ............................................................................. $38,597,000 

Budget estimate, 2018 ........................................................................... 65,271,000 

Committee recommendation ................................................................. 65,271,000 

COMMITTEE RECOMMENDATION

The Committee recommends $65,271,000 for Military Construction, Navy Reserve for fiscal year 2018. This amount is $26,674,000 

above the fiscal year 2017 enacted level and equal to the budget 

request. Further detail of the Committee’s recommendation is provided in the State table at the end of this report. 

MILITARY CONSTRUCTION, AIR FORCE RESERVE

Appropriations, 2017 ............................................................................. $188,950,000 

Budget estimate, 2018 ........................................................................... 63,535,000 

Committee recommendation ................................................................. 63,535,000 

COMMITTEE RECOMMENDATION

The Committee recommends $63,535,000 for Military Construction, Air Force Reserve for fiscal year 2018. This amount is 

$125,415,000 below the fiscal year 2017 enacted level and equal to 

the budget request. Further detail of the Committee’s recommendation is provided in the State table at the end of this report. 

NORTH ATLANTIC TREATY ORGANIZATION

SECURITY INVESTMENT PROGRAM

Appropriations, 2017 ............................................................................. $177,932,000 

Budget estimate, 2018 ........................................................................... 154,000,000 

Committee recommendation ................................................................. 154,000,000 

PROGRAM DESCRIPTION

The North Atlantic Treaty Organization [NATO] appropriation 

provides for the U.S. cost share of the NATO Security Investment 

Program for the acquisition and construction of military facilities 

and installations (including international military headquarters) 

and for related expenses for the collective defense of the NATO 

Treaty area. 
24 

COMMITTEE RECOMMENDATION

The Committee recommends $154,000,000 for the North Atlantic 

Treaty Organization Security Investment Program [NSIP] for fiscal 

year 2018 as requested. This amount is $23,932,000 below the fiscal year 2017 enacted level and equal to the budget request. 

DEPARTMENT OF DEFENSE BASE CLOSURE ACCOUNT

Appropriations, 2017 ............................................................................. $240,237,000 

Budget estimate, 2018 ........................................................................... 255,867,000 

Committee recommendation ................................................................. 255,867,000 

PROGRAM DESCRIPTION

Section 2711 of the National Defense Authorization Act for Fiscal 

Year 2014 (Public Law 112–239) consolidated the Base Closure Account 1990 and the Base Closure Account 2005 into a single Department of Defense Base Closure Account. The Base Closure Account provides for cleanup and disposal of property consistent with 

the four closure rounds required by the base closure acts of 1988 

and 1990, and with the 2005 closure round required by the Defense 

Base Closure and Realignment Act of 1990 (10 U.S.C. 2687 note). 

COMMITTEE RECOMMENDATION

The Committee recommends a total of $255,867,000 for the Department of Defense Base Closure Account for fiscal year 2018. 

This amount is $15,630,000 above the fiscal year 2017 enacted 

level and equal to the budget request. Funds provided for fiscal 

year 2018 are for environmental cleanup and ongoing operations 

and maintenance. 

FAMILY HOUSING OVERVIEW

Appropriations, 2017 ............................................................................. $1,276,289,000 

Budget estimate, 2018 ........................................................................... 1,407,155,000 

Committee recommendation ................................................................. 1,409,437,000 

FAMILY HOUSING ACCOUNTS—PROGRAM DESCRIPTION

The Family Housing appropriation provides funds for military 

family housing construction activities, operation and maintenance, 

the Family Housing Improvement Fund, and the Homeowners Assistance Program. Construction accounts provide funding for new 

construction, improvements and the Federal Government share of 

housing privatization. Operation and maintenance accounts fund 

costs associated with the maintenance and leasing of military family housing, including utilities, services, management, and furnishings. 

COMMITTEE RECOMMENDATION

The Committee recommends $1,409,437,000 for Family Housing 

Construction, Operations and Maintenance, and the Department’s 

family housing improvement fund for fiscal year 2018. This amount 

is $133,148,000 above the fiscal year 2017 enacted level and 

$2,282,000 above the budget request. 
25 

FAMILY HOUSING OPERATION AND MAINTENANCE, ARMY

Appropriations, 2017 ............................................................................. $325,995,000 

Budget estimate, 2018 ........................................................................... 346,625,000 

Committee recommendation ................................................................. 348,907,000 

COMMITTEE RECOMMENDATION

The Committee recommends $348,907,000 for family housing operation and maintenance, Army for fiscal year 2018. This amount 

is $22,912,000 above the fiscal year 2017 enacted level and 

$2,282,000 above the budget request. 

FAMILY HOUSING OPERATION AND MAINTENANCE, NAVY AND

MARINE CORPS

Appropriations, 2017 ............................................................................. $300,915,000 

Budget estimate, 2018 ........................................................................... 328,282,000 

Committee recommendation ................................................................. 328,282,000 

COMMITTEE RECOMMENDATION

The Committee recommends $328,282,000 for family housing operation and maintenance, Navy and Marine Corps, in fiscal year 

2018. This amount is $27,367,000 above the fiscal year 2017 enacted level and equal to the budget request. 

FAMILY HOUSING OPERATION AND MAINTENANCE, AIR FORCE

Appropriations, 2017 ............................................................................. $274,429,000 

Budget estimate, 2018 ........................................................................... 318,324,000 

Committee recommendation ................................................................. 318,324,000 

COMMITTEE RECOMMENDATION

The Committee recommends $318,324,000 for family housing operation and maintenance, Air Force, in fiscal year 2018. This 

amount is $43,895,000 above the fiscal year 2017 enacted level and 

equal to the budget request. 

FAMILY HOUSING OPERATION AND MAINTENANCE, DEFENSE-WIDE

Appropriations, 2017 ............................................................................. $59,157,000 

Budget estimate, 2018 ........................................................................... 59,169,000 

Committee recommendation ................................................................. 59,169,000 

COMMITTEE RECOMMENDATION

The Committee recommends $59,169,000 for family housing operation and maintenance, Defense-Wide, for fiscal year 2018. This 

amount is $12,000 above the fiscal year 2017 enacted level and 

equal to the budget request. 

FAMILY HOUSING CONSTRUCTION, ARMY

Appropriations, 2017 ............................................................................. $157,172,000 

Budget estimate, 2018 ........................................................................... 182,662,000 

Committee recommendation ................................................................. 182,662,000 

COMMITTEE RECOMMENDATION

The Committee recommends $182,662,000 for Army Family 

Housing Construction in fiscal year 2018. This amount is 
26 

$25,490,000 above the fiscal year 2017 enacted level and equal to 

the budget request. Further detail of the Committee’s recommendation is provided in the State table at the end of this report. 

FAMILY HOUSING CONSTRUCTION, NAVY AND MARINE CORPS

Appropriations, 2017 ............................................................................. $94,011,000 

Budget estimate, 2018 ........................................................................... 83,682,000 

Committee recommendation ................................................................. 83,682,000 

COMMITTEE RECOMMENDATION

The Committee recommends $83,682,000 for Family Housing 

Construction, Navy and Marine Corps. This amount is $10,329,000 

below the fiscal year 2017 enacted level and equal to the budget 

request. Further detail of the Committee’s recommendation is provided in the State table at the end of this report. 

FAMILY HOUSING CONSTRUCTION, AIR FORCE

Appropriations, 2017 ............................................................................. $61,352,000 

Budget estimate, 2018 ........................................................................... 85,062,000 

Committee recommendation ................................................................. 85,062,000 

COMMITTEE RECOMMENDATION

The Committee recommends $85,062,000 for Family Housing 

Construction, Air Force, in fiscal year 2018. This amount is 

$23,710,000 above the fiscal year 2017 enacted level and equal to 

the budget request. Further detail of the Committee’s recommendation is provided in the State table at the end of this report. 

DEPARTMENT OF DEFENSE FAMILY HOUSING IMPROVEMENT FUND

Appropriations, 2017 ............................................................................. $3,258,000 

Budget estimate, 2018 ........................................................................... 2,726,000 

Committee recommendation ................................................................. 2,726,000 

PROGRAM DESCRIPTION

The Family Housing Improvement Fund appropriation provides 

for the Department of Defense to undertake housing initiatives and 

to provide an alternative means of acquiring and improving military family housing and supporting facilities. This account provides 

seed money for housing privatization initiatives. 

COMMITTEE RECOMMENDATION

The Committee recommends $2,726,000 for the Family Housing 

Improvement Fund in fiscal year 2018. This amount is $532,000 

below the fiscal year 2017 enacted level and equal to the budget 

request. 

DEPARTMENT OF DEFENSE MILITARY UNACCOMPANIED HOUSING

IMPROVEMENT FUND

Appropriations, 2017 ............................................................................. ........................... 

Budget estimate, 2018 ........................................................................... $623,000 

Committee recommendation ................................................................. 623,000 
27 

PROGRAM DESCRIPTION

The Military Unaccompanied Housing Improvement Fund appropriation provides for the Department of Defense to undertake housing initiatives and to provide an alternative means of acquiring and 

improving military unaccompanied housing and supporting facilities. This account provides seed money for housing privatization 

initiatives. 

COMMITTEE RECOMMENDATION

The Committee recommends $623,000 for the Military Unaccompanied Housing Improvement Fund in fiscal year 2018. This 

amount is equal to the budget request. 

ADMINISTRATIVE PROVISIONS

Sec. 101. The Committee includes a provision that restricts payments under a cost-plus-a-fixed-fee contract for work, except in 

cases of contracts for environmental restoration at base closure 

sites. 

Sec. 102. The Committee includes a provision that permits the 

use of funds for the hire of passenger motor vehicles. 

Sec. 103. The Committee includes a provision that permits the 

use of funds for defense access roads. 

Sec. 104. The Committee includes a provision that prohibits construction of new bases inside the continental United States for 

which specific appropriations have not been made. 

Sec. 105. The Committee includes a provision that limits the use 

of funds for purchase of land or land easements. 

Sec. 106. The Committee includes a provision that prohibits the 

use of funds to acquire land, prepare a site, or install utilities for 

any family housing except housing for which funds have been made 

available. 

Sec. 107. The Committee includes a provision that limits the use 

of minor construction funds to transfer or relocate activities among 

installations. 

Sec. 108. The Committee includes a provision that prohibits the 

procurement of steel unless American producers, fabricators, and 

manufacturers have been allowed to compete. 

Sec. 109. The Committee includes a provision that prohibits payments of real property taxes in foreign nations. 

Sec. 110. The Committee includes a provision that prohibits construction of new bases overseas without prior notification. 

Sec. 111. The Committee includes a provision that establishes a 

threshold for American preference of $500,000 relating to architect 

and engineering services for overseas projects. 

Sec. 112. The Committee includes a provision that establishes 

preference for American contractors for military construction in the 

United States territories and possessions in the Pacific, and on 

Kwajalein Atoll, or in countries bordering the Arabian Gulf. 

Sec. 113. The Committee includes a provision that requires notification of military exercises involving construction in excess of 

$100,000. 
28 

Sec. 114. The Committee includes a provision that permits funds 

appropriated in prior years to be available for construction authorized during the current session of Congress. 

Sec. 115. The Committee includes a provision that permits the 

use of expired or lapsed funds to pay the cost of supervision for any 

project being completed with lapsed funds. 

Sec. 116. The Committee includes a provision that permits obligation of funds from more than 1 fiscal year to execute a construction project, provided that the total obligation for such project is 

consistent with the total amount appropriated for the project. 

Sec. 117. The Committee includes a provision that permits the 

transfer of funds from Family Housing Construction accounts to 

the DoD Family Housing Improvement Fund and from Military 

Construction accounts to the DoD Military Unaccompanied Housing Improvement Fund. 

Sec. 118. The Committee includes a provision that provides 

transfer authority to the Homeowners Assistance Fund. 

Sec. 119. The Committee includes a provision that requires all 

acts making appropriations for military construction be the sole 

funding source of all operation and maintenance for family housing, 

including flag and general officer quarters, and limits the repair on 

flag and general officer quarters to $35,000 per unit per year without prior notification to the congressional defense committees. 

Sec. 120. The Committee includes a provision that provides authority to expend funds from the ‘‘Ford Island Improvement’’ account. 

Sec. 121. The Committee includes a provision that allows the 

transfer of expired funds to the Foreign Currency Fluctuation, Construction, Defense Account. 

Sec. 122. The Committee includes a provision that allows the reprogramming of military construction and family housing construction funds among projects and activities within the account in 

which they are funded. 

Sec. 123. The Committee includes a provision that prohibits the 

use of funds in this title for planning and design and construction 

of projects at Arlington National Cemetery. 

Sec. 124. The Committee includes a provision defining the congressional defense committees. 

Sec. 125. The Committee includes a provision providing additional funds for unfunded military construction priorities. 

Sec. 126. The Committee includes a provision rescinding unobligated balances from the Military Construction Defense-Wide account. 

Sec. 127. The Committee includes a provision prohibiting the use 

of funds in this title to close or realign Naval Station Guantanamo 

Bay, Cuba. The provision is intended to prevent the closure or 

transfer of the installation out of the possession of the United 

States, and maintain the Naval Station’s long-standing regional security and migrant operations missions. 

Sec. 128. The Committee includes a provision regarding the consolidation or relocation of a U.S. Air Force RED HORSE Squadron 

outside of the United States. 
(29) 

TITLE II 

DEPARTMENT OF VETERANS AFFAIRS 

ITEMS OF SPECIAL INTEREST

HEARINGS

The Subcommittee on Military Construction, Veterans Affairs, 

and Related Agencies held one hearing related to the fiscal year 

2018 and 2019 Department of Veterans Affairs [VA] budget request. The subcommittee heard testimony from Poonam L. Alaigh, 

M.D., Acting Under Secretary for Health, Veterans Health Administration, Mr. Thomas J. Murphy, Acting Under Secretary for Benefits, Veterans Benefits Administration, Mr. Ronald E. Walters, Interim Under Secretary for Memorial Affairs, National Cemetery 

Administration, and the Honorable David J. Shulkin, Secretary of 

the Department of Veterans Affairs. 

SUMMARY OF COMMITTEE RECOMMENDATIONS

The Committee recommendation includes $182,366,088,000 for 

the Department of Veterans Affairs for fiscal year 2018, including 

$103,948,996,000 in mandatory spending and $78,417,092,000 in 

discretionary spending. The Committee also recommends 

$70,700,000,000 in advance appropriations for veterans medical 

care for fiscal year 2019 and $107,710,000,000 in advance appropriations for appropriated mandatories for fiscal year 2019. 

DEPARTMENT OVERVIEW

The Veterans Administration was established on July 21, 1930, 

as an independent agency by Executive Order 5398, in accordance 

with the act of July 3, 1930 (46 Stat. 1016). This act authorized the 

President to consolidate and coordinate Federal agencies specially 

created for or concerned with the administration of laws providing 

benefits to veterans, including the Veterans’ Bureau, the Bureau of 

Pensions, and the National Home for Disabled Volunteer Soldiers. 

On March 15, 1989, the Veterans Administration was elevated to 

Cabinet-level status as the Department of Veterans Affairs. 

VA’s mission is to serve America’s veterans and their families as 

their principal advocate in ensuring they receive the care, support, 

and recognition they have earned in service to the Nation. As of 

September 30, 2016, there were an estimated 21.4 million living 

veterans, with 21.3 million of them residing in the United States 

and Puerto Rico. There were an estimated 25.1 million dependents 

(spouses and dependent children) of living veterans in the United 

States and Puerto Rico, and there were 598,000 survivors of deceased veterans receiving VA survivor benefits in the United States 

and Puerto Rico. Thus, approximately 47.0 million people, or 14.4 
30 

percent of the total estimated resident population of the United 

States and Puerto Rico, were recipients or potential recipients of 

veterans benefits from the Federal Government. VA’s operating 

units include the Veterans Benefits Administration, Veterans 

Health Administration, National Cemetery Administration, and 

staff support offices. 

The Veterans Benefits Administration [VBA] provides an integrated program of nonmedical veterans benefits. VBA administers 

a broad range of benefits to veterans and other eligible beneficiaries through 56 regional offices and a records processing center 

in St. Louis, Missouri. The benefits provided include: compensation 

for service-connected disabilities; pensions for wartime, needy, and 

totally disabled veterans; vocational rehabilitation assistance; educational and training assistance; home buying assistance; estate 

protection services for veterans under legal disability; information 

and assistance through personalized contacts; and six life insurance programs. 

The Veterans Health Administration [VHA] develops, maintains, 

and operates a national healthcare delivery system for eligible veterans; carries out a program of education and training of 

healthcare personnel; conducts medical research and development; 

and furnishes health services to members of the Armed Forces during periods of war or national emergency. A system consisting of 

144 VA Hospitals; 22 Health Care Centers [HCC]; 210 Multi-Specialty Community-Based outpatient clinics; 527 Primary Care Community-Based outpatient clinics; 305 Outpatient Services Sites; 135 

community living centers; 115 domiciliary residential rehabilitation 

treatment programs [DRRTP]; 300 readjustment counseling vet 

centers; and 80 mobile vet centers is maintained to meet the VA’s 

medical mission. 

The National Cemetery Administration [NCA] provides for the 

interment of the remains of eligible deceased servicemembers and 

discharged veterans in any national cemetery with available grave 

space; permanently maintains these graves; provides headstones 

and markers for the graves of eligible persons in national and private cemeteries; administers the grant program for aid to States in 

establishing, expanding, or improving State veterans cemeteries; 

and provides certificates to families of deceased veterans recognizing their contributions and service to the Nation. In 2018, cemetery activities will encompass 136 national cemeteries, one national 

veterans’ burial ground, and 33 soldiers’ lots and monument sites. 

Staff support offices include the Office of Inspector General, 

Boards of Contract Appeals and Veterans Appeals, and General Administration offices, which support the Secretary, Deputy Secretary, Under Secretary for Benefits, Under Secretary for Health, 

Under Secretary for Memorial Affairs, and General Counsel. 

Contracting Oversight.—The Committee is concerned about the 

lack of transparency in the contract oversight process, given the 

substantial changes that are made by modifications, as well as the 

lack of visibility into contractor performance. For major contracts, 

whenever the Secretary provides notice to a contracted service provider that the service provider is failing to meet contractual obligations, VA must submit to the Committees on Appropriations and 

Veterans Affairs of both Houses of Congress notification of such 
31 

failure, along with: an explanation of the reasons for providing 

such notice; a description of the effect of such failure, including 

with respect to cost, schedule, and requirements; a description of 

the actions taken by the Secretary to mitigate such failure; and a 

description of the actions taken by the contractor to address such 

failure, and no later than 45 days after the last day of each quarter 

for the duration of the contract, submit to the Committees a report 

detailing any material change or modifications made to the contract, if any, and a justification for such modifications; and publish 

on the Internet website of the Department information about the 

contract and the modifications made to the contract, if any. 

Regrettable Turnover.—The Committee is concerned the Department has failed to follow-up on repeated recommendations of the 

Office of Inspector General to review data on regrettable turnover 

and consider implementing measures to reduce such losses. Given 

the staffing demands on the Department and the challenges it 

faces in recruiting personnel, VA should work expeditiously to better understand why personnel leave the Department and work to 

mitigate such losses. 

Veterans Service Centers.—The Committee remains concerned 

that in many small communities access to information and resources from VA can be difficult. Private, non-profit centers can 

help bridge the gap, provide subject matter experts and service providers to assist in a wide-variety of circumstances, including but 

not limited to homelessness, unemployment, VA benefits and disability, financial assistance, VA healthcare, education assistance, 

travel assistance, and community events. The Committee encourages the Department to evaluate the feasibility of establishing a 

competitive grant program to support local Veterans Service Centers including those that were previously funded under the Army 

Reserve’s Army Strong Community Center program. The Department is directed to report back to the Committees on Appropriations of both Houses of Congress on progress made or statutory 

changes needed to establish such a program. 

Financial Management and Health Care Delivery.—The Committee is aware of and fully supports the VA’s Financial Management Business Transformation [FMBT] effort to procure a new core 

accounting and financial management system. However, a new system, by itself, will not likely fix the Department’s persistent inability to reliably and accurately estimate budgetary needs for delivering healthcare to veterans. VA healthcare remains on the Government Accountability Office’s [GAO] High Risk List in part due 

to the Department’s inability to ensure its resourcing is improving 

veterans’ timely access to quality healthcare services. According to 

the GAO report Managing Risks and Improving VA Health Care 

(GAO–17–317 High Risk Series): ‘‘VA faces challenges regarding 

the reliability, transparency, and consistency of its budget estimates for medical services, as well as weaknesses in tracking obligations for medical services and estimating budgetary needs for future years.’’ VA faced multi-billion dollar healthcare budget shortfalls in fiscal year 2005 and in fiscal year 2015. And again this 

year, the Department faces a budgetary failure and has presented 

Congress with an urgent need for additional resources in the 

Choice Fund to maintain the Veterans Choice Program and its pro-
32 

vider network built by third party administrators. The Committee 

cannot reconcile how an Agency with 18 consecutive years of unmodified (‘‘clean’’) audit opinions on its consolidated financial statements can have such dysfunction. The Department is aware its 

data and budgeting system for veteran healthcare is ineffective and 

not scalable to accurately project appropriations in future years, 

but has not taken definitive action to make improvements to their 

system. The Committee requires the Department, in consultation 

with the Office of Management and Budget, to pursue a comprehensive healthcare modeling system and consider solutions and 

best practices from third party administrators or other healthcare 

systems as it relates to informing the Department of reforms to 

more accurately forecast the cost of healthcare for veterans. The 

Department is directed to provide an update on progress in this effort to the Committees on Appropriations of Houses of Congress 

within 120 days, as well as furnish quarterly reports on all major 

facets of the initiative, to include cooperation with an independent 

audit conducted by GAO. 

VETERANS BENEFITS ADMINISTRATION

Appropriations, 2017 ......................................................................... $105,577,085,000 

Advance Appropriations, 2018 ......................................................... 103,935,996,000 

Budget estimate, 2018 ...................................................................... 3,036,653,000 

Committee recommendation, 2018 ................................................... 3,103,214,000 

Budget estimate, advance appropriations, 2019 ............................. 107,709,727,000 

Committee recommendation, advance appropriations, 2019 ......... 107,710,000,000 

ADMINISTRATION OVERVIEW

The Veterans Benefits Administration [VBA] is responsible for 

the payment of compensation and pension benefits to eligible service-connected disabled veterans, as well as education benefits and 

housing loan guarantees. 

COMMITTEE RECOMMENDATION

In fiscal year 2017, the Committee provided $103,935,996,000 in 

advance appropriations for the Veterans Benefits Administration 

for fiscal year 2018. This included $90,119,449,000 for Compensation and pensions; $13,708,648,000 for Readjustment benefits; and 

$107,899,000 for Veterans insurance and indemnities. 

For fiscal year 2018, the Committee recommends an additional 

$13,000,000 for Veterans insurance and indemnities. Additionally, 

the Committee recommendation includes $178,626,000 for the Veterans Housing Benefit Program Fund administrative expenses; 

$30,000 for the Vocational Rehabilitation Loans Program account, 

with $395,000 for administrative expenses; $1,163,000 for the Native American Veteran Housing Loan Program account; 

$2,910,000,000 for General Operating Expenses, Veterans Benefits 

Administration account. The Committee recommendation also provides $107,710,000,000 in advance appropriations for the Veterans 

Benefits Administration for fiscal year 2019. 

Public Law 114–223 moved the General Operating Expenses, 

Veterans Benefits Administration account from Departmental Administration to the Veterans Benefits Administration, its appropriate section within the act, with the instruction that the Depart-
33 

ment should place GOE,VBA in this location with the fiscal year 

2018 request. The Committee notes this did not happen, and therefore, once again, instructs the Department to adhere to this direction with the fiscal year 2019 request. 

COMPENSATION AND PENSIONS

(INCLUDING TRANSFER OF FUNDS)

Appropriations, 2017 ............................................................................. $86,083,128,000 

Advance Appropriations, 2018 .............................................................. 90,119,449,000 

Budget estimate, advance appropriations, 2019 ................................. 95,768,462,000 

Committee recommendation, advance appropriations, 2019 .............. 95,769,000,000 

PROGRAM DESCRIPTION

Compensation is payable to living veterans who have suffered 

impairment of earning power from service-connected disabilities. 

The amount of compensation is based upon the impact of disabilities on a veteran’s earning capacity. Death compensation or dependency and indemnity compensation is payable to the surviving 

spouses and dependents of veterans whose deaths occur while on 

active duty or result from service-connected disabilities. A clothing 

allowance may also be provided for service-connected veterans who 

use a prosthetic or orthopedic device. In fiscal year 2018, the Department estimates it will obligate $84,598,945 for payments to 

4,616,764 veterans, 419,948 survivors, and 1,137 dependents receiving special benefits. 

Pensions are an income security benefit payable to needy wartime veterans who are precluded from gainful employment due to 

nonservice-connected disabilities which render them permanently 

and totally disabled. Public Law 107–103, the Veterans Education 

and Benefits Expansion Act of 2001, restored the automatic presumption of permanent and total nonservice connected disability 

for purposes of awarding a pension to veterans age 65 and older, 

subject to the income limitations that apply to all pensioners. 

Death pensions are payable to needy surviving spouses and children of deceased wartime veterans. The rate payable for both disability and death pensions is determined on the basis of the annual 

income of the veteran or their survivors. In fiscal year 2018, the 

Department estimates that the Pensions program will provide benefits to 289,178 veterans and 204,006 survivors totaling $5,989,847. 

The Compensation and Pensions program funds certain burial 

benefits on behalf of eligible deceased veterans. These benefits provide the purchase and transportation costs for headstones and 

markers, graveliners, and pre-placed crypts; and provide partial reimbursement for privately purchased outer burial receptacles. In 

fiscal year 2018, the Department estimates the Compensation and 

Pensions program will obligate $243,492,000 providing burial benefits. This funding will provide 37,212 burial allowances, 26,737 burial plot allowances, 21,222 service-connected death awards, 497,644 

burial flags, 373,895 headstones or markers, 41,759 graveliners or 

reimbursement for privately purchased outer burial receptacles, 

and 305 caskets and urns for the internment of the remains of veterans without next of kin. 
34 

COMMITTEE RECOMMENDATION

In fiscal year 2017, the Committee provided an advance appropriation of $90,119,449,000 for fiscal year 2018 for the Compensation and Pensions account. 

The Committee recommendation includes an advance appropriation of $95,769,000,000 for Compensation and pensions for fiscal 

year 2019. This is $538,000 above the request to reflect proper 

rounding of a budget estimate. 

READJUSTMENT BENEFITS

Appropriations, 2017 ............................................................................. $16,340,828,000 

Advance Appropriations, 2018 .............................................................. 13,708,648,000 

Budget estimate, advance appropriations, 2019 ................................. 11,832,175,000 

Committee recommendation, advance appropriations, 2019 .............. 11,832,000,000 

PROGRAM DESCRIPTION

The Readjustment benefits appropriation finances the education 

and training of veterans and servicemembers under chapters 30, 

31, 32, 33, 34, 35, 36, 37, 39, 41, 42 and 43 of title 38, United 

States Code. These benefits include the All-Volunteer Force Educational Assistance Program (Montgomery GI bill) and the Post 9/ 

11 Educational Assistance Program. Basic benefits are funded 

through appropriations made to the readjustment benefits appropriation and by transfers from the Department of Defense. This account also finances vocational rehabilitation, specially adapted 

housing grants, specially adapted automobile grants for certain disabled veterans, and educational assistance allowances for eligible 

dependents of those veterans who died from service-connected 

causes or who have a total permanent service-connected disability, 

as well as dependents of servicemembers who were captured or 

missing in action. 

COMMITTEE RECOMMENDATION

In fiscal year 2017, the Committee provided an advance appropriation of $13,708,648,000 for the Readjustment Benefits account 

for fiscal year 2018. 

The Committee recommendation includes an advance appropriation of $11,832,000,000 for Readjustment benefits for fiscal year 

2019. This is $175,000 below the request to reflect proper rounding 

of a budget estimate. 

VETERANS INSURANCE AND INDEMNITIES

Appropriations, 2017 ............................................................................. $108,525,000 

Advance Appropriations, 2018 .............................................................. 107,899,000 

Budget estimate, 2018 ........................................................................... 12,439,000 

Committee recommendation, 2018 ....................................................... 13,000,000 

Budget estimate, advance appropriations, 2019 ................................. 109,090,000 

Committee recommendation, advance appropriations, 2019 .............. 109,000,000 

PROGRAM DESCRIPTION

The Veterans insurance and indemnities appropriation consists 

of the former appropriations for military and naval insurance, applicable to World War I veterans; National Service Life Insurance, 

applicable to certain World War II veterans; servicemen’s indem-
35 

nities, applicable to Korean conflict veterans; and veterans mortgage life insurance to individuals who have received a grant for 

specially adapted housing. 

COMMITTEE RECOMMENDATION

In fiscal year 2017, the Committee provided an advance appro- priation of $107,899,000 for fiscal year 2018 for the Veterans Insurance and Indemnities account. The recommendation for fiscal year 

2018 also includes an additional $13,000,000. This is $561,000 

above the request to reflect proper rounding of a budget estimate. 

The Committee recommendation also includes an advance appro- priation of $109,000,000 for Veterans insurance and indemnities 

for fiscal year 2019. This is $90,000 below the request to reflect 

proper rounding of a budget estimate. 

VETERANS HOUSING BENEFIT PROGRAM FUND

Program account Administrative 

expenses 

Appropriations, 2017 ....................................................................................................... ............................ $198,856,000 

Budget estimate, 2018 ................................................................................................... ............................ 178,626,000 

Committee recommendation ........................................................................................... ............................ 178,626,000 

PROGRAM DESCRIPTION

The Veterans housing benefit program fund provides for all costs 

associated with VA’s direct and guaranteed housing loan programs, 

with the exception of the Native American veteran housing loan 

program. 

VA loan guaranties are made to servicemembers, veterans, reservists, and unremarried surviving spouses for the purchase of 

homes, condominiums, and manufactured homes, and for refinancing loans. VA guarantees part of the total loan, permitting the 

purchaser to obtain a mortgage with a competitive interest rate, 

even without a downpayment, if the lender agrees. VA requires a 

downpayment be made for a manufactured home. With a VA guaranty, the lender is protected against loss up to the amount of the 

guaranty if the borrower fails to repay the loan. 

COMMITTEE RECOMMENDATION

The Committee recommends such sums as may be necessary for funding subsidy payments, and $178,626,000 for administrative expenses for fiscal year 2018. Bill language limits gross obligations 

for direct loans for specially adapted housing to $500,000. 

VOCATIONAL REHABILITATION LOANS PROGRAM ACCOUNT

Program account Administrative 

expenses 

Appropriations, 2017 ....................................................................................................... $36,000 $389,000 

Budget estimate, 2018 ................................................................................................... 30,000 395,000 

Committee recommendation ........................................................................................... 30,000 395,000 

PROGRAM DESCRIPTION

The Vocational Rehabilitation Loans Program account covers the 

cost of direct loans for vocational rehabilitation of eligible veterans 
36 

and, in addition, includes administrative expenses necessary to 

carry out the direct loan program. Loans of up to $1,214 (based on 

the indexed chapter 31 subsistence allowance rate) are currently 

available to service-connected disabled veterans enrolled in vocational rehabilitation programs, as provided under 38 U.S.C. chapter 

31, when the veteran is temporarily in need of additional assistance. Repayment is made in monthly installments, without interest, through deductions from future payments of compensation, 

pension, subsistence allowance, educational assistance allowance, 

or retirement pay. Virtually all loans are repaid in full and most 

in less than one year. 

COMMITTEE RECOMMENDATION

The Committee recommends $30,000 for program costs and 

$395,000 for administrative expenses for the Vocational Rehabilitation Loans Program account. The administrative expenses may be 

paid to the General Operating Expenses, Veterans Benefits Administration account. Bill language is included limiting program direct 

loans to $2,356,000. It is estimated VA will make 2,402 loans in fiscal year 2018, with an average amount of $981. 

NATIVE AMERICAN VETERAN HOUSING LOAN PROGRAM ACCOUNT

Appropriations, 2017 ............................................................................. $1,163,000 

Budget estimate, 2018 ........................................................................... 1,163,000 

Committee recommendation ................................................................. 1,163,000 

PROGRAM DESCRIPTION

The Native American veteran housing loan program is authorized by 38 U.S.C. chapter 37, section 3761 to provide direct loans 

to Native American veterans living on trust lands. The loans are 

available to purchase, construct, or improve homes to be occupied 

as veteran residences or to refinance a loan previously made under 

this program in order to lower the interest rate. The principal 

amount of a loan under this authority generally may not exceed 

$424,100; however, in some locations this limit may be higher depending on median area home prices. Veterans pay a funding fee 

of 1.25 percent of the loan amount, although veterans with a service-connected disability are exempt from paying the fee. Before a 

direct loan can be made, the veteran’s tribal organization must sign 

a memorandum of understanding with VA regarding the terms and 

conditions of the loan. The Native American Veteran Housing Loan 

Program began as a pilot program in 1993 and was made permanent by Public Law 109–233, the Veterans Housing Opportunity 

and Benefits Act of 2006. 

COMMITTEE RECOMMENDATION

The Committee recommends $1,163,000 for administrative expenses associated with this program. This is equal to the fiscal 

year 2017 enacted level and equal to the budget request. 
37 

GENERAL OPERATING EXPENSES, VETERANS BENEFITS

ADMINISTRATION

Appropriations, 2017 ............................................................................. $2,844,160,000 

Budget estimate, 2018 ........................................................................... 2,844,000,000 

Committee recommendation ................................................................. 2,910,000,000 

PROGRAM DESCRIPTION

The General Operating Expenses, Veterans Benefits Administration account provides funding for the Veterans Benefits Administration to administer entitlement programs such as service-connected disability compensation, education benefits, and vocational 

rehabilitation services. 

COMMITTEE RECOMMENDATION

The Committee recommends $2,910,000,000 for the General Operating Expenses, Veterans Benefits Administration account, which 

is $65,840,000 above the fiscal year 2017 enacted level and 

$66,000,000 above the budget request. The Committee has included 

bill language to make available through September 30, 2019, up to 

10 percent of the General Operating Expenses, Veterans Benefits 

Administration account. 

Disability Claims Processing.—The Committee has not only fully 

funded the budget request for claims processing in recent years, 

but has provided increases above the budget requests for hiring 

and training claims processors, bolstering the migration to electronic claims processing systems, and addressing the increasing 

backlog of appeals at the Board of Veterans Appeals. The Committee commends the Department on its efforts to reduce the disability claims backlog and increase the accuracy of claims decisions, yet the processing of disability claims remains a major concern of the Committee. In particular, progress in reducing the 

backlog seems to have stalled this year, hovering weekly between 

99,000 and 90,000. The Department must consider processing all 

claims within 125 days with 98 percent accuracy a mandate of 

VBA, and the Department should fund and staff this agency accordingly. In addition to efforts to ensure there is not a recurrence 

of a sizeable disability claims backlog, the Department must also 

ensure that proper staffing and resources are available to reduce 

the growing wait time and backlog of disability decisions on appeal 

and meet demand for other benefit programs. To that end, the 

Committee recommends an additional $66,000,000 to VBA, GOE to 

hire additional claims and appellate staff, as well as to increase 

staff for the Vocational Rehabilitation and Employment Program. 

The VBA may also use these resources to finance overtime payments, if that becomes necessary, and support increased resources 

for the Veterans Claims Intake Program [VCIP] to scan and convert paper files into digital records. The Committee will continue 

to assert its oversight ability by monitoring the key agencies involved in veteran disability claims processing—VA, DoD, the Social 

Security Administration, and the Internal Revenue Service—these 

agencies as they work to better expedite the flow of interagency information needed to process claims in a timely manner. The Com-
38 

mittee will continue to require the Department provide monthly 

updates on performance measures for each Regional Office. 

Financial Hardship and Bankruptcy.—The Committee continues 

to support VA programs that combat the root causes of veteran and 

dependent financial hardship, which is a known contributory factor 

to negative outcomes such as mental health issues, substance use 

disorder, and suicide. For example, disability-related benefits not 

only honor the service and sacrifice of the veterans who receive 

them, but also help to replace lost wages and provide a critical 

source of economic well-being. The Committee is concerned by an 

inequity in current bankruptcy law that results in the inclusion of 

VA and DoD disability benefits in the calculation of a debtor’s disposable income, while at the same time excluding Social Security 

disability benefits for non-veterans. The Department is directed to 

submit to the Committees on Appropriations and Veterans Affairs 

of both Houses of Congress a report outlining the statutory and legislative authority is needed to end this inequity. 

Women Veterans Participation Rates.—The Committee directs VA 

to include an analysis of trends and satisfaction rates among 

women veterans participating in the Vocational Rehabilitation & 

Employment program in the annual report to Congress to ensure 

these services are adapting to changing demographics of veterans 

and the needs of women veterans with disabilities. 

State Accrediting Agency Oversight.—The Committee is concerned current laws and regulations related to conflicting interests 

may be inadequate to identify conflicts of interest that can develop 

through the provision of meals or de minimus gifts to officers of 

State Accrediting Agencies. The Department is directed to conduct 

an assessment of the effectiveness of 38 U.S.C. 3683 and 38 CFR 

21.4005 in preventing conflicts of interests and submit a report to 

the Committees on Appropriations of both Houses of Congress no 

later than 180 days after enactment of this act regarding the findings. 

State Approving Agencies.—Under the G.I. Bill and the Post-9/11 

Veterans Educational Assistance Improvements Act of 2010 (Public 

Law 111–377, 38 U.S.C. Ch. 36 sec. 3670) VA contracts with States 

to establish State Approving Agencies [SAAs] in promoting and 

safeguarding quality education and training programs for veterans, 

ensuring greater education and training opportunities for veterans, 

and protecting the integrity of the G.I. Bill. The Committee is concerned VA’s formula for determining each SAA’s allocation fails to 

take into account travel times. This is of particular concern in rural 

States where travel between school inspections can be costly in 

both time and monetary expense. The Committee instructs VA to 

ensure SAAs have sufficient resources to cover travel expenses and 

accomplish their mandate under the G.I. Bill. 

Rural Veterans Coordination Pilot.—Section 506 of the Caregivers and Veterans Omnibus Health Services Act of 2010 (Public 

Law 111–163; 38 U.S.C. 523 note) established the Rural Veterans 

Coordination Pilot [RVCP] at VA. Eligible grant recipients are community based organizations and/or local, State, or tribal government entities. The pilot enabled each grant recipient to support 

local veterans in unique ways that will be suitable for the challenges faced at these locations. Upon completion of the pilot, the 
39 

Department is directed to provide a report and recommendations to 

the Committee identifying effective models in which State and local 

entities are able to successfully coordinate multi-sector benefits for 

veterans and their families who reside in rural or underserved 

communities. The Committee urges the Department to consider extending the RVCP beyond its current deadline and expanding the 

program to include additional locations. 

Assessment of GI Bill Utilization.—The Committee notes the Department’s responsibility to provide GI bill benefits to 

servicemembers as they transition to civilian life and status as a 

veterans, however the Committee believes there is an opportunity 

to increase utilization of these benefits. To better understand the 

current utilization and drive future decisions regarding educational 

benefits to veterans, the Committee directs the Department to conduct a comprehensive assessment to accurately account the number 

of veterans utilizing their educational benefits. The first report 

should analyze fiscal years 2010 to 2017, but thereafter, the Committee directs the Department to submit an annual report that 

tracks outcomes for Post-9/11 GI bill benefits. The report should include: the number of veterans who qualify for either a partial or 

the full GI bill benefit; veteran use of the GI bill benefit among the 

total number of eligible veterans; veteran use or transfer of unused 

GI bill benefit to dependents; use of the GI bill benefit toward 4- 

year, 2-year, and vocational educational and training programs, 

and distinguish the programs; the average dollar amount of usage; 

and an aggregate graduation rate, loan default rate, and average 

indebtedness by degree program, type of degree, and field of study. 

Additionally, the Department is encouraged to make an effort to 

gather data on the jobs attained after graduation, specifically 

whether those jobs can be reasonably said to be in the field of 

study identified in the students’ education plans. The Department 

is directed to submit the first report to the Committees on Appropriations of both Houses of Congress no later than 180 days after 

enactment of this act. 

Education Benefits.—The Committee is concerned about the levels of overpayments and improper payments being paid to GI Bill 

beneficiaries. The Committee directs VA to work with education 

stakeholders to ensure that veteran educational benefits are paid 

in a timely and accurate manner and that efforts to recoup any 

overpayments or improper payments is done fairly and in a manner 

that is not overly burdensome on student veterans and their families. The Committee further directs VA, in collaboration with the 

Department of Defense and Department of Education, to provide 

an interagency report on the development and continued implementation of the Principles of Excellence, oversight of institutions 

complying with the Principles, and appropriate and timely accountability measures for educational programs receiving Federal funding. Lastly, the Committee directs VA to continue to reform the 

compliance survey process to allow early detection of fraudulent 

marketing or predatory recruiting practices among institutions of 

higher learning and to codify a set of tools that is sufficiently agile 

enough to curtail the behavior of scamming institutions that are 

wasting the VA education benefits of service members and their 

families. 
40 

Education Data Collection and Sharing.—The Committee wants 

for both students and VA to be able to make more evidence-based 

decisions when it comes to veterans’ education. The Committee directs VA to work with the Department of Education and Department of Defense to ensure that there is a comprehensive database 

or, at a minimum, a set of robust data-sharing agreements in place 

between Federal entities involved in the administration of Federal 

resources related to veteran educational attainment. The Committee further directs VA, in collaboration with the Department of 

Education and Department of Defense, to provide an interagency 

report on data-sharing priorities, the development and implementation of subsequent data-sharing agreements, and the uses and effectiveness of the data shared. 

Reforms to Expedite the Appeals Process.—The Committee directs 

the Secretary to fully implement the GAO’s recommendation to improve the timeliness of VA’s disability benefits appeals decisions 

and to document its progress in its monthly reports to the Committee on appeals claims processing performance. The Committee 

concurs with GAO’s recommendations that VA should apply sensitivity analyses when projecting staff needs, develop a more timely 

and detailed workforce plan, develop a robust plan monitoring process reform, develop a strategy for assessing process reform, and 

create a schedule for IT improvements that takes into account 

plans for potential process reform. The Committee also supports 

GAO’s view that any VA-proposed appeals process reforms be subject to a pilot test. 

Home Loan Counseling.—The Committee remains concerned 

about the percentage of veteran homeowners that are not using the 

VA home loan benefit because they were unaware of the program 

or because they were discouraged by their lender and/or realtor 

from using a VA loan. Despite significant demand among veterans 

for home buying counseling services and education, too few receive 

housing counseling or VA loan education while serving on active 

duty or after separating from the military. The Committee believes 

that in establishing the VA home loan benefit, Congress authorized 

and intended for VA to provide such counseling services and education in its administration of the program. Therefore, the Committee directs the Department to conduct a study to assess the feasibility of establishing a VA housing counseling program that 

would include a network of counselors across the country. To the 

extent practicable, the feasibility study should look at the Department of Housing and Urban Development’s Office of Housing Counseling for opportunities to collaborate, including sharing expertise 

and personnel. The Department is directed to submit a report to 

the Committees on Appropriations of both Houses of Congress no 

later than 180 days after enactment of this act on the findings of 

the study. 

Benefits for Veterans with Service-Connected Disabilities.—The 

Committee notes that many veterans are eligible for a full discharge of their Federal student loan debt due to a service-connected disability, but have not received the benefits Congress intended. Under Section 437 of the Higher Education Act of 1965, 

borrowers who have been determined by the Secretary to be unemployable due to a service-connected condition are eligible for a full 
41 

discharge of their liability to repay their loans and are not required 

to submit additional documentation. Beginning in April 2016, the 

Department of Education established a secure data sharing agreement with the Social Security Administration [SSA] to identify 

Federal student loan borrowers who also receive the relevant disability payments that qualify them for loan forgiveness under the 

Total and Permanent Disability [TPD] loan discharge program. Approximately 387,000 disabled borrowers were positively identified 

with SSA in the first set of matches. However, this data sharing 

did not include veterans who are also eligible for loan discharge 

and have submitted appropriate documentation to the Department. 

As a result, too many eligible veterans with severe service-connected disabilities have been left out of this streamlined path to 

loan discharge due to a lack of communication between the Department of Education, Department of Veterans Affairs, and Federal 

student loan servicers. Therefore, the Department is directed, in coordination with the Department of Education (including its student 

loan servicers), to make every practical effort to automate the application of loan discharge to eligible veterans using information in 

existing Federal databases at the Departments of Education and 

Veterans Affairs in a timely manner so that veterans can receive 

the benefits due under law. The Department is directed to submit 

a report to the Committees on Appropriations of both Houses of 

Congress no later than 90 days after enactment of this act on the 

plan of action for implementing this automation process. 

VETERANS HEALTH ADMINISTRATION

Appropriations, 2017 ............................................................................. $65,152,027,000 

Advance appropriations, 2018 .............................................................. 66,385,032,000 

Budget estimate, 2018 ........................................................................... 3,290,000,000 

Committee recommendation, 2018 ....................................................... 3,689,262,000 

Budget estimate, advance appropriations, 2019 ................................. 70,699,313,000 

Committee recommendation, advance appropriations, 2019 .............. 70,700,000,000 

ADMINISTRATION OVERVIEW

The Veterans Health Administration [VHA] is home to the 

United States’ largest integrated healthcare system consisting of 

144 VA Hospitals; 22 Health Care Centers [HCC]; 210 Multi-Specialty Community-Based outpatient clinics; 527 Primary Care Community-Based outpatient clinics; 305 Outpatient Services Sites; 135 

community living centers; 115 domiciliary residential rehabilitation 

treatment programs [DRRTP]; 300 readjustment counseling vet 

centers; and 80 mobile vet centers. 

The Department of Veterans Affairs Medical Care Collections 

Fund [MCCF] was established by the Balanced Budget Act of 1997 

(Public Law 105–33). In fiscal year 2004, Public Law 108–199 allowed the Department to deposit first-party and pharmaceutical copayments, third-party insurance payments and enhanced-use collections, long-term care co-payments, Compensated Work Therapy 

Program collections, Compensation and Pension Living Expenses 

Program collections, and Parking Program fees into the MCCF. 

The Parking Program provides funds for the construction, alteration, and acquisition (by purchase or lease) of parking garages at 

VA medical facilities authorized by 38 U.S.C. 8109. The Secretary 
42 

is required under certain circumstances to establish and collect fees 

for the use of such garages and parking facilities. Receipts from the 

parking fees are to be deposited into the MCCF and are used for 

medical services activities. 

COMMITTEE RECOMMENDATION

In fiscal year 2017, the Committee provided $66,385,032,000 in 

advance appropriations for VA’s medical care accounts for fiscal 

year 2018. This included $44,886,554,000 for Medical services, 

$9,409,118,000 for Medical community care, $6,654,480,000 for 

Medical support and compliance, and $5,434,880,000 for Medical 

facilities. The Committee also includes an Administrative Provision 

allowing the Department to carry forward into fiscal year 2018 certain amounts provided as an advance for fiscal year 2017. 

For fiscal year 2018, the Committee recommends an additional $1,923,000,000 for Medical services, $254,000,000 for Medical community care, $100,000,000 for Medical support and compliance, and 

$707,000,000 for Medical facilities. Additionally, the Committee 

recommendation includes $705,262,000 for Medical and prosthetic 

research. Medical care collections are expected to be 

$2,507,000,000. The Committee recommendation also provides 

$70,700,000,000 in advance appropriations for VA’s medical care 

accounts for fiscal year 2019. 

Education Debt Reduction Program.—The Department is directed 

provide a breakdown of spending by VA in connection with the education debt reduction program of the Department under subchapter 

VII of chapter 76 of title 38, United States Code. The breakout 

shall include the following elements: (1) the amount spent by the 

Department in debt reduction payments during the three year period preceding the submittal of the report disaggregated by the 

medical profession of the individual receiving the payments; (2) a 

description of how the Department prioritizes such spending by 

medical profession, including an assessment of whether such priority reflects the five occupations identified in the most recent determination by VA OIG as having the largest staffing shortages in 

VHA; and (3) a description of the actions taken by the Secretary 

to increase the effectiveness of such spending for purposes of recruitment of healthcare providers to the Department, including efforts to more consistently include eligibility for the education debt 

reduction program in vacancy announcements of positions for 

healthcare providers at VA. The Department is directed to submit 

a report to the Committees on Appropriations of both Houses of 

Congress no later than 90 days after enactment of this act detailing the findings. 

Office of Patient Advocacy.—The Committee urges the Department to swiftly and comprehensively implement the reforms made 

to the patient advocacy program as required by the Jason 

Simcakoski Memorial and Promise Act [Title IX, Public Law 114– 

198]. The law’s establishment of the Office of Patient Advocacy will 

ensure that patient advocates are independent of local facility management, work strictly on behalf of veterans, and are properly 

trained according to national standards. Furthermore, the Committee believes the Inspector General’s March 2017 audit of the patient advocacy program’s fiscal year 2015 operations [VA OIG 15– 
43 

05379–146] provides additional evidence of the need to institute 

strong operational controls and standardization to ensure program 

effectiveness and the reliability of complaint data. Accordingly, the 

Department is directed to submit a report to the Committees on 

Appropriations of both Houses of Congress no later than 30 days 

after enactment of this act outlining progress implementing the relevant sections of Public Law 114–198 and the OIG recommendations. 

Veteran Medical Debt.—The Committee is concerned that despite 

the Department’s efforts to streamline administrative burdens of 

the Veterans Choice Program, VA payments to non-VA healthcare 

providers continue to face delays, and medical bills continue to be 

inappropriately assigned to veterans rather than VA. Incorrectly 

assigned bills and delayed payments have resulted in medical bills 

going into collection and damaging veterans’ credit. Therefore, the 

Committee directs the Under Secretary for Health to consult with 

the Consumer Financial Protection Bureau, national credit reporting agencies, and appropriate consumer protection stakeholders 

and develop an action plan to protect veterans from collections efforts and credit damage due to medical bills that should have been 

paid by VA. The Department is directed to submit a report to the 

Committees on Appropriations of both Houses of Congress no later 

than 90 days after enactment of this act on the status of developing 

an action plan. 

Cross Government Credentialing of VA Healthcare Providers.—In 

order to better facilitate active recruitment of individuals who 

served in the healthcare field for the U.S. Armed Forces or while 

on duty with the U.S. Coast Guard, the Committee directs VA to 

establish coordinating relationships with the appropriate personnel 

divisions dealing with separating military personnel at the Departments of Defense and Homeland Security. As part of this coordination, the Department shall determine whether establishing a formal system for receiving advanced notice of separating members of 

the armed forces is feasible. The Committee further directs VHA to 

conduct an internal audit of its procedures for the recredentialing 

of providers when transferring within the VHA system. The Committee directs VHA to institute such policies and procedures to ensure the speedy and timely transfer of licensed personnel between 

facilities and to remove the unnecessary barrier of recredentaling 

triggered solely by a provider transferring facilities. 

West Los Angeles Master Plan.—While the Committee is encouraged by recent progress made at the West Los Angeles VA Campus, the Committee continues to be concerned that approximately 

3,000 veterans remain homeless in the Greater Los Angeles Area. 

The Committee directs VA to brief the Committees on Appropriations of both Houses of Congress each quarter on its progress toward implementing the Master Plan, ensuring that lease revenues 

are being used to benefit veterans, and coordinating closely with 

the local community. 

Corporate Planning and High Performing Networks.—Various 

documents published by VHA, such as the Blueprint for Excellence 

and the fiscal year 2016 Annual Restoring Trust in Veterans 

Health Care Report, recognize the need for creating a high-performing, integrated health network that includes VHA providers 
44 

and facilities, other federally funded providers and facilities, and 

VHA-credentialed community providers and facilities. To date, VA 

has not articulated an overarching strategy to achieve such a goal, 

does not provide metrics to show progress towards achieving stated 

goals, and has no structure to identify accountable senior officials 

for such an effort. The Committee recognizes the complex and 

transformative nature of creating a system capable of serving veterans in the future requires direct and sustained VHA leadership 

involvement. To achieve this goal, the Committee directs VHA to 

form a corporate planning function patterned after high performing 

commercial healthcare delivery systems. Such function must include representation from VHA clinical leadership, and leaders 

from VHA offices that control, oversee, or manage facility investments, transition, facility operations, and organizational change, as 

well as the appropriate VA offices that are dedicated to the planning and procurement of capital infrastructure, whether built or 

leased by VA. The corporate planning function shall be responsible 

for planning and implementing a high performing, integrated 

health network. The Department is directed to submit a report to 

the Committees on Appropriations of both Houses of Congress no 

later than 180 days after enactment of this act detailing the corporate planning function and a plan to achieve a high-performing, 

integrated health network for the next twenty years. At a minimum, the plan shall clearly articulate VA’s vision of a future network, include goals VA is working towards to achieve the vision, 

Key Performance Indicators, and other metrics VA will use to judge 

success, and an organizational chart detailing the corporate planning function’s direct reporting relationship to the Under Secretary 

of Health. The Committee recommends VA seek objective analysis 

and recommendations from organizations outside VA that have 

successfully created, implemented, or advised corporate planning 

functions at high-performing community healthcare systems. The 

Committee recommends VHA seek guidance from the leadership of 

the Department of Defense’s Military Health System Facility 

Shared Service. Additionally, the Committee understands VHA is 

now conducting market surveys to examine how VHA can develop 

a high-performing network by looking at community healthcare 

supplies and VHA services and capabilities. The Department is directed to report to the Committees on Appropriations of both 

Houses of Congress the findings of these market surveys within 

180 days of the completion of the surveys. 

MEDICAL SERVICES

(INCLUDING TRANSFER OF FUNDS)

Appropriations, 2017 ............................................................................. $45,421,812,000 

Advance appropriations, 2018 .............................................................. 44,886,554,000 

Budget estimate, 2018 ........................................................................... 1,031,808,000 

Committee recommendation, 2018 ....................................................... 1,923,000,000 

Budget estimate, advance appropriations, 2019 ................................. 49,161,165,000 

Committee recommendations, advance appropriations, 2019 ............ 49,161,000,000 
45 

PROGRAM DESCRIPTION

The Medical Services account provides for medical services for eligible enrolled veterans and other beneficiaries in VA healthcare 

facilities, including VA medical centers and VA outpatient clinics. 

COMMITTEE RECOMMENDATION

In fiscal year 2017, the Committee provided an advance appropriation of $44,886,554,000 for fiscal year 2018 for the Medical 

Services account. The recommendation for fiscal year 2018 includes 

an additional $1,923,000,000 which is $891,192,000 above the 

budget request. The additional appropriation coupled with the advance appropriation provided for fiscal year 2018 provides the Department with total budget authority of $46,809,554,000 which is 

$1,387,742,000 above the fiscal year 2017 enacted amount. In addition, VA has the authority to retain co-payments and third-party 

collections, estimated to total $2,507,000,000 in fiscal year 2018. 

The Committee recommendation also includes an advance appropriation of $49,161,000,000 for Medical services for fiscal year 

2019. This is $165,000 below the request to reflect proper rounding 

of a budget estimate. 

RURAL ACCESS TO CARE

Office of Rural Health.—The Committee recommendation includes $20,000,000 in addition to the budget request for the Office 

Rural Health [ORH]. Through collaborations with other VA program offices, Federal partners, State partners, and rural communities, ORH works to optimize the use of available and emerging 

technologies, establish new access points to care, and employ strategies to increase healthcare options for all rural veterans. Currently, ORH identifies and implements initiatives that support 

rural clinics and rural home-based primary care, address barriers 

to access and quality of healthcare delivery in rural areas, develop 

workforce recruitment and retention initiatives, and accelerate and 

expand telehealth. ORH also operates Rural Health Resource Centers and works with Federal and non-Federal community partners 

to share resources and expand access to care for rural veterans. 

Given the important role these centers play in expanding access, 

the Committee encourages the Department to consider expanding 

these centers. 

ORH has played a major role in VA’s overall strategy to combat 

opioid abuse by funding pilot programs through the Rural Health 

Initiative focused on pain coaching and modalities which increase 

veterans’ access to alternatives to opioid-centered pain management. Participants of one pain coaching program—which linked 

professional coaches to veteran patients for biweekly meetings by 

phone—reported a 40 percent reduction in pain outcomes after 1 

year. Another program allowed veterans to utilize noninvasive modality devices to help reduce pain intensity. Both of these programs 

have shown progress but more must be done. The Committee encourages ORH to build upon these programs by replicating them at 

additional sites. One of the objectives of VHA’s Pain Management 

Strategy policy is to provide for an interdisciplinary, multi-modal 

approach to pain management, and funding for these pilot pro-
46 

grams can help VA apply the successes of these and other programs in furtherance of this objective. 

Rural Veterans Health.—The Committee notes persistent issues 

for VA health facilities in rural areas to recruit and retain health 

providers in the face of national provider shortages and a highly 

competitive environment. The Committee encourages the Department to consider the expanded use of doctors of osteopathic medicine [DOs] and physician assistants [PAs] through physical facilities and expanded access to telehealth services to address the rural 

health provider gap. Furthermore, the Committee is concerned 

about lack of mental healthcare providers, counselors, and caseworkers in rural areas. The criteria used by the Department in establishing the priority of hiring and placement of mental 

healthcare providers, counselors, and caseworkers should take into 

consideration the higher rate of facility-use in rural States due to 

lower numbers of facilities and the increased amount of outreach 

they must do with geographical barriers. To better understand 

staffing gaps that exist in rural, highly rural and remote areas, the 

Department is directed to conduct an agency-wide assessment of 

the rural and highly rural healthcare workforce to identify geographic areas where staffing needs exist. The evaluation shall identify specific occupations within these geographic areas that are of 

the most need. 

TELEHEALTH SERVICES

Telehealth.—The Committee held an oversight hearing on May 4, 

2017, where testimony was received from experts within VA and 

the private sector on the topic of telehealth. The Committee is 

pleased to note the Department is a leader in this field of emerging 

technology and medicine. Telehealth creates a bridge between rural 

and urban centers—providers at an urban site can diagnose and 

provide a care plan for veterans hundreds of miles away, and 

therefore, VA is able to expand the resources of one facility by connecting those providers to providers in another area. Through telehealth, the Department has the means and flexibility to provide 

care to veterans who do not have easy access to a VA hospital or 

access to a VA hospital staffed with the care they need. Telehealth 

is not only allowing the Department to expand access to care in 

areas where services are limited, but telehealth also allows care to 

be provided more effectively and efficiently for veterans closer to 

home and also through direct in-home access. While VA is once 

again leading the healthcare industry in the expansion of in-home 

telehealth and remote patient monitoring services, these services 

are often limited by the lack of broadband service in remote and 

rural areas. In order to better leverage other Federal partners, the 

Department is directed to provide a report to the Committee on Appropriations of both Houses of Congress by January 31, 2018, regarding ongoing collaborations VA has with other Federal agencies 

in targeting remote and rural areas with veteran populations in 

order to ensure that grant programs administered by other Federal 

Agencies maximize coverage areas to veterans. The Committee is 

also aware telehealth has a potential for significant cost savings 

and cost avoidance for the Department, and the Department is 

urged to maintain its focus on this type of care, not only to better 
47 

serve veterans, but also to be a good steward of its financial resources. The positive findings from the use of telehealth for mental 

health services is especially encouraging to the Committee. The 

Committee supports the Departments expansive use of telehealth 

for medical services and encourages VA to strive to be even more 

innovative, more expansive, more connected in this area. The recommendation includes the full budget request of $1,343,883,000 for 

telehealth services. This is $121,108,000 more than fiscal year 

2017. 

PREVENTING VETERAN SUICIDE AND MENTAL HEALTHCARE

Pilot Program for Agritherapy.—An increasing number of States 

now have programs that assist veterans in starting farms, and 

many veterans turning to farming also suffer from Post-Traumatic 

Stress Disorder [PTSD]. The benefits of agritherapy have been reported in the news media; however limited research and insufficient opportunities exist to offer the benefits of agritherapy to those 

suffering from PTSD. Therefore, the Department is urged to consider agritherapy for inclusion among VA’s Complementary and Alternative Medicine therapies. Additionally, the Committee directs 

no less than $2,000,000, made available through the Office of Rural 

Health, toward a pilot program to train veterans in agricultural vocations while also tending to behavioral and mental health needs 

with behavioral healthcare services and treatments from licensed 

providers at no fewer than three locations. The pilot locations may 

be sites that currently have an operational construct to train veterans for agricultural vocations and have the potential to expand 

operations that tend to veterans medical needs while creating a 

pathway to employment in agriculture related fields. The Department is directed to submit a report to the Committees on Appropriations of both Houses of Congress no later than 180 days after 

enactment of this act detailing the metrics developed to determine 

the value of agritherapy as it relates to PTSD and steps taken to 

carry out the agritherapy pilot as directed. 

Preventing Veteran Suicide.—The Committee is encouraged that 

the Secretary of Veterans Affairs has made preventing veteran suicide his number one clinical priority. The Committee supports the 

Department’s ‘‘Getting to Zero’’ initiative, and the Committee is 

pleased to see the national implementation of the Recovery Engagement And Coordination for Health—Veterans Enhanced Treatment [REACH VET] program which uses predictive modeling to 

guide early interventions to prevent suicide for at risk veterans in 

VHA care. The Committee is grateful for those within the Department who work tirelessly each day to save the lives of veterans. 

For years, the Department has received from this Committee 

above budget request amounts for suicide prevention programs, yet 

veteran suicide rates remain steady year after year. While additional and targeted funding increases are important, the Committee remains concerned that more should be done to prevent veterans from taking their lives. To that end, the Committee held an 

oversight hearing on April 26, 2017, on this topic. The hearing discussion focused on options for supporting veterans that are not currently the primary means by which the Department aims to prevent veteran suicide, such as complementary and alternative treat-
48 

ments, job training and education, and family support, like marriage and family counseling, caregiver support, and mechanisms for 

connecting families caring for veterans in need. 

According to data compiled by the VA Office of Suicide Prevention, veterans experience a suicide rate 50 percent higher than the 

general population, and female veterans commit suicide at a rate 

6 times that of their civilian counterparts. The Committee notes 20 

percent of veterans with PTSD have a substance abuse disorder, 

and substance abuse is proven to lead to increased suicidal tendencies. The Committee encourages the prioritization of funding for 

substance abuse counseling based treatment for veterans in order 

to decrease suicide rates among veterans suffering from PTSD. On 

average, 20 veterans die by suicide a day, and only six of those 20 

are users of VHA services. 

The Committee remains concerned about the alarming prevalence of suicide among rural veterans as they are more likely than 

urban veterans to commit suicide. The Committee urges VA to 

prioritize suicide prevention within rural communities and increase 

the availability of mental health resources available within States 

with great geographic barriers. The Committee continues to be concerned about the prioritization of funding for mental healthcare 

providers, counselors, and caseworkers in rural areas. The criteria 

used by the Department in establishing the priority of hiring and 

placement of mental healthcare providers, counselors, and caseworkers should take into consideration the higher rate of facility 

use in rural States due to lower numbers of facilities and the increased amount of outreach needed given geographical barriers. 

The Department is directed to provide additional resources to rural 

or highly rural medical facilities to hire medical and clinical personnel who support veterans with mental health services for the 

prevention of veteran suicide. 

Veteran Crisis Line.—The Committee continues to be greatly concerned with the continued high rate of suicide among veterans and 

the growing mental health needs of veterans. Based on that concern, the Committee held an oversight hearing on April 4, 2017, titled ‘‘Preventing Veteran Suicide’’ and a topic of great concern and 

extensive discussion at the hearing was the performance of VA’s 

Veterans Crisis Line [VCL]. A number of recent VA Inspector General and Government Accountability Office [GAO] reports have 

highlighted serious, ongoing and distressing deficiencies in the 

operational performance of the VCL. (Three reports in particular: 

VA Inspector General reports Veterans Crisis Line Caller Response 

and Quality Assurance Concerns, Canandaigua, NY (14–03540– 

123, dated February 11, 2016) and Evaluation of the Veterans 

Health Administration Veterans Crisis Line (16–03985–181, dated 

March 20, 2017), and the Government Accountability Office [GAO] 

report Veterans Crisis Line: Additional Testing, Monitoring, and 

Information Needed to Ensure Better Quality Service [GAO–16– 

373, dated May 2016]). During the hearing, it became apparent the 

Department had not promptly implemented the recommendations 

made by these oversight agencies. For example, at the time of our 

April 4, 2017 hearing, all seven of the recommendations from the 

OIG’s February 2016 report remained open—some of them open a 

full year beyond the ‘‘target dates’’ for completion that VHA com-
49 

mitted to implement. Fortunately, and shortly after the Committee’s hearing, VHA did close 6 of the 7 open recommendations from 

that OIG report. The Committee directs the Secretary to implement the remaining recommendations of the Inspector General and 

the GAO immediately and with a demonstrable and necessary 

sense of urgency. The Committee recommends an additional 

$10,000,000 above the budget request to support the important 

work of the VCL. 

Suicide Data Report.—The Department’s Suicide Data Report, 

2012, was an important step in understanding the prevalence, distribution, and risk factors for suicide. The Committee further directs the Secretary to conduct a new study on the prevalence of suicide among veterans, which shall include an assessment of the data 

provided by each State and an identification of which States should 

increase or improve data reporting to the Department. 

Magnetic EEG/EKG-Guided Resonance Therapy.—The Committee understands Magnetic EEG/EKG-guided Resonance Therapy 

[MERT] has successfully treated veterans with Post Traumatic 

Stress Disorder [PTSD], Traumatic Brain Injuries [TBI], chronic 

pain, and opiate addiction. Recent non-significant risk and noninvasive clinical trials and pilot studies have produced promising 

results in the evolution of MERT treatment. The Committee encourages VA to undertake MERT pilot programs at up to five VA 

facilities of its determining to create access to MERT in treating 

larger populations of veterans suffering from PTSD/TBI, chronic 

pain, and addiction. One of these five pilot programs should demonstrate the viability of a mobile capability to provide access in 

rural areas. 

Marriage and Family Therapists and Licensed Professional Mental Health Counselors.—The Committee remains concerned about 

the number of veterans committing suicide each day, and is particularly concerned that of the 20 per day, 14 have not had contact 

with the Department. In an effort to increase the number of mental 

health providers at the Department able to provide care, the Committee encourages the Department to increase efforts to hire more 

Licensed Professional Mental Health Counselors [LPMHCs] and 

Marriage and Family Therapists [MFTs]. The Committee recognizes the Department has attempted to create qualification standards to permit the employment of LPMHCs and MFTs, however, 

the Committee is aware obstacles remain, given that there are still 

thousands of vacancies in mental healthcare delivery positions. The 

Committee strongly urges VA to report on the number of current 

vacancies that could be filled by MFTs and LPMHCs, as well as develop a strategic plan for hiring more MFTs and LPMHCs to both 

fill vacancies and also augment current mental healthcare teams 

within the Department. The Committee also recommends coordinating with the Office of Management and Budget to create an Occupational Series for LPMHCs and MFTs to permit the Department to more easily hire staff able to provide mental health services to veterans in a timely manner. 

National Center for Post-Traumatic Stress Disorder.—The National Center for Post-Traumatic Stress Disorder [NCPTSD] is the 

Federal Government’s foremost center of expertise on evidencebased treatment of post-traumatic stress. The Committee continues 
50 

to support the mission and work of the NCPTSD and has provided 

$40,000,000 to continue the center’s advancement of the clinical 

care and social welfare of America’s veterans who have experienced 

trauma or suffer from PTSD through research, education, and 

training in the science, diagnosis, and treatment of PTSD and 

stress-related disorders. In recent years, the Committee has invested in the addition of a brain bank for assisting researchers, 

and the expansion of the consultation program for providers so that 

clinicians, particularly those in rural areas, have access to expert 

advice on the latest evidence-based treatment for post-traumatic 

stress. The Committee directs the Department to ensure the 

NCPTSD has the appropriate number of full time staff to support 

both expansions. The Committee also directs the Department to 

submit a report to the Committees on Appropriations of both 

Houses of Congress no later than 180 days after enactment of this 

act on the activities of NCPTSD, including: (1) how the Center supports the implementation of evidence-based treatments as specified 

in the VA/DoD Clinical Practice Guideline for the Management of 

PTSD within veteran care at VA medical centers; (2) utilization of 

its resources and the consultation program by non-VA providers; 

(3) utilization of resources and the brain bank by researchers; (4) 

consultation and information sharing with other government entities; and (5) any resource or staffing gaps or near gaps that exist 

in carrying out its missions. 

Treatment for Post-Traumatic Stress Disorder.—One in five veterans with Post-Traumatic Stress Disorder have a substance abuse 

disorder, and the Department of Health and Human Services reports there is a connection to alcohol and substance abuse leading 

to suicidal tendencies. VA funds many substance abuse treatment 

options, but should not default to prescribing medicine rather than 

counseling and therapy, if counseling and therapy are available options. Overmedication has continued to be an issue within VA, and 

the impact of therapy and counseling for substance abuse treatment is, in many cases, reported to be of equal help to a veteran. 

The Department should prioritize substance abuse treatment for 

veterans through counseling for veterans struggling with substance 

abuse disorder given that 20 percent of veterans with Post-Traumatic Stress Disorder have a substance abuse disorder and substance abuse is proven to lead to increased suicidal tendencies. 

The Committee is aware that patient outcomes at universitybased medical clinics are a viable option for providing PTSD treatment to veterans and have shown great preliminary successes. As 

such, the Committee directs the Department to conduct a study to 

determine whether this model of care presents an opportunity to 

provide the best patient care to veterans. The Department is directed to submit a report to the Committees on Appropriations of 

both Houses of Congress no later than 180 days after enactment 

of this act on the feasibility of pursuing a pilot program at no fewer 

than 3 university sites providing PTSD treatments. 

Other Than Honorable Discharge.—The Committee remains concerned that for many veterans with other-than-honorable discharges, the misconduct that precipitated that discharge may have 

been related to in-service mental health issues. After service in 

combat or other high-stress environments, or after experiencing 
51 

military sexual trauma, service members may undergo behavioral 

changes stemming from post-traumatic stress disorder, traumatic 

brain injury, major depressive disorder, and operational stress. Behavioral changes may result in injuries, which superiors often do 

not recognize as symptoms of mental health conditions, but instead 

attribute to bad character. The Committee is pleased VA is beginning to address the problem by offering emergent care for up to 90 

days to veterans with other-than-honorable discharges. However, 

the Committee believes the Department has the statutory authority to provide care for many of these veterans. The statutory requirement under 38 U.S.C. 101 and 501 excludes only former service members whose conduct meets specific statutory bars or would 

justify a dishonorable discharge. The statute does not define that 

conduct standard explicitly, which leaves the Department with authority to adopt a standard by regulation. The Department is directed to conduct a review to align VA regulatory guidelines with 

the statutory authority and modern discharge characterizations 

issued by the Department of Defense. The Department is directed 

to submit a report to the Committees on Appropriations of both 

Houses of Congress no later than 180 days after enactment of this 

act detailing the findings of the review. 

WOMEN’S HEALTH

Women Veterans.—Women represent 15.5 percent of today’s active duty force and 19 percent of our National Guard and Reserves. 

Accordingly, women veterans are enrolling for VA healthcare at 

record levels. As these numbers continue to rise, most VA medical 

facilities across the country are not equipped to handle the specific 

needs of the women veterans’ population. Therefore, the Department should continue to expand efforts that address the current 

barriers to gender-specific healthcare services. The Committee continues to believe VA must be poised to address the changing demographic of today’s and tomorrow’s veterans in order to fulfill its 

mission. Toward this end, the Committee recommendation includes 

an additional $20,000,000 over the budget request for fiscal year 

2018 to support gender-specific healthcare services. The Committee 

also encourages the Department to consider a mobile healthcare 

pilot program, prioritizing rural and high need areas, to provide 

gender-specific services, awareness of benefits, and outreach to 

women veterans utilizing mobile healthcare infrastructure. This innovative model is designed to fill the current gap in gender-specific 

services as VA works to expand infrastructure and hire the needed 

staff for specialty care. 

Female Primary Care and Mental Healthcare Providers.—The 

Committee urges VA to make every effort to hire more women 

healthcare professionals and offer all women the opportunity to 

choose the gender of their primary care and mental healthcare providers. 

Intimate Partner Violence Program.—The VA Intimate Partner 

Violence Program expands VA’s screening, prevention, and intervention services to veterans and strengthens collaboration with 

community partners as well as the Caregivers Support Program 

and VA programs to address homelessness. The program focuses on 

developing a culture of safety and adopts a holistic, trauma-in-
52 

formed, veteran-centered approach to services and support for 

those veterans involved in a domestic violence situation. In recent 

years, VHA has run this program using general funds, and at 

times, the program has lapsed due to a lack of funds. The Committee directs the Department to fully resource this program at 

$17,000,000 in fiscal year 2018 and include it as a program of interest with budget detail in the justifications accompanying the fiscal year 2019 budget submission. 

ASSISTING HOMELESS VETERANS AND PREVENTING VETERAN

HOMELESSNESS

Assessing Homelessness in Rural Areas.—The Committee remains concerned about the fidelity of data on homeless and at-risk 

veterans in rural areas and directs the Department to identify 

more precise ways to obtain better and more accurate data for veterans in these areas. The Committee encourages VA to evaluate 

whether changes to the universal homeless screening clinical reminder would result in more accurate identification of these veterans, and to report to the Committees on Appropriations of both 

Houses of Congress actions VA is taking to reduce homelessness 

among the rural veteran population. 

Homeless Veterans Prevention Programs.—The Committee remains strongly supportive of VA’s homeless prevention programs 

and as such the recommendation includes $1,747,784,000 to support these programs. This total includes an additional $20,000,000 

over the current estimate of $320,000,000 for the Supportive Services for Veterans Families program. The Department has made significant progress toward ending veteran homelessness. According to 

VA, the number of veterans experiencing homelessness in the U.S. 

has declined almost 50 percent since 2010 and the 17 percent reduction between 2015 and 2016 is quadruple the previous year’s 

annual rate of decline. As communities nationwide reach critical 

junctures in their efforts to end veteran homelessness, occupancy 

in transitional housing programs continues to decrease. The Committee directs VA to continue to encourage and support community 

homeless providers to adapt to the bridge housing transitional 

housing model, emphasizing short lengths of stay and rapid connections to permanent supportive housing. Additionally, VA should 

use data to adapt homelessness programs to meet the needs of the 

changing homeless population and expand permanent supportive 

housing options. 

Legal Assistance for the Supportive Services for Veteran Families 

Program.—The Committee notes that university law schools are 

willing to work with veterans on a pro-bono basis to provide legal 

assistance. This can result in additional benefits such as training 

law students in veteran disability law and legal skills critical to 

providing advocacy within the VA system and inspiring next-generation lawyers to serve veterans in practice. The Committee encourages the Supportive Services for Veteran Families [SSVF] program to work with grantees to expand their legal service offerings, 

particularly in rural States where access to private legal assistance 

can be limited. Within funds provided, the Department is encouraged to establish one or more pilot projects to partner SSVF grant-
53 

ees with university law schools in rural areas to enhance legal assistance to Veterans. 

PREVENTING DRUG ABUSE

Oversight of Substance Inspection Programs.—The Committee 

understands the veteran population is at greater risk than the general population for opioid abuse and dependency. A recent GAO report recommended VA should ensure VAMCs have established an 

additional control procedure, such as an alternate controlled substance coordinator or a poll of extra inspectors, to help coordinators 

meet their responsibilities and prevent missed inspections. The 

Committee concurs with GAO’s recommendations and directs the 

Secretary to fully implement these recommendations to improve 

oversight of the controlled substance inspection program and to 

document its progress. 

Opioid Safety.—The Committee supports VA’s Opioid Safety Initiative [OSI] and encourages continued implementation at all VA 

medical facilities, as directed under Title IX of Public Law 114– 

198, the Jason Simcakoski Memorial and Promise Act. A critical 

aspect of the OSI is the Opioid Therapy Risk Report tool, an electronic tool that helps providers manage their entire panel of patients prescribed pharmacotherapy for acute or chronic pain. It is 

imperative all VA providers who prescribe opioids use this tool consistently, including prior to initiating opioid therapy, to ensure safe 

prescribing, and to help prevent diversion, abuse, and double-prescribing. Public Law 114–198 required the Department to implement mandatory use of such tool for all providers prior to initiating 

opioid therapy to assess the risk for adverse outcomes; to implement standards with respect to the use of routine and random drug 

tests; to ensure providers use the tool to access the State Prescription Drug Monitoring Program [PDMP]; and to ensure the tool includes information identifying when healthcare providers access 

the tool and the most recent drug test for each veteran. The Committee also urges VA to further improve the timeliness of data 

available in the tool to allow a provider to have real-time access to 

data on a patient who was prescribed opioid therapy by another facility, in another State, or by mail order to prevent overprescribing 

and abuse potential. It is critical that VA clinicians have access to 

a patient’s opioid therapy history from outside providers to ensure 

safe pain management care, as many veterans also seek care from 

providers in the community who may prescribe them medication. 

Sections 911 and 914 of Public Law 114–198 require the Department to ensure VA providers can access information in the State 

PDMP including by seeking to enter into memoranda of understanding with States to allow shared access of such information between VA and the States. The Department must also include such 

information in the Opioid Therapy Risk Report tool and require VA 

providers to disclose certain veteran information to State controlled 

substance or PDMPs. The Department is directed to submit a report to the Committees on Appropriations of both Houses of Congress no later than 180 days after enactment of this act assessing 

compliance with mandatory provider use of the tool, including a 

timeline of implementation, the rate of compliance and compliance 

measures, and utilization of and reporting to State PDMPs. 
54 

Prescription Drug Monitoring Program Utility.—Opioid addiction 

represents a major and growing epidemic in the public health system generally and specifically among America’s youngest veterans. 

Among combat-injured veterans serving in the wars in Afghanistan 

and Iraq, post-traumatic stress disorder [PTSD] and co-occurring 

substance use disorder [SU] is common and found to be associated 

with increases in opioid addiction and mortality. The Department 

is directed to submit a report to the Committees on Appropriations 

of both Houses of Congress on the Department’s usage of State prescription drug monitoring programs [PDMP] and databases used 

for detecting and reducing fraud, diversion, and abuse of prescription drugs. The report shall include—(A) an assessment of legal, 

technical, fiscal, privacy, or security challenges that have an impact 

on utility; (B) any recommendations for addressing challenges that 

impact the Department’s access to State prescription drug monitoring programs in order to reduce fraud, diversion, and abuse of 

prescription drugs; and (C) an assessment of the extent to which 

VA providers use prescription drug management programs in delivering care and preventing prescription drug abuse. 

Opioid Therapy Clinical Practice Guidelines and Training.—The 

Committee commends the Department for releasing the updated 

2017 VA/DoD Clinical Practice Guideline [CPG] for Management of 

Opioid Therapy for Chronic Pain, as required under Public Law 

114–198. The Committee is encouraged the new CPG includes enhanced guidance concerning contraindications and risk factors for 

opioid therapy, such as prescribing opioids and benzodiazepines 

concurrently, and for treating those with co-occurring mental 

health conditions, and recommendations against initiating longterm opioid therapy for chronic pain. To continue to improve chronic pain management and access to safe, quality care, the Committee directs the Department to immediately disseminate and implement the new CPG and update education and training materials 

for all VA employees who prescribe opioids to include the new recommendations. The Department is further directed to ensure pain 

management teams at each facility certify that all healthcare professionals responsible for coordinating and overseeing pain management therapy utilize the updated CPG. To ensure all providers 

have access to most recent scientific evidence, it is critical for 

opioid prescribing guidance to be as up to date and as consistent 

as possible across Federal agencies. As such, the Committee directs 

the Department to continue to routinely coordinate and consult 

with the Centers for Disease Control and Prevention [CDC] and 

other relevant groups and Federal agencies on continued implementation and compliance with the CPG and latest scientific recommendations. 

Opioid Addiction Treatment Protocols.—The Committee appreciates VA’s submittal of a report regarding the Department’s ongoing review of prescription practices and addiction treatment protocols for opioids. According to the report, however, VA has failed to 

adopt the Substance Abuse and Mental Health Administration’s 

[SAMHSA] full recommendation for treatment including ‘‘all drugs 

approved by the Food and Drug Administration for the treatment 

of opioid abuse disorder, including for maintenance, detoxification, 

overdose reversal, and relapse prevention; and appropriate coun-
55 

seling and appropriate ancillary services.’’ The Department is directed to submit a report to the Committee on Appropriations of 

both House of Congress no later than 180 days providing an update 

of this report to address VA’s intent to include the full spectrum 

of prescription practices and addiction treatment protocols for 

opioids recommended by SAMHSA and prescribed in Public Law 

114–198, the Comprehensive Addiction and Recovery Act of 2016. 

Capabilities in Treating Addiction.—The Committee directs the 

Government Accountability Office to conduct a study on VA’s capabilities and capacity to treat veterans with addiction. This study 

should include the following: (1) VA’s number of residential rehabilitation beds and the average wait time; (2) the number of veterans being treated in outpatient veterans centers based on current 

VA resources; (3) the percentage of veterans who are referred to either non-VA outpatient or residential rehabilitation treatment and 

wait times for both types of treatment; (4) statistics on staffing and 

other pertinent resources to the treatment of veterans struggling 

with addiction; and (5) the availability and accessibility of alternative facilities capable of providing comparable care in rural and 

highly rural areas. This study should also identify which States are 

particularly in need of increased resources to resolve the opioid epidemic. The Committee requests an update on this study no later 

than 90 days following the enactment of this act and a report within 180 days. 

Dependents and Prescription Drug Monitoring Programs.—The 

Committee commends the Department for efforts to increase participation in State prescription drug monitoring programs 

[PDMPs]. However, the Committee is concerned that due to deficiencies in Veterans Information Systems and Technology Architecture [VistA], VA is unable to provide information to PDMPs on 

non-veteran dependents who receive VA healthcare. Given the continued opioid epidemic, it is important VA correct this deficiency. 

Therefore, the Committee directs the Under Secretary for Health, 

in consultation with the Assistant Secretary for Information and 

Technology and General Counsel, to develop a plan to enable VA 

to provide relevant information on veterans’ dependents to State 

PDMPs. The Department is directed to submit a report to the Committees on Appropriations of both Houses of Congress no later than 

180 days after enactment of this act detailing the plan, to include 

recommendations for additional resources or authorities necessary 

to address this issue. 

STAFFING ISSUES

Transition of Military Healthcare Professionals.—The Committee 

has received reports that separating military healthcare professionals have expressed interest in transitioning to work within the 

VA healthcare system in the communities in which they separate. 

In some cases, the competencies and skills of these professionals 

match current local vacancies. The Committee notes in some places 

local VA managers lack a pathway within the VA recruitment and 

hiring process to ensure these experienced professionals are able to 

be hired where they live. The requirement that separating military 

healthcare professionals be recredentialed by VA through its own 

proprietary system creates additional applicant burden and delay. 
56 

VA is encouraged to establish a recruitment channel for separating 

military healthcare professionals to identify and receive expedited 

consideration for VA healthcare vacancies. 

Certified Surgical Assistant Training.—The Committee acknowledges VHA’s positive response to language in last year’s report regarding the potential benefits of using full-time surgical assistants 

in VHA surgical operations. The Committee strongly encourages 

the Department to follow through in the form of a proposal to fund 

Surgical Assistant education and certification for retiring military 

medics through its Office of Academic Affiliations helping them to 

provide a higher level of care to their fellow veterans. 

Hiring Clinical Psychologists.—The Committee understands VHA 

each year uses the services of the Association of Psychological 

Postdoctoral and Internship Centers [APPIC], a non-profit organization, to help select and match clinical psychologists for available 

VA internships. The Committee is concerned APPIC has decided to 

not include psychologists from programs accredited by the Psychological Clinical Science Accreditation System [PCSAS] even though 

VHA has just published new Psychologist Qualification Standards 

to encompass the graduates of PCSAS accredited programs. The 

Committee is pleased to learn VHA is working to resolve this situation to insure all appropriately trained and qualified psychologists 

are given equal access to VA internships. The Department is directed to submit a report to the Committees on Appropriations of 

both Houses of Congress no later than 90 days after enactment of 

this act on the status of this issue. 

Nursing Academic Partnerships.—The Committee encourages the 

Under Secretary for Health and the Chief Academic Affiliations Office to further support the VA Nursing Academic Partnership Programs [VANAP], expansion of the Post-Baccalaureate Nurse Residency [PBNR], the VA Nursing Academic Partnerships in Graduate 

Education [VANAP–GE], and the Enhancing Academic Partnerships programs. These programs enhance recruitment and retention of highly trained nursing professionals, while elevating interprofessional education concentrating on behavioral health services, 

women’s health, gerontology services, services for homeless veterans, and rural healthcare initiatives. These initiatives ensure 

that our nation’s veterans and their families have access to highquality and appropriate care by building strong partnerships between academia and VA practice. 

Orthotics and Prosthetics Workforce.—The Committee is concerned about the sustainability of the orthotics and prosthetics 

workforce treating veterans, particularly given an aging workforce 

with imminent retirements as well as a lack of availability of advanced degree programs necessary to train new professionals. Reports indicate that up to twenty percent of the field’s 7,100 clinicians nationwide are either past retirement age or within 5 years 

of retiring. The Committee recognizes the contributions made by 

VHA’s Orthotic and Prosthetic Residency Program to provide rotation opportunities throughout the VA system but acknowledges this 

program alone is inadequate to ensure a sustainable workforce for 

the future, especially in light of the skill set necessary to provide 

the increasingly complex, state-of-the-art orthotics and prosthetics 

care for OEF/OIF veterans. The Department is directed to explore 
57 

cost effective opportunities to grow the workforce pipeline in order 

to ensure the future orthotic and prosthetic workforce required by 

the nation’s new generation of veterans. The Department is directed to submit a report to the Committees on Appropriations of 

both Houses of Congress no later than 180 days after enactment 

of this act detailing the findings. 

Partnerships with Academic Medical Institutions.—In 2015, the 

Committee included report language encouraging the Department 

to seek out public-private partnerships, particularly with research 

universities, those with and without medical schools, to expand its 

efforts related to suicide prevention, post-traumatic stress disorder, 

traumatic brain injury, and substance abuse disorders. The Committee continues to believe, as stated in report language last year, 

the Department should make broader use of existing partnering 

authority to collaborate with academic institutions, and further encourages VA to enter into partnerships with accredited medical 

schools and teaching hospitals for the mutually beneficial coordination, use, or exchange of health-care resources with the goal of improving access to and quality of the hospital care and medical services furnished by the Department. 

Tribal Health Partnerships.—The Committee is pleased VA has 

implemented a robust series of partnerships with Indian Health 

Service facilities and tribally operated health facilities that operate 

under self-determination contracts and self-governance compacts 

with the Indian Health Service. These partnerships are necessary 

not only to extend care to the remote and highly rural areas where 

Native veterans reside but in some cases has also helped VA address capacity and personnel shortages affecting its overall beneficiary population. For example, to address longstanding staffing 

problems at the Wasilla Community Based Outpatient Clinic, the 

Alaska VA Healthcare System offers beneficiaries care at the 

Southcentral Foundation Benteh Nuutah Primary Care Center, a 

tribal facility in Wasilla. The Committee notes some of the initial 

5-year partnership agreements are expiring and VA has been reluctant to renew them for an additional 5-year term, preferring instead short-term extensions. This has caused VA’s tribal partners 

to question whether VA has a long-term commitment to continue 

these successful partnerships. The Committee encourages VA to express its commitment to maintain its tribal partnerships and work 

collaboratively with their tribal health partners on reimbursement 

formulas and terms going forward. The Committee notes losing 

these important partnerships over misunderstandings or contracting disagreements would have serious effects on VA healthcare 

in Alaska. 

Staffing of the Alaska VA Healthcare System.—The Committee 

continues to be concerned about chronic staffing issues within the 

Alaska VA Healthcare System. As of July 2017, the Wasilla Community Based Outpatient Clinic still lacks a single full time physician even though patient demand would justify two full time physicians. The Committee understands that recruitment and retention 

of medical professionals to serve in Alaska is difficult, but it is also 

worth noting that community hospitals and tribal health facilities 

in Alaska have faced and overcome similar difficulties. The Committee encourages VA to formulate a strategy to permanently fill 
58 

chronic vacancies in the Alaska VA Healthcare System. This requires Central Office cooperation to ensure recruitment and retention incentives are readily available to these positions and that 

medical professionals offered employment are smoothly on boarded. 

VA should reach out to other healthcare organizations in Alaska to 

identify best practices for recruitment of medical professionals from 

out of State. The Fairbanks Memorial Hospital, for example, has 

expressed a willingness to partner with VA in addressing recruitment issues. The Committee encourages VA to work in collaboration with willing Alaska healthcare providers to encourage medical 

professionals to consider work in Alaska. 

Critical Needs Occupational Staffing Model.—It is critical VHA 

develop a staffing model so that it can better understand, and more 

quickly address, its staffing needs in critical need occupations. The 

Committee remains concerned that after nearly 2 years, VA has 

failed to follow-up on repeated OIG recommendations to develop 

staffing models for critical need occupations, as well as set forth 

milestones and a timetable for further critical need occupations’ 

staffing model development, piloting, and implementation with the 

urgency required given the importance of having adequate staff to 

appropriately care for veterans. The Committee recognizes the Department has put forward some effort to move forward the process 

for creating a staffing model forward but is disappointed with the 

pace. As such, the Department is directed to accelerate the creation 

of such a model so that veterans have access to the care they need. 

Health Professional Scholarship Program.—The Health Professional Scholarship Program [HPSP] provides scholarships to students receiving education or training in a direct or indirect 

healthcare services discipline. Awards are offered on a competitive 

basis and are exempt from Federal taxation. In exchange for the 

award, scholarship program participants agree to a service obligation in a VA healthcare facility. The Committee continues to support this program and is concerned VA has not fully been utilizing 

this program in fiscal year 2017, based on data from fiscal year 

2016. The Committee believes strongly ample resources exist within the Department to ensure hard to fill specialties are not excluded from participation. In spite of this, the Committee continues 

to hear VA is not utilizing these tools in the most judicious and efficient manner. The Department is directed to submit a report to 

the Committees on Appropriations of both Houses of Congress no 

later than October 30, 2017, on each profession eligible to receive 

HPSP scholarship and any limitation VA is placing on awards. In 

addition, VHA is also directed to submit to the Committees on Appropriations of both Houses of Congress no later than 90 days after 

enactment of this act a strategic plan which identifies difficult to 

recruit occupations and outlines specific actions being taken to address those shortages. 

ITEMS OF INTEREST

Hepatitis C Treatment.—The Department has received targeted 

and significant resources for the past 2 years from this Committee 

to aggressively treat and cure veterans with hepatitis C, and the 

Committee is pleased VA has made significant progress doing so. 

The Department is to be commended for innovative and directed 
59 

outreach to the cohort most likely affected by the disease, including 

effective marketing campaigns, partnerships with veteran service 

organizations, and holding weekend and after hours clinics to increase access to care. The Committee is aware VA has treated upwards of 87,000 veterans with new generation oral hepatitis C 

drugs which have a cure rate of more than 90 percent. The remaining cohort of veterans who have not been treated but potentially 

have the disease are the most difficult to contact and persuade to 

seek treatment, but the Committee directs VA to continue efforts 

to reach all veterans who would benefit from care as soon as possible. 

Due to the change in drug pricing, the Committee notes VA has 

been able to treat more veterans with significantly less funding 

than was anticipated at the time of the original appropriation. 

Given that slightly more than half of the funding remaining available for Hepatitis C was specifically fenced in statute, the Department lacks the authority to transfer this funding before it lapses. 

Therefore, the Committee’s recommendation includes a rescission 

of $751,000,000 and appropriates back the same amount to the 

Medical Services account to ensure that this funding does not 

lapse. The Committee notes, that the Department will still have 

more than $600,000,000 in unobligated Hepatitis C funds originally 

appropriated in fiscal year 2016 and directs the Department to continue to aggressively fund the Hepatitis C program consistent with 

the fiscal year 2018 budget request. 

The Department is directed to continue its quarterly updates to 

the Committees on Appropriations of both Houses of Congress detailing the expenditures and obligations of funding hepatitis C 

treatment, the number of veterans treated, the number of veterans 

deemed cured, the projection of spending, the number of new starts 

for drug treatment, and number of veterans who have been cured. 

DoD and VA Prescription Drug Purchasing.—The Committee believes there are potential savings in combining DoD and VA prescription drug purchasing. A 2014 GAO report surveyed 83 common drugs purchased by both Departments and found that if purchasing drugs for both Departments at the lowest DoD or VA price, 

the taxpayer could have realized a combined savings of 

$120,000,000 in 2012. GAO recommended DoD, VA, and Medicare 

align the structure, statutory parameters, and regulatory guidance 

across all Federal prescription buying programs to increase buying 

power and reduce costs. The Department is directed to work with 

the Department of Defense and submit a report to the Committees 

on Appropriations of both Houses of Congress no later than 180 

days after enactment of this act detailing the feasibility of aligning 

their structures, statutory parameters, and regulatory guidance 

with the Department of Defense for their prescription buying program in order to increase buying power and reduce cost. 

Encouraging Public-Private Partnerships.—The Committee is 

aware of private-sector solutions and financial support that can effectively and efficiently develop and construct facilities that create 

greater access to care while reducing costs in the near and long 

term. The Committee encourages VA to pursue public-private partnerships to implement projects in VISN 15 and others that include 

but are not limited to VA facility leases, renovations, or construc-
60 

tion to increase access to healthcare services for veterans. The 

Committee further directs VA to utilize existing and new authorities that permit such partnerships and potential cost-share solutions, such as Communities Helping Invest through Property and 

Improvements Needed for Veterans Act of 2016 and the CHIP IN 

for Vets Act of 2016. The Department is directed to submit reports 

on a quarterly basis to the Committees on Appropriations of both 

Houses of Congress regarding current and new projects resulting 

from this initiative. 

Travel Reimbursement.—The Beneficiary Travel program provides eligible veterans and other beneficiaries mileage reimbursement, common carrier (plane, train, bus, taxi, light rail etc.), or 

when medically indicated, ‘‘special mode’’ (ambulance, wheelchair 

van) transport for travel to and from VA healthcare, or VA authorized non-VA healthcare for which the veteran is eligible. The Committee appreciates recent steps to modernize the program’s processes but remains concerned about the time it takes for veterans 

to be reimbursed. Therefore, the Department is directed to submit 

a report to the Committees on Appropriations of both Houses of 

Congress no later than 90 days after enactment of this act on steps 

taken to make the process to receive travel reimbursement more 

timely and user-friendly for veterans. The report should also include how filling vacancies in the travel office are prioritized and 

how the Department is addressing challenges with kiosks, particularly for veterans with disabilities such as blindness. 

Hearing Aid Specialists.—The Committee understands hearing 

loss and tinnitus are among the most common injuries facing veterans of the recent conflicts in Iraq and Afghanistan. Hearing loss 

can contribute to depression, heightened stress, fatigue, and other 

challenges veterans face as they reintegrate into civilian life. The 

Committee is aware of the high demand for healthcare services 

among veterans and supports the recent passage of legislation 

aimed at addressing gaps in the provision of care within VA by allowing the Department to hire hearing aid specialists. The Committee is concerned VA has not completed the process of developing 

basic qualification requirements, work assignments, and qualification standards under title 38 for this occupation. The Department 

is directed to submit a report to the Committees on Appropriations 

of both Houses of Congress no later than 90 days after enactment 

of this act detailing the progress made in developing and publishing this criteria and how and when VA will begin hiring such 

providers to offer such services. 

National Veterans Sports Programs and Special Events.—The 

Committee supports the continued efforts of the Department to provide disabled veterans and disabled members of the Armed Forces 

with unique alternative therapies such as adaptive sports. The Department is directed to submit a report to the Committees on Appropriations of both Houses of Congress no later than 90 days after 

enactment of this act on the status of the current adaptive sports 

program and recommendations for expansion of the program, as 

well as how the Department may better leverage grants for greater 

access to rural communities as well as possible integration into 

mental health alternative therapies. The Committee notes is has 

provided an additional $2,000,000 to support community-based 
61 

qualifying sports programs or other events in rural locations 

through the Office of Rural Health. 

Enabling Independent Federal Investigations of VA Health 

Care.—The Committee is concerned by reports that independent 

Federal investigations into VA opioid prescribing practices have 

been hampered by the Department’s inability or unwillingness to 

share information with investigators. The Committee places the 

highest priority on maintaining robust protections for veterans’ privacy but emphasizes these protections are for the rights of patients, not providers. The Committee believes the Department 

should take every appropriate action to fully comply with investigators requests to supply relevant information in ongoing and future 

investigations by the Drug Enforcement Agency into potential violations of the Controlled Substances Act by VA employees, and inform the Committees on Appropriations and Veterans Affairs of 

both Houses of Congress if additional authorities are required to do 

so. 

Complementary and Integrative Health.—Expanding access to 

comprehensive pain management and complementary and integrative health [CIH] services is vital to improving the delivery of highquality care for our veterans, especially those struggling with cooccurring conditions like chronic pain, mental health and substance 

use disorders. The Committee supports VA’s work in developing a 

plan to expand the scope of research, education, delivery, and integration of CIH into the healthcare services provided to veterans 

and urges robust implementation. In addition, as required under 

Section 932 of Public Law 114–198, VA must continue to prioritize 

implementation of the pilot program at VA medical centers, including polytrauma rehabilitation centers, to assess the feasibility, advisability, and methods of delivery of wellness-based programs to 

complement pain management and related healthcare services. 

While the Committee supports the progress being made to reduce 

misuse and abuse of opioids and to improve pain care, the Committee believes that consideration of VISNs or medical centers with 

a history of or current prescription rates of opioids inconsistent 

with the standards of appropriate and safe care should be given 

priority. The Committee encourages the Department to continue to 

expand access to CIH services as part of the VA’s Whole Health 

System approach, and the Department is directed to submit a report to the Committees on Appropriations of both Houses of Congress on later than 90 days after enactment of this act on the 

progress of the 18 flagship facilities being launched to effectuate 

this effort. 

Antimicrobial Stewardship Program.—The Committee is aware 

that commercially proven integrated technology for infectious disease and pharmacy management is the industry standard for meeting national Antimicrobial Stewardship directives. While VA has 

successfully used these tools in a limited number of facilities, VA 

has not deployed it system wide. Therefore, the Committee encourages VA to implement a system wide electronic solution for all 

medical facilities that would provide infectious disease control monitoring, provide appropriate treatment and pharmacy care plans, 

help prevent potential healthcare risks, document interventions 

that improve patient care, and reduce hospital costs. These capa-
62 

bilities would bring VA into compliance with all Federal and State 

regulatory antimicrobial program directives. 

Long-Term Care.—The bill provides $8,821,657,000 as requested 

by the Department for long-term care. This includes the 

$6,073,862,000 for institutional care and $2,747,795,000 for non-institutional care. The Committee is concerned about the Department’s fiscal year 2018 proposal to fund more than $690,000,000 of 

non-institutional care through the Choice program. Should Congress not provide additional funding for the Choice program, the 

Committee directs VA to fulfill its obligations to non-institutional 

care programs as proposed in the original fiscal year 2018 advance 

appropriation request. To ensure proper budgetary oversight of the 

non-institutional care programs, the Department is directed to report quarterly to the Committees on Appropriations of both Houses 

of Congress on the quarterly demand and execution of the non-institutional programs. In addition, VA is directed to include in the 

budget justifications accompanying the fiscal year 2019 budget request detailed data on the number of veterans receiving non-institutional care disaggregated by the appropriate medical care account. 

Headache Disorders Centers of Excellence.—The Committee recognizes that over 350,000 veterans sustained traumatic brain injury [TBI] during the Global War on Terror and that chronic migraine/post-traumatic headache is the signature symptom of TBI. 

The Committee is concerned that veterans with chronic migraine/ 

post-traumatic headache often do not receive specialty care, and 

that only three VA-affiliated physicians are certified with training 

in Headache Medicine by the United Council for Neurological Subspecialties. The Committee recognizes the importance of VA centers 

of excellence and the need for VA Headache Centers of Excellence. 

The Committee provides $10,000,000 for the creation of at least 

five headache centers to be placed at the existing sites for 

polytrauma and traumatic brain injury [TBI] or at locations that 

the Secretary sees fit. 

Readjustment Counseling.—The Committee strongly supports readjustment counseling provided through the Departments 300 Vet 

Centers, 80 mobile Vet Centers, and the Vet Center Combat Call 

Center. Vet Centers are community-based counseling centers that 

provide a wide range of social and psychological services. These 

services include: professional readjustment counseling to veterans 

and active duty servicemembers, counseling for the victims of military sexual trauma, bereavement counseling for families who experience an active duty death, substance abuse assessments and referrals, VBA benefit information and referrals to Regional Offices, 

and employment counseling. Certain services also extend to the 

family members as a means to assist in the readjustment for veterans and active duty servicemembers. In order to bolster readjustment counseling capacity across the country, the recommendation 

provides an additional $15,000,000 over the budget estimate for the 

Vet Center program. The Committee recognizes the unique opportunities that Vet Centers provide in collaborating and developing 

alternative treatments with other community organizations to create programs for veterans to share experiences, develop bonds, and 

address common challenges. Therefore, within the additional fund-
63 

ing provided, the Committee directs $2,500,000 be utilized to develop a program to partner with organizations that provide outdoor 

experiences for veterans as part of a continuum of care that helps 

support veterans in developing a community of support to treat 

combat-related injuries, including those related to behavioral 

health. 

Increased Infectious Disease Screening.—The Department is directed to submit a report to the Committees on Appropriations of 

both Houses of Congress no later than 180 days after enactment 

of this act on VHA’s efforts to improve HIV/AIDS and hepatitis 

screening rates in traditional and non-traditional settings, including to what extent the Department utilizes innovative strategies 

like point-of-care testing and public health outreach. The Committee notes the racial disparities in these diseases and requests 

that the report include a section which focuses on minority groups 

including but not limited to, Native Americans, Asian Americans, 

Pacific Islanders, Alaska Natives, Native Hawaiians, and African 

Americans. 

Colorectal Cancer Screening.—Approximately one-third of eligible 

U.S. adults have never been screened for colorectal cancer despite 

it being the second-leading cause of cancer death in the United 

States. To help address this, in 2016, the United States Preventive 

Services Task Force [USPSTF] updated its recommendation for 

colorectal cancer screening, issuing it an A-grade, and included several strategies determined with high certainty to have a substantial net benefit and noted that offering choice in screening strategies may increase the number of screened individuals. The strategies have subsequently been adopted by the National Committee 

for Quality Assurances Healthcare Effectiveness Data and Information Set [HEDIS] measures, which are used by more than 90 percent of America’s health plans to measure performance. TRICARE 

covers the majority of the strategies identified by USPSTF, however VA does not offer veterans coverage for the same options and 

covers fewer screening methodologies. To improve colorectal cancer 

screening of veterans and enhance access to the most updated 

screening technologies, the Committee directs VA to offer all seven 

USPSTF strategies now recognized in the HEDIS measures to all 

veterans enrolled in the VA health system. 

Domiciliary Program.—The Committee is concerned VA has not 

yet completed its assessment of the VA domiciliary program as required by Senate Report 114–237. The Committee directs VA to 

complete this assessment and within 60 days submit a formal report to the Committees on Appropriations of both Houses of Congress, with recommendations if applicable, addressing security gaps 

in the VA domiciliary program and whether the current program 

can meet the needs of veterans who are at heightened risk for overdose or suicide. The assessment should include alternatives to the 

domiciliary program if it is found that the current program cannot 

meet the needs of these veterans. 

Sleep Disorders.—The Committee recognizes the importance of 

sleep, including its impacts on PTSD, TBI, and mental health. The 

Committee supports VA considering all treatment options for these 

conditions, including ensuring proper sleep health. The Committee 

continues to recommend the Department assign a program man-
64 

ager for sleep disorders, including sleep apnea, which affects at 

least 200,000 veterans of the Persian Gulf War and Operations 

Iraqi Freedom and Enduring Freedom. The Department is directed 

to submit a report to the Committees on Appropriations of both 

Houses of Congress no later than 90 days after enactment of this 

act on the status of this recommendation. 

Stroke Care.—More than half of veterans are over age 65, putting them at an increased risk of stroke, a leading cause of serious, 

long-term disability and dementia. Immediate care is essential to 

preventing permanent disability, and it is critical the Department 

work to improve its stroke care and provide timely access to assessment and treatment. Unacceptably, there have been cases in which 

veterans have died or have suffered severe injury due to lack of 

timely diagnosis and treatment. A December 2015 report evaluating the quality of stroke care in VA facilities, conducted by the 

Department’s Office of Inspector General, found several areas needing improvement, including the need to increase access to clinicians 

with stroke expertise, and the need to ensure compliance with current stroke care requirements at each VA facility’s designated level. 

To improve access to providers with stroke expertise, the Committee urges VA to continue its efforts to implement stroke telemedicine, or telestroke, within VA medical centers that do not currently have around-the-clock neurological expertise available to veterans who suffer a stroke. Telestroke has proven to be beneficial 

in improving access to high quality stroke care in rural and underserved areas and in reducing disability and the need for long-term 

care following a stroke. The Committee also encourages the Department to continue to reinforce compliance with stroke care requirements, including prompt and thorough assessment, treatment, and 

patient education, and ensure the gathering and reporting of required stroke data elements, consistent with the recommendations 

in the December 2015 report. 

Prosthetic Digital Health Technology.—VA’s Office of Rehabilitation and Prosthetic Services shall, not later than 90 days after enactment of this act, provide a report to the Committees on Appropriations of both Houses of Congress, detailing which VA Medical 

Centers and Clinics this technology is available. In addition, the report shall include the number of veterans utilizing this technology, 

any plans for increasing the availability of this technology to more 

veterans, and any plans to make prosthetic related outcomes-based 

data collection standard throughout the Veterans Health Administration. 

Caregivers.—The Committee notes the robust usage of the post9/11 Caregiver program with its more than 23,000 approved applications, as well as the consistent reviews by caregiver families noting that the program’s stipend, respite care, formal training, and 

support structure are critical components to its success. Given the 

demonstrated success of the program, the Committee encourages 

VA to ensure the Caregiver coordinators at each Medical Center 

are fully resourced and, to the maximum extent possible, assigned 

designated Caregiver duties as their chief and only responsibility. 

In addition, the Committee encourages VA to examine expansion of 

the program beyond the post-9/11 population. The Committee encourages VA to work with the Department of Defense in order to 
65 

develop and share best practices. The Committee recognizes many 

caregivers for severely wounded veterans are working dramatically 

reduced hours outside the home or have left the workforce completely, leading to financial hardship. This reduction in outside 

earnings results in difficulties meeting financial obligations, including student loan debt held by the caregiver. VA is directed to survey all caregivers currently in the program to identify those possessing outstanding student loan debt, develop a plan to monitor 

this issue, including future data collection and regular reports to 

the Committee, and report survey findings and details of the plan 

to the Committees on Appropriations of both Houses of Congress 

no later than 120 days after enactment of this act and every 6 

months thereafter. The Committee is concerned by the steep decline in requested funding for the Caregivers Program. Given the 

increasing demand for these services and the consistent reports 

and findings of inconsistent or inappropriate removal of veterans 

from the program, the Committee questions whether the Department’s request is an accurate reflection of the program’s true 

needs. The Committee, therefore, recommends $839,828,000, which 

is consistent with the fiscal year 2018 advance appropriation, to 

continue full operation of this essential program. The Committee 

directs the Department to implement a freeze on reductions or removals of veterans from the program until all outstanding recommendations from the Office of Inspector General and the Comptroller General are fully implemented. 

Veterans Transportation Service.—In order to ensure the Veterans Transportation Service [VTS] is improving veterans’ access to 

healthcare and VA’s ability to provide quality care in a cost effective manner, the Department is directed to submit a report to the 

Committees on Appropriations of both Houses of Congress no later 

than 90 days after enactment of this act outlining the progress 

made on these metrics. At a minimum, the report should include 

analysis of the healthcare costs impacted by non-emergency medical transportation, the impact of VTS on missed appointment rates 

at facilities utilizing the program, and VTS impact on health outcomes for veterans. 

Center for Compassionate Innovation.—The Committee understands VA has been operating a Center for Compassionate Innovation. The Center’s stated purpose is to explore emerging therapies 

targeted to enhance veteran physical and mental well-being when 

other treatments have not been successful. The Committee encourages VA to always be testing and researching new and innovative 

treatments that may benefit veterans’ lives. To more fully understand these treatments, the Department is directed to submit a report to the Committees on Appropriations of both Houses of Congress no later than 180 days after enactment of this act with a description of the proposals the Center received in fiscal year 2017 

and the cost and disposition of such proposals. Further, to the extent the Center undertook any projects during fiscal year 2016, the 

Committee directs VA to report on the status of those projects and 

any findings or preliminary data. 

Nurse Advice Line.—The Department is directed to pursue a pilot 

program for a nurse advice line targeting rural areas and highly 

rural areas with a large percentage of veterans. Licensed Reg-
66 

istered Nurses at the call center will triage VHA-enrolled veteran 

callers to the clinically appropriate care venue and provide appointment and cancellation services and information on the availability 

of benefits from the VA. The pilot should be based on and improve 

upon the nurse advice line implemented by DoD for beneficiaries 

under the TRICARE program. The pilot shall provide responsive 

service around-the-clock for callers. The Department is directed to 

submit a report to the Committees on Appropriations of both 

Houses of Congress no later than 90 days after enactment of this 

act, and every 90 days thereafter, on the progress of pilot program. 

The reports shall contain information on utilization of the pilot, to 

include a description of the individuals who benefitted from advice 

under the pilot program, a description of any impediments in carrying out the pilot program, a description of any impediments encountered by individuals in seeking advice or services through the 

pilot program, a description of any cost savings to the Department, 

and an assessment of the feasibility and advisability of expanding 

the pilot program to more veterans. 

Gulf War Illness.—The role of the Research Advisory Committee 

on Gulf War Veterans’ Illnesses [RAC] was intended to provide a 

meaningful consultative role to help shape the Persian Gulf War 

research agenda, strengthen the process by which the government 

sets its Persian Gulf War research agenda, and lend credibility to 

future research activities. However, concerns continue to be raised 

that this role has been degraded and compromised. The RAC charter no longer requires it to assess the effectiveness of Federal Gulf 

War research, no longer contains a requirement for its own staff, 

and its purview is presently limited solely to research conducted by 

the Department. Determinations by the RAC and IOM that Gulf 

War illness is physiological and not psychological should be the 

basis in determining the type of medical practitioners and scientific 

researchers needed to create a well-qualified membership. The 

Committee notes the RAC has provided no new recommendations 

since September 2014 and encourages the RAC to renew its efforts 

in studying Gulf War Illness. The Committee directs the Department to brief the Committee on its efforts to address these concerns. The Committee also continues to urge the Department to restore regular reporting throughout the year of healthcare and benefits utilization by Gulf War and post-9/11 veterans, to publish these 

reports on the Department’s Web site, and to consider for adoption 

the ‘‘Recommendations for New VA Gulf War-Era Data Report,’’ 

adopted by the RAC on February 1, 2012. 

Lung Cancer Screening.—The Committee notes with concern that 

not all veterans who are at high risk for developing lung cancer 

have access to lung cancer screening programs offered to Medicare 

beneficiaries. The Department is directed to submit a report to the 

Committees on Appropriations of both Houses of Congress no later 

than 90 days after enactment of this act regarding how VHA can 

institute a high quality program to make lung cancer screening 

broadly available to the appropriate veterans who are at high risk. 

Hospice Care.—From 1964 to 1975, more than nine million Americans served in the armed services, with more than one-third of 

them having served in Vietnam. As these Vietnam-era veterans 

age, many of them are facing unique end-of-life challenges related 
67 

to their combat experience that standard hospice care and palliative services are not fully equipped to address. These challenges include psychological and post-traumatic stress disorders, a history of 

substance abuse, and neurological conditions resulting from toxic 

chemical exposure. While the VA provides hospice care and palliative services to qualified veterans, the Committee is aware that organizations such as the non-profit National Partnership for Hospice 

Innovation are developing programs designed to meet the specific 

end-of-life care needs for Vietnam-era veterans. The Committee 

also recognizes that such an approach could be beneficial to Iraq 

and Afghanistan combat veterans in the future. Therefore, VA is 

directed to undertake a study on the feasibility of implementing 

hospice care protocols tailored to the unique needs of combat veterans, including Vietnam-era veterans, and is encouraged to deploy 

a pilot program to develop the techniques, best practices and support mechanisms to serve these veterans. The Department is directed to submit a report to the Committees on Appropriations of 

both Houses of Congress no later than 180 days after enactment 

of this act on this effort. 

Improving Federal Burn Pits Registry.—The Committee provides 

an additional $5,000,000 for the purpose of implementing the recommendations included in the National Academies of Sciences, Engineering, and Medicine’s Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry for improving the registry. The Department is directed to submit a report 

to the Committees on Appropriations of both Houses of Congress 

no later than 90 days after enactment of this act assessing the cost 

and timeline of implementation of each of the report’s recommendations. 

MEDICAL COMMUNITY CARE

Appropriations, 2017 ............................................................................. $7,246,181,000 

Advance appropriations, 2018 .............................................................. 9,409,118,000 

Budget estimate, 2018 ........................................................................... 254,000,000 

Committee recommendation, 2018 ....................................................... 254,000,000 

Budget estimate, advance appropriations, 2019 ................................. 8,384,704,000 

Committee recommendation, advance appropriations, 2019 .............. 8,385,000,000 

PROGRAM DESCRIPTION

The Medical Community Care account provides for medical services for eligible enrolled veterans and other beneficiaries that is 

purchased from and provided by non-Department of Veterans Affairs facilities and providers, including contract hospitals, State 

homes, and outpatient services. 

COMMITTEE RECOMMENDATION

In fiscal year 2017, the Committee provided an advance appropriation of $9,409,118,000 for fiscal year 2018 for the Medical Community Care account. The recommendation for fiscal year 2018 includes an additional $254,000,000 as included in the budget request. The additional appropriation coupled with the advance appropriation provided for fiscal year 2018 provides the Department 

with total budget authority of $9,663,118,000 which is 

$2,416,937,000 above the fiscal year 2017 enacted amount. 
68 

The Committee recommendation also includes an advance appro- priation of $8,385,000,000 for Medical community care for fiscal 

year 2019. This is $296,000 above the request to reflect proper 

rounding of a budget estimate. 

The Future of Community Care.—The Department is directed to 

continue efforts to consolidate all types of community care available 

to veterans within one program in the Medical Community Care 

account. The Committee recognizes that the Committees on Veterans Affairs of both Houses of Congress have jurisdiction over the 

authorization of the consolidation, as well as the current Choice 

Program, which has been funded with mandatory appropriations. 

Once the latest round of funding available for the Choice Program 

has been expended, the functions of the Choice Program should be 

merged with the functions that are currently funded by and provided for under the Medical Community Care account, and that the 

consolidated program should be funded by this Committee. The 

Committee is aware that this would significantly increase discretionary spending for community care. The Committee would like to 

work with all interested parties within the Congress and the Administration to increase the discretionary spending limits to accommodate such increased future costs for a consolidated community 

care program. At the same time, the Committee directs the Department to maintain intense focus on responsibly providing care under 

the Choice Program, while working diligently to build the successor 

program and enable the consolidation of all community care under 

one account that would be funded by annual appropriations. 

Federally Qualified Health Centers in the Choice Program.—The 

Committee recognizes the importance of Federally Qualified Health 

Centers in [FQHCs] in providing care to Americans across the 

country, including the most vulnerable. The Department is directed 

to submit a report to the Committees on Appropriations of both 

Houses of Congress no later than 90 days after enactment of this 

act regarding the role of FQHCs play in providing veterans care 

through the Veterans Choice Program and outlining opportunities 

for further engagement. 

Community Provider Agreements.—As illustrated by the success 

of the former Access Received Closer to Home [ARCH] program, 

community provider agreements have successfully benefited veterans in rural and highly rural States by increasing access to care 

and significantly shortening travel times. The Committee supports 

sustaining continuity of care for rural veterans through community 

provider agreements, based on previous models such as the ARCH 

program, to ensure veterans do not experience a lapse in 

healthcare during the transition to the new Choice program and 

any resulting integrated networks. 

Home and Community Based Services.—The Committee supports 

the Department’s efforts to broaden veterans’ options regarding 

long-term care support and services. As the Department realigns 

these programs under the Medical Community Care account, the 

Committee encourages VA to continue to prioritize veterans’ preferences in receiving home based services. The Committee notes the 

positive results of pilot programs such as the Veterans Independence Program, a veterans-directed Home and Community Based 

Services [HCBS] grant program originally created as a pilot admin-
69 

istered jointly by VA and the Department of Health and Human 

Services [HHS]. The Committee encourages enhanced cooperation 

with HHS to expand and grow these programs. The Department is 

directed to submit a report to the Committees on Appropriations of 

both Houses of Congress no later than 180 days after enactment 

of this act on the cost avoidance associated with various non-institutional care programs. The report should include information on 

the demand for HCBS among the veteran population, the number 

of veterans currently being served by each program under HCBS, 

and the Department’s plans to expand the size and scope of HCBS. 

Given the success of current HCBS pilot programs, the Department 

should include a cost analysis of growing the existing pilot programs prior to national expansion to leverage coordination with 

HHS, in addition to detail regarding the Department’s efforts to coordinate with HHS on HCBS in future years. Given that mandatory eligibility for certain types of care is associated with disability 

levels adjudicated by VBA, this report should also include recommendations for modernizing the claims process for veterans requiring long-term care. 

Non-VA Long-Term Care.—The Committee supports enabling the 

Department to enter into provider agreements with non-VA longterm care providers, including skilled nursing facilities, in lieu of 

the current onerous Federal contracting requirements. 

Rural Health Continuity of Care.—The Committee notes the Access Received Closer to Home [ARCH] pilot program had been 

highly successful in some areas in providing healthcare services to 

veterans who live in the rural and highly rural States in which it 

operated, such as in northern Maine and in Kansas. During the 

pilot, VISN analysis demonstrated that more than 90 percent of 

veterans who received medical care though ARCH were ‘‘completely 

satisfied’’ with their care and cited significantly shortened travel 

and wait times to receive care. Further, the Committee is pleased 

the Department has made efforts to provide continuous, ARCH-like 

access to rural healthcare in northern Maine through the use of 

provider agreements. Accordingly, the Committee directs the Secretary to ensure that veterans who participated in the ARCH pilots 

maintain continuity of care through the use of provider agreements 

or other mechanisms. 

MEDICAL SUPPORT AND COMPLIANCE

Appropriations, 2017 ............................................................................. $6,498,000,000 

Advance appropriations, 2018 .............................................................. 6,654,480,000 

Budget estimate, 2018 ........................................................................... 284,397,000 

Committee recommendation, 2018 ....................................................... 100,000,000 

Budget estimate, advance appropriation, 2019 ................................... 7,239,156,000 

Committee recommendation, advance appropriation, 2019 ............... 7,239,000,000 

PROGRAM DESCRIPTION

The Medical Support and Compliance account provides funds for 

management, security, and administrative expenses within the VA 

healthcare system, in addition to providing costs associated with 

the operation of VA medical centers and clinics, VISN offices, and 

the VHA Central Office in Washington, DC. This appropriation also 

covers Chief of Staff and Facility Director operations, quality of 

care oversight, legal services, billing and coding activities, procure-
70 

ment, financial management, security, and human resource management. 

COMMITTEE RECOMMENDATION

In fiscal year 2017, the Committee provided an advance appropriation of $6,654,480,000 for fiscal year 2018 for the Medical Support and Compliance account. The recommendation for fiscal year 

2018 includes an additional $100,000,000 which is $184,397,000 

below the budget request. The additional appropriation coupled 

with the advance appropriation provided for fiscal year 2018 provides the Department with total budget authority of $6,754,480,000 

which is $256,480,000 above the fiscal year 2017 enacted amount. 

The Committee recommendation also includes an advance appropriation of $7,239,000,000 for Medical support and compliance for 

fiscal year 2019. This is $156,000 below the request to reflect proper rounding of a budget estimate. 

MEDICAL FACILITIES

Appropriations, 2017 ............................................................................. $5,312,668,000 

Advance appropriations, 2018 .............................................................. 5,434,880,000 

Budget estimate, 2018 ........................................................................... 1,079,795,000 

Committee recommendation, 2018 ....................................................... 707,000,000 

Budget estimate, advance appropriation, 2019 ................................... 5,914,288,000 

Committee recommendation, advance appropriation, 2019 ............... 5,915,000,000 

PROGRAM DESCRIPTION

The Medical Facilities account provides funds for the operation 

and maintenance of the VA healthcare system’s vast capital infrastructure. This appropriation provides for costs associated with 

utilities, engineering, capital planning, leases, laundry, 

groundskeeping, housekeeping, facility repair, and property disposition and acquisition. 

COMMITTEE RECOMMENDATION

In fiscal year 2017, the Committee provided an advance appropriation of $5,434,880,000 for fiscal year 2018 for the Medical Facilities account. The recommendation for fiscal year 2018 includes 

an additional $707,000,000 which is $372,795,000 below the budget 

request. The additional appropriation coupled with the advance appropriation provided for fiscal year 2018 provides the Department 

with total budget authority of $6,141,880,000 which is 

$829,212,000 above the fiscal year 2017 enacted amount. 

The Committee recommendation also includes an advance appropriation of $5,915,000,000 for Medical community care for fiscal 

year 2019. This is $712,000 above the request to reflect proper 

rounding of a budget estimate. 

Medical Facilities Leases Authorization.—The Committee continues to be concerned by the extensive delays in authorizing VA 

medical facilities leases, which would provide increased healthcare 

access for veterans across throughout the VA system and in many 

cases reduce inefficiencies and simplify veteran care by consolidating multiple existing facilities. The Committee is aware the Department recognizes the need for additional VA medical facilities 

and has proposed leases in its budget request, but budgetary chal-
71 

lenges have prevented the authorization of such leases. The Committee urges the Department to continue working with the Office 

of Management and Budget and Congressional Budget and Veterans’ Affairs Committees to identify a long-term solution to these 

budgetary challenges. 

MEDICAL AND PROSTHETIC RESEARCH

Appropriations, 2017 ............................................................................. $673,366,000 

Budget estimate, 2018 ........................................................................... 640,000,000 

Committee recommendation ................................................................. 722,262,000 

PROGRAM DESCRIPTION

The Medical and Prosthetic Research account provides funds for 

medical, rehabilitative, and health services research. Medical research supports basic and clinical studies that advance knowledge 

leading to improvements in the prevention, diagnosis, and treatment of diseases and disabilities. Rehabilitation research focuses 

on rehabilitation engineering problems in the fields of prosthetics, 

orthotics, adaptive equipment for vehicles, sensory aids and related 

areas. Health services research focuses on improving the effectiveness and economy of the delivery of health services. 

COMMITTEE RECOMMENDATION

The Committee recommends $722,262,000 for the Medical and 

Prosthetic Research account. This is $48,896,000 above the fiscal 

year 2017 enacted level and $82,262,000 above the budget request. 

The Committee remains highly supportive of this program, and 

recognizes its importance both in improving healthcare services to 

veterans and recruiting and retaining high quality medical professionals in the Veterans Health Administration. 

Through the Department’s research and development program, 

VA has implemented a comprehensive research agenda to develop 

new treatments and tools for clinicians to ease the physical and 

psychological pain of men and women returning from war zones, to 

improve access to VA healthcare services, and to accelerate discoveries and applications, especially for neurotrauma, sensory loss, 

amputation, polytrauma, and related prosthetic needs. The Committee encourages VA to continue its research into developing novel 

approaches to restoring veterans with amputation, central nervous 

system injuries, loss of sight or hearing, or other physical and cognitive impairments to full and productive lives. 

Advanced Medical Device Study.—The Committee commends VA 

for its research and use of exoskeleton technology. The Committee 

is also aware of an important pilot program to research the homebased use and medical advantages of exoskeletons for spinal cord 

injuries [SCI]. The Committee notes the early success that mobility-focused exoskeleton technologies are having with this patient 

population and the resulting improvement in health and wellbeing. The Committee directs the Department to undertake a study 

on the appropriateness and efficacy of exoskeletons in rehabilitation of patients who have suffered a stroke or traumatic brain injury. 

Continuous Health Monitoring Technology.—The Committee has 

a longstanding interest in improving VA healthcare outcomes by 
72 

decreasing hospital acquired complications, including reducing sepsis, falls, and pressure ulcers. Recent advancements in the ability 

of continuous vital signs monitoring for non-ICU patients have 

shown a tremendous potential for improved patient outcomes. The 

Committee is aware of research at the James A. Haley VAMC in 

Tampa, Florida, and the Boise VAMC in Boise, Idaho, that shows 

remarkable decreases in Medical Response Team [MRT] activations, Code Blue activations, ICU transfers and, most importantly, 

decreases in mortality rates following these activations. Furthermore, research has shown that continuous monitoring systems 

have allowed the VA to recover its investment in the technology 

within 6 months or less. All of the positive results show a significant decrease in length of patient stay which allows facilities 

adopting this technology to significantly increase the number of patients seen at the facility, thereby decreasing the waiting times and 

backlogs that have been of great concern to this Committee. To ensure VHA is benefitting from the outcomes achieved at these facilities and civilian facilities where continuous monitoring technology 

is deployed, the Committee urges the VA to expeditiously proceed 

with research surrounding continuous monitoring technologies and 

complete on-going projects related to contact-free technologies being 

conducted by the Health Services Research and Development Service [HSRD]. The Department is directed to submit a report to the 

Committees on Appropriations of both Houses of Congress no later 

than 90 days after enactment of this act detailing recommendations 

for increased deployment of proven continuous monitoring technologies within the VHA, including a proposed timeline. 

Burn Pits Research.—The Committee recommends VA continue 

conducting medical trials, using available treatments for pulmonary, cardiovascular, and other diseases and conditions related 

to the exposure to open air burn pits. The Department is directed 

to provide an update to the Committees on Appropriations of both 

Houses of Congress no later than 180 days after enactment of this 

act on the status and progress of such medical trials. Furthermore, 

where appropriate, VA is encouraged to work with private and public institutions which have already begun to research the chronic 

impacts of exposure to burn pits in order to develop treatments for 

veterans exposed to burn pits. 

Public Access to Scientific Publications and Data.—The Committee commends the Department on issuing its Policy and Implementation Plan for Public Access to Scientific Publications and Digital Data from Research Funded by the Department of Veterans Affairs on July 23, 2015. The Department is directed to continue its 

efforts toward full implementation of the plan and directs an update on progress made be included in its fiscal year 2019 budget 

request. 

Geriatrics and Extended Care Services.—The Committee recognizes VA’s growing need to prioritize research focusing on increasingly complex and chronic conditions of aging veterans, with more 

than half of veterans estimated to be over the age of 65 in 2018. 

As VA continues to develop successful models for innovative and 

clinically integrated care for veterans with more than one chronic 

disease and declining mental and physical capabilities, the findings 

from these models should be widely shared to inform Federal, State 
73 

and local efforts to address the healthcare needs of America’s aging 

population and American families. The Committee urges VA to continue to support evidence-based clinical research that reduces costs 

and improves the quality of care for older veterans by preventing 

hospital readmissions and enhancing the ability of older veterans 

to remain in their homes and communities safely, independently, 

and comfortably, through expanded tele-medicine, technological advances, coordinated care, and well-designed long-term services and 

supports. The Committee also recognizes the important contributions the Geriatrics and Extended Care Services [GEC] and Geriatric Research Education and Clinical Centers [GRECCs] have 

made in developing successful innovations in coordinated home and 

community-based care that benefit older veterans and provide 

proven, successful models that can inform development of integrated delivery systems for non-veteran seniors. The Committee 

encourages VA to continue utilizing its funds to bolster its existing 

research programs focusing on aging to meet the current and future needs of the veteran population. 

Enewetak Atoll Registry Research.—The Committee is aware that 

thousands of veterans served on the Enewetak Atoll to clean up the 

island following its use for nuclear weapons testing. The Committee is also aware of many instances of veterans who conducted 

the cleanup suffering serious health problems, such as brittle 

bones, cancers, and birth defects in their children. The Committee 

urges the Department to study whether there is a connection between certain illnesses and the potential exposure of individuals to 

radiation related to service at Enewetak Atoll between January 1, 

1977, and December 31, 1980. 

Exposure to Agent Orange by Certain Navy Veterans.—Under the 

Agent Orange Act of 1991 (Public Law 102–4), most veterans of deployments to Vietnam between 1962 and 1975 became entitled to 

compensation for certain illnesses linked to exposure to Agent Orange defoliant, including the ‘‘Blue Water’’ Navy veterans who 

served in the Navy outside of the riverine and coastal areas. However, beginning in 2002, new Department interpretation of the law 

prevented Blue Water Navy veterans from collecting benefits unless they could prove to have been on a ship proven to have entered 

inland water or sailors who proved they had been ashore. In 2016, 

the Department reiterated its policy and added further restrictions 

by removing certain harbors that used to carry a presumption of 

exposure, while outside the VA a growing body of research supports 

the assumption of presumption of exposure. In a fact sheet published about the decision, VA noted only a 2011 Institute of Medicine study on Agent Orange exposure among Blue Water Navy veterans, which found that exposure at sea could not be proven, assuming ships followed certain best practices that veterans 

anecdotally report were regularly ignored. The Department is directed to submit a report to the Committees on Appropriations of 

both Houses of Congress no later than 90 days after enactment of 

this act evaluating each of the U.S. and non-U.S. studies on Agent 

Orange exposure since 1980 that are relevant to the question of 

Blue Water Navy sailors to justify the 2016 decision. 

Cancer Moonshot Contribution.—The Committee supports the 

Beau Biden Cancer Moonshot initiative and the Department’s con-
74 

tribution utilizing advances in genomic science to provide targeted 

treatment to veterans. The Department has identified prostate cancer, triple-negative breast cancer, and colorectal cancer as areas of 

priority. Due to the prevalence of various skin cancers among service members, the Committee directs that skin cancer be included 

as well. 

Overprescription Prevention Report.—The Committee is discouraged by multiple GAO reports retaining VHA on the ‘‘high-risk’’ list 

and the unfathomable increase in polydrug use and narcotics prescriptions by VA related to pain management and mental health 

treatment. Specifically, combinations of opioid and Benzodiazepines 

have proven fatal when taken concurrently, with research demonstrating this phenomenon for nearly 40 years. The Committee 

provides $500,000 to enter into an agreement with the National 

Academies of Sciences, Engineering, and Medicine to conduct an 

assessment to research, collect, and analyze the potential overmedication of veterans during fiscal years 2010–2017 that led to veterans deaths, veterans suicides, treatment of mental disorders, 

pain management practices, mental health staffing levels, and combat related trauma. 

Gulf War Illness Studies.—The Committee recommends the Department continue to conduct epidemiological studies regarding the 

prevalence of Gulf War illness, morbidity, and mortality in Persian 

Gulf War veterans and the development of effective treatments, 

preventions, and cures. The Committee is concerned by the lack of 

public availability of the findings of all research conducted by or for 

the Executive Branch relating to the health consequences of military service in the Persian Gulf theater of operations during the 

Persian Gulf War and by the lack of coordination by the Department in ensuring the public availability of this information. The 

Committee urges the Department to publish disease-specific mortality data related specifically to Persian Gulf War veterans. The 

Committee remains concerned by VA’s ever-evolving terminology 

for the signature adverse health outcome of the Persian Gulf War 

as recognized by the Institute of Medicine [IOM]—Gulf War illness—and encourages the Department to utilize the term, ‘‘Gulf 

War illness,’’ as IOM has recommended. The Committee continues 

to urge the Secretary to consider revising and updating the Clinical 

Practice Guideline for Chronic Multisymptom Illness [CMI] consistent with the July 2011 Veterans Health Initiative, ‘‘Caring for 

Gulf War Veterans,’’ in that it, ‘‘cannot be reliably ascribed to any 

known psychiatric disorder,’’ and to focus on recent Gulf War illness treatment research findings and ongoing Gulf War illness 

treatment research direction. Furthermore, the Committee once 

again encourages VA to strengthen the training of primary, specialty, and mental healthcare providers on the Gulf War illness 

case definitions recommended by IOM. 

MEDICAL CARE COST RECOVERY COLLECTIONS

MEDICAL CARE COLLECTION FUND

Appropriations, 2017 ............................................................................. $2,637,000,000 

Budget estimate, 2018 ........................................................................... 2,507,000,000 

Committee recommendation ................................................................. 2,507,000,000 
75 

MEDICAL CARE COLLECTION FUND—REVENUES APPLIED

Appropriations, 2017 .............................................................................¥$2,637,000,000 

Budget estimate, 2018 ........................................................................... ¥2,507,000,000 

Committee recommendation ................................................................. ¥2,507,000,000 

PROGRAM DESCRIPTION

The Medical Care Collection Fund [MCCF] was established by 

the Balanced Budget Act of 1997 (Public Law 105–33). In fiscal 

year 2004, Public Law 108–199 allowed the Department of Veterans Affairs to deposit first-party and pharmacy co-payments; 

third-party insurance payments and enhanced-use collections; longterm care co-payments; Compensated Work Therapy Program collections; and Parking Program fees into the MCCF. The Secretary 

of Veterans Affairs has the authority to transfer funds from the 

MCCF to the Medical Services account. 

COMMITTEE RECOMMENDATION

The Committee recommendation includes the authority to retain 

co-payments and third-party collections, estimated to total 

$2,507,000,000 in fiscal year 2018. 

NATIONAL CEMETERY ADMINISTRATION

Appropriations, 2017 ............................................................................. $286,193,000 

Budget estimate, 2018 ........................................................................... 306,193,000 

Committee recommendation ................................................................. 306,193,000 

ADMINISTRATION OVERVIEW

The National Cemetery Administration [NCA] was established in 

accordance with Public Law 93–94, the National Cemeteries Act of 

1973. It has a four-fold mission: to provide for the interment in any 

national cemetery of the remains of eligible deceased 

servicemembers and discharged veterans, together with their 

spouses and certain dependents, and permanently maintain their 

graves; to provide headstones for, and to mark graves of, eligible 

persons in national, State, and private cemeteries; to administer 

the grant program for aid to States in establishing, expanding, or 

improving State veterans cemeteries; and to administer the Presidential Memorial Certificate Program. 

COMMITTEE RECOMMENDATION

The Committee recommends $306,193,000 for the National Cemetery Administration. This is an increase of $20,000,000 above the 

fiscal year 2017 enacted level and equal to the budget request. 

The Committee has included bill language to make available 

through September 30, 2019, up to 10 percent of the National Cemetery Administration appropriation. 

DEPARTMENTAL ADMINISTRATION

Appropriations, 2017 ............................................................................. $5,966,031,000 

Budget estimate, 2018 ........................................................................... 5,707,593,000 

Committee recommendation ................................................................. 5,725,391,000 
76 

ADMINISTRATION OVERVIEW

Departmental Administration provides for the administration of 

veterans benefits through the Veterans Benefits Administration 

[VBA], the executive direction of the Department, several top level 

supporting offices, the Board of Contract Appeals, and the Board 

of Veterans Appeals. 

COMMITTEE RECOMMENDATION

The Committee recommends $5,725,391,000 for Departmental 

Administration. The amount is composed of $329,891,000 for General administration; $166,000,000 for the Board of Veterans Appeals; $4,055,500,000 for Information technology systems; 

$164,000,000 for the Office of the Inspector General; $512,430,000 

for Construction, major projects; $342,570,000 for Construction, 

minor projects; $110,000,000 for Grants for construction of State 

extended care facilities; and $45,000,000 for Grants for the construction of State veterans cemeteries. 

Public Law 114–223 moved the General Operating Expenses, 

Veterans Benefits Administration account from Departmental Administration to the Veterans Benefits Administration, its appropriate section within the act, with the instruction that the Department should place GOE,VBA in this location with the fiscal year 

2019 request. The Committee notes this did not happen, and therefore, once again, instructs the Department to adhere to this direction with the fiscal year 2019 request. 

GENERAL ADMINISTRATION

(INCLUDING TRANSFER OF FUNDS)

Appropriations, 2017 ............................................................................. $345,391,000 

Budget estimate, 2018 ........................................................................... 346,891,000 

Committee recommendation ................................................................. 329,891,000 

PROGRAM DESCRIPTION

The General Administration account provides funding for the Office of the Secretary, six assistant secretaries, and three independent staff offices. 

COMMITTEE RECOMMENDATION

The Committee recommends $329,891,000 for General Administration. This amount is $15,500,000 below the fiscal year 2017 enacted level and $17,000,000 below the budget request. The Committee has included bill language to make available through September 30, 2019, up to 10 percent of the General Administration 

appropriation. 

Filling Vacant Positions.—The Committee remains concerned 

about the length of time veterans are waiting for appointments, 

claims processing, and other essential veteran’s services at VA. Exacerbating this problem has been VA’s failure to hire employees for 

a reported 49,000 vacant positions in the Department. VA must do 

more to hire, recruit, and retain quality employees to provide care 

and services for our nation’s veterans. The Department is directed 

to use the funds appropriated by this act to fill staff vacancies and 
77 

submit a report to the Committees on Appropriations of both 

Houses of Congress no later than 180 days after enactment of this 

act, and each month thereafter, detailing both the progress of hiring and filling vacant positions and what positions remain vacant. 

Veterans Identification Card Act of 2015.—Public Law 114–31 directed the Secretary of Veterans Affairs to issue an identification 

card to veterans. This bill was unanimously passed by Congress 

and signed into law on July 20, 2015. Unfortunately, these cards 

are still not available to veterans. The Committee directs the Department to move swiftly in making these cards available. 

BOARD OF VETERANS APPEALS

Appropriations, 2017 ............................................................................. $155,596,000 

Budget estimate, 2018 ........................................................................... 155,596,000 

Committee recommendation ................................................................. 166,000,000 

PROGRAM DESCRIPTION

As set forth in section 7101(a) of title 38 United States Code, the 

Board of Veterans Appeals is responsible for making final decisions 

on claims for veterans benefits presented to the Board for appellate 

review. The vast majority of the Board’s workload derives from 

benefit claims initiated by the Veterans Benefits Administration’s 

Regional Offices. The appellate process has multiple steps, most of 

which occur at the local Regional Office level. If a veteran is not 

satisfied with the Regional Office determination, he or she may appeal to the Board for a final agency decision. The Board adjudicates 

appeals covering all areas of veterans benefits, including: service 

connection, increased disability ratings, total disability ratings, 

pensions, insurance benefits, educational benefits, home loan guaranties, vocational rehabilitation, waivers of indebtedness, fee basis 

medical care, and dependency and indemnity compensation. 

COMMITTEE RECOMMENDATION

The Committee recommends $166,000,000 for the Board of Veterans Appeals, which is $10,404,000 above fiscal year 2017 enacted 

level and the budget request. The Committee has included bill language to make available through September 30, 2019, up to 10 percent of the Board of Veterans Appeals appropriation. 

Growing Backlog of Appeals.—The Committee remains concerned 

over the growing backlog of disability claims at all stages of the appeals process but is particularly concerned about the increase at 

the Board of Veterans Appeals. The fiscal year 2018 justification 

accompanying the Department’s budget submission notes the number of cases received by the Board continues to grow rapidly, projected to increase by 23 percent from 115,847 pending appeals at 

the end of 2016 to 142,756 pending appeals by the end of 2017. 

Each year since 1996, the volume of appeals received by VBA 

equated to 9 to 15 percent of the total claims completed in those 

years. The Committee understands as VBA sees increases in the 

number of claims, appeals at the Board increase proportionally. 

The Board notes that it expects the backlog to increase dramatically over the coming years without additional resources and legislative reform. To that end, the Committee recommends an additional $10,404,000 above the budget request for additional staffing 
78 

needs. In addition, BVA in conjunction with VBA shall provide a 

report to the Committee on Appropriations of both Houses of Congress no later than January 1, 2018, outlining a 5-year staffing 

plan to ensure that the appellate backlog is addressed in a timely 

manner. 

INFORMATION TECHNOLOGY SYSTEMS

Appropriations, 2017 ............................................................................. $4,270,259,000 

Budget estimate, 2018 ........................................................................... 4,055,500,000 

Committee recommendation ................................................................. 4,055,500,000 

PROGRAM DESCRIPTION

The Information Technology [IT] Systems appropriation, along 

with reimbursements, funds the costs of all IT staff salaries and 

expenses, the operations and maintenance of all existing information technology systems, and the development of new projects and 

programs designed to improve the delivery of service to veterans. 

This appropriation also funds the costs associated with the Office 

of Information and Technology which oversees the functions highlighted above. 

COMMITTEE RECOMMENDATION

The Committee recommends $4,055,500,000 for the Information 

Technology Systems account. This amount is $214,759,000 below 

the fiscal year 2017 enacted level and equal to the budget request. 

The Committee recommendation includes $1,230,320,000 for staff 

salaries and expenses, $2,466,650,000 for operation and maintenance of existing programs, and $358,530,000 for program development. 

The Committee has appropriated the Information Technology 

Systems account as three subaccounts. This funding structure enhances the Committee’s ability to ensure funds are executed in a 

manner consistent with the Department’s budget submission. The 

Committee has provided sufficient flexibility within the subaccounts by way of authorized carryover amounts and reprogramming authority to give the Office of Information Technology as 

much flexibility as possible to accomplish its mission and goals, 

while ensuring proper accountability and oversight. The Committee 

will continue to work with the Department to ensure the IT 

projects currently underway, as well as the projects planned for the 

future, have the resources needed for success. 

INFORMATION TECHNOLOGY DEVELOPMENT PROJECTS 

[In thousands of dollars] 

Project Fiscal year 2018 

budget request 

Committee recommendation 

Electronic Health Record [EHR] Interoperability and VLER Health ................................ 10,000 10,000 

Electronic Health Record [EHR] ...................................................................................... 39,000 39,000 

Veterans Benefits Management System [VBMS] ............................................................ 59,904 59,904 

Virtual Lifetime Electronic Record [VLER] ...................................................................... 20,968 20,968 

Veterans Customer Experience ....................................................................................... 58,473 58,473 

Other IT Systems Development ....................................................................................... 170,185 170,185 

Total Development ............................................................................................. 358,530 358,530 
79 

Electronic Health Record.—Achieving interoperability between 

the health records of the Department of Veterans Affairs and the 

Department of Defense remains one of the highest priorities of the 

Committee. The Committee believes from a servicemember’s initial 

military entrance physical to their final interaction with VA, a 

seamless health record should follow the individual. With the Secretary’s decision on June 5, 2017, to acquire by a sole-source contract the same electronic health record system as the DoD, the 

Committee is unable at the time of this printing to precisely and 

comprehensively opine on the future of the system. The Department has proactively offered to remain in regular contact about the 

acquisition of the new system and the needed addition 

functionalities VA will pursue to address the VA-specific mission. 

The Committee notes there is no direct request in the budget request this year to provide funding for an acquisition. Given the 

lack of information about the cost of a new EHR, but the Committee’s awareness of the final cost estimate of the DoD acquisition, 

it can be assumed the VA total cost will exceed previous estimates 

for VistA Evolution. To that end, in its oversight capacity, the Committee will reevaluate, with the Committee on Appropriations of 

the House of Representatives, the constraints on the obligation or 

expenditure of funding for the new acquisition at the appropriate 

time. 

Additionally, the Committee remains concerned about the continued status of electronic health record interoperability between VA 

and DoD and whether lack of interoperability limits VA clinicians’ 

ability to readily access information from DoD records, potentially 

impeding their ability to make the most informed decisions on 

treatment options, and possibly putting veterans’ health at risk. Although VA and DoD have certified interoperability, there are more 

developed goals that can be realized. While several applications 

exist to facilitate health data access for clinicians, more must be 

done to ensure that the most relevant data is accessible in a userfriendly format to facilitate efficient clinical encounters. Both Departments must remain committed to working towards assuring 

continued VA and DoD interoperability as each Department adopts 

its new electronic health record system. The Committee directs VA 

and DoD to establish clear and agreed-upon metrics and goals for 

interoperability, to establish clear timeframes for meeting those 

goals, to ensure clinician feedback is sought and considered as the 

respective electronic medical record systems are modernized, and to 

update the VA/DoD Interagency Program Office guidance to reflect 

agreed-upon metrics and goals. The need for well-functioning, upto-date electronic health record technology is absolutely critical as 

VA plans for a shift to a model of care that greatly expands its use 

of care in the community. 

Cybersecurity.—The Committee recommends the full budget request of $340,000,000 for the VA’s Office of Information Security. 

Over the past year, the Department has been executing an enterprise-wide cybersecurity strategy which defines a comprehensive 

set of actions, processes, and emerging security technologies that 

will further enhance the cybersecurity of VA’s information and assets and improve the resilience of VA networks. To better increase 

oversight and to ensure VA is aggressively pursuing a robust 
80 

cybersecurity plan, the Chief Information Officer id directed submit 

a report to the Committees on Appropriations of both Houses of 

Congress no later January 1, 2018, on VA’s current and future 

plans to increase security protocols across VA’s networks. At a minimum, the CIO should include how much was obligated in in fiscal 

year 2017 and estimates for fiscal year 2018 to: secure the over 

60,000 medical devices that connect to VA’s network, implement 

Digital Rights Management technology, strengthen encryption services, and improve VA’s cybersecurity workforce recruitment, hiring, 

and training. Given the sensitive nature of this topic, the CIO may 

provide this report as a briefing to the Committees. 

Network Capabilities.—As VA maximizes the use of telehealth 

and remote patient monitoring technology, particularly technology 

that which makes use of high-resolution interfaces, enhanced and 

modern network capability will be needed. In order to ensure proper budgetary resources are being utilized to modernize VA’s 

healthcare networks, the Department is directed to include in the 

justifications accompanying the fiscal year 2019 budget request a 

section specific to network modernization, including fiscal year 

2018 accomplishments. 

OFFICE OF INSPECTOR GENERAL

Appropriations, 2017 ............................................................................. $159,606,000 

Budget estimate, 2018 ........................................................................... 159,606,000 

Committee recommendation ................................................................. 164,000,000 

PROGRAM DESCRIPTION

The Office of Inspector General [OIG] was established by the Inspector General Act of 1978 and is responsible for the audit, investigation, and inspection of all Department of Veterans Affairs programs and operations. 

COMMITTEE RECOMMENDATION

The Committee recommends $164,000,000 for the Office of Inspector General. This is $4,394,000 above the fiscal year 2017 enacted level and the budget request. The Committee has included 

bill language to make available through September 30, 2019, up to 

10 percent of the Office of the Inspector General appropriation. 

CONSTRUCTION, MAJOR PROJECTS

Appropriations, 2017 ............................................................................. $528,110,000 

Budget estimate, 2018 ........................................................................... 512,430,000 

Committee recommendation ................................................................. 512,430,000 

PROGRAM DESCRIPTION

The Construction, Major Projects account provides for constructing, altering, extending, and improving any of the facilities 

(including parking projects) under the jurisdiction or for the use of 

VA, including planning, architectural and engineering services, 

needs assessment, and site acquisition where the estimated cost of 

a project is more than the amount set forth in 38 U.S.C. 

8104(a)(3)(A). Proceeds realized from Enhanced Use Lease activities may be deposited into the Construction, Major Projects and 

Construction, Minor Projects accounts. 
81 

COMMITTEE RECOMMENDATION

The Committee recommends an appropriation of $512,430,000 for 

the construction of major projects. This is $15,680,000 below the 

fiscal year 2017 enacted level and equal the budget request. 

The following table reflects the President’s budget request for 

major construction projects and the corresponding Committee recommendations. 

MAJOR CONSTRUCTION PROJECTS 

[In thousands of dollars] 

Location and description Fiscal year 2018 

budget request 

Committee 

recommendation 

Veterans Health Administration [VHA]: 

Livermore, CA: Realignment and Closure of the Livermore Campus ................... 117,300 117,300 

Advance Planning and Design Fund: Various Locations ...................................... 57,500 57,500 

Asbestos: Various Locations .................................................................................. 7,500 7,500 

Major Construction Staff: Various Locations ......................................................... 27,500 27,500 

Hazardous Waste: Various Locations ..................................................................... 15,000 15,000 

Judgement Fund: Various Locations ...................................................................... 10,000 10,000 

Non-Departmental Federal Entity Project Management Support .......................... 16,730 16,730 

Total, VHA .......................................................................................................... 251,530 251,530 

National Cemetery Administration [NCA]: 

Sacremento, California: Grave Site Expansion ...................................................... 35,000 35,000 

Bushnell, Florida: Grave Site Expansion and Cemetery Improvement Sites ......... 51,500 51,500 

Elwood, Illinois: Gravesite Expansion, Phase 3 ..................................................... 35,000 35,000 

Calverton, New York: Gravesite Expansion ............................................................ 50,000 50,000 

Phoenix, Arizona: Gravesite Expansion .................................................................. 31,900 31,900 

Bridgeville, Pennslyvania: Gravesite Expansion, Phase 3 ..................................... 39,000 39,000 

Advance Planning and Design Fund ..................................................................... 8,500 8,500 

NCA Land Acquisition Fund ................................................................................... 5,000 5,000 

Total, NCA .......................................................................................................... 255,900 255,900 

General Administration—Staff Offices, Advance Planning Fund .................................. 5,000 5,000 

Total Construction, Major Projects .................................................................... 512,430 512,430 

The Future of VA Construction.—The Committee remains concerned about the state of VA’s major construction program. In the 

wake of the massive cost overruns at the Denver VA Medical Center, Congress required VA to utilize the U.S. Army Corps of Engineers (the Corps) as its construction agent for all major construction projects over $100,000,000. Bringing the Corps into the VA 

construction process has exposed major differences between the 

standardized policies, practices and procedures the Corps follows in 

the military construction world and the procedures for major construction and capital investment VA uses in practice. This has 

forced VA to take a hard look at many of its construction business 

practices, and in many cases, implement changes to adhere to 

Corps polices into order for the Corps to agree to move forward 

managing VA projects. For example, VA traditionally views a 

project as a whole campus, meaning a project will consist of multiple buildings with construction timelines spanning an often indefinite number of years. In the military construction world, this 

would be known as a master plan, which would consist of multiple 

individual projects, each of which represents a complete and usable 

building. Each military construction project is planned in advance, 

has a set scope and estimated cost, and specific project details re-
82 

flected on a form DD 1391. The Committee believes the level of 

analysis and rigor put into the form DD 1391 and the Department 

of Defense processes for construction should serve as a model for 

VA to follow, particularly in light of the partnership with the 

Corps. 

Another Department of Defense process VA should begin to follow is the future years defense plan [FYDP], a document that lays 

out the military construction projects in the current year’s budget 

request and the projects anticipated to be in the next 5 year’s requests. Although always subject to change, the [FYDP] shows the 

Committee that DoD has a well-reasoned plan for the next few 

years to address its infrastructure needs. Contrast this with the 

VA’s SCIP list and the differences are glaring. The SCIP list is 

monstrous, laying out all VA’s infrastructure needs with seemingly 

no prioritization or indication of which projects VA intends to pursue first, and no timeline for when projects will be completed. 

Judging from the past several year’s budget requests, correcting 

seismic deficiencies seems to be one of the VA’s top priorities. However, other serious life, health, and safety projects seem to languish 

on the SCIP list. For example, the outpatient clinic at Hilo, Hawaii 

lies within a tsunami flood zone. While VA plans to close this facility and move to temporary space that veterans cite as difficult to 

get to and will likely result in a decrease in access, plans for the 

new permanent clinic remain stalled on the SCIP list, despite the 

fact that the current facility has to be closed because of the tsunami threat. The SCIP list also proves to be a very ineffective tool 

for the Committee to use to understand the future of VA construction. For example, projects move up or down the list from year to 

year without any obvious explanation to the Congressional staff 

who follow their home State project closely. The Committee and its 

staff are the primary consumers of the data included in VA’s annual budget justifications to Congress, yet the SCIP list as included 

in the justifications is not a useful document. The Committee directs the Department to work diligently to move towards a DoDlike 5-year construction plan and concurrently craft a better way 

to provide construction information annually to Congress. 

CONSTRUCTION, MINOR PROJECTS

Appropriations, 2017 ............................................................................. $372,069,000 

Budget estimate, 2018 ........................................................................... 342,570,000 

Committee recommendation ................................................................. 342,570,000 

PROGRAM DESCRIPTION

The Construction, Minor Projects account provides for constructing, altering, extending, and improving any of the facilities 

(including parking) under the jurisdiction or for the use of VA, including planning, assessment of needs, architectural and engineering services, and site acquisition, where the estimated cost of a 

project is equal to or less than $10,000,000. Public Law 106–117, 

the Veterans Millennium Health Care and Benefits Act of 1999, 

gave VA authority to make capital contributions from minor construction in enhanced-use leases. Proceeds realized from enhanceduse lease activities may be deposited into the Construction, Major 

Projects and Construction, Minor Projects accounts. 
83 

COMMITTEE RECOMMENDATION

The Committee recommends $342,570,000 for minor construction. This is $29,499,000 below the fiscal year 2017 enacted level 

and equal to the budget request. 

The recommendation includes $193,610,000 for the Veterans 

Health Administration, $97,950,000 for the National Cemetery Administration, and $29,895,000 for the Veterans Benefits Administration. The Department is directed to provide an expenditure plan 

to the Committees on Appropriations of both Houses of Congress 

no later than 30 days after enactment of this act for the amount 

appropriated for minor construction. 

GRANTS FOR CONSTRUCTION OF STATE EXTENDED CARE FACILITIES

Appropriations, 2017 ............................................................................. $90,000,000 

Budget estimate, 2018 ........................................................................... 90,000,000 

Committee recommendation ................................................................. 110,000,000 

PROGRAM DESCRIPTION

This account is used to provide grants to assist States in acquiring or constructing State home facilities for furnishing domiciliary 

or nursing home care to veterans, and to expand, remodel, or alter 

existing buildings for furnishing domiciliary, nursing home, or hospital care to veterans in State homes. The grant may not exceed 

65 percent of the total cost of the project. Public Law 102–585 

granted permanent authority for this program, and Public Law 

106–117 provided greater specificity in directing VA to prescribe 

regulations for the number of beds for which grant assistance may 

be furnished. This program has been a successful partnership between States and VA in meeting the long-term care needs of elderly veterans for decades. 

COMMITTEE RECOMMENDATION

The Committee recommends $110,000,000 for Grants for construction of State extended care facilities. This is $20,000,000 

above the budget request. 

Funding Prioritization.—The Committee continues to be concerned about the prioritization of funding for new State veterans 

homes. The criteria used by the Department when making funding 

decisions for new facilities should consider the unique needs of geographically small States that depend on just one facility, straining 

capacity and leaving those States without alternative facilities to 

care for veterans while their projects are pending. Similarly, the 

Department should also prioritize large rural States where veterans may live hundreds of miles from the next nearest facility. 

GRANTS FOR CONSTRUCTION OF VETERANS CEMETERIES

Appropriations, 2017 ............................................................................. $45,000,000 

Budget estimate, 2018 ........................................................................... 45,000,000 

Committee recommendation ................................................................. 45,000,000 

PROGRAM DESCRIPTION

Public Law 105–368 amended title 38 U.S.C. 2408 and established authority to provide aid to States for establishment, expan-
84 

sion, and improvement of State veterans cemeteries, which are operated and permanently maintained by the States. This statutory 

change increased the maximum Federal share from 50 percent to 

100 percent in order to fund construction costs and initial equipment expenses when the cemetery is established. States remain responsible for providing the land and for paying all costs related to 

operation and maintenance of the cemeteries, including the costs 

for subsequent equipment purchases. 

COMMITTEE RECOMMENDATION

The Committee recommends $45,000,000 for Grants for construction of State veterans cemeteries. This is equal to the budget request. 

ADMINISTRATIVE PROVISIONS

(INCLUDING TRANSFERS AND RESCISSIONS OF FUNDS)

Sec. 201. The Committee includes a provision which outlines 

transfer authority and responsibilities for the Veterans Benefits 

Administration. 

Sec. 202. The Committee includes a provision which outlines 

transfer authority and responsibilities for the Veterans Health Administration. 

Sec. 203. The Committee includes a provision which outlines the 

use of funds appropriated for salaries and expenses. 

Sec. 204. The Committee includes a provision mandating that 

only construction funds may be used for land procurement or the 

construction of any new hospital or home. 

Sec. 205. The Committee includes a provision allowing for reimbursements to the Medical Services account. 

Sec. 206. The Committee includes a provision allowing for payments of prior year obligations. 

Sec. 207. The Committee includes a provision which allows for 

the use of funds for prior year obligations. 

Sec. 208. The Committee includes a provision which allows for 

payments from the National Service Life Insurance Fund. 

Sec. 209. The Committee includes a provision which outlines the 

use of funds from enhanced-use lease proceeds. 

Sec. 210. The Committee includes a provision which provides for 

funds for the Office of Resolution Management, the Office of Employment Discrimination Complaint Adjudication, the Office of Accountability and Whistleblower Protection, and the Office of Diversity and Inclusion. 

Sec. 211. The Committee includes a provision which requires disclosure of third-party reimbursement information. 

Sec. 212. The Committee includes a provision which allows for 

the transfer of revenue derived from enhanced-use leases into the 

construction accounts. 

Sec. 213. The Committee includes a provision which outlines authorized uses for Medical Services account funds. 

Sec. 214. The Committee includes a provision which allows funds 

in the Medical Care Collection Fund to be transferred into the 

Medical Services and Medical Community Care accounts. 
85 

Sec. 215. The Committee includes a provision which allows eligible veterans in the State of Alaska to obtain medical care services. 

Sec. 216. The Committee includes a provision which allows for 

the transfer of funds into the construction accounts. 

Sec. 217. The Committee includes a provision rescinding funds 

from Medical services. 

Sec. 218. The Committee includes a provision requiring the Secretary of Veterans Affairs to submit quarterly financial reports on 

the Veterans Health Administration. 

Sec. 219. The Committee includes a provision outlining transfer 

authority for the Information Technology Systems account. 

Sec. 220. The Committee includes a provision prohibiting any 

funds to be used to contract out any functions performed by more 

than 10 employees without a fair competition process. 

Sec. 221. The Committee includes a provision allowing for the 

transfer of funds from certain accounts to the Joint Department of 

Defense/Department of Veterans Affairs Medical Facility Demonstration Fund, as authorized by Public Law 111–84. 

Sec. 222. The Committee includes a provision allowing for the 

transfer of funds from certain advance appropriation accounts to 

the Joint Department of Defense/Department of Veterans Affairs 

Medical Facility Demonstration Fund, as authorized by Public Law 

111–84. 

Sec. 223. The Committee includes a provision allowing for the 

transfer of certain funds deposited in the Medical Care Collections 

Fund to the Joint Department of Defense/Department of Veterans 

Affairs Medical Facility Demonstration Fund, as authorized by 

Public Law 111–84. 

Sec. 224. The Committee includes a provision directing a min- imum of $15,000,000 be transferred from Medical Services, Medical 

Support and Compliance, and Medical Facilities to the Department 

of Defense/Department of Veterans Affairs Health Care Sharing Incentive Fund, as authorized by section 8111 of title 38, United 

States Code. 

Sec. 225. The Committee includes a provision directing the Department to make every effort to fund State Veterans Nursing 

Home Construction grants on the fiscal year 2017 list. 

Sec. 226. The Committee includes a provision requiring notification of all bid savings for major construction projects. 

Sec. 227. The Committee includes a provision restricting scope 

increases for major construction projects above that specified in the 

original project justification. 

Sec. 228. The Committee includes a provision requiring the Department to submit reports relating to the Veterans Benefits Administration on claims processing at Regional Offices. 

Sec. 229. The Committee includes a provision limiting the funding from the Medical Support and Compliance account for the 

VistA Evolution and electronic health record interoperability 

projects. 

Sec. 230. The Committee includes a provision requiring VA to notify the Committee 15 days prior to any organizational changes 

within VA of 25 or more FTE. 

Sec. 231. The Committee includes a provision directing funding 

for non-recurring maintenance. 
86 

Sec. 232. The Committee includes a provision permitting the 

transfer to the Medical Services account of fiscal year discretionary 

2018 appropriated funds. 

Sec. 233. The Committee includes a provision permitting the 

transfer of funds between GOE,VBA and BVA. 

Sec. 234. The Committee includes a provision prohibiting the re- programming of funds in excess of $7,000,000 among major construction projects or programs. 

Sec. 235. The Committee includes a provision rescinding unobligated balances from the DoD–VA Health Care Sharing Incentive 

Fund. 

Sec. 236. The Committee includes a provision pertaining to Native Hawaiian small businesses. 

Sec. 237. The Committee includes a provision limiting bonuses 

for senior executives. 

Sec. 238. The Committee includes a provision directing the discontinuation of the usage of social security numbers with the Department of Veterans Affairs. 

Sec. 239. The Committee includes a provision pertaining to the 

certification of marriage and family therapists. 

Sec. 240. The Committee includes a provision restricting funds 

for the purpose of using groups of subject matter experts to evaluation compensation claims. 

Sec. 241. The Committee includes a provision prohibiting the 

transfer of funds from the Filipino Veterans Equity Compensation 

Fund to any other VA account. 

Sec. 242. The Committee includes a provision denying or revoking the eligibility of a healthcare provider to provide non-VA care 

for various reasons. 

Sec. 243. The Committee includes a provision relating to the 

availability of Construction, Major Projects funds. 

Sec. 244. The Committee includes a provision relating to the 

availability of Construction, Major Projects funds. 

Sec. 245. The Committee includes a provision regarding a 

childcare program. 

Sec. 246. The Committee includes a provision relating to the 

availability of chiropractic care. 

Sec. 247. The Committee includes a provision on a pilot program 

for the education and training of physician assistants. 

Sec. 248. The Committee includes a provision on coastwise merchant seamen. 

Sec. 249. The Committee includes a provision on fertility treatment and counseling for service-connected disabled veterans. 

Sec. 250. The Committee includes a provision rescinding funds 

from the Information Technology Systems account. 

Sec. 251. The Committee includes a provision related to a demand profile for healthcare services. 

Sec. 252. The Committee includes a provision regarding uniform 

access standards for healthcare services. 

Sec. 253. The Committee includes a provision regarding vacant, 

mostly vacant, or underutilized buildings and structures. 

Sec. 254. The Committee includes a provision ensuring particular 

ratios of veterans to full-time employment equivalents within any 

VA program of rehabilitation. 
87 

Sec. 255. The Committee includes a provision indicating that no 

funds may be used to deny the Inspector General timely access to 

VA records and documents. 

Sec. 256. The Committee includes a provision prohibiting funds 

to be used to restrict an individual’s ability to speak with a Member of Congress or his or her staff. 

Sec. 257. The Committee includes a provision providing authority 

for VHA to administer the National Veterans Sports Program. 

Sec. 258. The Committee includes a provision requiring certain 

data to be included in the budget justifications for the Construction, Major account. 

Sec. 259. The Committee includes a provision related to the 

Rural Veterans Coordination Pilot. 

Sec. 260. The Committee includes a provision on a national realignment strategy for VA facilities. 

Sec. 261. The Committee includes a provision concerning eligibility for burial at National Cemetery Administration cemeteries. 

Sec. 262. The Committee includes a provision related to veteran 

health and wellness programs. 

Sec. 263. The Committee includes a provision regarding new construction in the State Extended Care Facilities grant program. 

Sec. 264. The Committee includes a provision related to eligibility for certain medical services for veterans with other than honorable discharges. 

Sec. 265. The Committee includes a provision prohibiting the use 

of funds to interfere with the ability of veterans to participate in 

State-approved medicinal marijuana programs or deny services to 

such veterans. 
(88) 

TITLE III 

RELATED AGENCIES 

AMERICAN BATTLE MONUMENTS COMMISSION

OVERVIEW

The American Battle Monuments Commission was established by 

Congress in 1923 and is responsible for the following: designing, 

constructing, operating, and maintaining permanent American 

cemeteries in foreign countries; establishing and maintaining U.S. 

military memorials, monuments, and markers where American 

Armed Forces have served overseas since April 6, 1917, the date 

of the United States entry into World War I, and within the United 

States when directed by public law; and controlling the design and 

construction of permanent U.S. military monuments and markers 

by other U.S. citizens and organizations, both public and private, 

and encouraging their maintenance. ABMC administers, operates, 

and maintains 26 permanent American military cemeteries, 29 

Federal memorial, monuments, and markers, and 8 non-Federal 

memorials located in 15 foreign countries, the U.S. Commonwealth 

of the Northern Mariana Islands, the British Dependency of Gibraltar, and the United States of America. 

SALARIES AND EXPENSES

Appropriations, 2017 ............................................................................. $75,100,000 

Budget estimate, 2018 ........................................................................... 75,100,000 

Committee recommendation ................................................................. 79,000,000 

COMMITTEE RECOMMENDATION

The Committee recommends $79,000,000 for the Salaries and Expenses account. This amount is $3,900,000 above the fiscal year 

2017 enacted level and the budget request. The recommendation 

includes an additional $3,900,000 to bolster the Commission’s 

maintenance and infrastructure program, including the interpretive program. The additional funds will restore the reduction proposed in the budget request for this program and provide additional funds to accelerate the Commission’s 5-year plan, not only 

to maintain the cemeteries and monuments honoring America’s 

war dead, but also to preserve and communicate these veterans’ 

stories of courage and sacrifice. 

FOREIGN CURRENCY FLUCTUATIONS

The Committee includes in the accompanying act, as proposed by 

the administration, such sums as necessary for the Foreign Currency Fluctuations account. Funding the account in this manner allows the Commission to maintain cemeteries regardless of the volatility of foreign currency fluctuations. 
89 

UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS

OVERVIEW

The United States Court of Appeals for Veterans Claims was established by the Veterans’ Judicial Review Act of 1988. The Court 

is an independent judicial tribunal with exclusive jurisdiction to review decisions of the Board of Veterans Appeals. It has the authority to decide all relevant questions of law; interpret constitutional, 

statutory, and regulatory provisions; and determine the meaning or 

applicability of the terms of an action by the Secretary of Veterans 

Affairs. It is authorized to compel action by the Secretary. It is authorized to hold unconstitutional or otherwise unlawful and set 

aside decisions, findings, conclusions, rules, and regulations issued 

or adopted by the Secretary of Veterans Affairs, the Board of Veterans Appeals, or the Chairman of the Board that are found to be 

arbitrary or capricious. The Court’s principal office location is 

Washington, DC; however, it is a national court, empowered to sit 

anywhere in the United States. 

SALARIES AND EXPENSES

Appropriations, 2017 ............................................................................. $30,945,000 

Budget estimate, 2018 ........................................................................... 33,608,000 

Committee recommendation ................................................................. 33,608,000 

COMMITTEE RECOMMENDATION

The Committee recommends $33,608,000 for the U.S. Court of 

Appeals for Veterans Claims. This amount is $2,663,000 above the 

fiscal year 2017 enacted level and equal to the budget request. The 

Committee recommends $800,000 to be transferred to the General 

Services Administration for the planning and design of a new 

courthouse as included in the budget request. 

DEPARTMENT OF DEFENSE—CIVIL

CEMETERIAL EXPENSES, ARMY

OVERVIEW

The Secretary of the Army is responsible for the administration, 

operation, and maintenance of Arlington National Cemetery and 

the Soldiers’ and Airmen’s Home National Cemetery. In addition to 

its principal function as a national cemetery, Arlington hosts more 

than 3,000 public wreath laying ceremonies, approximately 100 distinguished visitor honors wreath laying ceremonies, and approximately 4,000,000 visitors annually. 

SALARIES AND EXPENSES

Appropriations, 2017 ............................................................................. $70,800,000 

Budget estimate, 2018 ........................................................................... 70,800,000 

Committee recommendation ................................................................. 81,000,000 

COMMITTEE RECOMMENDATION

The Committee recommends $81,000,000 for the Salaries and Expenses account. This amount is $10,200,000 above both the fiscal 

year 2017 enacted level and the budget request. 
90 

The Committee convened a field hearing at Arlington National 

Cemetery on March 29, 2017, which was a fitting and special place 

to hold the Committee’s first hearing of this Congress. The field 

hearing was very informative and productive and carefully examined the Cemetery’s current operations and workload, existing expansion plans, and the serious capacity constraints on the Cemetery in the 2040–2050 timeframe. 

The hearing identified a significant shortfall in the Cemetery’s 

operating account which directly funds the Cemetery’s day-to-day 

operations, salaries, maintenance, and expenses. The Committee 

determined ANC’s operating account had been held artificially flat 

for a number of years, and this action is beginning to have deleterious effects on the Cemetery’s performance and ability to meet its 

mission. 

Arlington performs over 7,000 burial services each year for veterans and family members and an average of 27–30 each weekday. 

With this heavy workload, ANC cannot be under-resourced, and accordingly, the Committee has provided an additional $10,200,000 to 

correct this problem. 

This Committee will be unwavering in its support for the Cemetery and the successful completion of the Cemetery’s truly unique 

and honored mission. Accordingly, the Secretary of the Army is directed to include this increase in the Cemetery’s baseline budget 

and ensure future budget requests provide ample resources for Arlington National Cemetery. 

ARMED FORCES RETIREMENT HOME

TRUST FUND

OVERVIEW

Appropriations, 2017 ............................................................................. $64,300,000 

Budget estimate, 2018 ........................................................................... 64,300,000 

Committee recommendation ................................................................. 64,300,000 

COMMITTEE RECOMMENDATION

The Committee recommends authority to expend $64,300,000 

from the Armed Forces Retirement Home [AFRH] Trust Fund to 

operate and maintain the Armed Forces Retirement Home—Washington, DC, and the Armed Forces Retirement Home—Gulfport, 

Mississippi. 

Trust Fund Solvency.—The Explanatory Statement accompanying H.R. 5325, the Continuing Appropriations and Military 

Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2017, and Zika Response and Preparedness Act (Public 

Law 114–223) directed AFRH and the Department of Defense to 

submit by October 1, 2016, a proposal to ensure the long-term sustainability of the Trust Fund by replenishing the Trust Fund’s revenues, not by cutting core AFRH operations. The Committee also 

requested further information regarding an in-depth study that 

DoD has undertaken to develop plans to improve Trust Fund solvency. The Committee is disappointed to note neither this report 

nor the requested information has been made available as directed. 

AFRH and DoD are directed to deliver these materials as soon as 
91 

possible to the Committees on Appropriations of both Houses of 

Congress. 

ADMINISTRATIVE PROVISIONS

Sec. 301. The Committee includes a provision allowing the relocation of a federally owned water main. 

Sec. 302. The Committee includes a provision making available 

funds as authorized by 10 U.S.C. 4727. 
(92) 

TITLE IV 

OVERSEAS CONTINGENCY OPERATIONS 

DEPARTMENT OF DEFENSE 

The Committee recommends title IV, Overseas Contingency Operations, for military construction projects related to the Global 

War on Terrorism and the European Reassurance Initiative that 

were requested by the Administration in the Fiscal Year 2018 

Overseas Contingency Operations [OCO] budget request. 

MILITARY CONSTRUCTION, ARMY

The Committee recommends $139,700,000 for ‘‘Military Construction, Army’’, as requested in the Fiscal Year 2018 Overseas Contingency Operations budget request, for military construction and 

planning and design in support of Overseas Contingency Operations and the European Reassurance Initiative. 

MILITARY CONSTRUCTION, NAVY AND MARINE CORPS

The Committee recommends $18,500,000 for ‘‘Military Construction, Navy and Marine Corps’’, as requested in the Fiscal Year 

2018 Overseas Contingency Operations budget request, for planning and design in support of the European Reassurance Initiative. 

MILITARY CONSTRUCTION, AIR FORCE

The Committee recommends $478,030,000 for ‘‘Military Construction, Air Force’’, as requested in the Fiscal Year 2018 Overseas 

Contingency Operations budget request, for military construction 

and planning and design in support of Overseas Contingency Operations and the European Reassurance Initiative. 

MILITARY CONSTRUCTION, DEFENSE-WIDE

The Committee recommends $1,900,000 for ‘‘Military Construction, Defense-Wide’’, as requested in the Fiscal Year 2018 Overseas 

Contingency Operations budget request, for planning and design in 

support of the European Reassurance Initiative. 

ADMINISTRATIVE PROVISION

SEC. 401. The Committee includes a provision which provides the 

contingent emergency designation for the Overseas Contingency 

Operations accounts. 
93 

TITLE V 

GENERAL PROVISIONS 

Sec. 501. The Committee includes a provision that prohibits the 

obligation of funds beyond the current fiscal year unless expressly 

so provided. 

Sec. 502. The Committee includes a provision that prohibits the 

use of funds for programs, projects, or activities not in compliance 

with Federal law relating to risk assessment, the protection of private property rights, or unfunded mandates. 

Sec. 503. The Committee includes a provision that encourages 

the expansion of E-commerce technologies and procedures. 

Sec. 504. The Committee includes a provision that specifies the 

congressional committees that are to receive all reports and notifications. 

Sec. 505. The Committee includes a provision that limits funds 

from being transferred from this appropriations measure to any instrumentality of the United States Government without authority 

from an appropriations act. 

Sec. 506. The Committee includes a provision regarding the posting of congressional reports on agency Web sites. 

Sec. 507. The Committee includes a provision prohibiting the use 

of funds to establish or maintain a computer network unless such 

network blocks the viewing, downloading, and exchanging of pornography, except for law enforcement investigation, prosecution, or 

adjudication activities. 

Sec. 508. The Committee includes a provision prohibiting the use 

of funds for the payment of first-class travel by an employee of the 

executive branch. 

Sec. 509. The Committee includes a provision limiting the construction of facilities in the United States, its territories, or possessions for the purposes of housing individuals detained at 

Guanta ́namo Bay, Cuba. 
(94) 

PROGRAM, PROJECT, AND ACTIVITY 

In fiscal year 2017, for purposes of the Balanced Budget and 

Emergency Deficit Control Act of 1985 (Public Law 99–177) or the 

Balanced Budget and Emergency Deficit Control Reaffirmation Act 

of 1987 (Public Law 100–119), the following information provides 

the definition of the term ‘‘program, project, and activity’’ for departments, agencies and programs under the jurisdiction of the 

Military Construction and Veterans Affairs, and Related Agencies 

subcommittee. The term ‘‘program, project, and activity’’ shall include the most specific level of budget items identified in the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2017, the House and Senate Committee reports, and 

the conference report and accompanying joint explanatory statement of managers of the committee of conference. 

If a sequestration order is necessary, in implementing the Presidential order, departments, and agencies shall apply any percentage reduction required for fiscal year 2017 pursuant to the provisions of Public Law 99–177 or Public Law 100–119 to all items 

specified in the justifications submitted to the Committees on Appropriations of the Senate and House of Representatives in support 

of the fiscal year 2017 budget estimates, as amended, for such departments and agencies, as modified by congressional action, and 

in addition, for the Department of Defense, Military Construction, 

the definition shall include specific construction locations as identified in the explanatory notes. 

COMPLIANCE WITH PARAGRAPH 7, RULE XVI, OF THE 

STANDING RULES OF THE SENATE 

Paragraph 7 of rule XVI requires that Committee reports accompanying general appropriations bills identify each recommended 

amendment which proposes an item of appropriation which is not 

made to carry out the provisions of an existing law, a treaty stipulation, or an act or resolution previously passed by the Senate during that session. 

The Committee recommends funding for the following programs 

which currently lack authorization: 

Title I: Department of Defense 

Military Construction, Army 

Military Construction, Navy and Marine Corps 

Military Construction, Air Force 

Military Construction, Defense-Wide 

Military Construction, Army National Guard 

Military Construction, Air National Guard 

Military Construction, Army Reserve 

Military Construction, Navy Reserve 

Military Construction, Air Force Reserve 
95 

North Atlantic Treaty Organization Security Investment Program 

Department of Defense Base Closure Account 

Family Housing Operation and Maintenance, Army 

Family Housing Operation and Maintenance, Navy and Marine 

Corps 

Family Housing Operation and Maintenance, Air Force 

Family Housing Operation and Maintenance, Defense-Wide 

Family Housing Construction, Army 

Family Housing Construction, Navy and Marine Corps 

Family Housing Construction, Air Force 

Department of Defense Family Housing Improvement Fund 

Department of Defense Military Unaccompanied Housing Improvement Fund 

Title II: Department of Veterans Affairs 

Veterans Benefits Administration 

Veterans Health Administration 

National Cemetery Administration 

Departmental Administration 

Title III: Related Agencies 

American Battle Monuments Commission 

U.S. Court of Appeals for Veterans Claims 

Cemeterial Expenses, Army 

Armed Forces Retirement Home 
96 

COMPLIANCE WITH PARAGRAPH 7(c), RULE XXVI OF THE 

STANDING RULES OF THE SENATE 

Pursuant to paragraph 7(c) of rule XXVI, on July 13, 2017, the 

Committee ordered favorably reported a bill (S. 1557) making appropriations for military construction, the Department of Veterans 

Affairs, and related agencies for the fiscal year ending September 

30, 2018, and for other purposes, provided, that the bill be subject 

to amendment and that the bill be consistent with the funding 

level approved by the subcommittee, by a recorded vote of 31–0, a 

quorum being present. The vote was as follows: 

Yeas Nays 

Chairman Cochran 

Mr. McConnell 

Mr. Shelby 

Mr. Alexander 

Ms. Collins 

Ms. Murkowski 

Mr. Graham 

Mr. Blunt 

Mr. Moran 

Mr. Hoeven 

Mr. Boozman 

Mrs. Capito 

Mr. Lankford 

Mr. Daines 

Mr. Kennedy 

Mr. Rubio 

Mr. Leahy 

Mrs. Murray 

Mrs. Feinstein 

Mr. Durbin 

Mr. Reed 

Mr. Tester 

Mr. Udall 

Mrs. Shaheen 

Mr. Merkley 

Mr. Coons 

Mr. Schatz 

Ms. Baldwin 

Mr. Murphy 

Mr. Manchin 

Mr. Van Hollen 
97 

COMPLIANCE WITH PARAGRAPH 12, RULE XXVI OF THE 

STANDING RULES OF THE SENATE 

Paragraph 12 of rule XXVI requires that Committee reports on 

a bill or joint resolution repealing or amending any statute or part 

of any statute include ‘‘(a) the text of the statute or part thereof 

which is proposed to be repealed; and (b) a comparative print of 

that part of the bill or joint resolution making the amendment and 

of the statute or part thereof proposed to be amended, showing by 

stricken-through type and italics, parallel columns, or other appropriate typographical devices the omissions and insertions which 

would be made by the bill or joint resolution if enacted in the form 

recommended by the committee.’’ 

In compliance with this rule, changes in existing law proposed to 

be made by the bill are shown as follows: existing law to be omitted 

is enclosed in black brackets; new matter is printed in italic; and 

existing law in which no change is proposed is shown in roman. 

TITLE 38—VETERANS’ BENEFITS 

PART II—GENERAL BENEFITS

CHAPTER 5—AUTHORITY AND DUTIES OF THE SECRETARY

SUBCHAPTER II—SPECIFIED FUNCTIONS

§ 523. Coordination and promotion of other programs affecting veterans and their dependents 

PILOT PROGRAM ON USE OF COMMUNITY-BASED ORGANIZATIONS AND

LOCAL AND STATE GOVERNMENT ENTITIES TO ENSURE THAT VETERANS RECEIVE CARE AND BENEFITS FOR WHICH THEY ARE ELIGIBLE

‘‘(a) PILOT PROGRAM REQUIRED.—* * * 

* * * * * * * 

‘‘ø(b) DURATION OF PROGRAM.—The pilot program shall be carried out during the 2-year period beginning on the date that is 180 

days after the date of the enactment of this Act [May 5, 2010].¿ 

(b) DURATION OF PROGRAM.—The Secretary may not carry out 

the pilot program after September 30, 2019. 

‘‘(c) PROGRAM LOCATIONS.— 

‘‘(1) IN GENERAL.—* * * 

‘‘(2) CONSIDERATIONS.—In selecting locations for the pilot 

program, the Secretary shall consider the advisability of selecting 

locations in— 

‘‘(A) * * * 

* * * * * * * 

‘‘(D) * * * 

(3) ADDITIONAL LOCATIONS.—The Secretary may expand the 

pilot program to include additional locations if the Secretary rec-
98 

ommends that the pilot program be expanded in the initial report 

submitted under subsection (g)(2)(C). 

* * * * * * * 

‘‘(g) øREPORT ON PROGRAM¿ REPORTS.— 

‘‘(1) IN GENERAL.—Not later than September 30, 2017 and 

not later than 180 days after the completion of the pilot program, 

the Secretary shall submit to Congress a report on the pilot program. 

‘‘(2) ELEMENTS.—øThe report¿ Each report required by paragraph (1) shall include the following: 

‘‘(A) * * * 

* * * * * * * 

‘‘(C) The recommendations of the Secretary as to the advisability of continuing or expanding the pilot program. 

* * * * * * * 

CHAPTER 17—HOSPITAL, NURSING HOME, DOMICILIARY, AND

MEDICAL CARE

SUBCHAPTER I—GENERAL

§ 1701. Definitions 

For the purpose of this chapter— 

(1) * * * 

* * * * * * * 

(6) The term ‘‘medical services’’ includes, in addition to medical 

examination, treatment, and rehabilitative services, the following: 

(A) Surgical services. 

* * * * * * * 

(G) Travel and incidental expenses pursuant to section 111 

of this title. 

(H) Chiropractic services. 

* * * * * * * 

(8) The term ‘‘rehabilitative services’’ means such professional, 

chiropractic, counseling, and guidance services and treatment programs as are necessary to restore, to the maximum extent possible, 

the physical, mental, and psychological functioning of an ill or disabled person. 

(9) The term ‘‘preventive health services’’ means— 

(A) periodic medical and dental examinations; 

* * * * * * * 

(F) periodic and preventive chiropractic examinations and 

services; 

ø(F)¿ (G) immunizations against infectious diseases, including each immunization on the recommended adult immunization 

schedule at the time such immunization is indicated on that schedule; 
99 

ø(G)¿ (H) prevention of musculoskeletal deformity or other 

gradually developing disabilities of a metabolic or degenerative nature; 

ø(H)¿ (I) genetic counseling concerning inheritance of genetically determined diseases; 

ø(I)¿ (J) routine vision testing and eye care services; 

ø(J)¿ (K) periodic reexamination of members of likely target 

populations (high-risk groups) for selected diseases and for functional decline of sensory organs, together with attendant appropriate remedial intervention; and 

ø(K)¿ (L) such other health-care services as the Secretary 

may determine to be necessary to provide effective and economical 

preventive health care. 

* * * * * * * 

SUBCHAPTER II—HOSPITAL, NURSING HOME, OR DOMICILIARY CARE

AND MEDICAL TREATMENT

Sec. 

1710. Eligibility for hospital, nursing home, and domiciliary care 

* * * * * * * 

1712C. Dental insurance plan for veterans and survivors and dependents of veterans 

1712D. Mental and behavioral health care for certain individuals discharged or released from the active military, naval, or air service under conditions 

other than honorable 

SUBCHAPTER II—HOSPITAL, NURSING HOME, OR DOMICILIARY CARE

AND MEDICAL TREATMENT

§ 1710. Eligibility for hospital, nursing home, and domiciliary care 

CHIROPRACTIC TREATMENT

‘‘(a) REQUIREMENT FOR PROGRAM.—* * * 

* * * * * * * 

‘‘(c) LOCATION OF PROGRAM.—(1) The program shall be carried 

out at sites designated by the Secretary for purposes of the program. The Secretary shall designate at least one site for such program in each geographic service area of the Veterans Health Administration. The sites so designated shall be medical centers and 

clinics located in urban areas and in rural areas. 

(2) The program shall be carried out at not fewer than two 

medical centers or clinics in each Veterans Integrated Service 

Network by not later than December 31, 2019, and at not fewer 

than 50 percent of all medical centers in each Veterans Integrated Service Network by not later than December 31, 2021. 

* * * * * * * 
100 

§ 1712C. Dental insurance plan for veterans and survivors 

and dependents of veterans 

(a) IN GENERAL.—* * * 

* * * * * * * 

(j) TERMINATION.—This section terminates on December 31, 

2021. 

§ 1712D. Mental and behavioral health care for certain individuals discharged or released from the active military, naval, or air service under conditions other 

than honorable 

(a) IN GENERAL.—Notwithstanding section 5303(a) of this title 

and subject to subsection (c), the Secretary shall furnish to an eligible individual covered mental and behavioral health care. 

(b) ELIGIBLE INDIVIDUALS.—For purposes of this section, an eligible individual is any of the following: 

(1) An individual who— 

(A) served in the active military, naval, or air service for a 

period of more than 180 days and was deployed in a theater of 

combat operations, in support of a contingency operation, or in 

an area at a time during which hostilities are occurring in that 

area, for a period of more than 30 days during such service; 

(B) was discharged or released from such service by reason of 

committing a covered offense; and 

(C) was diagnosed by a qualified mental health care provider 

with a mental or behavioral health condition before committing 

the covered offense. 

(2) An individual who— 

(A) served in the active military, naval, or air service for a 

period of more than 180 days and was deployed in a theater of 

combat operations, in support of a contingency operation, or in 

an area at a time during which hostilities are occurring in that 

area, for a period of more than 30 days during such service; 

(B) was discharged or released from such service by reason of 

committing a covered offense; 

(C) is diagnosed with a mental or behavioral health condition 

after committing such covered offense but before the expiration 

of the five-year period beginning on the later of— 

(i) the date of the enactment of this section; or 

(ii) the date on which the individual is discharged or released from such service; 

(D) submits to the Secretary— 

(i) a certification from a qualified mental health care provider that the provider believes such condition may have led the 

individual to commit such offense; and 

(ii) the Certificate of Release or Discharge from Active Duty 

(DD Form 214) of the individual; and 

(E) is determined by the Secretary pursuant to subsection (c) 

to have had a mental or behavioral health condition at the time 
101 

the individual committed the covered offense that contributed to 

the commission of the offense. 

(c) DETERMINATION BY SECRETARY.—(1) Not later than 90 days 

after receiving the information submitted under subsection (b)(2)(D) 

with respect to an individual,23 the Secretary shall determine 

whether, at the time of committing the covered offense, the individual had a mental or behavioral health condition that contributed 

to the commission of the offense. 

(2) If the Secretary does not make a determination under paragraph (1) with respect to a mental or behavioral health condition 

of an individual before the end of the 90-day period beginning on 

the date of the submittal of the information described in subsection 

(b)(2)(D), the condition is deemed to be a mental or behavioral 

health condition that contributed to the commission of the offense 

until such time as the Secretary makes the determination. 

(d) INITIAL MENTAL HEALTH SCREENING.—(1) The Secretary may 

furnish to each individual described14 in paragraph (2) an initial 

mental health screening not later than the later of— 

(A) five years after the date of the enactment of this section; 

or 

(B) five years after the date on which the individual was discharged or released from the active military, naval, or air service. 

(2) Individuals described in this paragraph are the following: 

(A) Eligible individuals described in subsection (b)(1). 

(B) Individuals described in subparagraphs (A), (B), and 

(C) of subsection (b)(2). 

(3) The mental health screening provided to an individual 

under paragraph (1) shall be at no cost to the individual. 

(e) NOTIFICATION OF ELIGIBILITY.—The Secretary shall notify each 

eligible individual described in subsection (b)(1) about the eligibility 

of the individual for covered mental and behavioral health care 

under this section not later than the later of— 

(1) 180 days after the date of the enactment of this section; or 

(2) 180 days after the date on which the individual was discharged or released from the active military, naval, or air service. 

(f) ANNUAL REPORT.—Not less frequently than annually, the Secretary shall submit to the Committee on Veterans’ Affairs of the 

Senate and the Committee on Veterans’ Affairs of the House of Representatives a report that includes, with respect to the year preceding the submittal of the report, the following: 

(1) The number of eligible individuals who were furnished covered mental and behavioral health care under this section. 

(2) The number of individuals who the Secretary determined 

under subsection (c) did not have a mental or behavioral health condition at the time of committing a covered offense that contributed 

to the commission of the offense. 

(3) The number of individuals who requested an initial mental 

health screening under subsection (d). 

(4) The number of individuals who were furnished an initial 

mental health screening under subsection (d). 
102 

(g) DEFINITIONS.—In this section: 

(1) The term ‘‘covered mental and behavioral health care’’ 

means the same types of medical services furnished by the Department to individuals with service-connected mental or behavioral 

health conditions to treat such conditions. 

(2) The term ‘‘covered offense’’ means an offense for which an 

individual is discharged or separated from the active military, 

naval, or air service under conditions other than honorable but not 

a dishonorable discharge or a discharge by court-martial. 

(3) The term ‘‘qualified mental health care provider’’ means a 

licensed or certified health care provider whose scope of practice includes diagnosing mental or behavioral health conditions and includes physicians, psychologists, psychiatric nurse practitioners, 

physician assistants, clinical social workers, and licensed professional counselors. 

* * * * * * * 

CHAPTER 24—NATIONAL CEMETERIES AND MEMORIALS

§ 2402. Persons eligible for interment in national cemeteries 

(a) * * * 

(1) * * * 

* * * * * * * 

(9)(A) * * * 

(B) * * * 

(i) * * * 

* * * * * * * 

(iii) undergoing that hospitalization or treatment at 

the expense of the United States. 

(10) Any individual— 

(A) who— 

(i) was naturalized pursuant to section 2(1) of the 

Hmong Veterans’ Naturalization Act of 2000 (Public Law 

106–207; 8 U.S.C. 1423 note); and 

(ii) at the time of the individual’s death resided in the 

United States; or 

(B) who— 

(i) the Secretary determines served honorably with a 

special guerrilla unit or irregular forces operating from a 

base in Laos in support of the Armed Forces of the United 

States at any time during the period beginning February 

28, 1961, and ending May 7, 1975; and 

(ii) at the time of the individual’s death— 

(I) was a citizen of the United States or an alien lawfully admitted for permanent residence in the United 

States; and 

(II) resided in the United States. 

* * * * * * * 
103 

PART VI—ACQUISITION AND DISPOSITION OF PROPERTY

CHAPTER 81—ACQUISITION AND OPERATION OF HOSPITAL AND

DOMICILIARY FACILITIES; PROCUREMENT AND SUPPLY; ENHANCED-USE LEASES OF REAL PROPERTY

SUBCHAPTER III—STATE HOME FACILITIES FOR FURNISHING

DOMICILIARY, NURSING HOME, AND HOSPITAL CARE

§ 8135. Applications with respect to projects; payments 

(a) * * * 

* * * * * * * 

(c)(1) * * * 

(2) Subject to øparagraphs (3) and (5)(C)¿ paragraphs (3), 

(4)(B), and (5)(C) of this subsection, the Secretary shall accord priority to applications in the following order: 

* * * * * * * 

(4) øThe Secretary¿ (A) The Secretary shall establish a list 

of approved projects (including projects that have been conditionally approved under paragraph (6) of this subsection), in the 

order of their priority, as of August 15 of each year. The Secretary 

shall award grants in the order of their priority on the list during 

the fiscal year beginning on October 1 of the calendar year in 

which the list was made. 

(B) With respect to a project that is approved in a fiscal 

year but for which a grant has not been awarded under this 

subchapter in that fiscal year, the Secretary may not accord a 

lower priority on the list described in subparagraph (A) to that 

project in any subsequent fiscal year (as compared to the priority accorded that project in any previous fiscal year) unless 

the reason for such lower priority is the inclusion in such list 

of a project described in subparagraph (A) or (B) of paragraph 

(2). 

* * * * * * * 

(7)(A) * * * 

(B) A grant may not be increased under subparagraph (A) 

of this paragraph by more than 10 percent of the amount of 

the grant initially awarded for such project, and the amount of 

such grant, as increased, may not exceed 65 percent of the cost 

of the project. 

(8) In determining under subparagraphs (D), (F), and (H) of 

paragraph (2) whether a State has a great, significant, or limited 

need for beds in connection with an application under subsection 

(a), the Secretary shall— 

(A) consider the availability and accessibility to individuals 

in that State of private facilities providing similar care to the 

care for which the application is submitted under such subsection; and 

(B) accord a lower priority in the list established under 

paragraph (4) to applications by States with a significant number of such private facilities, as determined by the Secretary. 
104 

CONTINUING APPROPRIATIONS AND MILITARY CONSTRUCTION, VETERANS AFFAIRS, AND RELATED 

AGENCIES APPROPRIATIONS ACT, 2017, AND ZIKA RESPONSE AND PREPAREDNESS ACT, PUBLIC LAW 114– 

223 

DIVISION A—MILITARY CONSTRUCTION AND VETERANS 

AFFAIRS, AND RELATED AGENCIES APPROPRIATIONS 

ACT, 2017 

* * * * * * * 

TITLE II 

DEPARTMENT OF VETERANS AFFAIRS 

ADMINISTRATIVE PROVISIONS

* * * * * * * 

ø(INCLUDING TRANSFER OF FUNDS)

SEC. 222. Of the amounts appropriated to the Department of 

Veterans Affairs which become available on October 1, 2017, for 

‘‘Medical Services’’, ‘‘Medical Support and Compliance’’, and ‘‘Medical Facilities’’, up to $280,802,000, plus reimbursements, may be 

transferred to the Joint Department of Defense-Department of Veterans Affairs Medical Facility Demonstration Fund, established by 

section 1704 of the National Defense Authorization Act for Fiscal 

Year 2010 (Public Law 111–84; 123 Stat. 3571) and may be used 

for operation of the facilities designated as combined Federal medical facilities as described by section 706 of the Duncan Hunter National Defense Authorization Act for Fiscal Year 2009 (Public Law 

110–417; 122 Stat. 4500): Provided, That additional funds may be 

transferred from accounts designated in this section to the Joint 

Department of Defense-Department of Veterans Affairs Medical 

Facility Demonstration Fund upon written notification by the Secretary of Veterans Affairs to the Committees on Appropriations of 

both Houses of Congress.¿ Repealed. 
105 

BUDGETARY IMPACT OF BILL 

PREPARED IN CONSULTATION WITH THE CONGRESSIONAL BUDGET OFFICE PURSUANT TO SEC. 

308(a), PUBLIC LAW 93–344, AS AMENDED 

[In millions of dollars] 

Budget authority Outlays 

Allocation 1 Amount 

in bill Allocation 1 Amount in bill 

Comparison of amounts in the bill with the subcommittee 

allocation for 2018: Subcommittee on Military Construction and Veterans Affairs, and Related Agencies: 

Mandatory .................................................................... 97,618 97,618 97,272 2 97,272 

Discretionary ................................................................ 88,211 88,849 84,677 2 84,683 

Security ............................................................... 9,536 10,174 NA NA 

Nonsecurity ......................................................... 78,675 78,675 NA NA 

Projections of outlays associated with the recommendation: 

2018 ............................................................................. ...................... ...................... ...................... 3 104,134 

2019 ............................................................................. ...................... ...................... ...................... 5,151 

2020 ............................................................................. ...................... ...................... ...................... 4,108 

2021 ............................................................................. ...................... ...................... ...................... 2,819 

2022 and future years ................................................ ...................... ...................... ...................... 2,195 

Financial assistance to State and local governments for 

2018 ................................................................................. NA 234 NA 3 52 

1 There is no section 302(a) allocation to the Committee on Appropriations for fiscal year 2018. 

2 Includes outlays from prior-year budget authority. 

3 Excludes outlays from prior-year budget authority. 

NA: Not applicable. 

NOTE.—Consistent with the funding recommended in the bill for overseas contingency operations and in accordance with subparagraph 

(A)(ii) of section 251(b)(2) of the BBEDCA of 1985, the Committee anticipates that the Budget Committee will provide, at the appropriate 

time, a 302(a) allocation for the Committee on Appropriations reflecting an upward adjustment of $638,000,000 in budget authority plus the 

associated outlays. 
106 

MILITARY CONSTRUCTION PROJECT LISTING BY LOCATION 

[In thousands of dollars] 

Installation and project Budget 

estimate 

Committee recommendation 

Committee recommendation 

compared to 

budget estimate 

ALABAMA 

ARMY: 

FORT RUCKER: 

TRAINING SUPPORT FACILITY ................................................... 38,000 38,000 ........................

ALASKA 

AIR FORCE: 

EIELSON AFB: 

F–35A ADAL CONVENTIONAL MUNITIONS FACILITY .................. 2,500 2,500 ........................

F–35A AGE FACILITY / FILLSTAND ........................................... 21,000 21,000 ........................

F–35A CONSOLIDATED MUNITIONS ADMIN FACILITY ................ 27,000 27,000 ........................

F–35A EXTEND UTILIDUCT TO SOUTH LOOP ............................ 48,000 48,000 ........................

F–35A OSS/WEAPONS/INTEL FACILITY ...................................... 11,800 11,800 ........................

F–35A R–11 FUEL TRUCK SHELTER ........................................ 9,600 9,600 ........................

F–35A SATELLITE DINING FACILITY .......................................... 8,000 8,000 ........................

REPAIR CENTRAL HEAT/POWER PLANT BOILER PH 4 .............. 41,000 41,000 ........................

TOTAL, ALASKA .............................................................................. 168,900 168,900 ........................

ARIZONA 

ARMY: 

DAVIS-MONTHAN AFB: 

GENERAL INSTRUCTION BUILDING ........................................... 22,000 22,000 ........................

FORT HUACHUCA: 

GROUND TRANSPORT EQUIPMENT BUILDING ........................... 30,000 30,000 ........................

NAVY: 

YUMA: 

ENLISTED DINING FACILITY & COMMUNITY BLDGS .................. 36,358 36,358 ........................

TOTAL, ARIZONA ................................................................... 88,358 88,358 ........................

CALIFORNIA 

ARMY: 

FORT IRWIN: 

LAND ACQUISITION ................................................................... 3,000 3,000 ........................

NAVY: 

BARSTOW: 

COMBAT VEHICLE REPAIR FACILITY ......................................... 36,539 36,539 ........................

CAMP PENDLETON: 

AMMUNITION SUPPLY POINT UPGRADE .................................... 61,139 61,139 ........................

LEMOORE: 

F/A 18 AVIONICS REPAIR FACILITY REPLACEMENT .................. 60,828 60,828 ........................

MIRAMAR: 

AIRCRAFT MAINTENANCE HANGAR (INC 2) .............................. 39,600 39,600 ........................

TWENTYNINE PALMS: 

POTABLE WATER TREATMENT/BLENDING FACILITY .................. 55,099 55,099 ........................

AIR FORCE: 

TRAVIS AFB: 

Note: Budget request is under worldwide unspecified Air 

Force. The Secretary of the Air Force determined the specific projects and costs after the submission. 

AIRCRAFT 3–BAY MAINTENANCE HANGAR ............................... ........................ 107,000 ∂107,000 

ALTER B811 CORROSION CONTROL HANGAR .......................... ........................ ........................ ........................

ALTER B181/185/187 SQUAD OPS/AMU ................................... ........................ ........................ ........................

ADAL D14 FUEL CELL HANGAR ................................................ ........................ ........................ ........................

DEFENSE-WIDE: 

CAMP PENDLETON: 

AMBULATORY CARE CENTER REPLACEMENT ........................... 26,400 26,400 ........................

SOF MARINE BATTALION COMPANY/TEAM FACILITIES .............. 9,958 9,958 ........................

SOF MOTOR TRANSPORT FACILITY EXPANSION ........................ 7,284 7,284 ........................
107 

MILITARY CONSTRUCTION PROJECT LISTING BY LOCATION—Continued 

[In thousands of dollars] 

Installation and project Budget 

estimate 

Committee 

recommendation 

Committee 

recommendation 

compared to 

budget estimate 

CORONADO: 

SOF BASIC TRAINING COMMAND .............................................. 96,077 96,077 ........................

SOF LOGISTICS SUPPORT UNIT ONE OPS FAC. #3 ................... 46,175 46,175 ........................

SOF SEAL TEAM OPS FACILITY ................................................. 66,218 66,218 ........................

SOF SEAL TEAM OPS FACILITY ................................................. 50,265 50,265 ........................

AIR NATIONAL GUARD: 

MARCH AFB: 

TFI CONSTRUCT RPA FLIGHT TRAINING UNIT ........................... 15,000 15,000 ........................

ARMY RESERVE: 

FALLBROOK: 

ARMY RESERVE CENTER .......................................................... 36,000 36,000 ........................

NAVY RESERVE: 

LEMOORE: 

NAVAL OPERATIONAL SUPPORT CENTER .................................. 17,330 17,330 ........................

TOTAL, CALIFORNIA .............................................................. 626,912 733,912 ∂107,000 

COLORADO 

ARMY: 

FORT CARSON: 

AMMUNITION SUPPLY POINT .................................................... 21,000 21,000 ........................

BATTLEFIELD WEATHER FACILITY ............................................. 8,300 8,300 ........................

AIR FORCE: 

BUCKLEY AIR FORCE BASE: 

SBIRS OPERATIONS FACILITY ................................................... 38,000 38,000 ........................

FORT CARSON, COLORADO: 

13 ASOS EXPANSION ................................................................ 13,000 13,000 ........................

U.S. AIR FORCE ACADEMY: 

AIR FORCE CYBERWORX .......................................................... 30,000 30,000 ........................

DEFENSE-WIDE: 

SCHRIEVER AFB: 

AMBULATORY CARE CENTER/DENTAL ADD./ALT ....................... 10,200 10,200 ........................

AIR NATIONAL GUARD: 

PETERSON AFB: 

SPACE CONTROL FACILITY ....................................................... 8,000 8,000 ........................

TOTAL, COLORADO ........................................................................ 128,500 128,500 ........................

CONNECTICUT 

AIR NATIONAL GUARD: 

BRADLEY IAP: 

CONSTRUCT BASE ENTRY COMPLEX ........................................ 7,000 7,000 ........................

DELAWARE 

ARMY NATIONAL GUARD: 

NEW CASTLE: 

COMBINED SUPPORT MAINTENANCE SHOP .............................. 36,000 36,000 ........................

DISTRICT OF COLUMBIA 

NAVY: 

NSA WASHINGTON: 

ELECTRONICS SCIENCE AND TECHNOLOGY LABORATORY ....... 37,882 37,882 ........................

WASHINGTON NAVY YARD AT/FP .............................................. 60,000 ........................ ¥60,000 

TOTAL, DISTRICT OF COLUMBIA .................................................... 97,882 37,882 ¥60,000 

FLORIDA 

ARMY: 

EGLIN AFB: 

MULTIPURPOSE RANGE COMPLEX ............................................ 18,000 18,000 ........................
108 

MILITARY CONSTRUCTION PROJECT LISTING BY LOCATION—Continued 

[In thousands of dollars] 

Installation and project Budget 

estimate 

Committee recommendation 

Committee recommendation 

compared to 

budget estimate 

NAVY: 

MAYPORT: 

ADVANCED WASTEWATER TREATMENT PLANT .......................... 74,994 74,994 ........................

MISSILE MAGAZINES ................................................................. 9,824 9,824 ........................

AIR FORCE: 

EGLIN AFB: 

F–35A ARMAMENT RESEARCH FAC ADDITION (B614) ............. 8,700 8,700 ........................

LONG–RANGE STAND–OFF ACQUISITION FAC ........................... 38,000 38,000 ........................

MACDILL AFB: 

KC–135 BEDDOWN OG/MXG HQ ............................................... 8,100 8,100 ........................

DEFENSE-WIDE: 

EGLIN AFB: 

SOF SIMULATOR FACILITY ........................................................ 5,000 5,000 ........................

UPGRADE OPEN STORAGE YARD .............................................. 4,100 4,100 ........................

HURLBURT FIELD: 

SOF COMBAT AIRCRAFT PARKING APRON ................................ 34,700 34,700 ........................

SOF SIMULATOR & FUSELAGE TRAINER FACILITY .................... 11,700 11,700 ........................

AIR FORCE RESERVE: 

PATRICK AFB: 

GUARDIAN ANGEL FACILITY ...................................................... 25,000 25,000 ........................

TOTAL, FLORIDA ............................................................................ 238,118 238,118 ........................

GEORGIA 

ARMY: 

FORT BENNING: 

TRAINING SUPPORT FACILITY ................................................... 28,000 28,000 ........................

FORT GORDON: 

ACCESS CONTROL POINT ......................................................... 33,000 33,000 ........................

AUTOMATION–AIDED INSTRUCTIONAL BUILDING ...................... 18,500 18,500 ........................

AIR FORCE: 

ROBINS AFB: 

COMMERCIAL VEHICLE VISITOR CONTROL FACILITY ................ 9,800 9,800 ........................

DEFENSE-WIDE: 

FORT GORDON: 

BLOOD DONOR CENTER REPLACEMENT ................................... 10,350 10,350 ........................

NAVY RESERVE: 

FORT GORDON: 

NAVAL OPERATIONAL SUPPORT CENTER .................................. 17,797 17,797 ........................

TOTAL, GEORGIA ........................................................................... 117,447 117,447 ........................

HAWAII 

ARMY: 

FORT SHAFTER: 

COMMAND AND CONTROL FACILITY, INCR 3 ........................... 90,000 90,000 ........................

NAVY: 

JOINT BASE PEARL HARBOR-HICKAM: 

SEWER LIFT STATION & RELIEF SEWER LINE .......................... 73,200 73,200 ........................

KANEOHE BAY: 

LHD PAD CONVERSIONS MV–22 LANDING PADS ..................... 19,012 19,012 ........................

WAHIAWA: 

COMMUNICATIONS/CRYPTO FACILITY ....................................... 65,864 65,864 ........................

DEFENSE-WIDE: 

KUNIA: 

NSAH KUNIA TUNNEL ENTRANCE ............................................. 5,000 5,000 ........................

AIR FORCE RESERVE: 

JOINT BASE PEARL HARBOR-HICKAM: 

CONSOLIDATED TRAINING FACILITY .......................................... 5,500 5,500 ........................

TOTAL, HAWAII .............................................................................. 258,576 258,576 ........................
109 

MILITARY CONSTRUCTION PROJECT LISTING BY LOCATION—Continued 

[In thousands of dollars] 

Installation and project Budget 

estimate 

Committee recommendation 

Committee recommendation 

compared to 

budget estimate 

IDAHO 

ARMY NATIONAL GUARD: 

ORCHARD TRAINING AREA: 

DIGITAL AIR/GROUND INTEGRATION RANGE ............................. 22,000 22,000 ........................

INDIANA 

ARMY: 

CRANE ARMY AMMUNITION PLANT: 

SHIPPING AND RECEIVING BUILDING ....................................... 24,000 24,000 ........................

KANSAS 

AIR FORCE: 

MCCONNELL AFB: 

COMBAT ARMS FACILITY .......................................................... 17,500 17,500 ........................

KENTUCKY 

AIR NATIONAL GUARD: 

LOUISVILLE IAP: 

ADD/ALTER RESPONSE FORCES FACILITY ................................ 9,000 9,000 ........................

MAINE 

NAVY: 

KITTERY: 

PAINT, BLAST, AND RUBBER FACILITY ..................................... 61,692 61,692 ........................

ARMY NATIONAL GUARD: 

PRESQUE ISLE: 

NATIONAL GUARD READINESS CENTER .................................... 17,500 17,500 ........................

TOTAL, MAINE ............................................................................... 79,192 79,192 ........................

MARYLAND 

AIR FORCE: 

JOINT BASE ANDREWS: 

PAR LAND ACQUISITION ........................................................... 17,500 17,500 ........................

PRESIDENTIAL AIRCRAFT RECAP COMPLEX ............................. 254,000 100,000 ¥154,000 

DEFENSE-WIDE: 

BETHESDA NAVAL HOSPITAL: 

MEDICAL CENTER ADDITION/ALTERATION INCR 2 .................... 123,800 123,800 ........................

FORT MEADE: 

NSAW RECAPITALIZE BUILDING #2 INCR 3 .............................. 313,968 313,968 ........................

ARMY NATIONAL GUARD: 

SYKESVILLE: 

NATIONAL GUARD READINESS CENTER .................................... 19,000 19,000 ........................

TOTAL, MARYLAND ............................................................... 728,268 574,268 ¥154,000 

MASSACHUSETTS 

AIR FORCE: 

HANSCOM AFB: 

VANDENBERG GATE COMPLEX ................................................. 11,400 11,400 ........................

AIR FORCE RESERVE: 

WESTOVER ARB: 

INDOOR SMALL ARMS RANGE .................................................. 10,000 10,000 ........................

TOTAL, MASSACHUSETTS .............................................................. 21,400 21,400 ........................

MINNESOTA 

ARMY NATIONAL GUARD: 

ARDEN HILLS: 

NATIONAL GUARD READINESS CENTER .................................... 39,000 39,000 ........................
110 

MILITARY CONSTRUCTION PROJECT LISTING BY LOCATION—Continued 

[In thousands of dollars] 

Installation and project Budget 

estimate 

Committee 

recommendation 

Committee 

recommendation 

compared to 

budget estimate 

MISSOURI 

DEFENSE-WIDE: 

FORT LEONARD WOOD: 

BLOOD PROCESSING CENTER REPLACEMENT .......................... 11,941 11,941 ........................

HOSPITAL REPLACEMENT ......................................................... 250,000 100,000 ¥150,000 

ST LOUIS: 

NEXT NGA WEST (N2W) COMPLEX ........................................... 381,000 175,000 ¥206,000 

AIR NATIONAL GUARD: 

ROSECRANS MEMORIAL AIRPORT: 

REPLACE COMMUNICATIONS FACILITY ..................................... 10,000 10,000 ........................

TOTAL, MISSOURI .......................................................................... 652,941 296,941 ¥356,000 

NEVADA 

AIR FORCE: 

NELLIS AFB: 

RED FLAG 5TH GEN FACILITY ADDITION .................................. 23,000 23,000 ........................

VIRTUAL WARFARE CENTER OPERATIONS FACILITY ................. 38,000 38,000 ........................

TOTAL, NEVADA ............................................................................. 61,000 61,000 ........................

NEW JERSEY 

AIR FORCE: 

JOINT BASE MCGUIRE-DIX-LAKEHURST: 

Note: Budget request is under worldwide unspecified Air 

Force. The Secretary of the Air Force determined the specific projects and costs after the submission. 

2–BAY GENERAL PURPOSE MIX HANGAR ................................ ........................ 72,000 ∂72,000 

ADAL B2324 REGIONAL MAINTENANCE TRAINING FACILITY ..... ........................ 18,000 ∂18,000 

ALTER APRON AND FUEL HYDRANT ......................................... ........................ 17,000 ∂17,000 

ALTER BUILDINGS FOR OPS AND TFI AMU–AMXS .................... ........................ 9,000 ∂9,000 

ADAL B1816 FOR SUPPLY ........................................................ ........................ 6,900 ∂6,900 

ADAL B2319 FOR BOOM OPERATOR TRAINER ......................... ........................ 6,100 ∂6,100 

ALTER FACILITIES FOR MAINTENANCE ..................................... ........................ 5,800 ∂5,800 

AEROSPACE GROUND EQUIPMENT STORAGE ........................... ........................ 4,100 ∂4,100 

ADAL B3209 FOR FUSELAGE TRAINER ..................................... ........................ 3,300 ∂3,300 

ADD TO B1837 FOR BODY TANKS STORAGE ............................ ........................ 2,300 ∂2,300 

ADAL 1749 FOR ATGL AND LST SERVICING ............................. ........................ 2,000 ∂2,000 

NAVY RESERVE: 

JOINT BASE MCGUIRE-DIX-LAKEHURST: 

AIRCRAFT APRON, TAXIWAY & SUPPORT FACILITIES ............... 11,573 11,573 ........................

TOTAL, NEW JERSEY ..................................................................... 11,573 158,073 ∂146,500 

NEW MEXICO 

AIR FORCE: 

CANNON AFB: 

DANGEROUS CARGO PAD RELOCATE CATM ............................. 42,000 42,000 ........................

HOLLOMAN AFB: 

RPA FIXED GROUND CONTROL STATION FACILITY ................... 4,250 4,250 ........................

DEFENSE-WIDE: 

CANNON AFB: 

SOF C–130 AGE FACILITY ........................................................ 8,228 8,228 ........................

ARMY NATIONAL GUARD: 

LAS CRUCES: 

NATIONAL GUARD READINESS CENTER ADDITION .................... 8,600 8,600 ........................

TOTAL, NEW MEXICO ..................................................................... 63,078 63,078 ........................
111 

MILITARY CONSTRUCTION PROJECT LISTING BY LOCATION—Continued 

[In thousands of dollars] 

Installation and project Budget 

estimate 

Committee 

recommendation 

Committee 

recommendation 

compared to 

budget estimate 

NEW YORK 

ARMY: 

U.S. MILITARY ACADEMY: 

CEMETERY ................................................................................ 22,000 22,000 ........................

AIR NATIONAL GUARD: 

HANCOCK FIELD: 

ADD TO FLIGHT TRAINING UNIT, BUILDING 641 ....................... 6,800 6,800 ........................

TOTAL, NEW YORK ........................................................................ 28,800 28,800 ........................

NORTH CAROLINA 

NAVY: 

CAMP LEJEUNE: 

BACHELOR ENLISTED QUARTERS ............................................. 37,983 37,983 ........................

WATER TREATMENT PLANT REPLACEMENT HADNOT PT ........... 65,784 65,784 ........................

CHERRY POINT MARINE CORPS AIR STATION: 

F–35B VERTICAL LIFT FAN TEST FACILITY ............................... 15,671 15,671 ........................

DEFENSE-WIDE: 

CAMP LEJEUNE: 

AMBULATORY CARE CENTER ADDITION/ALTERATION ............... 15,300 15,300 ........................

AMBULATORY CARE CENTER/DENTAL CLINIC .......................... 21,400 21,400 ........................

AMBULATORY CARE CENTER/DENTAL CLINIC .......................... 22,000 22,000 ........................

SOF HUMAN PERFORMANCE TRAINING CENTER ...................... 10,800 10,800 ........................

SOF MOTOR TRANSPORT MAINTENANCE EXPANSION ............... 20,539 20,539 ........................

FORT BRAGG: 

SOF HUMAN PERFORMANCE TRAINING CTR ............................. 20,260 20,260 ........................

SOF SUPPORT BATTALION ADMIN FACILITY .............................. 13,518 13,518 ........................

SOF TACTICAL EQUIPMENT MAINTENANCE FACILITY ................ 20,000 20,000 ........................

SOF TELECOMM RELIABILITY IMPROVEMENTS ......................... 4,000 4,000 ........................

SEYMOUR JOHNSON AFB: 

CONSTRUCT TANKER TRUCK DELIVERY SYSTEM ..................... 20,000 20,000 ........................

AIR FORCE RESERVE: 

SEYMOUR JOHNSON AFB: 

KC–46A ADAL FOR ALT MISSION STORAGE ............................. 6,400 6,400 ........................

TOTAL, NORTH CAROLINA .................................................... 293,655 293,655 ........................

NORTH DAKOTA 

AIR FORCE: 

MINOT AFB: 

INDOOR FIRING RANGE ............................................................ 27,000 27,000 ........................

OHIO 

AIR NATIONAL GUARD: 

TOLEDO EXPRESS AIRPORT: 

NORTHCOM—CONSTRUCT ALERT HANGAR .............................. 15,000 15,000 ........................

OKLAHOMA 

AIR FORCE: 

ALTUS AFB: 

KC–46A FTU FUSELAGE TRAINER PHASE 2 ............................. 4,900 4,900 ........................

OREGON 

AIR NATIONAL GUARD: 

KLAMATH FALLS IAP: 

CONSTRUCT CORROSION CONTROL HANGAR ........................... 10,500 10,500 ........................

CONSTRUCT INDOOR RANGE .................................................... 8,000 8,000 ........................

TOTAL, OREGON ............................................................................ 18,500 18,500 ........................
112 

MILITARY CONSTRUCTION PROJECT LISTING BY LOCATION—Continued 

[In thousands of dollars] 

Installation and project Budget 

estimate 

Committee recommendation 

Committee recommendation 

compared to 

budget estimate 

SOUTH CAROLINA 

ARMY: 

FORT JACKSON: 

RECEPTION BARRACKS COMPLEX, PH1 ................................... 60,000 60,000 ........................

SHAW AFB: 

MISSION TRAINING COMPLEX ................................................... 25,000 25,000 ........................

DEFENSE-WIDE: 

SHAW AFB: 

CONSOLIDATE FUEL FACILITIES ................................................ 22,900 22,900 ........................

TOTAL, SOUTH CAROLINA .............................................................. 107,900 107,900 ........................

SOUTH DAKOTA 

AIR NATIONAL GUARD: 

JOE FOSS FIELD: 

AIRCRAFT MAINTENANCE SHOPS .............................................. 12,000 12,000 ........................

TENNESSEE 

AIR NATIONAL GUARD: 

MCGHEE-TYSON AIRPORT: 

REPLACE KC–135 MAINTENANCE HANGAR AND SHOPS .......... 25,000 25,000 ........................

TEXAS 

ARMY: 

CAMP BULLIS: 

VEHICLE MAINTENANCE SHOP .................................................. 13,600 13,600 ........................

FORT HOOD: 

BATTALION HEADQUARTERS COMPLEX ..................................... 37,000 37,000 ........................

AIR FORCE: 

JOINT BASE SAN ANTONIO: 

AIR TRAFFIC CONTROL TOWER ................................................. 10,000 10,000 ........................

BMT CLASSROOMS/DINING FACILITY 4 .................................... 38,000 38,000 ........................

BMT RECRUIT DORMITORY 7 ................................................... 90,130 90,130 ........................

CAMP BULLIS DINING FACILITY ................................................ 18,500 18,500 ........................

DEFENSE-WIDE: 

FORT BLISS: 

BLOOD PROCESSING CENTER .................................................. 8,300 8,300 ........................

HOSPITAL REPLACEMENT INCR 8 ............................................. 251,330 100,000 ¥151,330 

NAVY RESERVE: 

FORT WORTH: 

KC130–J EACTS FACILITY ......................................................... 12,637 12,637 ........................

TOTAL, TEXAS ................................................................................ 479,497 328,167 ¥151,330 

UTAH 

AIR FORCE: 

HILL AFB: 

UTTR CONSOLIDATED MISSION CONTROL CENTER .................. 28,000 28,000 ........................

DEFENSE-WIDE: 

HILL AFB: 

REPLACE POL FACILITIES ......................................................... 20,000 20,000 ........................

AIR FORCE RESERVE: 

HILL AFB: 

ADD/ALTER LIFE SUPPORT FACILITY ........................................ 3,100 3,100 ........................

TOTAL, UTAH ................................................................................. 51,100 51,100 ........................

VIRGINIA 

ARMY: 

FORT BELVOIR: 

SECURE ADMIN/OPERATIONS FACILITY, INCR 3 ....................... 14,124 14,124 ........................
113 

MILITARY CONSTRUCTION PROJECT LISTING BY LOCATION—Continued 

[In thousands of dollars] 

Installation and project Budget 

estimate 

Committee recommendation 

Committee recommendation 

compared to 

budget estimate 

JOINT BASE LANGLEY-EUSTIS: 

AIRCRAFT MAINTENANCE INSTRUCTIONAL BLDG ..................... 34,000 34,000 ........................

JOINT BASE MYER-HENDERSON: 

SECURITY FENCE ...................................................................... 20,000 20,000 ........................

NAVY: 

DAM NECK: 

ISR OPERATIONS FACILITY EXPANSION .................................... 29,262 29,262 ........................

JOINT EXPEDITIONARY BASE LITTLE CREEK—STORY: 

ACU–4 ELECTRICAL UPGRADES ............................................... 2,596 2,596 ........................

NORFOLK: 

CHAMBERS FIELD MAGAZINE RECAP PH 1 .............................. 34,665 34,665 ........................

PORTSMOUTH: 

SHIP REPAIR TRAINING FACILITY ............................................. 72,990 72,990 ........................

YORKTOWN: 

BACHELOR ENLISTED QUARTERS ............................................. 36,358 36,358 ........................

DEFENSE-WIDE: 

JOINT EXPEDITIONARY BASE LITTLE CREEK—STORY: 

SOF SATEC RANGE EXPANSION ................................................ 23,000 23,000 ........................

NORFOLK: 

REPLACE HAZARDOUS MATERIALS WAREHOUSE ...................... 18,500 18,500 ........................

PENTAGON: 

PENTAGON CORR 8 PEDESTRIAN ACCESS CONTROL PT .......... 8,140 8,140 ........................

S.E. SAFETY TRAFFIC AND PARKING IMPROVEMENTS .............. 28,700 28,700 ........................

SECURITY UPDATES .................................................................. 13,260 13,260 ........................

PORTSMOUTH: 

REPLACE HARARDOUS MATERIALS WAREHOUSE ..................... 22,500 22,500 ........................

ARMY NATIONAL GUARD: 

FORT PICKETT: 

TRAINING AIDS CENTER ........................................................... 4,550 4,550 ........................

TOTAL, VIRGINIA ............................................................................ 362,645 362,645 ........................

WASHINGTON 

ARMY: 

JOINT BASE LEWIS-MCCHORD: 

CONFINEMENT FACILITY ........................................................... 66,000 66,000 ........................

YAKIMA: 

FIRE STATION ........................................................................... 19,500 19,500 ........................

NAVY: 

INDIAN ISLAND: 

MISSILE MAGAZINES ................................................................. 44,440 44,440 ........................

ARMY NATIONAL GUARD: 

TURNWATER: 

NATIONAL GUARD READINESS CENTER .................................... 31,000 31,000 ........................

TOTAL, WASHINGTON ..................................................................... 160,940 160,940 ........................

WISCONSIN 

ARMY RESERVE: 

FORT MCCOY: 

AT/MOB DINING FACILITY ......................................................... 13,000 13,000 ........................

WYOMING 

AIR FORCE: 

F. E. WARREN AFB: 

CONSOLIDATED HELO/TRF OPS/AMU AND ALERT FAC ............. 62,000 62,000 ........................

CONUS CLASSIFIED 

DEFENSE-WIDE: 

CLASSIFIED LOCATION: 

BATTALION COMPLEX, PH 1 ..................................................... 64,364 64,364 ........................
114 

MILITARY CONSTRUCTION PROJECT LISTING BY LOCATION—Continued 

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Installation and project Budget 

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Committee recommendation 

Committee recommendation 

compared to 

budget estimate 

AUSTRALIA 

AIR FORCE: 

DARWIN: 

APR—BULK FUEL STORAGE TANKS ......................................... 76,000 76,000 ........................

DJIBOUTI 

NAVY: 

CAMP LEMONIER: 

AIRCRAFT PARKING APRON EXPANSION ................................... 13,390 13,390 ........................

GERMANY 

ARMY: 

STUTTGART: 

EIC: COMMISSARY .................................................................... 40,000 40,000 ........................

WIESBADEN: 

EIC: ADMINISTRATIVE BUILDING ............................................... 43,000 43,000 ........................

DEFENSE-WIDE: 

RHINE ORDNANCE BARRACKS: 

MEDICAL CENTER REPLACEMENT INCR 7 ................................ 106,700 106,700 ........................

SPANGDAHLEM AB: 

SPANGDAHLEM ELEMENTARY SCHOOL REPLACEMENT ............ 79,141 79,141 ........................

STUTTGART: 

ROBINSON BARRACKS ELEM. SCHOOL REPLACEMENT ............ 46,609 46,609 ........................

TOTAL, GERMANY .......................................................................... 315,450 315,450 ........................

GREECE 

NAVY: 

SOUDA BAY: 

STRATEGIC AIRCRAFT PARKING APRON EXPANSION ................ 22,045 22,045 ........................

DEFENSE-WIDE: 

SOUDA BAY: 

CONSTRUCT HYDRANT SYSTEM ................................................ 18,100 18,100 ........................

TOTAL, GREECE ............................................................................. 40,145 40,145 ........................

GUAM 

NAVY: 

JOINT REGION MARIANAS: 

AIRCRAFT MAINTENANCE HANGAR #2 ...................................... 75,233 75,233 ........................

CORROSION CONTROL HANGAR ............................................... 66,747 66,747 ........................

MALS FACILITIES ...................................................................... 49,431 49,431 ........................

NAVY–COMMERCIAL TIE–IN HARDENING ................................. 37,180 37,180 ........................

WATER WELL FIELD .................................................................. 56,088 56,088 ........................

DEFENSE-WIDE: 

ANDERSEN AFB: 

CONSTRUCT TRUCK LOAD & UNLOAD FACILITY ....................... 23,900 23,900 ........................

AIR FORCE RESERVE: 

JOINT REGION MARIANAS: 

RESERVE MEDICAL TRAINING FACILITY .................................... 5,200 5,200 ........................

TOTAL, GUAM ................................................................................ 313,779 313,779 ........................

ITALY 

AIR FORCE: 

AVIANO AB: 

GUARDIAN ANGEL OPERATIONS FACILITY ................................. 27,325 27,325 ........................

DEFENSE-WIDE: 

SIGONELLA: 

CONSTRUCT HYDRANT SYSTEM ................................................ 22,400 22,400 ........................
115 

MILITARY CONSTRUCTION PROJECT LISTING BY LOCATION—Continued 

[In thousands of dollars] 

Installation and project Budget 

estimate 

Committee recommendation 

Committee recommendation 

compared to 

budget estimate 

VICENZA: 

VICENZA HIGH SCHOOL REPLACEMENT ................................... 62,406 62,406 ........................

TOTAL, ITALY ................................................................................. 112,131 112,131 ........................

JAPAN 

NAVY: 

IWAKUNI: 

KC130J ENLISTED AIRCREW TRAINER FACILITY ....................... 21,860 21,860 ........................

DEFENSE-WIDE: 

IWAKUNI: 

CONSTRUCT BULK STORAGE TANKS PH 1 ............................... 30,800 30,800 ........................

KADENA AB: 

SOF MAINTENANCE HANGAR .................................................... 3,972 3,972 ........................

SOF SPECIAL TACTICS OPERATIONS FACILITY .......................... 27,573 27,573 ........................

OKINAWA: 

REPLACE MOORING SYSTEM .................................................... 11,900 11,900 ........................

SASEBO: 

UPGRADE FUEL WHARF ............................................................ 45,600 45,600 ........................

TORRI COMMO STATION: 

SOF TACTICAL EQUIPMENT MAINTENANCE FACILITY ................ 25,323 25,323 ........................

YOKOTA AB: 

AIRFIELD APRON ....................................................................... 10,800 10,800 ........................

HANGAR/AIRCRAFT MAINTENANCE UNIT ................................... 12,034 12,034 ........................

OPERATIONS AND WAREHOUSE FACILITIES .............................. 8,590 8,590 ........................

SIMULATOR FACILITY ................................................................ 2,189 2,189 ........................

TOTAL, JAPAN ................................................................................ 200,641 200,641 ........................

KOREA 

ARMY: 

KUNSAN AB: 

UNMANNED AERIAL VEHICLE HANGAR ..................................... 53,000 53,000 ........................

MARIANA ISLANDS 

AIR FORCE: 

TINIAN: 

APR LAND ACQUISITION ........................................................... 12,900 12,900 ........................

PUERTO RICO 

DEFENSE-WIDE: 

PUNTA BORINQUEN: 

RAMEY UNIT SCHOOL REPLACEMENT ...................................... 61,071 61,071 ........................

ARMY RESERVE: 

AGUADILLA: 

ARMY RESERVE CENTER .......................................................... 12,400 12,400 ........................

TOTAL, PUERTO RICO .................................................................... 73,471 73,471 ........................

QATAR 

AIR FORCE: 

AL UDEID: 

CONSOLIDATED SQUADRON OPERATIONS FACILITY .................. 15,000 15,000 ........................

TURKEY 

ARMY: 

TURKEY VARIOUS: 

FORWARD OPERATING SITE ...................................................... 6,400 6,400 ........................

AIR FORCE: 

INCIRLIK AB: 

DORMITORY .............................................................................. 25,997 25,997 ........................
116 

MILITARY CONSTRUCTION PROJECT LISTING BY LOCATION—Continued 

[In thousands of dollars] 

Installation and project Budget 

estimate 

Committee recommendation 

Committee recommendation 

compared to 

budget estimate 

TOTAL, TURKEY ............................................................................. 32,397 32,397 ........................

UNITED KINGDOM 

AIR FORCE: 

ROYAL AIR FORCE FAIRFORD: 

EIC RC–135 INFRASTRUCTURE ................................................ 2,150 2,150 ........................

EIC RC–135 INTEL AND SQUAD OPS FACILITY ........................ 38,000 38,000 ........................

EIC RC–135 RUNWAY OVERRUN RECONFIGURATION .............. 5,500 5,500 ........................

ROYAL AIR FORCE LAKENHEATH: 

CONSOLIDATED CORROSION CONTROL FACILITY ..................... 20,000 20,000 ........................

F–35A 6–BAY HANGAR ............................................................ 24,000 24,000 ........................

F–35A F–15 PARKING .............................................................. 10,800 10,800 ........................

F–35A FIELD TRAINING DETACHMENT FACILITY ....................... 12,492 12,492 ........................

F–35A FLIGHT SIMULATOR FACILITY ........................................ 22,000 22,000 ........................

F–35A INFRASTRUCTURE ......................................................... 6,700 6,700 ........................

F–35A SQUADRON OPERATIONS AND AMU .............................. 41,000 41,000 ........................

DEFENSE-WIDE: 

MENWITH HILL STATION: 

RAFMH MAIN GATE REHABILITATION ........................................ 11,000 11,000 ........................

TOTAL, UNITED KINGDOM .............................................................. 193,642 193,642 ........................

NATO SECURITY INVESTMENT PROGRAM ................................. 154,000 154,000 ........................

WORLDWIDE UNSPECIFIED 

ARMY: 

HOST NATION SUPPORT ..................................................................... 28,700 28,700 ........................

MINOR CONSTRUCTION ..................................................................... 31,500 41,500 ∂10,000 

PLANNING AND DESIGN ..................................................................... 72,770 72,770 ........................

NAVY: 

PLANNING AND DESIGN ..................................................................... 219,069 228,069 ∂9,000 

MINOR CONSTRUCTION ..................................................................... 23,842 23,842 ........................

AIR FORCE: 

KC–46A MAIN OPERATING BASE 4 ................................................... 269,000 ........................ ¥269,000 

Note: The recommended funding is provided under Travis Air 

Force Base, CA and Joint Base McGuire-Dix-Lakehurst, NJ as 

determined by the Secretary of the Air Force. 

PLANNING AND DESIGN ............................................................ 97,852 97,852 ........................

MINOR CONSTRUCTION ............................................................ 31,400 31,400 ........................

DEFENSE-WIDE: 

CONTINGENCY CONSTRUCTION ......................................................... 10,000 ........................ ¥10,000 

ENERGY RESILIENCE CONSERVATION INVESTMENT PROGRAM ......... 150,000 165,000 ∂15,000 

PLANNING AND DESIGN: 

DEFENSE WIDE ......................................................................... 23,500 23,500 ........................

DEFENSE HEALTH AGENCY ....................................................... 40,220 40,220 ........................

DEPARTMENT OF DEFENSE DEPENDENT EDUCATION ............... 26,147 26,147 ........................

DEFENSE INFORMATION SYSTEMS AGENCY ............................. 1,150 1,150 ........................

DEFENSE LOGISTICS AGENCY ................................................... 23,012 23,012 ........................

MISSILE DEFENSE AGENCY ...................................................... ........................ ........................ ........................

NATIONAL SECURITY AGENCY .................................................. 20,000 20,000 ........................

SPECIAL OPERATIONS COMMAND ............................................. 39,746 39,746 ........................

WASHINGTON HEADQUARTERS SERVICE .................................. 1,942 1,942 ........................

SUBTOTAL, PLANNING AND DESIGN .............................................. 175,717 175,717 ........................

UNSPECIFIED MINOR CONSTRUCTION: 

DEFENSE-WIDE ......................................................................... 3,000 3,000 ........................

DEPARTMENT OF DEFENSE DEPENDENT EDUCATION ............... 8,000 8,000 ........................

DEFENSE HEALTH AGENCY ....................................................... 10,000 10,000 ........................

DEFENSE LOGISTICS AGENCY ................................................... 2,039 2,039 ........................

JOINT CHIEFS OF STAFF ........................................................... 11,490 11,490 ........................

MISSILE DEFENSE AGENCY ...................................................... 3,000 3,000 ........................

NATIONAL SECURITY AGENCY .................................................. 3,000 3,000 ........................
117 

MILITARY CONSTRUCTION PROJECT LISTING BY LOCATION—Continued 

[In thousands of dollars] 

Installation and project Budget 

estimate 

Committee recommendation 

Committee recommendation 

compared to 

budget estimate 

SPECIAL OPERATIONS COMMAND ............................................. 7,384 7,384 ........................

SUBTOTAL, UNSPECIFIED MINOR CONSTRUCTION ........................ 47,913 47,913 ........................

ARMY NATIONAL GUARD: 

PLANNING AND DESIGN ..................................................................... 16,271 16,271 ........................

MINOR CONSTRUCTION ..................................................................... 16,731 16,731 ........................

AIR NATIONAL GUARD: 

PLANNING AND DESIGN ..................................................................... 18,000 18,000 ........................

MINOR CONSTRUCTION ..................................................................... 17,191 17,191 ........................

ARMY RESERVE: 

PLANNING AND DESIGN ..................................................................... 6,887 6,887 ........................

MINOR CONSTRUCTION ..................................................................... 5,425 5,425 ........................

NAVY RESERVE: 

PLANNING AND DESIGN ..................................................................... 4,430 4,430 ........................

MINOR CONSTRUCTION ..................................................................... 1,504 1,504 ........................

AIR FORCE RESERVE: 

PLANNING AND DESIGN ..................................................................... 4,725 4,725 ........................

MINOR CONSTRUCTION ..................................................................... 3,610 3,610 ........................

FAMILY HOUSING, ARMY 

OPERATION AND MAINTENANCE: 

UTILITIES ACCOUNT ........................................................................... 60,251 60,251 ........................

SERVICES ACCOUNT .......................................................................... 8,930 9,106 ∂176 

MANAGEMENT ACCOUNT ................................................................... 37,089 37,089 ........................

MISCELLANEOUS ACCOUNT ............................................................... 400 400 ........................

FURNISHINGS ACCOUNT .................................................................... 12,816 12,816 ........................

LEASING ............................................................................................. 148,538 150,644 ∂2,106 

MAINTENANCE OF REAL PROPERTY .................................................. 57,708 57,708 ........................

PRIVATIZATION SUPPORT COSTS ....................................................... 20,893 20,893 ........................

SUBTOTAL, OPERATION AND MAINTENANCE ................................. 346,625 348,907 ∂2,282 

FAMILY HOUSING, NAVY AND MARINE CORPS 

OPERATION AND MAINTENANCE: 

UTILITIES ACCOUNT ........................................................................... 62,167 62,167 ........................

SERVICES ACCOUNT .......................................................................... 15,649 15,649 ........................

MANAGEMENT ACCOUNT ................................................................... 50,989 50,989 ........................

MISCELLANEOUS ACCOUNT ............................................................... 336 336 ........................

FURNISHINGS ACCOUNT .................................................................... 14,529 14,529 ........................

LEASING ............................................................................................. 61,921 61,921 ........................

MAINTENANCE OF REAL PROPERTY .................................................. 95,104 95,104 ........................

PRIVATIZATION SUPPORT COSTS ....................................................... 27,587 27,587 ........................

SUBTOTAL, OPERATION AND MAINTENANCE ................................. 328,282 328,282 ........................

FAMILY HOUSING, AIR FORCE 

OPERATION AND MAINTENANCE: 

UTILITIES ACCOUNT ........................................................................... 47,504 47,504 ........................

MANAGEMENT ACCOUNT ................................................................... 53,464 53,464 ........................

SERVICES ACCOUNT .......................................................................... 13,517 13,517 ........................

FURNISHINGS ACCOUNT .................................................................... 29,424 29,424 ........................

MISCELLANEOUS ACCOUNT ............................................................... 1,839 1,839 ........................

LEASING ............................................................................................. 16,818 16,818 ........................

MAINTENANCE ................................................................................... 134,189 134,189 ........................

PRIVATIZATION SUPPORT COSTS ....................................................... 21,569 21,569 ........................

SUBTOTAL, OPERATION AND MAINTENANCE ................................. 318,324 318,324 ........................
118 

MILITARY CONSTRUCTION PROJECT LISTING BY LOCATION—Continued 

[In thousands of dollars] 

Installation and project Budget 

estimate 

Committee recommendation 

Committee recommendation 

compared to 

budget estimate 

FAMILY HOUSING, DEFENSE-WIDE 

OPERATION AND MAINTENANCE: 

NATIONAL SECURITY AGENCY: 

UTILITIES .................................................................................. 268 268 ........................

FURNISHING .............................................................................. 407 407 ........................

LEASING .................................................................................... 12,390 12,390 ........................

MAINTENANCE OF REAL PROPERTY ......................................... 655 655 ........................

DEFENSE INTELLIGENCE AGENCY: 

UTILITIES .................................................................................. 4,100 4,100 ........................

FURNISHINGS ............................................................................ 641 641 ........................

LEASING .................................................................................... 39,716 39,716 ........................

DEFENSE LOGISTICS AGENCY: 

UTILITIES .................................................................................. 86 86 ........................

FURNISHINGS ............................................................................ 6 6 ........................

SERVICES ................................................................................. 14 14 ........................

MANAGEMENT ........................................................................... 319 319 ........................

MAINTENANCE OF REAL PROPERTY ......................................... 567 567 ........................

SUBTOTAL, OPERATION AND MAINTENANCE ................................. 59,169 59,169 ........................

FAMILY HOUSING, ARMY 

CONSTRUCTION: 

GEORGIA: 

FORT GORDON: 

FAMILY HOUSING NEW CONSTRUCTION .......................... 6,100 6,100 ........................

MASSACHUSETTS: 

NATICK SOLDIER SUPPORT CENTER (28 UNITS) ...................... 21,000 21,000 ........................

KOREA: 

CAMP HUMPHRIES: 

FAMILY HOUSING NEW CONSTRUCTION INC 2 ................ 34,402 34,402 ........................

KWAJALEIN: 

FAMILY HOUSING NEW CONSTRUCTION (22 UNITS) ................. 31,000 31,000 ........................

GERMANY: 

SOUTH CAMP VILSECK: 

FAMILY HOUSING NEW CONSTRUCTION (36 UNITS) ........ 22,445 22,445 ........................

CONSTRUCTION IMPROVEMENTS—BAUMHOLDER (96 UNITS) .......... 34,156 34,156 ........................

ITALY: 

PLANNING AND DESIGN ............................................................ 33,559 33,559 ........................

SUBTOTAL, CONSTRUCTION .......................................................... 182,662 182,662 ........................

FAMILY HOUSING, NAVY AND MARINE CORPS 

CONSTRUCTION: 

MARIANA ISLANDS: 

NSA ANDERSON: 

REPLACEMENT HOUSING PHASE II .................................. 40,875 40,875 ........................

BAHRAIN: 

SW ASIA: 

CONSTRUCTION OF ON-BASE GENERAL FLAG OFFICER: 

QUARTERS .............................................................. 2,138 2,138 ........................

CONSTRUCTION IMPROVEMENTS ....................................................... 36,251 36,251 ........................

PLANNING AND DESIGN ..................................................................... 4,418 4,418 ........................

SUBTOTAL, CONSTRUCTION .......................................................... 83,682 83,682 ........................

FAMILY HOUSING, AIR FORCE 

CONSTRUCTION: 

CONSTRUCTION IMPROVEMENTS ....................................................... 80,617 80,617 ........................

PLANNING AND DESIGN ..................................................................... 4,445 4,445 ........................
119 

MILITARY CONSTRUCTION PROJECT LISTING BY LOCATION—Continued 

[In thousands of dollars] 

Installation and project Budget 

estimate 

Committee recommendation 

Committee recommendation 

compared to 

budget estimate 

SUBTOTAL, CONSTRUCTION .......................................................... 85,062 85,062 ........................

DOD MILITARY UNACCOMPANIED HOUSING IMPROVEMENT FUND ............. 623 623 ........................

DOD FAMILY HOUSING IMPROVEMENT FUND ............................................. 2,726 2,726 ........................

BASE REALIGNMENT AND CLOSURE 

BASE REALIGNMENT AND CLOSURE ACCOUNT .......................................... 255,867 255,867 ........................

MILITARY CONSTRUCTION, ARMY ............................................................... ........................ 68,800 ∂68,800 

MILITARY CONSTRUCTION, NAVY AND MARINE CORPS .............................. ........................ 110,100 ∂110,100 

MILITARY CONSTRUCTION, AIR FORCE ....................................................... ........................ 127,300 ∂127,300 

MILITARY CONSTRUCTION, ARMY NATIONAL GUARD .................................. ........................ 83,500 ∂83,500 

MILITARY CONSTRUCTION, AIR NATIONAL GUARD ..................................... ........................ 24,000 ∂24,000 

MILITARY CONSTRUCTION, ARMY RESERVE ............................................... ........................ 30,000 ∂30,000 

MILITARY CONSTRUCTION, NAVY RESERVE ................................................ ........................ ........................ ........................

MILITARY CONSTRUCTION, AIR FORCE RESERVE ....................................... ........................ 35,100 ∂35,100 

RESCISSIONS FROM PRIOR YEAR UNOBLIGATED BALANCES 

ARMY .......................................................................................................... ........................ ........................ ........................

NAVY AND MARINE CORPS ......................................................................... ........................ ........................ ........................

AIR FORCE .................................................................................................. ........................ ........................ ........................

DEFENSE-WIDE ........................................................................................... ........................ ¥14,703 ¥14,703 

AIR NATIONAL GUARD ................................................................................ ........................ ........................ ........................

42 USC 3374 (SEC. 135) ........................................................................... ........................ ........................ ........................

NATO SECURITY INVESTMENT PROGRAM ................................................... ........................ ........................ ........................

FAMILY HOUSING CONSTRUCTION, ARMY .................................................. ........................ ........................ ........................

FAMILY HOUSING CONSTRUCTION, NAVY AND MARINE CORPS ................. ........................ ........................ ........................

FAMILY HOUSING CONSTRUCTION, AIR FORCE .......................................... ........................ ........................ ........................

RECAP 

ARMY .......................................................................................................... 920,394 930,394 ∂10,000 

RESCISSION .............................................................................. ........................ ........................ ........................

NAVY AND MARINE CORPS ......................................................................... 1,616,665 1,565,665 ¥51,000 

RESCISSION .............................................................................. ........................ ........................ ........................

AIR FORCE .................................................................................................. 1,738,796 1,569,296 ¥169,500 

RESCISSION .............................................................................. ........................ ........................ ........................

DEFENSE-WIDE ........................................................................................... 3,114,913 2,612,583 ¥502,330 

RESCISSION .............................................................................. ........................ ¥14,703 ¥14,703 

ARMY NATIONAL GUARD ............................................................................. 210,652 210,652 ........................

RESCISSION .............................................................................. ........................ ........................ ........................

AIR NATIONAL GUARD ................................................................................ 161,491 161,491 ........................

RESCISSION .............................................................................. ........................ ........................ ........................

ARMY RESERVE .......................................................................................... 73,712 73,712 ........................

RESCISSION .............................................................................. ........................ ........................ ........................

NAVY RESERVE ........................................................................................... 65,271 65,271 ........................

RESCISSION .............................................................................. ........................ ........................ ........................

AIR FORCE RESERVE .................................................................................. 63,535 63,535 ........................

RESCISSION .............................................................................. ........................ ........................ ........................

NATO ........................................................................................................... 154,000 154,000 ........................

RESCISSION .............................................................................. ........................ ........................ ........................

CHEMICAL DEMILITARIZATION CONSTRUCTION, DEFENSE-WIDE ................ ........................ ........................ ........................

RESCISSION .............................................................................. ........................ ........................ ........................

DOD MILITARY UNACCOMPANIED HOUSING IMPROVEMENT FUND ............. 623 623 ........................

RESCISSION .............................................................................. ........................ ........................ ........................

DOD FAMILY HOUSING IMPROVEMENT FUND ............................................. 2,726 2,726 ........................

RESCISSION .............................................................................. ........................ ........................ ........................

HOMEOWNERS ASSISTANCE PROGRAM ...................................................... ........................ ........................ ........................

RESCISSION .............................................................................. ........................ ........................ ........................

FAMILY HOUSING, ARMY ............................................................................ 529,287 531,569 ∂2,282 

CONSTRUCTION ................................................................................. (182,662) (182,662) ........................

OPERATION AND MAINTENANCE ........................................................ (346,625) (348,907) (∂2,282) 

RESCISSION .............................................................................. ........................ ........................ ........................
120 

MILITARY CONSTRUCTION PROJECT LISTING BY LOCATION—Continued 

[In thousands of dollars] 

Installation and project Budget 

estimate 

Committee 

recommendation 

Committee 

recommendation 

compared to 

budget estimate 

FAMILY HOUSING, NAVY AND MARINE CORP ............................................. 411,964 411,964 ........................

CONSTRUCTION ................................................................................. (83,682) (83,682) ........................

OPERATION AND MAINTENANCE ........................................................ (328,282) (328,282) ........................

RESCISSION .............................................................................. ........................ ........................ ........................

FAMILY HOUSING, AIR FORCE .................................................................... 403,386 403,386 ........................

CONSTRUCTION ................................................................................. (85,062) (85,062) ........................

OPERATION AND MAINTENANCE ........................................................ (318,324) (318,324) ........................

RESCISSION .............................................................................. ........................ ........................ ........................

FAMILY HOUSING, DEFENSE-WIDE .............................................................. 59,169 59,169 ........................

CONSTRUCTION ................................................................................. ........................ ........................ ........................

OPERATION AND MAINTENANCE ........................................................ (59,169) (59,169) ........................

RESCISSION .............................................................................. ........................ ........................ ........................

BRAC .......................................................................................................... 255,867 255,867 ........................

RESCISSION .............................................................................. ........................ ........................ ........................

42 USC 3374 (Sec. 135) ........................................................................... ........................ ........................ ........................

ADMINISTRATIVE PROVISIONS .................................................................... ........................ 478,800 ∂478,800 

RESCISSION .............................................................................. ........................ ........................ ........................

GRAND TOTAL ............................................................................... 9,782,451 9,536,000 ¥246,451 
121 

OVERSEAS CONTINGENCY OPERATIONS 

[In thousands of dollars] 

Budget 

estimate 

Committee 

recommendation 

Committee 

recommendation 

compared to 

budget estimate 

CUBA 

ARMY: 

GUANTANAMO BAY NAVAL STATION: 

BARRACKS ................................................................................ 115,000 115,000 ........................

WORLDWIDE UNSPECIFIED 

ARMY: 

PLANNING AND DESIGN ..................................................................... 9,000 9,000 ........................

AIR FORCE: 

PLANNING AND DESIGN ..................................................................... 41,500 41,500 ........................

JORDAN 

AIR FORCE: 

MUWAFFAQ SALTI AIR BASE: 

MUWAFFAQ SALTI AIR BASE ..................................................... 143,000 ........................ ¥143,000 

AIRFIELD PAVEMENTS ............................................................... ........................ 52,735 ∂52,735 

ISR SHELTERS .......................................................................... ........................ 10,000 ∂10,000 

CAS REVETMENTS/SUN SHADES ............................................... ........................ 11,168 ∂11,168 

DORMITORY .............................................................................. ........................ 8,003 ∂8,003 

CARGO MARSHALLING YARD FACILITY ..................................... ........................ 1,034 ∂1,034 

SUPPORTING FACILITIES/UTILITIES ........................................... ........................ 60,060 ∂60,060 

AIR FORCE: 

INCIRLIK AB: 

RELOCATE BASE MAIN ACCESS CONTROL POINT .................... 14,600 14,600 ........................

REPLACE PERIMETER FENCE ................................................... 8,100 8,100 ........................

TOTAL, OVERSEAS CONTINGENCY OPERATIONS ............................ 331,200 331,200 ........................

ARMY ........................................................................................ (124,000) (124,000) ........................

AIR FORCE ................................................................................ (207,200) (207,200) ........................

EUROPEAN REASSURANCE INITIATIVE 

ESTONIA: 

AIR FORCE: 

AMARI AIR BASE: 

POL CAPACITY PHASE II ........................................................... 4,700 4,700 ........................

TACTICAL FIGHTER AIRCRAFT PARKING APRON ....................... 9,200 9,200 ........................

HUNGARY 

AIR FORCE: 

KECSKEMET AIR BASE: 

AIRFIELD UPGRADES ................................................................ 12,900 12,900 ........................

CONSTRUCT PARALLEL TAXIWAY .............................................. 30,000 30,000 ........................

INCREASE POL STORAGE CAPACITY ......................................... 12,500 12,500 ........................

ICELAND 

AIR FORCE: 

KEFLAVIK: 

AIRFIELD UPGRADES ................................................................ 14,400 14,400 ........................

LATVIA 

AIR FORCE: 

LIELVARDE AIR BASE: 

EXPAND STRATEGIC RAMP PARKING ........................................ 3,850 3,850 ........................

LUXEMBOURG 

AIR FORCE: 

SANEM: 

ECAOS DEPLOYABLE AIRBASE SYSTEM STORAGE .................... 67,400 67,400 ........................
122 

OVERSEAS CONTINGENCY OPERATIONS—Continued 

[In thousands of dollars] 

Budget 

estimate 

Committee 

recommendation 

Committee 

recommendation 

compared to 

budget estimate 

NORWAY 

AIR FORCE: 

RYGGE: 

REPLACE/EXPAND QUICK REACTION ALERT PAD ..................... 10,300 10,300 ........................

ROMANIA 

AIR FORCE: 

CAMP TURZII: 

UPGRADE UTILITIES INFRASTRUCTURE .................................... 2,950 2,950 ........................

SLOVAKIA 

AIR FORCE: 

MALACKY: 

AIRFIELD UPGRADES ................................................................ 4,000 4,000 ........................

INCREASE POL STORAGE CAPACITY ......................................... 20,000 20,000 ........................

SLIAC AIRPORT: 

AIRFIELD UPGRADES ................................................................ 22,000 22,000 ........................

WORLDWIDE UNSPECIFIED 

ARMY: 

PLANNING AND DESIGN ..................................................................... 15,700 15,700 ........................

NAVY: 

PLANNING AND DESIGN ..................................................................... 18,500 18,500 ........................

AIR FORCE: 

PLANNING AND DESIGN ..................................................................... 56,630 56,630 ........................

DEFENSE-WIDE: 

SOCOM: 

PLANNING AND DESIGN ............................................................ 1,900 1,900 ........................

TOTAL, EUROPEAN REASSURANCE INITIATIVE .............................. 306,930 306,930 ........................

ARMY ................................................................................... (15,700) (15,700) ........................

NAVY AND MARINE CORPS .................................................. (18,500) (18,500) ........................

AIR FORCE ........................................................................... (270,830) (270,830) ........................

DEFENSE-WIDE ..................................................................... (1,900) (1,900) ........................

TOTAL, FY2018 OVERSEAS CONTINGENCY OPERATIONS .............. 638,130 638,130 ........................
123 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2017 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2018 

[In thousands of dollars] 

Item 2017 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2017 

appropriation Budget estimate 

TITLE I—DEPARTMENT OF DEFENSE 

Military Construction, Army .................................................................................................................................................. 513,459 920,394 930,394 ∂416,935 ∂10,000 Military Construction, Navy and Marine Corps .................................................................................................................... 1,021,580 1,616,665 1,565,665 ∂544,085 ¥51,000 Military Construction, Air Force ............................................................................................................................................ 1,491,058 1,738,796 1,569,296 ∂78,238 ¥169,500 Military Construction, Defense-Wide .................................................................................................................................... 2,025,444 3,114,913 2,612,583 ∂587,139 ¥502,330 

Subtotal ................................................................................................................................................................... 5,051,541 7,390,768 6,677,938 ∂1,626,397 ¥712,830 

Military Construction, Army National Guard ........................................................................................................................ 232,930 210,652 210,652 ¥22,278 ..........................Military Construction, Air National Guard ............................................................................................................................ 143,957 161,491 161,491 ∂17,534 ..........................Military Construction, Army Reserve .................................................................................................................................... 68,230 73,712 73,712 ∂5,482 ..........................Military Construction, Navy Reserve .................................................................................................................................... 38,597 65,271 65,271 ∂26,674 ..........................Military Construction, Air Force Reserve .............................................................................................................................. 188,950 63,535 63,535 ¥125,415 ..........................

Subtotal, .................................................................................................................................................................. 672,664 574,661 574,661 ¥98,003 ..........................

North Atlantic Treaty Organization Security Investment Program ....................................................................................... 177,932 154,000 154,000 ¥23,932 ..........................

Department of Defense Base Closure Account ........................................................................................................... 240,237 255,867 255,867 ∂15,630 ..........................

Total, Military Construction .................................................................................................................................... 6,142,374 8,375,296 7,662,466 ∂1,520,092 ¥712,830 

Family Housing Operation and Maintenance, Army .................................................................................................... 325,995 346,625 348,907 ∂22,912 ∂2,282 Family Housing Operation and Maintenance, Navy and Marine Corps ...................................................................... 300,915 328,282 328,282 ∂27,367 ..........................Family Housing Operation and Maintenance, Air Force ............................................................................................. 274,429 318,324 318,324 ∂43,895 ..........................Family Housing Operation and Maintenance, Defense-Wide ...................................................................................... 59,157 59,169 59,169 ∂12 ..........................

Subtotal ................................................................................................................................................................... 960,496 1,052,400 1,054,682 ∂94,186 ∂2,282 

Family Housing Construction, Army ..................................................................................................................................... 157,172 182,662 182,662 ∂25,490 ..........................Family Housing Construction, Navy and Marine Corps ....................................................................................................... 94,011 83,682 83,682 ¥10,329 ..........................
124 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2017 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2018—Continued 

[In thousands of dollars] 

Item 2017 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2017 

appropriation Budget estimate 

Family Housing Construction, Air Force ............................................................................................................................... 61,352 85,062 85,062 ∂23,710 ..........................

Subtotal ................................................................................................................................................................... 312,535 351,406 351,406 ∂38,871 ..........................

DoD Family Housing Improvement Fund .............................................................................................................................. 3,258 2,726 2,726 ¥532 ..........................DoD Military Unaccompanied Housing Improvement Fund .................................................................................................. .......................... 623 623 ∂623 ..........................

Total, Family Housing ............................................................................................................................................. 1,276,289 1,407,155 1,409,437 ∂133,148 ∂2,282 

ADMINISTRATIVE PROVISIONS 

Military Construction, Army (Sec. 126) (rescission) ............................................................................................................ ¥29,602 .......................... .......................... ∂29,602 ..........................Military Construction, Navy and Marine Corps (H. Sec. 126) (rescission) ......................................................................... .......................... .......................... .......................... .......................... ..........................Military Construction, Air Force (Sec. 127) (rescission) ...................................................................................................... ¥51,460 .......................... .......................... ∂51,460 ..........................Military Construction, Defense-Wide—Planning and Design (Sec. 127) ............................................................................ ¥30,000 .......................... .......................... ∂30,000 ..........................Military Construction, Army (Sec. 125) ................................................................................................................................ 40,500 .......................... 68,800 ∂28,300 ∂68,800 Military Construction, Navy and Marine Corps (Sec. 125) .................................................................................................. 227,099 .......................... 110,100 ¥116,999 ∂110,100 Military Construction, Air Force (Sec. 125) .......................................................................................................................... 149,500 .......................... 127,300 ¥22,200 ∂127,300 Military Construction, Army National Guard (Sec. 125) ...................................................................................................... 67,500 .......................... 83,500 ∂16,000 ∂83,500 Military Construction, Air National Guard (Sec. 125) .......................................................................................................... 11,000 .......................... 24,000 ∂13,000 ∂24,000 Military Construction, Army Reserve (Sec. 125) .................................................................................................................. 30,000 .......................... 30,000 .......................... ∂30,000 Military Construction, Air Force Reserve (Sec. 125) ............................................................................................................ .......................... .......................... 35,100 ∂35,100 ∂35,100 NATO Security Investment Program (Sec. 127) (rescission) ................................................................................................ ¥30,000 .......................... .......................... ∂30,000 ..........................42 USC 3374 (Sec. 128) ...................................................................................................................................................... ¥25,000 .......................... .......................... ∂25,000 ..........................Military Construction, Navy and Marine Corps (Sec. 126) .................................................................................................. 89,400 .......................... .......................... ¥89,400 ..........................Military Construction, Defense-Wide (Sec. 126) (rescission) .............................................................................................. ¥141,600 .......................... ¥14,703 ∂126,897 ¥14,703 NATO Security Investment Program (Sec. 126) ................................................................................................................... .......................... .......................... .......................... .......................... ..........................Family Housing Construction, Army (Sec. 126) ................................................................................................................... .......................... .......................... .......................... .......................... ..........................Family Housing Construction, Navy and Marine Corps (Sec. 126) ..................................................................................... .......................... .......................... .......................... .......................... ..........................Family Housing Construction, Air Force (Sec. 126) ............................................................................................................. .......................... .......................... .......................... .......................... ..........................
125 

Total, Administrative Provisions ............................................................................................................................. 307,337 .......................... 464,097 ∂156,760 ∂464,097 

Appropriations .................................................................................................................................................... (614,999 ) .......................... (478,800 ) (¥136,199 ) (∂478,800 ) Rescissions ......................................................................................................................................................... (¥307,662 ) .......................... (¥14,703 ) (∂292,959 ) (¥14,703 ) 

Total, title I, Department of Defense ..................................................................................................................... 7,726,000 9,782,451 9,536,000 ∂1,810,000 ¥246,451 

Appropriations .................................................................................................................................................... (8,033,662 ) (9,782,451 ) (9,550,703 ) (∂1,517,041 ) (¥231,748 ) Rescissions ......................................................................................................................................................... (¥307,662 ) .......................... (¥14,703 ) (∂292,959 ) (¥14,703 ) 

TITLE II—DEPARTMENT OF VETERANS AFFAIRS 

Veterans Benefits Administration 

Compensation and pensions: 

Advance from prior year .............................................................................................................................................. (86,083,128 ) (90,119,449 ) (90,119,449 ) (∂4,036,321 ) ..........................

Subtotal, current year .................................................................................................................................... 86,083,128 90,119,449 90,119,449 ∂4,036,321 ..........................

Advance appropriation, fiscal year 2019 .................................................................................................................... 90,119,449 95,768,462 95,769,000 ∂5,649,551 ∂538 

Readjustment benefits: 

Advance from prior year .............................................................................................................................................. (16,340,828 ) (13,708,648 ) (13,708,648 ) (¥2,632,180 ) ..........................

Subtotal .......................................................................................................................................................... 16,340,828 13,708,648 13,708,648 ¥2,632,180 ..........................

Advance appropriation, fiscal year 2019 .................................................................................................................... 13,708,648 11,832,175 11,832,000 ¥1,876,648 ¥175 

Veterans insurance and indemnities: 

Advance from prior year .............................................................................................................................................. (91,920 ) (107,899 ) (107,899 ) (∂15,979 ) ..........................Current year request ................................................................................................................................................... 16,605 12,439 13,000 ¥3,605 ∂561 

Subtotal ................................................................................................................................................................... 108,525 120,338 120,899 ∂12,374 ∂561 

Advance appropriation, fiscal year 2019 .................................................................................................................... 107,899 109,090 109,000 ∂1,101 ¥90 

Veterans housing benefit program fund: 

(Limitation on direct loans) ........................................................................................................................................ (500 ) (500 ) (500 ) .......................... ..........................Administrative expenses .............................................................................................................................................. 198,856 178,626 178,626 ¥20,230 ..........................

Vocational rehabilitation loans program account ............................................................................................................... 36 30 30 ¥6 ..........................

(Limitation on direct loans) ............................................................................................................................... (2,517 ) (2,356 ) (2,356 ) (¥161 ) ..........................Administrative expenses ..................................................................................................................................... 389 395 395 ∂6 ..........................Native American veteran housing loan program account ................................................................................. 1,163 1,163 1,163 .......................... ..........................General operating expenses, VBA ...................................................................................................................... 2,856,160 2,844,000 2,910,000 ∂53,840 ∂66,000 

Total, Veterans Benefits Administration ................................................................................................................. 107,009,205 110,746,380 110,813,214 ∂3,804,009 ∂66,834 
126 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2017 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2018—Continued 

[In thousands of dollars] 

Item 2017 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2017 

appropriation Budget estimate 

Appropriations .................................................................................................................................................... (3,073,209 ) (3,036,653 ) (3,103,214 ) (∂30,005 ) (∂66,561 ) Advance appropriations, fiscal year 2019 ......................................................................................................... (103,935,996 ) (107,709,727 ) (107,710,000 ) (∂3,774,004 ) (∂273 ) Advances from prior year appropriations .......................................................................................................... (102,515,876 ) (103,935,996 ) (103,935,996 ) (∂1,420,120 ) ..........................

Veterans Health Administration 

Medical services: 

Advance from prior year .............................................................................................................................................. (51,673,000 ) (44,886,554 ) (44,886,554 ) (¥6,786,446 ) ..........................Current year request ................................................................................................................................................... 1,078,993 1,031,808 1,923,000 ∂844,007 ∂891,192 Supplemental funding for opioid abuse prevention (Public Law 115–31) 1 .............................................................. 50,000 .......................... .......................... ¥50,000 ..........................

Medical Services (Sec. 217) (rescission) ........................................................................................................... ¥7,246,181 .......................... .......................... ∂7,246,181 ..........................

Subtotal ................................................................................................................................................................... 45,555,812 45,918,362 46,809,554 ∂1,253,742 ∂891,192 

Advance appropriation, fiscal year 2019 .................................................................................................................... 44,886,554 49,161,165 49,161,000 ∂4,274,446 ¥165 

Medical community care: 

Advance from prior year .............................................................................................................................................. .......................... (9,409,118 ) (9,409,118 ) (∂9,409,118 ) ..........................Current year request ................................................................................................................................................... 7,246,181 254,000 254,000 ¥6,992,181 ..........................

Subtotal ................................................................................................................................................................... 7,246,181 9,663,118 9,663,118 ∂2,416,937 ..........................

Advance appropriation, fiscal year 2019 .................................................................................................................... 9,409,118 8,384,704 8,385,000 ¥1,024,118 ∂296 

Medical support and compliance: 

Advance from prior year .............................................................................................................................................. (6,524,000 ) (6,654,480 ) (6,654,480 ) (∂130,480 ) ..........................Current year request ................................................................................................................................................... .......................... 284,397 100,000 ∂100,000 ¥184,397 

Subtotal ................................................................................................................................................................... 6,524,000 6,938,877 6,754,480 ∂230,480 ¥184,397 

Advance appropriation, fiscal year 2019 .................................................................................................................... 6,654,480 7,239,156 7,239,000 ∂584,520 ¥156 

Medical facilities: 

Advance from prior year .............................................................................................................................................. (5,074,000 ) (5,434,880 ) (5,434,880 ) (∂360,880 ) ..........................
127 

Current year request ................................................................................................................................................... 247,668 1,079,795 707,000 ∂459,332 ¥372,795 

Subtotal ................................................................................................................................................................... 5,321,668 6,514,675 6,141,880 ∂820,212 ¥372,795 

Advance appropriation, fiscal year 2019 .................................................................................................................... 5,434,880 5,914,288 5,915,000 ∂480,120 ∂712 

Medical and prosthetic research ......................................................................................................................................... 675,366 640,000 722,262 ∂46,896 ∂82,262 Medical care cost recovery collections: 

Offsetting collections .................................................................................................................................................. ¥2,637,000 ¥2,507,000 ¥2,507,000 ∂130,000 ..........................Appropriations (indefinite) .......................................................................................................................................... 2,637,000 2,507,000 2,507,000 ¥130,000 ..........................

Subtotal ................................................................................................................................................................... .......................... .......................... .......................... .......................... ..........................

DoD–VA Joint Medical Funds (transfer out) ........................................................................................................................ (¥274,731 ) (¥297,137 ) (¥297,137 ) (¥22,406 ) ..........................DoD–VA Joint Medical Funds (by transfer) .......................................................................................................................... (274,731 ) (297,137 ) (297,137 ) (∂22,406 ) ..........................DoD-VA Health Care Sharing Incentive Fund (Transfer out) (¥15,000 ) (¥15,000 ) (¥15,000 ) .......................... ..........................DoD-VA Health Care Sharing Incentive Fund (by transfer) (15,000 ) (15,000 ) (15,000 ) .......................... ..........................

Total, Veterans Health Administration ................................................................................................................... 68,437,059 73,989,313 74,406,262 ∂5,969,203 ∂416,949 

Appropriations ................................................................................................................................................ (2,052,027 ) (3,290,000 ) (3,706,262 ) (∂1,654,235 ) (∂416,262 ) Rescissions .................................................................................................................................................... .......................... .......................... .......................... .......................... ..........................(By transfer) ................................................................................................................................................... (289,731 ) (312,137 ) (312,137 ) (∂22,406 ) ..........................Advance appropriations, fiscal year 2019 .................................................................................................... (66,385,032 ) (70,699,313 ) (70,700,000 ) (∂4,314,968 ) (∂687 ) 

Advances from prior year appropriations ............................................................................................................... (63,271,000 ) (66,385,032 ) (66,385,032 ) (∂3,114,032 ) ..........................

National Cemetery Administration 

National Cemetery Administration ....................................................................................................................................... 286,193 306,193 306,193 ∂20,000 ..........................

Departmental Administration 

General administration ......................................................................................................................................................... 345,391 346,891 329,891 ¥15,500 ¥17,000 Board of Veterans Appeals .................................................................................................................................................. 156,096 155,596 166,000 ∂9,904 ∂10,404 Information technology systems ........................................................................................................................................... 4,278,259 4,055,500 4,055,500 ¥222,759 ..........................Office of Inspector General .................................................................................................................................................. 160,106 159,606 164,000 ∂3,894 ∂4,394 Construction, major projects ................................................................................................................................................ 528,110 512,430 512,430 ¥15,680 ..........................Construction, minor projects ................................................................................................................................................ 372,069 342,570 342,570 ¥29,499 ..........................Grants for construction of State extended care facilities ................................................................................................... 90,000 90,000 110,000 ∂20,000 ∂20,000 Grants for the construction of veterans cemeteries ............................................................................................................ 45,000 45,000 45,000 .......................... ..........................

Total, Departmental Administration ....................................................................................................................... 5,975,031 5,707,593 5,725,391 ¥249,640 ∂17,798 
128 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2017 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2018—Continued 

[In thousands of dollars] 

Item 2017 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2017 

appropriation Budget estimate 

Administrative Provisions 

JIF rescission (Sec. 235) ...................................................................................................................................................... ¥40,000 .......................... ¥15,000 ∂25,000 ¥15,000 General rescission (Sec. 233) .............................................................................................................................................. ¥169,000 .......................... .......................... ∂169,000 ..........................General reduction (Sec. 234) ............................................................................................................................................... ¥23,000 .......................... .......................... ∂23,000 ..........................Proposed mandatory disability exams language ................................................................................................................. .......................... 40,000 .......................... .......................... ¥40,000 Medical services (Sec. 217) (rescission) ............................................................................................................................. .......................... .......................... ¥751,000 ¥751,000 ¥751,000 Information technology services (Sec. 250) (rescission) .......................... .......................... ¥30,000 ¥30,000 ¥30,000 Construction, major projects: 

Sec. 243(a) rescission (emergency) ............................................................................................................................ .......................... .......................... .......................... .......................... ..........................Sec. 243(b) reappropriation (emergency) ................................................................................................................... .......................... .......................... .......................... .......................... ..........................Sec. 244(a) rescission ................................................................................................................................................. .......................... .......................... ¥10,000 ¥10,000 ¥10,000 Sec. 244(b) reappropriation ........................................................................................................................................ .......................... .......................... 10,000 ∂10,000 ∂10,000 Sec. 244(c) rescission ................................................................................................................................................. .......................... .......................... ¥410,000 ¥410,000 ¥410,000 Sec. 244(d) reappropriation ........................................................................................................................................ .......................... .......................... 410,000 ∂410,000 ∂410,000 

Total. Administrative Provisions ............................................................................................................................. ¥232,000 40,000 ¥796,000 ¥564,000 ¥836,000 Total, title II ............................................................................................................................................................ 181,475,488 190,789,479 190,455,060 ∂8,979,572 ¥334,419 

Appropriations ................................................................................................................................................ (11,363,460 ) (12,380,439 ) (12,841,060 ) (∂1,477,600 ) (∂460,621 ) Reappropriations ............................................................................................................................................ .......................... .......................... (420,000 ) (∂420,000 ) (∂420,000 ) Reappropriations (emergency) ....................................................................................................................... .......................... .......................... .......................... .......................... ..........................Rescissions .................................................................................................................................................... (¥209,000 ) .......................... (¥1,216,000 ) (¥1,007,000 ) (¥1,216,000 ) Rescissions (emergency) ................................................................................................................................ .......................... .......................... .......................... .......................... ..........................(By transfer) ................................................................................................................................................... (289,731 ) (312,137 ) (312,137 ) (∂22,406 ) ..........................

Advance Appropriations, fiscal year 2019: 

(Limitation on direct loans) ........................................................................................................................................ (3,017 ) (2,856 ) (2,856 ) (¥161 ) ..........................

Advances from prior year less fiscal year 2019 advances ............................................................................... .......................... .......................... .......................... .......................... ..........................Advances from prior year less fiscal year 2019 advances ............................................................................... .......................... .......................... .......................... .......................... ..........................
129 

TITLE III—RELATED AGENCIES 

American Battle Monuments Commission 

Salaries and expenses ......................................................................................................................................................... 75,100 75,100 79,000 ∂3,900 ∂3,900 Foreign currency fluctuations account ................................................................................................................................. .......................... .......................... .......................... .......................... ..........................

Total, American Battle Monuments Commission ................................................................................................... 75,100 75,100 79,000 ∂3,900 ∂3,900 

U.S. Court of Appeals for Veterans Claims 

Salaries and expenses ......................................................................................................................................................... 30,945 33,608 33,608 ∂2,663 ..........................

Department of Defense—Civil 

Cemeterial Expenses, Army 

Salaries and expenses ......................................................................................................................................................... 70,800 70,800 81,000 ∂10,200 ∂10,200 

Armed Forces Retirement Home—Trust Fund 

Operation and maintenance ................................................................................................................................................. 41,300 41,300 41,300 .......................... ..........................Capital program ................................................................................................................................................................... 1,000 1,000 1,000 .......................... ..........................Payment from General Fund ................................................................................................................................................ 22,000 22,000 22,000 .......................... ..........................

Total, Armed Forces Retirement Home ................................................................................................................... 64,300 64,300 64,300 .......................... ..........................Total, title III ........................................................................................................................................................... 241,145 243,808 257,908 ∂16,763 ∂14,100 

TITLE IV—OVERSEAS CONTINGENCY OPERATIONS 

Overseas Contingency Operations 

Army ...................................................................................................................................................................................... .......................... 124,000 124,000 ∂124,000 ..........................

Additional funding for planning and design (Public Law 115–31) ........................................................................... 39,500 .......................... .......................... ¥39,500 ..........................

Navy .................................................................................................................................................................... 38,409 .......................... .......................... ¥38,409 ..........................

Additional funding for construction (Public Law 115–31) ......................................................................................... 66,708 .......................... .......................... ¥66,708 ..........................

Subtotal ................................................................................................................................................................... 105,117 .......................... .......................... ¥105,117 ..........................

Air Force ............................................................................................................................................................................... 11,440 207,200 207,200 ∂195,760 ..........................

Additional funding for construction (Public Law 115–31) ......................................................................................... 93,000 .......................... .......................... ¥93,000 ..........................

Subtotal ................................................................................................................................................................... 104,440 207,200 207,200 ∂102,760 ..........................

Defense-Wide ........................................................................................................................................................................ .......................... .......................... .......................... .......................... ..........................
130 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2017 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2018—Continued 

[In thousands of dollars] 

Item 2017 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2017 

appropriation Budget estimate 

Army National Guard: 

Additional funding for planning and design (Public Law 115–31) ........................................................................... 12,000 .......................... .......................... ¥12,000 ..........................

Air National Guard: 

Additional funding for construction (Public Law 115–31) ......................................................................................... 13,000 .......................... .......................... ¥13,000 ..........................

Army Reserve: 

Additional funding for planning and design (Public Law 115–31) ........................................................................... 10,000 .......................... .......................... ¥10,000 ..........................

Navy Reserve: 

Additional funding for construction (Public Law 115–31) ......................................................................................... 4,525 .......................... .......................... ¥4,525 ..........................

Air Force Reserve: 

Additional funding for planning and design (Public Law 115–31) ........................................................................... 9,000 .......................... .......................... ¥9,000 ..........................

Subtotal .......................................................................................................................................................... 297,582 331,200 331,200 ∂33,618 ..........................

European Reassurance Initiative 

Army ...................................................................................................................................................................................... 18,900 15,700 15,700 ¥3,200 ..........................Navy ...................................................................................................................................................................................... 21,400 18,500 18,500 ¥2,900 ..........................Air Force ............................................................................................................................................................................... 68,280 270,830 270,830 ∂202,550 ..........................

Additional funding for planning and design (Public Law 115–31) ........................................................................... 12,300 .......................... .......................... ¥12,300 ..........................

Subtotal ................................................................................................................................................................... 80,580 270,830 270,830 ∂190,250 ..........................

Defense-Wide ........................................................................................................................................................................ 5,000 1,900 1,900 ¥3,100 ..........................

Administrative Provision 

Military Construction, Air Force (Sec. 101, Public Law 115–31) (rescission) .................................................................... ¥12,300 .......................... .......................... ∂12,300 ..........................

Subtotal ................................................................................................................................................................... 113,580 306,930 306,930 ∂193,350 ..........................

Counterterrorism Support 

Air Force ............................................................................................................................................................................... 8,571 .......................... .......................... ¥8,571 ..........................
131 

Total, title IV ........................................................................................................................................................... 419,733 638,130 638,130 ∂218,397 ..........................Grand total .............................................................................................................................................................. 189,862,366 201,453,868 200,887,098 ∂11,024,732 ¥566,770 

Appropriations ................................................................................................................................................ (19,638,267 ) (22,406,698 ) (22,649,671 ) (∂3,011,404 ) (∂242,973 ) Reappropriations ............................................................................................................................................ .......................... .......................... (420,000 ) (∂420,000 ) (∂420,000 ) Reappropriations (emergency) ....................................................................................................................... .......................... .......................... .......................... .......................... ..........................Rescissions .................................................................................................................................................... (¥516,662 ) .......................... (¥1,230,703 ) (¥714,041 ) (¥1,230,703 ) Rescission of OCO ......................................................................................................................................... (¥12,300 ) .......................... .......................... (∂12,300 ) ..........................Rescissions (emergency) ................................................................................................................................ .......................... .......................... .......................... .......................... ..........................Advance appropriations, fiscal year 2019 .................................................................................................... (170,321,028 ) (178,409,040 ) (178,410,000 ) (∂8,088,972 ) (∂960 ) Overseas contingency operations .................................................................................................................. (432,033 ) (638,130 ) (638,130 ) (∂206,097 ) ..........................

Advances from prior year appropriations ............................................................................................................... (165,786,876 ) (170,321,028 ) (170,321,028 ) (∂4,534,152 ) ..........................(By transfer) ............................................................................................................................................................ (289,731 ) (312,137 ) (312,137 ) (∂22,406 ) ..........................(Transfer out) .......................................................................................................................................................... (¥289,731 ) (¥312,137 ) (¥312,137 ) (¥22,406 ) ..........................(Limitation on direct loans) .................................................................................................................................... (3,017 ) (2,856 ) (2,856 ) (¥161 ) ..........................

1 Funding for opioid abuse prevention was included in the fiscal year 2017 supplemental. In fiscal year 2018, it is provided within the amount recommended by the Committee. 

Æ