99–765 

114TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 2d Session 114–497 

MILITARY CONSTRUCTION, VETERANS AFFAIRS, AND 

RELATED AGENCIES APPROPRIATIONS BILL, 2017 

APRIL 15, 2016.—Committed to the Committee of the Whole House on the State of 

the Union and ordered to be printed 

Mr. DENT, from the Committee on Appropriations, 

submitted the following 

R E P O R T 

together with 

MINORITY AND ADDITIONAL VIEWS 

[To accompany H.R. 4974] 

The Committee on Appropriations submits the following report in 

explanation of the accompanying bill making appropriations for 

military construction, the Department of Affairs, and related agencies for the fiscal year ending September 30, 2017, and for other 

purposes. 

CONTENTS 

Page 

Purpose of the Bill ................................................................................................... 2 

Summary of Committee Recommendation ............................................................ 2 

Comparative Statement of New Budget Authority ............................................... 4 

Management and Oversight Initiatives ................................................................. 15 

Department of Defense: 

Military Construction ....................................................................................... 17 

NATO Security Investment Program .............................................................. 25 

Family Housing Construction and Operation and Maintenance .................. 27 

Department of Defense Family Housing Improvement Fund ....................... 28 

Department of Defense Base Closure Account ............................................... 28 

Administrative Provisions ................................................................................ 28 

Department of Veterans Affairs: 

Veterans Benefits Administration ................................................................... 31 

Veterans Health Administration ..................................................................... 34 

National Cemetery Administration ................................................................. 53 

Departmental Administration ......................................................................... 54 

Administrative Provisions ................................................................................ 69 


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Related Agencies: 

American Battle Monuments Commission ..................................................... 73 

U.S. Court of Appeals for Veterans Claims .................................................... 74 

Cemeterial Expenses, Army ............................................................................ 74 

Armed Forces Retirement Home ..................................................................... 74 

Administrative Provisions ................................................................................ 75 

Department of Defense: 

Overseas Contingency Operations .................................................................. 76 

General Provisions ................................................................................................... 77 

House of Representatives Report Requirements ................................................... 78 

Statement of General Performance Goals and Objectives ............................ 78 

Rescissions ........................................................................................................ 78 

Transfer of Funds ............................................................................................. 79 

Disclosure of Earmarks and Congressionally Directed Spending Items ...... 80 

Changes in Application of Existing Law ........................................................ 80 

Appropriations Not Authorized by Law .......................................................... 84 

Program Duplication ........................................................................................ 86 

Directed Rule Making ...................................................................................... 86 

Full Committee Votes ...................................................................................... 87 

Ramseyer Rule .................................................................................................. 88 

Comparison With the Budget Resolution ....................................................... 88 

Five-Year Projection of Outlays ...................................................................... 88 

Assistance to State and Local Governments .................................................. 89 

State Project List .............................................................................................. 89 

Minority and Additional Views.................................................................... 103, 106 

PURPOSE OF THE BILL

The purpose of the bill is to support our military and their families and provide the benefits and medical care that our veterans 

have earned for their service to our Nation. This is accomplished 

through the programs funded in the bill, which provide the facilities and infrastructure needed to house, train, and equip our military personnel to defend this Nation, both in the United States and 

abroad; provide the housing and military community infrastructure 

that supports a good quality of life for them and their families; and 

allow the military to maintain an efficient and effective base structure. The bill also funds programs to ensure that all veterans receive the benefits and medical care that they have earned as a result of the sacrifices they have made in their service to our country. 

Finally, the bill funds four related agencies that provide support to 

our Nation’s heroes: the American Battle Monuments Commission, 

Cemeterial Expenses, Army (including Arlington National Cemetery), the United States Court of Appeals for Veterans Claims, and 

the Armed Forces Retirement Home. 

SUMMARY OF COMMITTEE RECOMMENDATION

The Committee recommends $184,175,481,000 in budget authority for the fiscal year 2017 programs and activities funded in the 

bill. The fiscal year 2017 recommendation is an increase of 

$13,050,419,000 above the fiscal year 2016 enacted level and 

$1,277,405,000 below the President’s request. Of the increase over 

the fiscal year 2016 enacted level, $11,276,419,000 is in mandatory 

programs. Included in the total budget authority is 

$102,532,481,000 in mandatory budget authority and 

$81,643,000,000 in discretionary budget authority. 

The Committee recommendation highlights the continued commitment to our servicemembers and their families and to our veterans. In discretionary budget authority, the bill is 2.2 percent over 

the fiscal year 2016 enacted level. The bill includes a slight deVerDate Sep 11 2014 04:42 Apr 16, 2016 Jkt 099765 PO 00000 Frm 00002 Fmt 6659 Sfmt 6602 E:\HR\OC\HR497.XXX HR497

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crease in military construction, which is 3.7 percent below the fiscal year 2016 level, and an increase in the Department of Veterans 

Affairs budget, which is 3.0 percent over the fiscal year 2016 level. 

While the Committee recommendation continues essential support 

for servicemembers and veterans, it does not provide funds for 

projects or activities that lacked sufficient justification or were less 

mission-critical. Where it was prudent, the Committee recommendation rescinds prior year funding that is no longer needed 

for the purpose for which it was appropriated while leaving sufficient resources to close out contracts. 

The programs funded in the bill for the Department of Defense 

address the priorities of the Department’s Agencies and the Services for numerous facility challenges that they face. The funds provided support new construction, family housing, continued cleanup 

of military bases closed during previous Base Realignment and Closure rounds, resource Combatant Commanders requirements where 

appropriate, and ensure that our military personnel and their families’ quality of life is preserved. 

The total recommended funding level for military construction 

and family housing, including base and Overseas Contingency Operations funding is $7,866,000,000, which is $305,000,000 below 

the fiscal year 2016 enacted level and $249,495,000 above the 

budget request. The recommendation includes full funding for Family Housing, funding for necessary construction on our bases, including barracks, health facilities and schools, and support for critical overseas investments, including the European Reassurance Initiative. 

The total funding level for fiscal year 2017 for the Department 

of Veterans Affairs is $176,068,336,000, an increase of 

$13,397,331,000 over the fiscal year 2016 enacted level. Of the 

total, $102,532,481,000 is provided for mandatory benefit programs 

and $73,535,855,000 is allocated to discretionary programs such as 

medical care, claims processing, and construction. In this bill, discretionary funding for the Department of Veterans Affairs is recommended at 3.0 percent over the fiscal year 2016 level. For fiscal 

year 2017, $63,271,000,000 for medical care has been appropriated 

in advance, and the recommendation includes an additional 

$850,000,000 in newly identified needs for VA, focusing on hepatitis C treatment, homelessness, long-term care, and caregiver stipends. The recommendation fully funds the request for the administrative costs of Veterans Benefits Administration, including funding for paperless claims, centralized mail, and additional staff. The 

bill also provides the full request of $156,096,000 for the Board of 

Veterans Appeals, a $46,212,000 increase, to target the growing 

caseload of appeals of initial benefits decisions. In addition, the 

Committee recommendation includes $66,385,032,000 in advance 

appropriations for fiscal year 2018 for the four health care accounts 

of the Department and $103,935,996,000 in advance appropriations 

for mandatory benefits programs for fiscal year 2018. 

The following table compares amounts recommended in the bill 

to the President’s request and amounts appropriated in fiscal year 

2016: 


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MANAGEMENT AND OVERSIGHT INITIATIVES

The Committee believes the effective stewardship of taxpayer 

dollars is of the highest priority. In the interest of eliminating 

waste, fraud, and abuse in Federal programs, the Committee has 

and will continue to use public hearings, briefings, and information 

requests, and reviews by the Government Accountability Office and 

the Inspectors General to promote strong financial and program 

management, oversight and leadership at the Department of Defense, the Department of Veterans Affairs, and other agencies 

under the jurisdiction of this bill. 

The fiscal year 2017 appropriations Act and the accompanying 

report address management challenges of the Federal agencies 

funded herein, including directives to strengthen financial and program management, eliminate redundancy, and improve implementation and oversight of initiatives that support the mission of this 

bill. The Committee will use every means at its disposal to reduce 

mismanagement that results in waste, fraud, and abuse. 

Department of Defense (DOD).—In addition to the notification 

and reporting requirements for military construction programs contained in Title 10, United States Code, the Committee’s recommendations include several provisions requiring the Department 

of Defense to report on various aspects of military construction programs, or to provide notification to the Committee when certain actions are taken. The Committee also retains prior approval authority for any reprogramming of funds exceeding a specific threshold. 

Department of Veterans Affairs (VA).—With the $176,068,336,000 

provided for VA in this bill and the increase in the number of veterans seeking VA medical services, the Committee believes it is important to strengthen its tools to monitor spending as well the operating procedures of the VA workforce. The following initiatives 

demonstrate the Committee’s oversight focus: 

VA electronic health record.—The Committee continues to feel it 

is critical to closely track VA’s development of its electronic health 

record. In the aftermath of the DOD and VA decision not to pursue 

a single integrated health record, it becomes doubly important to 

ensure that the two health records are designed in a way that permits interoperability between the two in order that computable 

data from one record can be viewed and used by clinicians with a 

different electronic record system. In addition, the Committee now 

understands that VA is reconsidering whether it should modernize 

its existing health record or instead purchase a commercial product. Especially with the uncertainties VA has now introduced regarding the development, timing and cost of its electronic health 

record, the Committee continues its practice of including language 

requiring VA to provide information on cost, timeline, performance 

benchmarks, and interoperability capacity of whichever electronic 

record system it ultimately chooses before release of the funding 

provided. 

Disability and appeals claims.—The Committee bill continues the 

aggressive monthly reporting requirements from each specific regional office on claims processing performance and quarterly reports on remediation efforts at the poorest performing regional offices. As the backlog of initial benefits claims continues to drop, the 

workload for the Board of Veterans Appeals is skyrocketing. The 


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Committee provides the full request for the Board, $156,096,000, 

which is a $46,212,000 increase, to provide the staffing power it 

needs to manage appeals. 

Information technology (IT).—The Committee continues to include bill language prohibiting obligation or expenditure of funds 

for information technology systems development, modernization 

and enhancement until VA submits to the Committees a certification of the amounts. The bill limits the amount of funds that can 

be transferred into IT to 10 percent of the total of either the source 

or destination account. The bill contains language which permits 

the reprogramming of funds among development, modernization 

and enhancement projects upon prior notification to, and approval 

by, the Committees. 

Stricter control of construction funding.—In response to the egregious management of the Denver hospital construction project, the 

Committee includes bill language to fence funding for major construction projects over $100,000,000 in cost until VA certifies that 

it has contracted with a non-VA governmental entity to design and 

manage the project. Several additional bill language provisions are 

included to enhance the Committee’s capacity to conduct oversight 

on VA’s facility construction efforts: (1) no funding greater than 

$5,000,000 may be reprogrammed between construction projects 

unless approved by the Committees on Appropriations of both 

House of Congress; (2) any change to the scope of a construction 

project is prohibited without the approval of the Committees; and 

(3) VA must report any bid savings of $5,000,000 or more on 

projects as soon as they are identified. 

ITEM OF SPECIAL INTEREST

Construction contracting outreach.—Department of Defense 

(DOD) and Department of Veterans Affairs (VA) construction 

projects funded in this Act are, in general, executed by the U.S. 

Army Corps of Engineers, the Naval Facilities Command, and the 

VA Office of Construction. Effective communication and collaboration between Federal procurement officials and the local construction industry is essential to improve opportunities for local contractors and businesses to compete for local DOD and VA construction 

projects. But despite the efforts of the Office of Federal Procurement Policy to increase communication between procurement officers and industry, local business owners often do not know about 

nor have the opportunity to compete for contracts for Federally 

funded construction projects. Therefore, the Secretaries of the 

Army and the Navy, and the Secretary of Veterans Affairs are directed to ensure that their respective regional/district offices responsible for construction projects inform and engage local construction industry contractors, especially small businesses, minority-owned businesses, and women-owned businesses, about Federal 

procurement opportunities and the bidding process. 


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TITLE I 

DEPARTMENT OF DEFENSE 

MILITARY CONSTRUCTION OVERVIEW

Fiscal year 2016 enacted level (including rescissions) .................... $8,171,000,000 

Fiscal year 2017 budget request ....................................................... 7,444,056,000 

Committee recommendation in the bill (including rescissions) ...... 7,694,000,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... (477,000,000) 

Fiscal year 2017 budget request ................................................ 249,944,000 

Military construction accounts provide funds for new construction, construction improvements, planning and design, and host nation support. Projects funded by these accounts include facilities for 

operations, training, maintenance, research and development, supply, medical care, and force protection, as well as unaccompanied 

housing, utilities infrastructure, and land acquisition. 

Reprogramming guidelines.—The following reprogramming 

guidelines apply for all military construction and family housing 

projects. A project or account (including the sub-elements of an account) which has been specifically reduced by the Congress in acting on the budget request is considered to be a Congressional interest item and as such, prior approval is required. Accordingly, no reprogramming to an item specifically reduced below the threshold 

by the Congress is permitted, except that the Department of Defense may seek reprogramming for appropriated increments. 

The reprogramming criteria that apply to military construction projects (25 percent of the funded amount or $2,000,000, whichever 

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

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

delay, the costs associated with environmental hazard remediation 

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

could not be reasonably anticipated at the time of the budget submission. This exclusion applies to projects authorized in this budget 

year, as well as projects authorized in prior years for which construction has not been completed. Planning and design costs associated with military construction and family housing projects may 

also be excluded from these guidelines. In instances where prior 

approval to a reprogramming request for a project or account has 

been received from the Committees on Appropriations of both 

Houses of Congress, the adjusted amount approved becomes the 

new base for any future increase or decrease via below-threshold 

reprogramming (provided that the project or account is not a Congressional interest item as defined above). 

In addition to these guidelines, the services are directed to adhere to the guidance for military construction reprogramming actions and notifications, including the pertinent statutory authorities contained in Department of Defense Financial Management 

Regulation 7000.14–R and relevant updates and policy memoranda. 

The Committee further encourages the Office of the Director of National Intelligence to use a format similar to that used by the Office 

of the Secretary of Defense to submit reprogramming requests. 


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Facilities Sustainment, Restoration and Modernization 

(FSRM).—The Department of Defense is directed to continue describing on form 1390 the backlog of FSRM requirements at installations with future construction projects. For troop housing requests, form 1391 should describe any FSRM conducted in the past 

two years. Likewise, future requirements for unaccompanied housing at the corresponding installation should be included. Additionally, the forms should include English equivalent measurements for 

projects presented in metric measurement. Rules for funding repairs of facilities under the Operation and Maintenance accounts 

are described below: 

(1) components of the facility may be repaired by replacement. Such replacement can be up to current standards or 

codes; 

(2) interior arrangements and restorations may be included 

as repair; 

(3) additions, new facilities, and functional conversions must 

be performed as military construction projects. Such projects 

may be done concurrently with repair projects as long as the 

final conjunctively funded project is a complete and usable facility; and 

(4) the appropriate service secretary shall notify the appropriate committees 21 days prior to carrying out any repair 

project with an estimated cost in excess of $7,500,000. The 

Committee strongly encourages the services and defense agencies to indicate the plant replacement value of the facility to 

be repaired on each such notification. 

Quarterly summary of notifications.—The Committee directs the 

services and the Office of the Secretary of Defense (on behalf of 

itself and defense agencies) to continue to submit a quarterly report listing all notifications that have been submitted to the Committees during the preceding three-month period. 

Work in Progress or Planned (WIP) curve.—The Committee directs the services and the Office of the Secretary of Defense (on behalf of itself and defense agencies) to submit a WIP curve for each 

project requested in a budget submission over $100,000,000 with 

the 1391 justification to the congressional defense committees. 

Transfer of funds to and from the Foreign Currency Fluctuations, 

Construction, Defense Account.—The Committee directs the Department of Defense to submit a quarterly report to the Committees on 

Appropriations of both Houses of Congress on the transfer of funds 

from military construction and family housing accounts to the Foreign Currency Fluctuations, Construction, Defense account. The report shall specify the amount transferred to the Foreign Currency 

account from each military construction and/or family housing account, and all other accounts for which an appropriation is provided in this Act, during the preceding fiscal quarter, and the 

amounts transferred from the Foreign Currency account to the 

above accounts during the same period. This report shall be submitted no later than 30 days after the close of each fiscal quarter. 

In addition, the Department of Defense shall notify the Committees 

on Appropriations of both Houses of Congress within 7 days of 

transferring any amount in excess of $10,000,000 to or from the 

Foreign Currency account. 


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Bid savings.—The Committee has ascertained from cost variation 

notices required by 10 U.S.C. 2853 that the Department of Defense 

continues to have bid savings on previously appropriated military 

construction projects. The Committee’s recommendation therefore 

includes rescissions to the Army, Navy and Marine Corps, and Defense-Wide construction accounts. The Committee directs the Secretary of Defense to continue to submit 1002 reports on military 

construction bid savings at the end of each fiscal quarter to the 

Subcommittee on Military Construction, Veterans Affairs, and Related Agencies of both the House and Senate. 

Defense Access Roads (DAR).—The Committee is concerned about 

the surface transportation infrastructure around key military installations, especially those that handle the important protective 

functions required for the President and diplomats. The Committee 

strongly supports the utilization of the DAR program to address 

these congestion issues. The Committee urges the Department to 

examine if adjustments in Defense Access Roads eligibility thresholds are needed for installations that provide protective functions. 

Therefore, the Department should report back to the Committee 

not later than 60 days after enactment of this Act on whether the 

DAR program adequately addresses the needs of installations that 

handle protective functions. 

High performance and sustainable building requirements.—The 

Committee notes that in March 2013, the Department of Defense 

released Unified Facilities Criteria (UFC) 1–200–02, High Performance and Sustainable Building Requirements. UFC 1–200–02 defines the minimum requirements for planning, design and construction, renovation, repair, maintenance and operations, and equipment installation in new and existing facilities. In a policy memorandum issued in November 2013, military components were authorized to pursue greater energy and water efficiency if such initiatives are shown to reduce total ownership cost of the facility, or 

preserve or increase mission effectiveness in the face of projected 

resource scarcity. The Committee regrets that the Department of 

Defense has done little to increase the use of innovative building 

materials following the inclusion of similar language in the report 

accompanying the Howard P. Buck McKeon National Defense Authorization Act for Fiscal Year 2015, H.R. 4435. The Committee 

recognizes that innovative technologies have expanded the availability of materials with lower embodied energy for facilities that 

require tall walls and large open spaces with minimal intermediate 

supports. In addition, design techniques such as advanced framing 

contribute to lower material costs, increased energy efficiency, and 

reduced waste in facilities. Therefore, the Committee encourages 

the Department of Defense to incorporate the use of innovative renewable building materials, systems, and design techniques that 

support the requirements of UFC 1–200–02 and the goals of achieving greater efficiency and lower environmental impacts at a lower 

material cost. Furthermore, the Committee encourages the Department of Defense to collaborate with the United States Department 

of Agriculture and the United States Forest Service to advance its 

understanding of innovative renewable building materials and systems and jointly develop a plan on expanding their use as appropriate. 


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Alternative building materials.—The Committee believes that the 

Department of Defense (DOD) should explore other materials for 

the construction of its facilities. It has come to the Committee’s attention that the use of Cross Laminated Timber (CLT) has been 

used as an alternative building method to concrete and steel construction. CLT is an applicable material for low-rise, as well as 

mid-rise to high-rise construction and has a lighter environmental 

footprint than traditional concrete and steel construction systems. 

The advantages to using CLT are many, but the main benefits include: shorter construction times, fewer skilled laborers, better tolerances and quality, safer work environment, utilization of regional, sustainable materials, and reduction of carbon footprint of 

buildings. Therefore, the Committee directs the Secretary of Defense to study the economic viability of utilizing CLT in future 

DOD facilities and determine if any fiscal year 2017 or fiscal year 

2018 project could be used as a demonstration project to accelerate 

the testing of CLT and report back to the Committee not later than 

60 days after enactment of this Act on its findings. 

MILITARY CONSTRUCTION, ARMY

Fiscal year 2016 enacted level ........................................................... $663,245,000 

Fiscal year 2017 budget request ....................................................... 503,459,000 

Committee recommendation in the bill ............................................ 503,459,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... (159,786,000) 

Fiscal year 2017 budget request ................................................ – – – 

The Committee recommendation includes a rescission of 

$25,000,000 from bid savings under Administrative Provisions. 

The Committee recommendation includes additional funding for 

the Army in section 128 under Administrative Provisions for 

projects on the Services Unfunded Priority lists as approved by the 

Secretary of Defense and submitted to Congress in priority order. 

Aging army hangars for Combat Aviation Units.—The Committee 

recognizes that the Army’s aging hangars housing combat aviation 

units are structurally deficient and do not meet the operational requirements of the Army’s Combat Aviation Brigades. A critical 

need exists for the Army to modernize infrastructure associated 

with operational needs, inclement weather, personnel changes, and 

other unforeseen circumstances. The Committee directs the Secretary of the Army to submit a report to the congressional defense 

committees not later than 90 days after the enactment of this Act 

detailing the age and condition of the Army’s Combat Aviation Brigade aircraft maintenance hangars, a prioritization of the most deficient infrastructure assets, the plan to modernize or replace those 

hangars, and the required resources. 

Air traffic control facilities.—The Committee is concerned that 

many of the Army’s air traffic control facilities are unsafe, antiquated, and do not provide adequate control, communications or observation abilities for the current air traffic levels at certain locations. For example, the current facility located at Fort Benning will 

become wholly inadequate at the current pace of operations and a 

replacement facility is necessary to ensure Air Traffic Services are 

available to support mission readiness and deployment platforms 

and the military flying community. The Committee is concerned 

that this could be a problem throughout the Army enterprise with 


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the recent reductions to the Department of Defense’s construction 

accounts. Therefore, the Secretary of the Army is directed to conduct a risk assessment on Army air traffic control facilities 

throughout the Army enterprise and develop a plan to update these 

facilities. This assessment shall be submitted to the congressional 

defense committees not later than 60 days after enactment of this 

Act. 

MILITARY CONSTRUCTION, NAVY AND MARINE CORPS

Fiscal year 2016 enacted level ........................................................... $1,669,239,000 

Fiscal year 2017 budget request ....................................................... 1,027,763,000 

Committee recommendation in the bill ............................................ 1,021,580,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... (647,659,000) 

Fiscal year 2017 budget request ................................................ (6,183,000) 

The Committee recommendation includes a rescission of 

$51,848,000 from bid savings under Administrative Provisions. 

The Committee recommendation includes additional funding for 

the Navy and Marine Corps in section 129 under Administrative 

Provisions for projects on the Services Unfunded Priority lists as 

approved by the Secretary of Defense and submitted to Congress 

in priority order. 

Townsend Bombing Range.—The Committee is closely monitoring the impact that the range expansion would have on the local 

timber economy. The Committee is concerned that the Department 

of the Navy is still failing to consider the impact this project will 

have on the local community and urges the Navy to quickly find 

a resolution on this issue. 

F–35C Basing at MCAS Miramar.—During budget briefings the 

Committee was informed by the Marine Corps that a change in 

mission by the Navy to support the Pacific Commander had occurred. The new mission requirement involved the movement of an 

aircraft carrier from the East Coast to the West Coast. The Marine 

Corps requested in their fiscal year 2017 budget the hangars for 

the F–35B assets to be stationed on the East Coast. Therefore, the 

assets to support the West Coast-based carrier were not requested 

in fiscal year 2017 but planned for fiscal year 2019 when a carrier 

was to be on the West Coast. The Marine Corps provided the Committee the unfunded priorities list for fiscal year 2017 that was approved by the Secretary of Defense which included the assets necessary to support the West Coast-based carrier. Therefore, Committee has provided $193,600,000 for the Marine Corps’ number 1, 

2 and 3 priorities from the Services Unfunded Priority lists as approved by the Secretary of Defense and submitted to Congress in 

priority order to support the Department of the Navy operational 

requirement in the Pacific Area of Responsibility. 

MILITARY CONSTRUCTION, AIR FORCE

Fiscal year 2016 enacted level ........................................................... $1,389,185,000 

Fiscal year 2017 budget request ....................................................... 1,481,058,000 

Committee recommendation in the bill ............................................ 1,398,758,000 

Comparison with:.

Fiscal year 2016 enacted level ................................................... 9,573,000 

Fiscal year 2017 budget request ................................................ (82,300,000) 

The Committee recommendation includes additional funding for 

the Air Force in section 132 under Administrative Provisions for 


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one project on the Services Unfunded Priority lists as approved by 

the Secretary of Defense and submitted to Congress in priority 

order. 

Air traffic control towers.—The Committee is concerned that the 

Department of the Air Force’s air traffic control towers have been 

neglected over the years and funding for military construction has 

been deferred to the out years of budget submissions. Many of the 

air towers are deteriorating and antiquated, creating significant 

life, safety, and health concerns. In some cases, towers have developed extensive mold issues and contain health risks related to the 

use of asbestos and lead-based paint. Additionally, obstructed views 

in some cases prevent 100 percent positive visual control of aircraft 

landing and taxiing on the airfield. The Committee urges the Department of the Air Force to prioritize funding for these towers in 

a much timelier manner. The Committee believes that these towers 

are valuable national security assets that the Department of the 

Air Force should maintain in a manner that will ensure their vital 

role in protecting U.S. national security interests. 

Conditions at expeditionary facilities.—The Committee is concerned about reports of black mold at Al Udeid Air Base in Qatar 

and the effect it is having on the health of those serving at the Air 

Base. Therefore, the Air Force shall provide a report to the congressional defense committees on the status and way ahead to alleviate 

the mold issue as well as a comprehensive remediation plan not 

later than 60 days after enactment of this Act. 

F–35A Aircraft Weather Shelter (SQD 2).—The Committee is concerned that the Air Force brought numerous new starts into the 

fiscal year 2017 budget submission that may prove difficult to execute in States with limited construction time periods. Therefore, 

the recommendation does not include $82,300,000 for F–35A aircraft weather shelters for squad 2. 

Offutt Air Force Base runway repair.—The Committee understands that the Air Force is providing operation and maintenance 

funding for runway repair at Offutt Air Force Base. The Committee 

directs the Air Force to follow the appropriate notification process 

for using operation and maintenance funding for large repair 

projects and to keep the Committee informed as to how the repair 

is proceeding. 

MILITARY CONSTRUCTION, DEFENSE-WIDE

(INCLUDING TRANSFER OF FUNDS)

Fiscal year 2016 enacted level ........................................................... $2,242,867,000 

Fiscal year 2017 budget request ....................................................... 2,056,091,000 

Committee recommendation in the bill ............................................ 2,024,643,000 

Comparison with:.

Fiscal year 2016 enacted level ................................................... (218,224,000) 

Fiscal year 2017 budget request ................................................ (31,448,000) 

The Committee recommendation includes a rescission of 

$37,377,000 from bid savings under Administrative Provisions. 

Transfer of funds.—The accompanying bill provides transfer authority to the Secretary of Defense to allow the transfer of funds 

to such appropriations of the Department of Defense available for 

military construction or family housing as the Secretary may designate. 


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National Geospatial Intelligence Agency West Campus.—The 

Committee is concerned that the site selection and land acquisition 

for the new National Geospatial Intelligence Agency (NGA) West 

Campus Headquarters does not satisfy all existing Federal directives regarding federal construction projects. This includes Federal 

partnership, grant and contract programs requirements; maximizing return on Federal investment and minimizing environmental impact; and Executive Order 12072, which states that when 

a Federal agency’s mission is to relocate or build a new facility, 

preference should be given to an urban site that provides the greatest socioeconomic redevelopment opportunity for the considered region. The Committee urges the Department to follow its current 

guidelines regarding federal construction projects. 

The Committee is also concerned that site selection and land acquisition has yet to take place; therefore, the bill does not include 

the fiscal year 2017 request of $801,000 for land acquisition. The 

Committee was informed that the cost of the land acquisition could 

be as much as $15,000,000 and that one of the potential sites 

would be of no cost to the agency; therefore, the Committee directs 

NGA to request the full funding for the land after site selection has 

occurred. Finally, the military construction funding profile has not 

been determined and does not include a utility plant or a main office building; therefore, the Committee reduces the planning and 

design request and provides $36,000,000 instead of $71,647,000. 

Special Operations Command military construction requirements.—The Committee remains concerned about the lack of transparency and consistency in SOCOM’s process of evaluating and accounting for the military construction requirements for facilities 

writ large, including the out-years. The Committee notes that on 

many bases, there may be excess capacity as missions have relocated. However, as part of military construction planning, SOCOM 

does not as a matter of course assess the suitability of existing, 

non-SOCOM structures on installations that the Command may be 

able to modify and use if the structure is excess to the base commander’s requirements. At a time of shrinking military construction budgets, and the drawdown of forces overall, this should be a 

planning requirement. The Committee is further concerned about 

the costing of facilities. There have been instances in which a facility cost has increased multiple times, and by a significant percentage, prior to award of the contract. Therefore, the Committee directs the SOCOM Commander to report to the congressional defense committees not later than 90 days after enactment of this Act 

on the construction requirements with respect to all SOCOM military priorities in priority order, to include unfunded requirements, 

the costs of each project, and an explanation of how the costing for 

each facility is determined by the command. 

GUARD AND RESERVE ITEMS OF INTEREST

Enforcement of border security.—Recognizing the need to bolster 

resources for the enforcement of border security, the Committee instructs the Army National Guard and the Air National Guard to 

explore public-private partnerships with state and local governments, to design, and construct facilities adjacent to our southwestern border that will support National Guard activities and 

house and support assets used by Customs and Border Protection 


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and other law enforcement agencies for the terrestrial, maritime, 

and aerial surveillance of those borders, to include aircraft hangars 

suitable for unmanned aerial systems, and report back to the Committee not later than 180 days after the enactment of this Act. 

Security/Access points at Air Reserve facilities.—Military construction budget constraints are negatively affecting the ability of 

the Department of Defense to address urgent transportation requirements at certain U.S. military installations. This includes 

both Security Forces Facilities and access that are necessary for 

the safety and well-being of employees, both civilian and military. 

The Committee is concerned that many Reserve facilities in the Department’s inventory do not meet anti-terrorism and force protection requirements. Furthermore, these deficiencies contribute to 

traffic congestion at Reserve facilities and are serious problems 

both on base and on surrounding public roads. The Committee is 

concerned that the Department does not have a coherent strategy 

to address the growing problem of access and traffic congestion on 

Reserve installations during a time of severe budget constraints. As 

a result, traffic congestion and safety concerns on both internal 

base roads and public connecting roads at growth installations are 

likely to increase. Therefore, the Secretary of Defense is directed to 

submit to the Committee with the fiscal year 2018 military construction budget request the following reports: an updated list of 

certified unfunded Reserve access point requirements and list of 

unfunded requirements for Security Installations at Reserve facilities. Finally, each of the Reserve Components is further directed to 

submit, with the fiscal year 2018 military construction budget request, a list of how those requirements will be incorporated into 

their construction requests for fiscal years 2018 through 2022. 

MILITARY CONSTRUCTION, ARMY NATIONAL GUARD

Fiscal year 2016 enacted level ........................................................... $197,237,000 

Fiscal year 2017 budget request ....................................................... 232,930,000 

Committee recommendation in the bill ............................................ 232,930,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... 35,693,000 

Fiscal year 2017 budget request ................................................ – – – 

The Committee recommendation includes additional funding for 

the Army National Guard in section 130 under Administrative Provisions for projects on the Services Unfunded Priority lists as approved by the Secretary of Defense and submitted to Congress in 

priority order. 

MILITARY CONSTRUCTION, AIR NATIONAL GUARD

Fiscal year 2016 enacted level ........................................................... $138,738,000 

Fiscal year 2017 budget request ....................................................... 143,957,000 

Committee recommendation in the bill ............................................ 143,957,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... 5,219,000 

Fiscal year 2017 budget request ................................................ – – – 


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MILITARY CONSTRUCTION, ARMY RESERVE

Fiscal year 2016 enacted level ........................................................... $113,595,000 

Fiscal year 2017 budget request ....................................................... 68,230,000 

Committee recommendation in the bill ............................................ 68,230,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... (45,365,000) 

Fiscal year 2017 budget request ................................................ – – – 

The Committee recommendation includes additional funding for 

the Army Reserve in section 131 under Administrative Provisions 

for projects on the Services Unfunded Priority lists as approved by 

the Secretary of Defense and submitted to Congress in priority 

order. 

MILITARY CONSTRUCTION, NAVY RESERVE

Fiscal year 2016 enacted level ........................................................... $36,078,000 

Fiscal year 2017 budget request ....................................................... 38,597,000 

Committee recommendation in the bill ............................................ 38,597,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... 2,519,000 

Fiscal year 2017 budget request ................................................ – – – 

MILITARY CONSTRUCTION, AIR FORCE RESERVE

Fiscal year 2016 enacted level ........................................................... $65,021,000 

Fiscal year 2017 budget request ....................................................... 188,950,000 

Committee recommendation in the bill ............................................ 188,950,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... 123,929,000 

Fiscal year 2017 budget request ................................................ – – – 

NORTH ATLANTIC TREATY ORGANIZATION SECURITY INVESTMENT

PROGRAM

Fiscal year 2016 enacted level ........................................................... $135,000,000 

Fiscal year 2017 budget request ....................................................... 177,932,000 

Committee recommendation in the bill ............................................ 177,932,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... 42,932,000 

Fiscal year 2017 budget request ................................................ – – – 

The Committee recommendation includes a rescission of 

$30,000,000 from unobligated balances under Administrative Provisions. 

The North Atlantic Treaty Organization (NATO) Security Investment Program (NSIP) consists of annual contributions by NATO 

member countries. The program finances the costs of construction 

needed to support the roles of the major NATO commands. The investments cover facilities such as airfields, fuel pipelines and storage, harbors, communications and information systems, radar and 

navigational aids, and military headquarters, both within NATO 

nations and for ‘‘out of area’’ operations such as Afghanistan. 

The U.S. occasionally has been forced to temporarily delay the 

authorization of projects due to shortfalls in U.S. obligation authority. The Committee directs the Secretary of Defense to notify the 

Committee within 14 days of the U.S. taking action to temporarily 

delay the authorization of projects, or to temporarily withhold 

funds from previously authorized projects, due to shortfalls in U.S. 

obligation authority. 


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FAMILY HOUSING OVERVIEW

Fiscal year 2016 enacted level ........................................................... $1,404,281,000 

Fiscal year 2017 budget request ....................................................... 1,319,852,000 

Committee recommendation in the bill ............................................ 1,319,852,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... (84,429,000) 

Fiscal year 2017 budget request ................................................ – – – 

Family housing construction accounts provide funds for new construction, construction improvements, the Federal government 

costs for family housing privatization projects, and planning and 

design. The operation and maintenance accounts provide funds to 

pay for maintenance and repair, furnishings, management, services, utilities, leasing, interest, mortgage insurance, and miscellaneous expenses. 

Family housing privatization progress reports.—The Committee 

directs the Department of Defense to continue submitting semi-annual progress reports on the family housing privatization program, 

including a breakout of military tenant satisfaction rates by 

project. 

Foreign currency savings and sub-account transfers.—The Committee directs that savings in family housing operation and maintenance accounts from foreign currency re-estimates be used to maintain and repair existing family housing units. The Comptroller is 

directed to report to the Committees on Appropriations of both 

Houses of Congress on how these savings are allocated not later 

than 90 days after enactment of this Act. In addition, the Committee directs the services and Defense agencies to notify the Committees on Appropriations of both Houses of Congress not later 

than 30 days of a transfer of funds between sub-accounts within 

the family housing construction and family housing operation and 

maintenance accounts, if such transfer is in excess of 10 percent of 

the funds appropriated to the sub-account to which the funds are 

being transferred. Notifications to the Committees shall indicate 

the sub-accounts and amounts that are being used to source the 

transfer. 

Leasing reporting requirements.—The Secretary of Defense is directed to report to the Committees on Appropriations of both 

Houses of Congress quarterly on the details of all new or renewed 

domestic leases entered into during the previous quarter that exceed the cost threshold set by 10 U.S.C. 2828(b)(2), including certification that less expensive housing was not available for lease. 

For foreign leases, the Department is directed to: (1) perform an 

economic analysis on all new leases or lease/contract agreements 

where more than 25 units are involved; (2) report the details of 

new or renewed lease agreements that exceed the cost threshold 

set by 10 U.S.C. 2828(e)(1) 21 days prior to entering into such an 

agreement; and (3) base leasing decisions on the economic analysis. 

Prioritizing base housing.—The Department of Defense should 

take into consideration, when prioritizing base housing projects: 

the commuting times for base personnel, length of waitlist for base 

housing and land available for development on the base. 


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FAMILY HOUSING CONSTRUCTION, ARMY

Fiscal year 2016 enacted level ........................................................... $108,695,000 

Fiscal year 2017 budget request ....................................................... 200,735,000 

Committee recommendation in the bill ............................................ 200,735,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... 92,040,000 

Fiscal year 2017 budget request ................................................ – – – 

FAMILY HOUSING OPERATION AND MAINTENANCE, ARMY

Fiscal year 2016 enacted level ........................................................... $375,611,000 

Fiscal year 2017 budget request ....................................................... 325,995,000 

Committee recommendation in the bill ............................................ 325,995,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... (49,616,000) 

Fiscal year 2017 budget request ................................................ – – – 

FAMILY HOUSING CONSTRUCTION, NAVY AND MARINE CORPS

Fiscal year 2016 enacted level ........................................................... $16,541,000 

Fiscal year 2017 budget request ....................................................... 94,011,000 

Committee recommendation in the bill ............................................ 94,011,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... 77,470,000 

Fiscal year 2017 budget request ................................................ – – – 

FAMILY HOUSING OPERATION AND MAINTENANCE, NAVY AND

MARINE CORPS

Fiscal year 2016 enacted level ........................................................... $353,036,000 

Fiscal year 2017 budget request ....................................................... 300,915,000 

Committee recommendation in the bill ............................................ 300,915,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... (52,121,000) 

Fiscal year 2017 budget request ................................................ – – – 

FAMILY HOUSING CONSTRUCTION, AIR FORCE

Fiscal year 2016 enacted level ........................................................... $160,498,000 

Fiscal year 2017 budget request ....................................................... 61,352,000 

Committee recommendation in the bill ............................................ 61,352,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... (99,146,000) 

Fiscal year 2017 budget request ................................................ – – – 

FAMILY HOUSING OPERATION AND MAINTENANCE, AIR FORCE

Fiscal year 2016 enacted level ........................................................... $331,232,000 

Fiscal year 2017 budget request ....................................................... 274,429,000 

Committee recommendation in the bill ............................................ 274,429,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... (56,803,000) 

Fiscal year 2017 budget request ................................................ – – – 

FAMILY HOUSING OPERATION AND MAINTENANCE, DEFENSE-WIDE

Fiscal year 2016 enacted level ........................................................... $58,668,000 

Fiscal year 2017 budget request ....................................................... 59,157,000 

Committee recommendation in the bill ............................................ 59,157,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... 489,000 

Fiscal year 2017 budget request ................................................ – – – 


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DEPARTMENT OF DEFENSE FAMILY HOUSING IMPROVEMENT FUND

Fiscal year 2016 enacted level ........................................................... $ – – – 

Fiscal year 2017 budget request ....................................................... 3,258,000 

Committee recommendation in the bill ............................................ 3,258,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... 3,258,000 

Fiscal year 2017 budget request ................................................ – – – 

THE DEPARTMENT OF DEFENSE BASE CLOSURE ACCOUNT

Fiscal year 2016 enacted level ........................................................... $266,334,000 

Fiscal year 2017 budget request ....................................................... 205,237,000 

Committee recommendation in the bill ............................................ 230,237,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... (36,097,000) 

Fiscal year 2017 budget request ................................................ 25,000,000 

Accelerated clean-up.—The Committee has included additional 

funding for the Army and the Navy to accelerate environmental remediation at installations closed during previous Base Realignment 

and Closure (BRAC) rounds. The Committee recognizes that many 

factors hinder the cleanup of BRAC sites. However, the Committee 

believes that strategic investments can lead to quicker clean-ups 

and faster turnover of DOD property to the local community. 

Therefore, the Secretary of Defense should submit to the congressional defense committees a spend plan for the additional BRAC 

funds not later than 30 days after enactment of this Act. 

ADMINISTRATIVE PROVISIONS

The bill includes 36 provisions of which 25 were in effect in fiscal 

year 2016 and 11 are new provisions. The administrative provisions included in the bill are as follows: 

The bill includes section 101 prohibiting the use of funds for payments under a cost-plus-a-fixed-fee contract for construction where 

cost estimates exceed $25,000. An exception for Alaska is provided. 

The bill includes section 102 permitting the use of construction 

funds for the hire of passenger motor vehicles. 

The bill includes section 103 permitting funds to be expended on 

the construction of defense access roads under certain circumstances. 

The bill includes section 104 prohibiting construction of new 

bases in the United States without a specific appropriation. 

The bill includes section 105 limiting the use of funds for the 

purchase of land or land easements that exceed 100 percent of 

value except under certain conditions. 

The bill includes section 106 prohibiting the use of funds to acquire land, prepare sites, or install utilities for family housing except housing for which funds have been appropriated. 

The bill includes section 107 limiting the use of minor construction funds to relocate any activity from one installation to another 

without prior notification. 

The bill includes section 108 prohibiting the procurement of steel 

unless American producers, fabricators, and manufacturers have 

been allowed to compete. 

The bill includes section 109 prohibiting the use of funds to pay 

real property taxes in foreign nations. 


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The bill includes section 110 prohibiting the use of funds to initiate a new installation overseas without prior notification. 

The bill includes section 111 establishing a preference for United 

States architectural and engineering services where the services 

are in Japan, NATO member countries, or countries bordering the 

Arabian Sea. 

The bill includes section 112 establishing a preference for United 

States contractors for military construction in the United States 

territories and possessions in the Pacific and on Kwajalein Atoll, or 

countries within the Central Command area of responsibility, except bids by Marshallese contractors for military construction on 

Kwajalein Atoll. 

The bill includes section 113 requiring the Secretary of Defense 

to give prior notice to Congress of military exercises where construction costs exceed $100,000. 

The bill includes section 114 allowing funds appropriated in prior 

years to be used for new projects authorized during the current session of Congress. 

The bill includes section 115 allowing the use of expired or 

lapsed funds to pay the cost of supervision for any project being 

completed with lapsed funds. 

The bill includes section 116 providing that funds for military 

construction projects are available until the end of the fourth fiscal 

year following the fiscal year in which funds are appropriated, subject to certain conditions. 

(INCLUDING TRANSFER OF FUNDS)

The bill includes section 117 allowing for the transfer of funds 

from Family Housing Construction accounts to the Department of 

Defense Family Housing Improvement Fund and funds from Military Construction accounts to the Department of Defense Military 

Unaccompanied Housing Improvement Fund. 

(INCLUDING TRANSFER OF FUNDS)

The bill includes section 118 providing transfer authority to the 

Homeowners Assistance Program. 

The bill includes section 119 requiring that funds in this title be 

the sole source of all operation and maintenance for flag and general officer quarter houses, and limits the repair on these quarters 

to $35,000 per year without notification. 

The bill includes section 120 making funds in the Ford Island 

Improvement Fund available until expended. 

(INCLUDING TRANSFER OF FUNDS)

The bill includes section 121 allowing the transfer of expired 

funds to the ‘‘Foreign Currency Fluctuations, Construction, Defense’’ account. 

The bill includes section 122 prohibiting the use of funds to relocate a unit of the Army that would impact more than 200 personnel. 

The bill includes section 123 allowing the transfer of funds 

among projects and activities in accordance with the reprogramming guidelines. 


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The bill includes section 124 prohibiting the use of funds for 

projects at Arlington National Cemetery. 

(INCLUDING RESCISSION OF FUNDS)

The bill includes section 125 rescinding funds from prior appropriations Acts. 

(INCLUDING RESCISSION OF FUNDS)

The bill includes section 126 rescinding funds from prior appropriations Acts. 

(INCLUDING RESCISSION OF FUNDS)

The bill includes section 127 rescinding funds from prior appropriations Acts. 

The bill includes section 128 providing additional funding for 

Military Construction, Army. 

The bill includes section 129 providing additional funding for 

Military Construction, Navy and Marine Corps. 

The bill includes section 130 providing additional funding for 

Military Construction, Army National Guard. 

The bill includes section 131 providing additional funding for 

Military Construction, Army Reserve. 

The bill includes section 132 providing additional funding for 

Military Construction, Air Force. 

(INCLUDING RESCISSION OF FUNDS)

The bill includes section 133 rescinding unobligated balances 

from the fund established by Sec. 103(d) of 42 U.S.C. 3374 for expenses associated with the Homeowners Assistance Program. 

The bill includes section 134 defining the congressional defense 

committees. 

(INCLUDING RESCISSION OF FUNDS)

The bill includes section 135 rescinding unobligated balances 

from prior appropriations Acts. 

The bill includes section 136 prohibiting the use of funds to close 

or realign Naval Station Guantanamo Bay. The provision is intended to prevent the closure or realignment of the installation out 

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

The bill does not include section 121 as requested to provide authority under a continuing resolution when an authorization bill 

has been enacted to obligate funds that have not been appropriated. 


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TITLE II 

DEPARTMENT OF VETERANS AFFAIRS 

Fiscal year 2016 enacted level 1 .................................................... $162,671,005,000 

Fiscal year 2017 budget request 1 ................................................. 177,545,236,000 

Committee recommendation in the bill 1 ...................................... 176,068,336,000 

Comparison with: 

Fiscal year 2016 enacted level ............................................... 13,397,331,000 

Fiscal year 2017 budget request ............................................ (1,476,900,000) 

Fiscal year 2018 advance budget request 1 .................................. 170,321,028,000 

Fiscal year 2018 Committee recommendation in the bill 1 ......... 170,321,028,000 1 All funding cited excludes amounts in the Medical Care Collections Fund. 

The Department of Veterans Affairs (VA) serves approximately 

48,300,000 people or 14.8 percent of the total estimated resident 

population of the U.S. and Puerto Rico: 21,700,000 veterans and 

26,600,000 family members of living veterans or survivors of deceased veterans. To serve adequately the nation’s veterans, VA employs 350,000 people, making it one of the largest Federal agencies 

in terms of employment. 

VETERANS BENEFITS ADMINISTRATION (VBA) 

COMPENSATION AND PENSIONS

(INCLUDING TRANSFER OF FUNDS)

Fiscal year 2016 enacted level ........................................................... $76,865,545,000 

Fiscal year 2017 enacted level ........................................................... 86,083,128,000 

Fiscal year 2018 advance budget request ......................................... 90,119,449,000 

Fiscal year 2018 Committee recommendation in the bill ............... 90,119,449,000 

Comparison with: 

Fiscal year 2017 enacted level ................................................... 4,036,321,000 

Fiscal year 2017 budget request ................................................ – – – 

This appropriation will provide funds for service-connected compensation payments to an estimated 4,832,000 veterans, survivors, 

and dependents in 2017. In addition, pension payments will be 

funded for 507,000 veterans and their survivors. The average cost 

per compensation case for veterans in 2017 is estimated at $16,273 

and pension payments are projected at $13,369. 

The appropriation includes authority to transfer funding not to 

exceed $17,224,000 in 2018 to General Operating Expenses, Veterans Benefits Administration and Information Technology Systems. These funds are for the administrative expenses of implementing cost-saving provisions required by the Omnibus Budget 

Reconciliation Act of 1990, Public Law 101–508, the Veterans’ Benefits Act of 1992, Public Law 102–568, and the Veterans’ Benefits 

Improvements Act of 1994, Public Law 103–446. These cost-saving 

provisions include verifying pension income against Internal Revenue Service (IRS) and Social Security Administration (SSA) data; 

establishing a match with the SSA to obtain verification of Social 

Security numbers; and applying the VA pension cap for Medicaideligible single veterans and surviving spouses alone in Medicaidcovered nursing homes. The bill also continues to include language 

permitting this appropriation to reimburse such sums as may be 

earned to the Medical Care Collections Fund to help defray the operating expenses of individual medical facilities for nursing home 

care provided to pensioners. 


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READJUSTMENT BENEFITS

Fiscal year 2016 enacted level ........................................................... $14,313,357,000 

Fiscal year 2017 enacted level ........................................................... 16,340,828,000 

Fiscal year 2018 advance budget request ......................................... 13,708,648,000 

Fiscal year 2018 Committee recommendation in the bill ............... 13,708,648,000 

Comparison with: 

Fiscal year 2017 enacted level ................................................... (2,632,180,000) 

Fiscal year 2018 budget request ................................................ – – – 

This appropriation finances the education and training of veterans and servicemembers through the Post-9/11 GI Bill and the 

All-Volunteer Force Educational Assistance Program. Supplemental 

education benefits are also provided to certain veteran members of 

the Selected Reserve and are funded through transfers from the 

Department of Defense (DOD). In addition, certain disabled veterans are provided with vocational rehabilitation, specially adapted 

housing grants, and grants for automobiles with approved adaptive 

equipment. This account also finances educational assistance allowances for eligible dependents of veterans who died from service-connected causes or have a total and permanent service-connected disability, as well as dependents of servicemembers who were captured or are missing in action. More than 82 percent of the funds 

in the account support the Post-9/11 GI Bill. The reduction in the 

fiscal year 2018 budget request is due to the availability of carriedover unobligated balances. 

VETERANS INSURANCE AND INDEMNITIES

Fiscal year 2016 enacted level ........................................................... $77,160,000 

Fiscal year 2017 enacted level ........................................................... 91,920,000 

Fiscal year 2017 current year request .............................................. 16,605,000 

Fiscal year 2017 Committee recommendation in the bill ............... 16,605,000 

Fiscal year 2018 advance budget request ......................................... 107,899,000 

Fiscal year 2018 Committee recommendation in the bill ............... 107,899,000 

Comparison with: 

Fiscal year 2017 enacted level ................................................... 15,979,000 

Fiscal year 2018 budget request ................................................ – – – 

The Veterans Insurance and Indemnities appropriation is made 

up of the former appropriations for military and naval insurance, 

applicable to World War I veterans; national service life insurance 

(NSLI), applicable to certain World War II veterans; servicemen’s 

indemnities, applicable to Korean conflict veterans; and veterans 

mortgage life insurance, applicable to individuals who have received a grant for specially adapted housing. 

The amount provided will enable the Department to transfer 

funding to the service-disabled veterans insurance fund and transfer additional amounts for payments for policies under the veterans 

mortgage life insurance program. These policies are identified 

under the Veterans Insurance and Indemnity appropriation since 

they provide insurance to service-disabled veterans unable to qualify under basic NSLI. 


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VETERANS HOUSING BENEFIT PROGRAM FUND

Program account (indefinite) 

Limitation on direct loans for specially adapted 

housing loans 

Administrative ex- penses 

Fiscal year 2016 enacted level ........................................................ – – – ($500,000) $164,558,000 

Fiscal year 2017 budget request est. .............................................. – – – (500,000) 198,856,000 

Committee recommendation est. in the bill .................................... – – – (500,000) 167,612,000 

Comparison with: 

Fiscal year 2016 enacted level ............................................... – – – – – – 3,054,000 

Fiscal year 2017 budget request ............................................ – – – – – – (31,244,000) 

The purpose of the home loan guaranty program is to facilitate 

the extension of mortgage credit on favorable terms by private 

lenders to eligible veterans. This appropriation provides for all 

costs, with the exception of the Native American veterans housing 

loan program, of the Department’s direct and guaranteed loans programs. The Federal Credit Reform Act of 1990 requires budgetary 

resources to be available prior to incurring a direct loan obligation 

or a loan guaranty commitment. In addition, the bill requires all 

administrative expenses of a direct or guaranteed loan program to 

be funded through a program account. Loan guaranties are made 

to servicemembers, veterans, reservists, and single surviving 

spouses for the purchase of homes, condominiums, and manufactured homes and for refinancing loans. The Department guarantees 

part of the total loan, permitting the purchaser to obtain a mortgage with a competitive interest rate, even without a down payment if the lender agrees. The Department requires that a down 

payment be made for a manufactured home. With a Department 

guaranty, the lender is protected against loss, up to the amount of 

the guaranty, if the borrower fails to repay the loan. 

The increase above fiscal year 2016 funding for administrative 

expenses is directed to personal services (staffing) cost increases. 

At this time, the Committee has not approved the remainder of the 

requested administrative expenses increase for fiscal year 2017 because of a lack of any justification in the budget materials. 

VA Loan Mortgage Service.—The Committee remains encouraged 

that the VA Loan Mortgage Service continues to perform favorably 

when compared to its commercial counterparts. However, the Committee recognizes the ongoing need to continually upgrade software 

tools that incorporate the latest analytic, forecasting and workflow 

methods. Such upgrades will further reduce the number of troubled 

loans still experienced by a segment of the veteran population. Further improved software will strengthen program accountability 

while simultaneously enhancing the veteran’s Loan Guaranty experience. The Committee encourages the VA Loan Mortgage Service 

to consider using a common software with embedded analytic and 

forecasting tools in its upgrade. 


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VOCATIONAL REHABILITATION LOANS PROGRAM ACCOUNT

Program account Limitation on direct loans 

Administrative expenses 

Fiscal year 2016 enacted level ........................................................ $31,000 ($2,952,000) $367,000 

Fiscal year 2017 budget request ..................................................... 36,000 (2,517,000) 389,000 

Committee recommendation in the bill ............................................ 36,000 (2,517,000) 389,000 

Comparison with: 

Fiscal year 2016 enacted level ............................................... 5,000 (¥435,000) 22,000 

Fiscal year 2017 budget request ............................................ – – – – – – – – – 

This appropriation covers the subsidy cost of direct loans for vocational rehabilitation of eligible veterans and includes administrative expenses necessary to carry out the direct loan program. Loans 

of up to $1,210 (based on indexed chapter 31 subsistence allowance 

rates) are available to service-connected disabled veterans enrolled 

in vocational rehabilitation programs when the veteran is temporarily in need of additional assistance. Repayment is made in 

monthly installments, without interest, through deductions from 

future payments of compensation, pension, subsistence allowance, 

educational assistance allowance, or retirement pay. Most loans are 

repaid in full in less than one year. The Federal Credit Reform Act 

of 1990 requires budgetary resources to be available prior to incurring a direct loan obligation. 

It is estimated that the Department will make 2,618 loans in fis- cal year 2017, with an average amount of $962. 

NATIVE AMERICAN VETERAN HOUSING LOAN PROGRAM ACCOUNT

Administrative expenses: 

Fiscal year 2016 enacted level ........................................................... $1,134,000 

Fiscal year 2017 budget request ....................................................... 1,163,000 

Committee recommendation in the bill ............................................ 1,163,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... 29,000 

Fiscal year 2017 budget request ................................................ – – – 

The Native American Veteran Housing Loan Program, as authorized by title 38 United States Code, chapter 37, subchapter V, provides the Secretary with authority to make direct housing loans to 

Native American veterans for the purpose of purchasing, constructing, or improving dwellings on trust lands. The program will 

not require a new subsidy appropriation and has an unobligated indefinite subsidy authority balance of $2,256,000. 

VETERANS HEALTH ADMINISTRATION (VHA) 

The Department operates the largest Federal medical care delivery system in the country, with 144 hospitals, 113 domiciliary rehabilitation treatment programs, 135 nursing homes, 300 Vet Centers, 80 mobile Vet Centers, and 755 outpatient clinics which include independent, satellite, community-based, and rural outreach 

clinics. Almost 7,000,000 patients will be treated in 2017. 

The Veterans Health Administration is comprised of five accounts: Medical Services, Medical Community Care, Medical Support and Compliance, Medical Facilities, and Medical and Prosthetic Research. For the first four accounts, the Administration has 

requested total resources for fiscal year 2018 of $66,385,032,000 in 

direct appropriations to fund the four advance appropriations of the 

VHA. In addition, VA will receive an estimated $2,637,000,000 in 


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35 

the Medical Care Collections Fund in fiscal year 2017. The Committee also provides $663,366,000 for medical and prosthetic research. 

MEDICAL SERVICES

Fiscal year 2016 enacted level ..................................................... $49,972,360,000 

Fiscal year 2017 enacted level ..................................................... 51,673,000,000 

Fiscal year 2017 additional request ............................................ 1,078,993,000 

Committee 2017 additional recommendation ............................. 850,000,000 

Fiscal year 2018 advance budget request ................................... 44,886,554,000 

Committee 2018 recommendation in the bill ............................. 44,886,554,000 

Comparison with: 

Fiscal year 2017 enacted level ............................................. *(6,786,446,000 ) 

Fiscal year 2018 budget request .......................................... – – – 

*due to establishment of the new Medical Community Care account 

This appropriation provides for medical services of eligible veterans and beneficiaries in Department medical centers, outpatient 

clinic facilities, contract hospitals, State homes, and outpatient programs on a fee basis. VA also supports hospital and outpatient care 

through the private sector for certain dependents and survivors of 

veterans under the DOD civilian health and medical programs. 

The bill includes $850,000,000 of the $1,078,993,000 current year 

budget request, which is in addition to the advance appropriation 

that has already been provided. Within the funds provided, the 

Committee expects the resources to be used at the request level for 

hepatitis C, homeless programs, the post-9/11 caregiver program, 

longterm care, and the staffing costs VA must absorb as the Choice 

Act section 801 funds evaporate. 

The Committee has included requested bill language to make 

available through September 30, 2019, $1,400,000,000 of the Medical Services appropriation for fiscal year 2018. 

Funding identified in the bill is in addition to the anticipated 

$5,482,975,000 for medical services from the Veterans Choice Act 

in fiscal year 2017. 

Uncertainties in advance appropriation requirements.—The Committee has become accustomed to the estimating problems inherent 

in providing large appropriations one year in advance. Each year, 

the ‘‘second bite at the apple’’ request for additional funding is a 

tell-tale sign of the shortcomings in the advance appropriation concept. But fiscal year 2018 seems like a watershed year for inaccuracy in estimating the advance appropriation. The Committee has 

provided the full advance request, but feels certain it is way off the 

mark. When considering the consolidated estimates for VA-provided care and the care in the community program, the budget request for the advance appropriation is more than four billion dollars below the equivalent program level for fiscal year 2017. Given 

recent history, it is inconceivable that VA health care costs would 

decline, especially with more veterans demanding more intensive 

services. The budget documents reveal that the budget estimate 

would require a reduction of almost 14,000 medical staff in 2018 

and major cuts to programs like hepatitis C treatment and homeless assistance. A request that assumes such cuts to staff and services is irresponsible and is counter to the stability that VA says it 

needs. The Committee will expect periodic updates throughout the 

year as VA tries to generate a more realistic estimate. 


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Changes in funding requirements due to modeling.—The Committee expects VA to continue to include in the sufficiency letter required by section 117(d) of title 38, United States Code, that is due 

to the Congress on July 31 of each year, a description of any 

changes exceeding $250,000,000 in funding requirements for the 

Medical Services account resulting from the spring recalculation of 

the Enrollee Healthcare Projection Model. 

Allocation of health funding.—The Committee continues to be 

concerned that the process VA uses to allocate the health services 

appropriation through the Veterans Integrated Service Networks 

(VISNs) and from them to the medical centers may shortchange the 

ultimate users because of excessive funding retained at headquarters or at the VISNs. The Committee continues to request a 

report each year not later than 30 days after VA allocates the medical services appropriation to the VISNs that identifies: (1) the 

amount of general purpose funding that is allocated to each VISN; 

(2) the amount of funding that is retained by central headquarters 

for specific purposes, with amounts identified for each purpose; and 

(3) the amount of funding that is retained by each VISN before allocating it to the medical centers, identifying separately the 

amounts retained for purposes such as network operations, network initiatives, and emergencies. 

Hepatitis C 

Hepatitis C treatment initiative.—One of the Committee’s highest 

priorities is treatment services for veterans suffering from Hepatitis C. The veteran population has a much higher incidence of hepatitis C than the general population. VA indicates that 157,000 veterans in the VA healthcare system are potential candidates for 

hepatitis C treatment. Making investments now to provide the 

highly effective medications available will have profound effects in 

preventing liver disease and cancer for those veterans as well as 

the costs otherwise borne by VA for treating these illnesses. The 

VA healthcare system is uniquely positioned to treat its hepatitis 

C patients with trained clinicians and the necessary infrastructure. 

VA provides the full continuum of care that includes screening, 

linkage to care, adequate treatment, and follow up. Recent reductions in the price of hepatitis C drugs will make it possible for VA 

to treat as many as 1,500 new patients per week, with possible 

treatment of all cases within three years. To enable VA to reach 

these goals, the bill provides $1,500,000,000 for hepatitis C treatment in fiscal year 2017, the same amount as fiscal year 2016 and 

the administration request. 

Hepatitis C-related liver disease.—The Committee is pleased that 

the Department leads the country in hepatitis screening, testing, 

treatment, and research and requests the Department to lead research and prevention activities for Hepatitis C-related liver disease, cirrhosis, liver failure, and liver cancer. 

Homeless assistance 

The Committee provides the full fiscal year 2017 budget request 

of $1,591,365,000 for VA homeless assistance programs, in addition 

to an estimated $5,643,053,000 for homeless veterans treatment 

costs. These programs include the Homeless Providers Grant and 

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portive Services for Low-Income Veterans and Families, and the 

Department of Housing and Urban Development—Department of 

Veterans Affairs Supported Housing (HUD–VASH) programs. 

Female homeless veterans.—The Committee remains committed 

to helping homeless veterans and commends VA for its efforts in 

reducing homelessness among the veteran population. However, 

the Committee is concerned about VA’s efforts to reduce homelessness among female veterans, and particularly those with dependent 

children. Dependent children often present additional challenges to 

those providing resources to homeless veterans. The Committee 

urges VA to work to provide equal treatment and assistance for female veterans and veterans with children. 

Additional housing options.—The Department has made great efforts to find housing for homeless veterans and their families. However, to date, VA has not tested the concept of awarding grants to 

eligible entities to purchase and renovate abandoned homes for 

homeless veterans, who would then make rent or mortgage payments to the grantee. This approach could provide a pathway to 

stable housing for veterans, as well as address the problem of 

abandoned or foreclosed properties in some communities. The Committee directs the Department to outline what legislative changes 

would be required to establish such a program on a pilot basis and 

the feasibility and estimated cost of the concept. The report should 

be provided to the Committee not later than 60 days after enactment of this Act. 

Related needs of homeless veterans.—While VA has made strides 

in reducing veteran homelessness, its program clients need additional support beyond shelter. The Committee remains interested 

in the feasibility, advisability and cost of VA conducting a pilot program to award grants to eligible organizations to provide furniture, 

household items, and other assistance to formerly homeless veterans who have transitioned to permanent housing. The Committee 

requests a report on this concept not later than 60 days after enactment of this Act. 

HUD–VASH program.—The Committee recognizes the important 

contributions the HUD–VASH program has made in reducing the 

number of homeless veterans and commends VA for implementing 

a case management system that keeps veterans housed longer by 

providing the supportive care many of them require. The Committee encourages VA to more creatively and collaboratively work 

with local social service agencies, especially in rural and small communities, to ensure that HUD–VASH voucher recipients are receiving the most comprehensive services available to them. Multiple jurisdictions around the country are implementing their own coordinated care initiatives alongside public housing programs, and in 

the interest of maximizing public investment and providing the 

best, most comprehensive care available, VA should seek to partner 

with local and State governments when possible. The Committee 

requests a report not later than 60 days after enactment of this Act 

identifying how many HUD–VASH vouchers are given to female 

veterans with children, female veterans without children, male veterans with children, and male veterans without children in each 

State. The report should also include the number of HUD–VASH 

vouchers distributed to veterans in rural, suburban, and urban 

areas per State. 


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Mental health issues 

The Committee provides the full fiscal year 2017 budget request of $7,831,890,000 for mental health programs. Of the amounts provided for mental health programs in fiscal year 2017, $164,305,000 

shall be used for suicide prevention outreach. Of the funds provided 

in the fiscal year 2018 advance appropriation, $186,128,000 shall 

be used for suicide prevention outreach. The Department is directed to provide a report to the Committee not later than 30 days 

after enactment of this Act identifying a detailed expenditure plan 

for all suicide outreach programs for both fiscal years. 

Veterans crisis line.—In light of the alarming number of suicides 

committed by veterans each day, the Committee is very concerned 

by recent failures involving the Veterans Crisis Line (VCL). As reported by the VA Inspector General (IG), some calls directed to the 

VCL were not answered or sent to voicemail or were answered by 

untrained volunteers, with a lack of quality control. The Committee 

includes bill language requiring the Secretary to ensure that the 

hotline provides immediate assistance from a trained professional 

for those who call and that the VCL adheres to all prevailing suicide counseling provider standards. The Committee is pleased that 

VA has already responded to the troubling IG report by increasing 

staffing, hiring a new program manager with proven experience 

running a mental health call center, establishing a larger working 

space for the VCL, and enhancing training. 

Suicide among female veterans.—Female veterans are six times 

more likely to commit suicide than women in the general population. This alarming trend must be addressed by the Department 

without delay. The Committee directs VA to renew its focus on improving access to mental health services for female veterans and 

ensure that female mental health needs, which often differ from 

male needs in prevalence and expression, are met. 

Collaboration with research universities.—The Committee continues to encourage VA to establish collaborations with research 

universities and teaching hospitals for the treatment of and research on mental health disorders, such as postraumatic stress disorder (PTSD) and traumatic brain injury (TBI), to improve the psychological health of veterans and train mental health professionals 

so they will understand the unique needs of veterans. The Committee requests a report on current VA-university partnerships on 

mental health research and training not later than 90 days after 

enactment of this Act. 

Law enforcement liaison.—The Department is urged to implement a program that would designate a VA liaison to work with 

local law enforcement to ensure that the subsequent needs of veterans who are considered an immediate threat to themselves and 

others are addressed in a humane and respectful manner. 

Mental health provider training.—The Committee is concerned 

about the impact of VA’s flawed accreditation process that excludes 

qualified marriage and family therapists (MFTs) from employment 

at VA, unnecessarily causing vacant mental health provider positions within the VHA system at a time when these services are in 

critical need. The bill includes language requiring that marriage 

and family therapists meeting certain rigorous requirements be 

permitted to participate in VA healthcare. The requirements that 

must be met by the MFTs are: 1) holding at least a master’s degree 


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in marriage and family therapy, or a related field, from a regionally accredited program; 2) being licensed as an MFT in a U.S. jurisdiction and possessing the highest level of licensure offered from 

the State, the District of Columbia, or U.S. territory in which they 

are licensed; and 3) passing the Association of Marital and Family 

Therapy Regulatory Board Examination in Marital and Family 

Therapy (AMFTRB–EMFT) or California MFT Exam. 

Clinical psychology training.—The Committee understands that 

after long delay VHA is close to completing the process of modifying its regulations to permit the training and employment of psychologists who are graduates of the Psychological Clinical Science 

Accreditation System (PCSAS), which now accredits 29 universitybased PhD clinical psychology programs. The Committee urges 

VHA to complete this regulatory process to help increase the number of mental health clinicians available to the VA health care system. 

Relationships with outside voluntary organizations.—The Committee urges VA to continue utilizing funds to establish and bolster 

existing relationships with veterans service organizations working 

closely with veterans suffering mental health issues, and to partner 

with organizations that work with both male and female survivors 

of sexual assault. 

Mental health treatments.—The Committee is deeply concerned 

about the mental health of veterans and wants to ensure that all 

necessary tools for healing and successfully re-integrating into society are made available to them. One such tool is handheld all-inone therapeutic listening devices. Over 200 medical studies, including several conducted within the VA system, have found improved 

mental health outcomes from using such tools, such as reduced 

symptoms of PTSD. The Committee is concerned that VA’s use of 

these devices has decreased since their provision was shifted from 

the Prosthetic and Sensory Aids Service to individual medical centers. The Committee urges VA to emphasize to local medical centers the utility of therapeutic listening devices as an important 

component of treatment for a variety of mental health issues. 

Access issues 

Choice program.—The implementation of the Choice program has 

been rocky, and its effect on the use of VA appropriated funds has 

been very dynamic. The program started with slow usage but attracted veterans to use the traditional VA healthcare system for 

additional medical conditions. As VA appropriated funds ran short 

during 2015, funds were transferred from Choice on an emergency 

basis to prevent hospital closures. Currently, VA predicts that 

usage of Choice will accelerate and that Choice funding for section 

801 of the program will begin to be exhausted in fiscal year 2016, 

with all Choice funds being spent by the end of fiscal year 2017. 

The unfortunate consequence is that appropriated VA funding will 

be required to backfill the substantial base of medical care created 

by the Choice Act. For fiscal year 2017, these additional costs to 

the appropriated funds included in the request are $885,000,000, 

which come with no adjustment in overall appropriated discretionary caps. The fiscal year 2018 costs related to extension of services for veterans formerly provided by Choice will be in the billions 


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of dollars, and discretionary caps are not likely to accommodate 

such growth. 

Communication problems within the Choice Program.—The Committee is concerned about communication gaps between contract 

care providers and veterans and the Choice third party administrators. The Committee is aware of numerous complaints from veterans and providers in some areas that they have experienced communication issues when scheduling appointments or resolving payment issues. Furthermore, even when veterans are able to connect 

with a contract provider, referrals are not always timely or within 

a reasonable geographic distance to receive care. There have been 

reports of veterans receiving questionable care and treatment from 

facilities to which they were directed. To address these problems, 

the Committee urges VA to work with outside contractors to hire 

personnel in underserved areas to strengthen the Choice Program’s 

provider network based on existing and projected need. 

Further expansion of Choice Program eligibility.—Subsequent eligibility expansions of the Choice Program by VA and by legislation 

have been welcome developments. These expansions, particularly 

those regarding geographic distance factors, have opened the aperture for the Choice Program and will allow more veterans to utilize 

non-VA care options. The Department is encouraged to implement 

these eligibility changes to the Choice Program in an expedited 

manner and to consider including travel time and total distance to 

a VA medical facility, which can address the veteran’s specific 

healthcare needs, when determining eligibility for the Choice Program. 

The Committee encourages VA to continue exploring options to 

further broaden the Veterans Choice Program so that more veterans can utilize non-VA care options when their health circumstances warrant a waiver. Specifically, the Committee requests 

the Department to consider, when approving waivers for treatment, 

the veteran’s ability to travel given their medical and/or physical 

condition, in particular, when seeking treatment for chemotherapy 

or dialysis. The Committee requests a report not later than 90 days 

after enactment of this Act on the number of instances where waiver requests submitted by veterans were granted and/or denied. 

Choice access problems in rural areas.—The Committee remains 

concerned about issues with access to healthcare in rural areas for 

veterans. A number of these veterans are having difficulties with 

a lack of network providers in the Choice Program. There are also 

concerns about access to specialized care within a reasonable distance. The Department is instructed to submit a report to the Committee not later than 180 days after enactment of this Act that 

shows a plan of action to address the deficiencies in access to care, 

both primary and specialty, in rural areas. 

Choice Act staffing increases.—The Committee requests a report 

not later than 90 days after enactment of this Act that describes 

the amount of Choice Act funding each VISN received to hire additional staff; the number of staff hired; the number of employees 

who left VA in the same period; and the net gain for each of the 

following position categories—primary care, specialty care physicians and medical staff—at each VA VISN. 

Medical staff retention.—The Committee expects VA to continue 

to report every six months on the number of medical staff who 


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have left the VA system, including a summary of the principal reasons explaining their departure, and a detailed plan of how VA will 

address and mitigate the principal reasons providers leave. The report should also identify the percentage of staff in primary care 

versus specialty care, and the percentage of medical staff at each 

facility, who complete an exit survey upon their departure. 

Consolidation of non-VA care Programs.—The Committee is 

pleased that VA has submitted to Congress a comprehensive plan 

to restructure the Choice Program and consolidate it with the myriad other non-VA care programs operated by the Department. The 

Committee believes that a Choice-type model will be an important 

component of providing healthcare to veterans and encourages VA 

to embrace such changes. 

Community health care center participation in the Choice Program.—The Committee understands that returning warfighters 

often prefer to receive care close to home and their families, and 

notes the high quality services provided by community health centers (CHCs). The Committee is pleased that some CHCs serve veterans through the Choice program by participating as part of local 

Choice networks. The Committee encourages the third party administrators currently operating these networks to enhance the 

quality of services they provide to veterans by recruiting additional 

CHCs as providers. 

Integration of services.—The Committee is aware of private sector 

programs that effectively and efficiently leverage information technology and data interoperability capabilities to better coordinate 

and integrate health services for veterans across care settings. The 

Department is encouraged to consider the use of these private sector programs as a way to develop service integration and data sharing; monitor protocols; conduct performance metrics and trend 

analysis; and complete predictive analytics and systems improvement. 

Comparison of care between in-house VA care and the Choice Program.—The Government Accountability Office (GAO) is directed to 

submit to the Committee not later than six months after enactment 

of this Act a report that evaluates from a sample survey the quality 

of care for veterans with respect to receiving correct medication, 

counseling, and the ability to see specialists in a timely manner. 

The GAO report should compare and contrast veterans who regularly go to a VA facility versus those who use the Choice Program 

and highlight the relative deficiencies or achievements in quality of 

care. 

Access in outlying areas.—The Committee directs GAO to review 

the staffing, outreach, scheduling, and access management practices at the Department of Veterans Affairs Pacific Islands 

Healthcare System and report to the Committee not later than six 

months after enactment of this Act. The report should include comparisons between the VA Pacific Islands Healthcare System and 

VA healthcare in the continental U.S. on the following measures: 

healthcare quality; patient waiting times; follow up care appointment delays; community-based outpatient clinic (CBOC) staffing 

levels and retention; staff working environment; and outreach programs. 

Shared DOD–VA medical resources.—The Committee is concerned that veterans continue to experience delays in accessing 


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medical treatment in a timely fashion following the enactment of 

the Choice Act. Since 2012, VA and DOD have agreed to share resources to improve access to quality health care or increase costeffectiveness of the health care provided by the Military Health 

System and the VHA as authorized in Section 8111 of title 38 USC 

and section 1104 of title 10 USC. The Committee encourages the 

Secretary to direct the network director of each of the VISNs to 

work with the appropriate representative of the armed services and 

enter into agreements with the military treatment facilities within 

their geographic footprint, as authorized, to increase access to care 

for veterans willing to be treated at those locations. Furthermore, 

the Committee requests that the Secretary report to the Committee 

not later than 60 days after enactment of this Act about the plan 

to execute this request. 

Delayed payments.—The Committee is concerned with reports of 

delayed payments by VA to community care providers. Ensuring 

prompt payment to these providers is essential to encouraging their 

participation in an expansion of access to healthcare outside of the 

traditional VA system. Accordingly, VA is expected to comply with 

section 1315 of Title 5, Code of Federal Regulations, commonly referred to as the Prompt Pay rule. Not later than 90 days after enactment of this Act, VA is directed to provide to the Committee a 

comprehensive report detailing the reimbursements owed to outside providers in each State. The report will also document the dollar value of outstanding invoices more than six months overdue 

and the corrective actions being implemented to address these outstanding balances. This report should also describe the agency’s 

plans to correct this delayed payment problem in the future. 

Payments to veterans for emergency care.—The Committee directs 

VA to report to the Committee not later than 60 days after the enactment of this Act how VA intends to process emergency room 

care payments to veterans within 60 days of receipt of the bill. 

Office of Rural Health.—The Committee provides the full fiscal year 2017 and 2018 budget requests of $250,000,000 to improve access and quality of care for the 3,000,000 veterans residing in rural 

and highly rural areas. The Committee directs the Office of Rural 

Health to submit to the Committee not later than 30 days after enactment of this Act an operating plan for this funding, as well as 

any changes to that operating plan at the start of the fiscal year 

for which the funds are provided. 

Caregivers in rural areas.—Recent studies have indicated that, 

while there are many similarities in tasks for caregivers of aging 

veterans in urban and rural areas, there are also a number of 

issues and needs unique to rural caregivers. The Department is requested to provide a report to the Committee not later than 90 

days after enactment of this Act identifying the needs of caregivers 

for veterans in rural areas that may not be addressed by existing 

VA assistance and outreach programs. 

Use of telemedicine.—The Committee remains concerned about 

rural veterans’ access to care and encourages VA to explore and implement innovative uses of telemedicine to provide care for rural 

and infirm veterans who do not have easy access to medical facilities. 

Disruption in medical facility moves.—The Committee is concerned about past instances when VA announced plans to close a 


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CBOC without any publicly announced plan for alternative facilities to serve the veterans affected. To prevent future disruptions, 

the Committee directs VA to submit a written notification to the 

community and to the State’s Congressional delegation 30 days before it plans to close a healthcare facility. Such notification should 

identify the alternative facility or facilities where VA plans for veterans in the area to receive care; address distance and travel concerns that may occur for veterans; and provide information on the 

type of care available at the alternative facilities. 

Access expansion.—The Committee encourages VA to identify 

CBOC facilities for expansion possibilities in order to accommodate 

additional patients and provide enhanced services, particularly in 

rural areas. The VA is encouraged to consider existing CBOCs 

which are operating at full capacity, have a proven record of delivering services, and have community support to expand the facility. 

Women’s issues 

Challenges for women veterans’ care.—The Committee appreciates the progress made within the VA health care system to address the growing needs of women veterans, but it realizes that 

there is more to be done. Therefore, the Committee requests an 

analysis of the challenges facing female veterans within the VA 

health care system and the means within VA to address those challenges. The report should include what VA has accomplished and 

how it plans to bring more services to women. The report should 

be provided not later than 90 days after enactment of this Act. 

Facility inadequacies for female VA patients.—VA healthcare facilities are often not structured to address the unique healthcare 

requirements presented by women veterans. In many cases, facilities lack the equipment and cannot execute the medical procedures 

that women expect when visiting their healthcare providers. VA is 

directed to ensure that all VA medical facilities meet VA standards 

to provide the specific health care needs of female veterans. 

Delivery of gender-specific care to female VA patients.—The Committee is concerned that VA is not adequately addressing the 

health needs of female veterans, including obstetrics and gynecological care, and treatment for gender-specific conditions and diseases, whether through direct VA or contract care. The Committee 

is also concerned that VA services do not adequately address female veterans’ unique needs in the research and treatment of 

PTSD. VA shall report to the Committee not later than 60 days 

after enactment of this Act on its efforts to improve the delivery 

of health care for female veterans, particularly in regard to these 

specific disease areas. 

Female providers.—The Committee urges the Secretary to seek to 

hire more female health care professionals in order to provide female veterans greater opportunities to choose the gender of their 

healthcare provider. 

Women’s mobile medical care.—The Committee encourages VA to 

consider the provision of female veterans’ healthcare through mobile units that could operate in either rural or urban underserved 

areas. These units would have the capacity to provide preventive 

and primary healthcare services, education about the availability of 

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ment of this Act describing how a mobile medical unit program designed for women would be structured, whether the geographic concentration of female veterans makes such a program feasible, areas 

in the country with female veterans who currently lack access and 

for whom the mobile units would be appropriate, and the likely cost 

of a mobile unit program, including vehicles, equipment, staffing, 

and information technology. 

Prescription drug abuse 

Opioid epidemic.—The Committee is concerned with the ongoing 

opioid epidemic impacting the veteran community and requests a 

report on the availability of treatment and wait times for services 

for veterans with opioid addiction seeking care within the VA 

health care system. The report should include what VA has accomplished and how it would bring more services to those veterans. 

The Committee requests that this report be provided not later than 

90 days after enactment of this Act. 

Full spectrum of treatment options for opioid abuse.—The Committee is pleased that the Department has established and is implementing the VA Opioid Safety Initiative and is encouraged by 

the results it is producing in reducing the dependence of veterans 

on prescription opioids. However, the Committee is concerned that 

VA is not utilizing the full spectrum of treatment options for dealing with opioid addiction recommended by the Substance Abuse 

and Mental Health Services Administration. The Committee encourages VA to expand the use of medication-assisted treatment 

and other clinically appropriate services to achieve and maintain 

abstinence from all opioids and heroin. The Committee directs VA 

to submit a report not later than 90 days after enactment of this 

Act on VA’s ongoing review of prescription practices and addiction 

treatment protocols. 

State prescription drug monitoring programs.—The Committee 

notes that, with the problem of opioid use disorders escalating 

among veterans, it is important that VA continue its efforts to 

partner with States to ensure that they have the capacity to exchange prescription drug information with VA. The Committee understands that 36 States currently have installed the technology to 

exchange data from their State prescription drug monitoring 

boards with VA and that 12 additional States will achieve that capacity by the end of 2016. VA is urged to assist these remaining 

States to speed their exchange capacity. 

Other health issues 

Nursing full practice authority.—The Committee understands 

that VHA will soon publish a proposed regulation to recognize the 

full practice authority of advanced practice registered nurses working at VHA. The Committee encourages VHA to seek input from 

appropriate external professional stakeholders and to give consideration to the policies of existing Handbooks, prior to publishing the 

final regulation. The Committee believes all possible outreach efforts should be used to communicate the proposed changes, to gather public comment, and to collaborate with Congress, stakeholders, 

VA medical staff, and external organizations. 

Collaboration with historically black health professions schools.— 

Since 2008, the Committee has encouraged improved collaboration 


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45 

between VA healthcare facilities and Historically Black Colleges 

and Universities (HBCUs) health professions schools. The Committee acknowledges the progress made but recognizes that almost 

all improvements have been with smaller CBOCs, not the larger, 

urban VA hospitals. Although the Committee finally received the 

report on medical school affiliations well after the 90 day deadline, 

VA has yet to organize a national symposium of VA headquarters 

and VISN health leaders and leaders of the HBCU health professions schools, despite several Committee directives. Therefore, the 

Secretary is directed, again, to convene a symposium where minority collaboration concerns are discussed and addressed. A plan for 

this symposium should be submitted to the Committee not later 

than 60 days after enactment of this Act. 

Hispanic-Serving Institution affiliations with VA health care facilities.—The Committee continues to be concerned by the lack of 

Hispanic-Serving Institutions (HSIs) medical school participation 

and collaboration with local VA hospitals in areas where HSI medical schools are located. The Committee urges the Secretary to develop a plan to expand local VA medical facilities’ participation 

with HSI medical schools. 

Hepatitis B virus (HBV).—The Committee is aware that: (1) Hepatitis B is more common among veterans than in the general population; (2) rates of testing of veteran patients fail to meet the guidelines recommended by the medical profession; and (3) only a fraction of those veterans who test positive receive treatment. Hepatitis B, if left untreated, may lead to advanced liver disease, liver 

cancer and the need for liver transplants, placing a greater financial burden on the veteran health care system. The Committee 

urges an aggressive and targeted outreach program, consistent 

with the Centers for Disease Control and Prevention’s viral hepatitis testing and treatment recommendations, to identify veterans 

with Hepatitis B and to facilitate and encourage treatment for 

those identified with the disease. 

Infectious diseases screening.—The Committee applauds VHA for 

developing electronic clinical reminders for recommended HIV/ 

AIDS and viral hepatitis screening and urges VHA to implement 

these reminders in all appropriate settings. To further improve 

screening rates, the Committee urges VHA to offer support to 

VISNs to implement recommended screening, including innovative 

strategies like point-of-care testing. 

Blast injury treatment.—The nature of the current military conflict and increasing use of improvised explosive devices has left 

some servicemembers with blast injuries that include spinal cord 

injury and trauma to the reproductive and urinary tracts. The 

Committee is concerned about the care of these injured 

servicemembers after they return home, and notes that there is not 

parity between the DOD and VA treatment of servicemembers with 

these injuries. In House Report 114–92, the Committee directed VA 

to provide a report not later than 180 days after enactment of that 

Act detailing the scope and extent of veterans facing infertility 

issues due to military service during Operation Iraqi Freedom 

(OIF) and Operation Enduring Freedom (OEF). The Committee expects to receive this report within the mandated timeframe. 

End of life care.—Veterans often have unique physical, psychological and emotional needs at the end of life, including PTSD, 


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service-related disabilities, and other emotional and spiritual 

needs. The Committee applauds VA for its efforts to develop and/ 

or strengthen partnerships with local hospice organizations, increase access to hospice and palliative care for veterans in their 

communities, and provide information and resources to improve 

end-of-life care for veterans. The Committee encourages the Department to continue to foster delivery models that allow veterans 

to receive concurrent hospice or palliative care while receiving active disease treatment. 

Medical opinions from non-VA health care providers.—In order to 

conserve VA’s resources, enable faster rating decisions, and reduce 

the number of appeals, the Committee encourages VA to accept 

medical opinions from non-VA health care providers when the evidence is sufficient for rating purposes. 

Volunteer physicians.—The Committee is concerned with the 

delay in required reporting on and implementation of the Physician 

Ambassadors Helping Veterans Program. The pilot program continues to remain a priority of the Committee and the delays in implementation and reporting as required by P.L. 113–235 are of significant concern. The Committee directs VA to submit the required 

reports not later than 30 days after enactment of this Act. 

Marketing and outreach efforts.—The Committee requests VA to 

submit a report not later than 90 days after enactment of this Act 

identifying the range, scope and cost of its current marketing and 

outreach efforts, both for traditional VA programs and the Choice 

Act. 

Eligibility for vet centers.—The Committee is aware of the barriers that prohibit former members of the military from obtaining 

care for service-related disabilities if they were separated from the 

military in an other than honorable status. The Committee recognizes that veterans who separated from the armed forces in an 

other than honorable status may be treated through the Vet Center 

Program as long as they meet the eligibility requirements of 38 

U.S.C. Section 1712A(c). Recognizing that the provision of treatment to this population is in the best interest of the individual, the 

Committee encourages the Secretary to reach out proactively to 

veterans who were separated from the armed forces in an other 

than honorable status to notify them of the services they may obtain at Vet Centers. 

Caregiver program.—The Committee recognizes the value provided to caregivers by the VA Caregiver Support program. However, eligibility for the Caregiver Support Program extends only to 

those veterans who served on or after September 11, 2001. The 

Committee requests that the Department provide a report to the 

Committee not later than six months after enactment of this Act 

which identifies: (1) the estimated population of veterans who 

would be eligible for the Caregiver Support Program, if program 

eligibility were made available to veterans of all service eras; (2) 

estimated projections of the number of veteran caregivers who 

would seek to enroll and participate in the Caregiver Support Program, if program eligibility were made available to veterans of all 

service eras; and (3) the estimated cost and resources necessary to 

incorporate all service era veterans in the Caregiver Support Program. 


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VA teleradiology program.—The Committee is aware that VA 

provides much of its teleradiology service through its national program, but understands that, with the initiation of the Choice program, VA has additional options for radiology services through nonVA providers. The Committee requests a report not later than 60 

days after enactment of this Act describing the agency’s long-term 

plan to provide radiology services, identifying the relative costs and 

efficiencies of the options that have been considered relative to its 

final plan. 

Vaccine procurement.—The Committee encourages VA to consider 

including vaccines produced through recombinant DNA technology 

in addition to traditionally produced vaccines in future solicitations 

to facilitate the competitive process for all vaccine manufacturers. 

Data-driven veterans prosthetic care outcomes.—The Committee 

commends the Department for deploying advanced, proven lowerlimb prosthetic digital health technology to provide real-world data 

documenting activity in the community for veterans with lower 

limb prostheses. Accurate activity data documenting how veterans 

function with their prosthetic devices offers new opportunities to 

improve outcomes, increase activity, and improve the quality of life 

for veterans who have lost limbs. The Committee requests the 

Prosthetics and Sensory Aids Service to provide a report not later 

than 120 days after enactment of this Act detailing the location of 

VA medical centers and other VA facilities where this technology 

is available; the number of veterans who have utilized the technology; and plans for making the technology more widely available 

to benefit veterans with limb loss, including possible plans to making the collection of such outcomes data the standard of care 

throughout VHA. 

Reporting VA care capacity for severely disabled veterans.—The 

Committee encourages VA to reinstate the reporting initially required in the Veterans Health Care Eligibility Reform Act of 1996 

on the Department’s capacity to provide for the health care needs 

of severely disabled veterans, including veterans with spinal cord 

dysfunction, blindness, amputations, and mental illness. This reporting requirement should be presented by facility and by VISN. 

The information will assist Congress in determining whether VA 

has maintained its capacity to provide for the special and rehabilitative needs of veterans. 

Use of antimicrobial cleaning technology.—The Committee requests VA to submit a report to the Committee not later than 180 

days after enactment of this Act detailing the VA’s current use of 

antimicrobial cleaning agents in its facilities, the cost of such cleaning supplies and the application process, and the potential cost and 

safety benefits of utilizing antimicrobial cleaning technology that 

has the ability to reduce toxicity and remain active and effective 

on surfaces and equipment over a multi-day period. 

PTEN mutation awareness.—The Committee encourages VA to 

ensure that screening for the phosphatase and tensin homolog 

(PTEN) tumor suppression gene and its possible mutations are included in its cancer panels, when appropriate, and that medical 

staff are trained to recognize cancer genetic syndromes, including 

PTEN. The Committee understands that the mutation may pass 

from generation to generation, with evidence that families of Vietnam veterans are particularly affected. 


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National Veterans Sport Programs.—The bill includes for fiscal 

year 2017 the fiscal year 2016 level of $9,005,000 for the Office of 

National Veterans Sports Programs and Special Events. 

VA Pre-Medicine Internship Program.—Pre-medicine internships 

are designed to help interested individuals understand the realities 

of life as a doctor. One of the common pieces missing in applications is the experience of shadowing. The Committee recognizes the 

obstacles young professionals face in obtaining shadowing opportunities required for entrance into many healthcare professional 

schools. The Committee also understands that while VA allows 

shadowing there is no formal shadowing program at VA. The Committee urges VA to explore the feasibility of creating a system to 

facilitate shadowing opportunities with VA medical professionals 

for individuals pursuing advanced medical training. 

MEDICAL COMMUNITY CARE

Fiscal year 2018 advance appropriation request ............................. $9,409,118,000 

Committee 2018 advance appropriation recommendation .............. 9,409,118,000 

Comparison with: Fiscal year 2017 enacted level ................................................... +$9,409,118,000 

Fiscal year 2018 advance budget request ................................. – – – 

The Medical Community Care account was created in the Surface 

Transportation and Veterans Health Care Choice Improvement Act 

of 2015. It is intended to consolidate all community care programs 

under a single appropriation. For fiscal year 2017, the bill finances 

the account through a transfer of $7,246,181,000 from the advancefunded Medical Care accounts. The amount transferred is equivalent to the funding of the separate non-VA community care programs that are being consolidated through an authorizing bill. 

Funding of the account for fiscal year 2018 is provided in the bill 

through an advance appropriation of $9,409,118,000, comparable to 

the advance appropriations for the other Medical Care accounts. Of 

the 2018 advance appropriation, $1,500,000,000 is available until 

September 30, 2019. 

MEDICAL SUPPORT AND COMPLIANCE

Fiscal year 2016 enacted level ........................................................... $6,144,000,000 

Fiscal year 2017 enacted level ........................................................... 6,524,000,000 

Fiscal year 2018 advance budget request ......................................... 6,654,480,000 

Committee 2018 recommendation in the bill ................................... 6,654,480,000 

Comparison with: 

Fiscal year 2017 enacted level ................................................... 130,480,000 

Fiscal year 2018 advance budget request ................................. – – – 

The Medical Support and Compliance appropriation funds the expenses of management and administration of the Department’s 

health care system, including financial management, public health 

and environmental hazard, quality and performance management, 

medical inspection, human research oversight, training programs 

and continuing education, security, volunteer operations, and 

human resources. 

The Committee has included requested bill language to make 

available through September 30, 2019, $100,000,000 of the Medical 

Support and Compliance appropriation for fiscal year 2018. 

Funding identified in the bill is in addition to the anticipated 

$16,262,000 for medical support and compliance from the Veterans 

Choice Act in fiscal year 2017. 


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MEDICAL FACILITIES

Fiscal year 2016 enacted level ........................................................... $5,020,132,000 

Fiscal year 2017 enacted level ........................................................... 5,074,000,000 

Fiscal year 2017 additional request .................................................. 649,000,000 

Committee 2017 additional recommendation ................................... – – – 

Fiscal year 2018 advance budget request ......................................... 5,434,880,000 

Committee 2018 recommendation in the bill ................................... 5,434,880,000 

Comparison with: 

Fiscal year 2017 enacted level ................................................... 360,880,000 

Fiscal year 2018 advance budget request ................................. – – – 

The Medical Facilities appropriation provides funds for the operation and maintenance of the Department’s health care system’s 

capital infrastructure. Included under this heading are provisions 

for costs associated with utilities, engineering, capital planning, 

leases, laundry, grounds keeping, garbage, housekeeping, facility 

repair, and property disposition and acquisition. 

The bill does not include the current year budget request of $649,000,000, which would be in addition to the advance appropriation that has already been provided. If the Secretary determines 

that additional fiscal year 2017 funds are required, he can request 

a transfer from the other Medical Care accounts. 

The Committee has included requested bill language to make available through September 30, 2019, $250,000,000 of the advance 

Medical Facilities appropriation for fiscal year 2018. 

Funding identified in the bill is in addition to the anticipated $15,512,000 for medical facilities from the Veterans Choice Act in 

fiscal year 2017. 

Within the funds provided for the green management program, 

no funding shall be used for solar or wind projects due to concerns 

about mismanagement of previous projects. 

Medical imaging equipment.—The Committee remains committed 

to helping VA in its efforts to ensure a timely process for VA medical centers to receive the medical imaging equipment that they 

need to take care of veterans. The Committee urges VA to strive 

for a 120-day turnaround for these equipment orders. The Committee requests that VA consider more education at individual VA 

medical centers regarding high-tech medical equipment purchasing 

processes and seek ways to eliminate redundant paperwork requirements for such orders. The Committee encourages VA to add 

information regarding procurement processes in the area of hightech medical equipment, including support for VISN Imaging Committees, to its existing educational opportunities. In addition, the 

Committee urges VA to coordinate between capital equipment purchases, facilities funding for site readiness, and training of staff to 

use the equipment to ensure that facilities can use it as quickly as 

possible after purchase. 

Mechanical insulation assessments.—The Committee acknowledges the cost savings possible through energy savings associated 

with proper insulation, and encourages VA to work in collaboration 

with industry partners to conduct a mechanical insulation energy 

and water assessment at several representative VA hospitals. The 

assessment should study the potential for improved energy and 

water efficiency of the selected medical center mechanical systems 

by applying mechanical insulation in repair, replacement, or upgrade applications. Assessment results shall be shared through a 


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report to the Committee not later than 60 days after enactment of 

this Act. 

Bakersfield outpatient clinic.—The Committee is concerned with 

the lengthy period VA has taken to lease a new outpatient clinic 

in Bakersfield, CA pursuant to Public Law 111–82. Outpatient clinics greatly reduce the need for veterans to travel long distances for 

care by providing reliable medical services closer to a veteran’s 

home. The new outpatient clinic would replace the Bakersfield community-based outpatient clinic and would provide expanded primary care and mental health services while offering a range of specialty care clinics. This project would simultaneously increase veterans’ access to healthcare locally as well as reduce the caseload 

at other facilities in the VA Greater Los Angeles Healthcare System. While VA received congressional authorization for the project 

in fiscal year 2010 and has allocated funding for it, the project has 

been delayed for years and is still in the acquisition phase. The 

Committee urges the Department to expedite the project in light of 

the urgent need for expanded healthcare services. The Committee 

directs the Secretary to report to the Committee not later than 60 

days after enactment of this Act on past actions and the future 

plan forward, including the timeline for this project, and to provide 

periodic progress reports to the Committee every 120 days. These 

periodic progress reports shall include an explanation of any 

changes to: (1) the project’s status; (2) the expected cost of the 

lease; and (3) the projected completion date. 

MEDICAL AND PROSTHETIC RESEARCH

Fiscal year 2016 enacted level ........................................................... $630,735,000 

Fiscal year 2017 budget request ....................................................... 663,366,000 

Committee recommendation in the bill ............................................ 663,366,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... 32,631,000 

Fiscal year 2017 budget request ................................................ – – – 

This appropriation provides for medical, rehabilitative, and 

health services research. The bill makes this account funding available through September 30, 2018. Medical research is an important 

aspect of the Department’s programs, providing complete medical 

and hospital services for veterans. The prosthetic research program 

is also essential in the development and testing of prosthetic, orthopedic, and sensory aids for the purpose of improving the care and 

rehabilitation of eligible disabled veterans, including amputees, 

paraplegics, and the blind. The health services research program 

provides unique opportunities to improve the effectiveness and efficiency of the health care delivery system. Budgetary resources from 

a number of areas, including appropriations from the medical care 

accounts, reimbursements from DOD, grants from the National Institutes of Health, private proprietary sources, and voluntary organizations, provide support for the Department’s researchers. Estimated 2017 research resources beyond the research account are 

$1,249,000,000. 

PTSD research.—The National Center for Posttraumatic Stress 

Disorder sets the VA agenda for research and education on PTSD, 

with seven research divisions located at VA facilities. The Center 

also conducts education and training, and coordinates the VA National PTSD Brain Bank. The bill provides up to $40,000,000 for 


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the Center in fiscal year 2017, compared to the budget request of 

$19,107,000. 

The Committee recognizes the importance of the VA National 

Center for PTSD in promoting better prevention, diagnoses, and 

treatment of PTSD. The Committee further recognizes the importance of this research for veterans, their family members and those 

experiencing community violence. The Committee encourages the 

National Center to conduct further research on the effects of PTSD 

for veterans who live in communities affected by violence, particularly in low-income areas and communities of color. 

Respiratory diseases.—The Committee notes the high rates of 

respiratory diseases in returning OEF and OIF veterans, and encourages VA to expand its research portfolio to better understand 

the causes of these respiratory diseases and potential treatment options. 

Innovative treatments.—The Committee recognizes that VA rightly provides only those medical treatments that are based on sound 

clinical research results. On occasion, practitioners and companies 

have brought to VA new treatments which seem promising, but 

which lack clinical trial-tested results on large groups of subjects. 

The Committee understands that VA has recognized the difficulties 

practitioners face in gathering enough clinical evidence to justify 

their treatments and is considering developing a Center of Innovation for research support. The Committee encourages VA to start 

such a Center and suggests two possible treatments as appropriate 

candidates for initial research—hyperbaric oxygen therapy and 

magnetic EEG/EKG-guided resonance therapy. • The Committee understands that private clinical studies 

have demonstrated that hyperbaric oxygen therapy can provide 

positive results for patients suffering from PTSD and TBI. The 

Committee encourages VA to begin studies through the Center to 

develop evidence that would more conclusively demonstrate the effectiveness of this treatment. Studies should explore partnering 

with private clinics currently providing hyperbaric oxygen therapy, 

provided that such clinics meet appropriate standards and guidelines for the screening of patients and provision of care. 

• The Committee understands that magnetic EEG/EKG-guided 

resonance therapy (MeRT) has successfully treated a number of 

veterans with PTSD, TBI, chronic pain, and opiate addiction. Recent clinical trials have produced promising results in the evolution 

of MeRT treatment. The Center is encouraged to conduct research 

on the possible benefits of EEG/EKG-guided resonance therapy 

with a larger population of veterans suffering from PTSD, TBI, 

chronic pain, and opiate addiction. 

Stroke research.—The Committee understands that in the aftermath of the closure of the VA QUERI stroke health services research center in fiscal year 2015, VA has lacked a central entity 

to focus research on the disease. The Committee encourages VA to 

designate a centralized research hub for stroke research to bring 

together treatment, research, and education to support health provider competencies; identify gaps in medical research and coordinate research efforts; and integrate new knowledge and the latest 

technology—such as adaptive software-enabled robotic exoskeleton 

rehabilitation and robotic prosthetics—into stroke patient care delivery across VA. 


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Exoskeleton research.—The Committee recommends that VA investigate the possible cardiovascular, musculoskeletal, and economic benefits of powered exoskeletons, provided by multiple manufacturers, for spinal cord injury and stroke rehabilitation and 

home/community use. 

Canine therapy.—The Committee is aware that canine therapy 

for treatment of PTSD and TBI symptoms is an emerging alternative therapy to pharmaceutical treatments. While still experimental, canine therapy has demonstrated effectiveness in treating 

PTSD and other psychological disorders for psychiatric patients, 

patients with substance abuse problems, and victims of trauma. 

The Committee notes that canine therapy is a promising area for 

further research as a complementary or alternative treatment for 

the signature wounds of the wars in Iraq and Afghanistan. The 

Committee continues to encourage VA to expand its research on canine therapy to validate its therapeutic effectiveness in the treatment of PTSD and TBI. 

Sleep research.—The Committee is encouraged by the robust VA 

portfolio of basic and clinical sleep research and requests the Department to explore the linkages between sleep and cognitive functioning in veterans. 

Intergenerational effects of toxic exposures.—The Committee understands that exposure to toxic chemicals can have lifelong and intergenerational effects, the impacts of which are still being determined. The Committee recognizes that the generational effects of 

toxic exposure have not been sufficiently studied to determine what 

conditions children and grandchildren of exposed veterans may 

face. The Committee encourages VA to continue to monitor scientific studies regarding the effects of toxic exposure on veterans 

and their family members. 

Prosthetics for females.—The Committee believes that a proportionate amount of prosthetics research should be focused on prosthetics meant for females, based on the number of female veterans 

with prostheses. The need for this type of research is acute, as 

most prostheses are designed to fit male veterans. The Committee 

repeats its direction that VA, in collaboration with the Prosthetic 

Women’s Workgroup, issue a comprehensive report on female veteran amputees and their access to prosthetics. This report shall be 

submitted to the Committee not later than 90 days after enactment 

of this Act. 

Colorectal cancer research.—Colorectal cancer is treatable if detected early, yet it is the second leading cause of cancer death in 

America. The National Cancer Institute estimates the annual cost 

of colorectal cancer will be almost $20 billion by 2020, with Medicare and VA responsible for much of that cost. VA has made 

screening patients for colorectal cancer a priority. The Committee 

encourages VA to support additional research and development in 

the field, including investigation of a less costly diagnostic blood 

test and a stool-based screening test. 

Alzheimer’s disease research.—The Committee is aware of recent 

research that suggests TBI and PTSD may increase the chances of 

Alzheimer’s disease or related dementias. Furthermore, the Committee is concerned by VA estimates that the number of veterans 

with dementia will be as high as 218,000 in fiscal year 2017, a 

more than five-fold increase in the last decade. Therefore, the ComVerDate Sep 11 2014 03:42 Apr 16, 2016 Jkt 099765 PO 00000 Frm 00052 Fmt 6659 Sfmt 6602 E:\HR\OC\HR497.XXX HR497

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mittee encourages VA to conduct additional peer-reviewed research 

on Alzheimer’s disease. To the maximum extent possible, VA 

should target its research activities to the milestones issued in the 

National Plan to Address Alzheimer’s Disease and coordinate its efforts with the National Institutes of Health. 

Antimalarial medications.—Mefloquine is an antimalarial medication, both discovered and utilized by DOD. It is known to have 

specific acute side effects such as dreams, and its use has raised 

concern about possible long-term adverse health effects. Although 

DOD has initiated two research studies intended to review the potential adverse health effects of this medication, the studies have 

been hampered by the poor quality of data available on deployed 

troops who took the medication and what health care they received. 

The Committee understands that VA currently has a survey underway which asks veterans about the use of antimalarial medications 

and symptoms experienced, such as imbalance, dizziness or 

lightheadedness, vertigo, and fatigue. The Committee requests VA 

to provide to the Committee not later than 90 days after enactment 

of this Act a summary of the survey results when complete and to 

outline what possible research projects the survey data suggest. 

Research coordination.—The Committee recognizes the critical 

gap between basic research and clinical implementation of effective 

treatments for PTSD and TBI for veterans and urges VA to share 

its research on neuroscience with the private sector and consider 

establishing a consortium to coordinate with private sector research efforts. If a consortium is feasible, VA should organize public-private partners to work together to drive collaborative and innovative research on the neurobiology of PTSD with regard to trauma-associated genetic, epigenetic and transcriptional mechanisms 

and to galvanize efforts across basic research, translational science, 

and clinical delivery of treatments for TBI. 

MEDICAL CARE COLLECTIONS FUND

The Department of Veterans Affairs Medical Care Collections 

Fund (MCCF) was established by the Balanced Budget Act of 1997 

(Public Law 105–33). The Department deposits first-party and 

pharmacy co-payments, third-party insurance payments and enhanced-use collections, long-term care co-payments, Compensated 

Work Therapy Program collections, Compensation and Pension Living Expenses Program collections, and Parking Program fees into 

the MCCF. The Department uses these funds for medical care and 

services to veterans. The estimate of fees that will be collected in 

fiscal year 2017 is $2,637,000,000. 

NATIONAL CEMETERY ADMINISTRATION

Fiscal year 2016 enacted level ........................................................... $271,220,000 

Fiscal year 2017 budget request ....................................................... 286,193,000 

Committee recommendation in the bill ............................................ 271,220,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... – – – 

Fiscal year 2017 budget request ................................................ (14,973) 

The National Cemetery Administration was established in accordance with Public Law 93–43, the National Cemeteries Act of 

1973. It has a fourfold mission: to provide for the interment of, in 

any national cemetery with available grave space, the remains of 


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eligible deceased servicemembers and discharged veterans, together 

with their spouses and certain dependents, and to permanently 

maintain their graves; to provide headstones for, and to mark 

graves of eligible persons in national, State and tribal, and private 

cemeteries; to administer the grant program for aid to States and 

tribal governments in establishing, expanding, or improving State 

and tribal government veterans’ cemeteries; and to administer the 

Presidential Memorial Certificate Program. This appropriation will 

provide for the operation and maintenance of 134 operational national cemeteries, two rural National Veterans Burial Grounds, and 

33 other cemeterial installations. 

The bill includes language making $26,600,000 of the total available until September 30, 2018. 

Placement of emblems of belief on headstones of unclaimed, deceased veterans.—The Committee encourages the Secretary to permit the placement of emblems of belief on headstones of unclaimed, 

deceased veterans if reliable, recent documentation of the veteran’s 

beliefs can be produced (such as through dog tags or other military 

identification documents). 

Rural burial access.—The Committee continues to be concerned 

that there are geographic pockets in the country that would qualify 

for the VA rural veterans burial grounds initiative, but which are 

not served because their State as a whole does not qualify for it. 

Since eight percent of veterans live in areas that do not meet the 

VA goal of having access to a burial option within 75 miles of their 

home, the Committee requests a report not later than 90 days after 

enactment of this Act describing VA’s future plans to narrow the 

gap of veterans without reasonable access to burial. The Committee 

encourages VA to include in its plans consideration of options in 

which private entities would donate land to establish rural cemeteries and the establishment of satellite cemeteries. 

DEPARTMENTAL ADMINISTRATION

GENERAL ADMINISTRATION

(INCLUDING TRANSFER OF FUNDS)

Fiscal year 2016 enacted level ........................................................... $336,659,000 

Fiscal year 2017 budget request ....................................................... 417,959,000 

Committee recommendation in the bill ............................................ 336,659,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... – – – 

Fiscal year 2017 budget request ................................................ (81,300) 

The General Administration account provides funds for the Office 

of the Secretary, six Assistant Secretaries, and three independent 

staff offices. The Committee has included bill language to make 

available through September 30, 2018, up to $10,000,000 of these 

funds and to permit the transfer of funds in this account to the 

General Operating Expenses, Veterans Benefits Administration account. 

The bulk of the requested increase for General Administration— $72,600,000 and 204 additional fulltime equivalent staff—is intended for the establishment of the Veterans Experience Office. 

While the Committee supports the Secretary’s efforts to improve 

the ways VA interacts with veterans, it has doubts about the wisdom of establishing a large new office with regional staffing at this 


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late date in the administration. The bill does not include specific 

funding for this purpose. 

Position vacancies.—The Committee is concerned about the large 

number of vacancies among senior positions at VA medical centers 

throughout the country. The Committee directs the Secretary to develop and submit to Congress not later than 30 days after enactment of this Act a plan to: (1) hire highly qualified medical directors for each medical center that lacks a permanent director; (2) 

identify possible impediments to staffing facilities with permanent 

directors; and (3) assess the possibility of promoting and training 

qualified candidates from within VA for promotion to Senior Executive Service positions. 

Delays in hiring.—The Committee is concerned about whether 

the hiring and credentialing process may contribute to longer wait 

times for veterans seeking healthcare. The Committee requests a 

report on the average length of time to fill a healthcare provider 

slot at a representative sample of medical centers, including: the 

time it takes the resource board to approve the hire of a new position; the time it takes to post the job announcement; how long the 

interview process takes; and the length of time for credentialing; as 

well as any internal VA goals that exist for the time each step in 

the process should take. The report should also describe how often 

a healthcare provider reaches the credentialing process phase of 

the process, but does not end up hired because of another hiring 

opportunity outside VA. If VA does not collect this data in a systematic way, it should report this to the Committee and begin efforts to collect it in the future. This report should be provided to 

the Committee not later than 60 days after enactment of this Act. 

VA budget office communication.—The Committee has traditionally channeled most of its inquiries and requests for information 

and assistance through the VA budget office. The Committee reiterates its longstanding position that, while the Committee reserves 

the right to call upon all VA offices, the primary communication between the Committee and VA should normally be through the 

budget office. Responses to Committee inquiries, regardless of 

whether they concern funding or policy, are to be transmitted without delay by other offices within VA, unless otherwise requested by 

the Committee. In addition, to facilitate the work of the Committee, it expects that the Department will make available to all 

personal and committee staff of Members of the Committee the 

same direct contact with the budget office. The Committee also expects that a staff member of the VA budget office will be present 

at every meeting held between the chairman and ranking member 

of the Full Committee and Subcommittee and the Secretary or 

other senior VA officials. 

Additional budgetary information.—The Committee continues its 

request that items described in the fiscal year 2015 House report 

113–416 continue to be included in the budget justifications submitted each year. These items include: displaying a current year 

estimate for all accounts and for the budget year and the advance 

year; providing a reimbursable FTE summary chart for the General 

Administration account; providing an FTE by grade and regional/ 

central office totals chart for the Information Technology Systems 

account; and providing the appeals caseload information requested 

for the Board of Veterans Appeals. The Committee would also like 


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a quarterly report identifying the total amount the Department obligates for outreach and awareness marketing campaigns, with a 

description of each campaign supported. 

In addition, in an effort to improve the Committee’s understanding of the Department’s mental health services treatment programs, the Committee requests the Secretary to include the following data in the fiscal year 2018 budget materials: • information on mental health treatment to include the 

number of veterans treated, by each type of VA medical facility, including hospitals, nursing homes, CBOCs, and domiciliaries; the number of visits; number of discharges; and the average length of stay for inpatient and residential treatment; • the annual incidence of veteran suicides nationwide; • the number of clinical fulltime equivalent psychiatrists, 

advanced practice psychiatric nurses, psychologists, social 

workers providing mental health services, mental health counselors, and marriage and family therapists reported by setting 

of care or program type; and • a diagnostic composition of patients treated based on the 

health problems listed in the International Classification of 

Diseases. 

The Committee requests that VA return in the 2018 budget to 

prior year data presentation in the budget justifications in several 

areas: • The Medical Care charts shown on pages VHA–17–23 of 

the fiscal year 2017 budget justification should be 

disaggregated as in prior years into the four Medical Care accounts with Choice funding for each account shown separately 

within the account. • Program area highlights should be aggregated into one 

area of the justification rather than being spread throughout 

the justification. • Explanations of changes from the budget year to the advance budget year should be included for the three mandatory 

accounts with advance appropriations. 

Quarterly financial information reports.—The bill includes an administrative provision which continues the requirement for submission of the quarterly financial information required in the Military 

Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2016. 

Staff relocations within VA.—The bill continues the administrative provision requiring written notification 15 days prior to organizational changes which result in the transfer of 25 or more fulltime 

equivalent staff from one organizational unit of the Department to 

another. 

Data on women and minority veterans.—The Committee recognizes the lack of data specific to women and minority veterans that 

is made available to Congress by VA. The Committee recommends, 

when applicable and when data exist, that the Secretary display information in reports submitted to Congress identifying information 

separately for women veterans and minority veterans. 

Asian American representation on the Advisory Committee on Minority Veterans.—The Committee commends the Advisory Committee for its work over the past calendar year, and encourages the 

Secretary to consider appointing, in keeping with the demographic 


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make-up of America’s veteran community, an additional Asian 

American to the Advisory Committee in the coming year. 

Small, minority- and women-owned businesses.—The Committee 

directs the Department to submit a quarterly report to the Committee on its efforts to work with small, minority- and womenowned businesses. The report shall specify the number of small, 

minority- and women-owned businesses receiving contracts from 

funds appropriated under this Act, and the amount awarded to 

each small, minority- and women-owned business receiving contracts from funds appropriated under this Act. 

Customer service improvements.—As part of its new focus on improving the veteran experience with the Department, the Committee encourages VA to review and update its customer service 

policies described in documents such as the Service Recovery section of the Veterans Health Administration Handbook (VHA Handbook 1003.2). The most recent update to this customer service section was in August, 2003, more than 12 years ago. The section specifically outlines the patient communication and service improvement standards that VA employees should be striving to meet. The 

provision of VA health services has dramatically changed since this 

section of the handbook was issued, along with the agency mission 

priorities advocated by the Secretary. As part of the overall agency 

reboot of procedures and culture that is underway, the handbook 

should be overhauled. 

Public relations and communications spending.—The Committee 

has heard reports of substantial VA spending on outside contracts 

for public relations and communication activities. While the Committee supports the outreach services for which VA has used external contracts, such as public service announcements informing veterans of available mental health and homelessness programs, the 

Committee feels it needs to maintain a level of oversight for these 

contract activities. The Department is requested to provide a biannual report identifying the number of contracts signed with external entities for public relations and communications activities that 

are over $1,000,000 in value, along with a brief summary of the 

purpose of the contracts. 

Fee basis claims processing.—The Committee recognizes the need 

for veterans and their community care providers to have accurate 

and timely processing of veteran and vendor claims for medical 

services. There have been multiple problems with processing these 

claims, throwing some veterans and providers into debt collection 

status because of VA’s failure to pay claims promptly. The contract 

for the current VA Fee Basis Claims System (FBCS) will be recompeted at the end of the year. The Committee understands that VA 

plans to use this opportunity to standardize and redesign the capabilities of the system in anticipation of higher rates of fee basis 

claims, as non-VA care programs are consolidated. The Committee 

requests a report once the new contract is awarded, identifying the 

system’s enhanced capabilities, improved timeliness, and imbedded 

standardization and security features. 

Randolph-Sheppard Act.—The Committee encourages VA’s activities pertaining to the Randolph-Sheppard Act, which creates opportunities for blind business owners, including veterans, to operate vending facilities on Federal properties. The Committee requests a report not later than 90 days after enactment of this Act 


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identifying: (1) the universe of VA facilities subject to the Randolph-Sheppard Act requirements to extend to State licensing agencies the opportunity to seek space for blind vendors to conduct business; (2) the number of licensing opportunities that have been offered to State licensing agencies; and (3) the number of facilities 

that currently have a vending operation managed by a blind entrepreneur. 

BOARD OF VETERANS APPEALS

Fiscal year 2016 enacted level ........................................................... $109,884,000 

Fiscal year 2017 budget request ....................................................... 156,096,000 

Committee recommendation in the bill ............................................ 156,096,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... 46,212,000 

Fiscal year 2017 budget request ................................................ – – – 

The bill makes $15,610,000 of this funding available through 

September 30, 2018. 

The Board of Veterans Appeals (BVA) is the component of VA responsible for making final decisions on behalf of the Secretary for 

the thousands of claims for veterans benefits that are presented to 

BVA for appellate review. The majority of the BVA’s workload derives from the benefit claims initiated at the VBA regional offices. 

The appellate process has multiple steps, most of which occur at 

the local regional office level. If a veteran is not satisfied with a 

regional office determination, he or she may appeal to BVA for a 

final agency decision. BVA adjudicates appeals covering all areas 

of veterans benefits, but most of the workload concerns appeals for 

veterans’ disability compensation or pension benefits. As the disability compensations claims backlog at VBA dwindles, the appeals 

workload at the Board increases correspondingly. Pending appeals 

are projected to increase by 57 percent from 66,778 at the end of 

2014 to 105,012 by the end of 2016. 

The bulk of the requested fiscal year 2017 increase is targeted 

to increasing staffing by 242 fulltime equivalents that are needed 

to adjudicate and process appeals dispositions. The Committee appreciates the Board’s comprehensive analysis of what future steps 

need to be taken to manage its burgeoning backlog of cases. The 

solution proposed by the Board is a combination of a time-limited 

increase in staffing aligned with significant legislation changes to 

limit some of the statutory provisions that produce long delays in 

appeals. Although VA is working with affected stakeholders to develop legislation that will win the support of veterans and Congress 

for the needed statutory changes, the Committee is somewhat skeptical that the Board’s proposal will prevail during the current administration’s tenure. Nevertheless, the Committee supports the 

budget request as a necessary step to address the appeals backlog 

within the current statutory limitations. 

The bill also provides the $19,100,000 requested in the Information Technology Systems budget to support the Appeals Modernization initiative. The initiative will convert the Board’s largely paperbased system to an electronic one that will be integrated with the 

Veterans Benefits Management System that is used to process initial disability claims. 


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GENERAL OPERATING EXPENSES, VETERANS BENEFITS

ADMINISTRATION

Fiscal year 2016 enacted level ........................................................... $2,707,734,000 

Fiscal year 2017 budget request ....................................................... 2,826,160,000 

Committee recommendation in the bill ............................................ 2,826,160,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... 118,426,000 

Fiscal year 2017 budget request ................................................ – – – 

The General Operating Expenses, Veterans Benefits Administration (VBA) account provides funding for VBA to administer entitlement programs such as service-connected disability compensation, 

education benefits, and vocational rehabilitation services. 

The bill makes available through September 30, 2018, up to $141,000,000 of these funds. 

The Committee provides $2,826,160,000 for the General Operating Expenses, VBA account. Despite the funding constraints 

faced by the Committee, the Committee believes that one of its top 

priorities must be to support the activities in this request. The bill 

supports the full request of $26,695,000 for the centralized mail initiative to consolidate inbound paper mail from the regional offices 

to a centralized intake site and $152,924,000, $10,000,000 above 

the request, for the Veterans Claims Intake Program (VCIP) to 

scan paper claims and convert them into digital format. The Committee provides the full request ($37,356,000 from VBA and 

$143,000,000 from IT) for the Veterans Benefits Management System (VBMS), the paperless claims processing system. VBMS allows 

VBA to centrally manage the claims workload at the national level 

and direct cases electronically across its network of regional offices 

to match claims demand with available processing capacity. Lastly, 

the bill provides $19,100,000 in IT for the Board of Veterans Appeals modernization initiative to convert its largely paper-based 

process to an automated, integrated system. 

Claims backlog.—VA has no greater responsibility than ensuring 

veterans and their survivors receive timely, accurate decisions on 

their disability compensation and pension claims. For many years, 

too many veterans have waited too long to receive their benefits. 

While the backlog has dropped dramatically, the Committee directs 

the Department to continue its efforts to address the remaining 

backlog of disability benefit claims and develop and incorporate 

new information technology and customer service enhancements to 

put VA on a path to reach a functional zero backlog by the end of 

2016. The Committee further urges VA to continue to develop 

methods by which it can work closely with DOD, the IRS, the SSA, 

and other Federal partners to identify electronic data-sharing opportunities and process reforms to streamline workflows and limit 

paper claims filing. 

Performance reporting.—The Committee directs VA to continue 

the specific reporting requirements on claims processing performance and backlog first identified in House Report 113–416 and incorporated into section 229 of the Military Construction, Veterans 

Affairs, and Related Agencies Appropriations Act, 2016. 

Claims processing deficiencies.—The Committee continues to be 

concerned with the backlog at the Oakland, California VA regional 

office (VARO). According to the January 2016, VA Office of Inspector General report, the Oakland VARO continues to have delays in 


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processing informal claims and a number of veterans whose claims 

were not processed in a timely manner faced significant delays in 

benefit payments. The Committee encourages the Oakland VARO 

Director to conduct a complete review of all remaining claims that 

may be informal and ensure adequate training for Oakland VARO 

staff on processing informal claims. VBA is requested to submit a 

report not later than 30 days after the end of calendar year 2016 

outlining the number of claims received and processed at the Oakland regional office in 2016; the accuracy scores for those claims; 

the average time to complete a claim; employee scores on speed and 

quality of rating; the amount and type of employee training that 

was conducted; and the amount of overtime that was used. 

Staffing levels.—The Committee appreciates the efforts by VBA 

to reduce the disability compensation claims backlog. However, the 

Committee urges VBA to reevaluate its staffing levels at the regional office level and increase staff at a rate similar to increases 

in claims receipts to help better meet the needs of veterans. 

Appeals claims processing.—The Committee has provided the full 

request for VBA activities, including VBA activities at the initiation of an appeal. It is essential that the growing backlog in veteran appeals claims be addressed by VA. VBA has neglected its 

share of responsibility for the first stage of appeals of veteran 

claims in its effort to reduce the initial disability claims backlog 

and has lost sight of the appeals process. 

The Committee directs VBA to provide veterans with a thorough 

explanation of the analysis and information used to deny an initial 

claim when issuing its notification letter. 

Population diversity.—The Committee recognizes the diversity of 

the veteran population. Currently, VA recognizes many special 

groups of veterans and tailors the delivery of earned benefits and 

services to ensure that the particular needs of these groups are 

met. The preferences of millennial veterans pose specific challenges 

to the Department as it seeks to fulfill its mission. The Committee 

encourages VA to recognize millennial veterans as a special group 

within the veteran population and to establish a panel of millennial 

veterans to provide advice and insight to the Secretary into Department efforts, with additional emphasis on military-to-civilian transition and retraining opportunities. 

Administrative relief.—House Report 114–92 urged the Secretary 

to continue to grant or extend equitable relief to eligible veterans 

initially deemed eligible in instances of administrative error. In addition, the report also directed the Secretary to provide a report 

containing a statement as to the disposition of each case recommended to the Secretary for equitable relief under 38 U.S.C. 503 

for each preceding year. The Committee expects this report to be 

submitted on time and looks forward to the Equitable Relief report 

and a resolution on this issue. 

Access in underserved areas.—The Committee urges VBA to increase its presence and outreach to veterans living in remote and 

underserved areas such as the Commonwealth of the Northern 

Mariana Islands by sending VBA staff to areas beyond the VA offices every 3 to 4 months, especially areas where veterans are unable to travel by car or ferry to reach a VBA office. Veterans living 

in these areas, particularly elderly and disabled veterans who may 


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have difficulty accessing VBA services via the internet or phone, 

should have an opportunity to speak, in-person, with VBA staff. 

Military sexual assault (MST) claims.—The Committee understands VBA is developing and implementing new training initiatives and procedures for PTSD claims related to military sexual 

trauma. The Committee is pleased with the increased focus on this 

area and encourages VA to continue to build on the strides that 

have been made, including intensive training and identifying specialized claims employees for MST-related claims. The Committee 

also directs VA to conduct veteran outreach initiatives and publicize benefits veterans may be entitled to as a result of MST. In 

addition, the Committee recognizes that MST affects both female 

and male veterans and encourages VA to continue its efforts to provide equal treatment and assistance for both female and male veterans. 

Transition to civilian jobs.—The Committee is aware of efforts 

such as the Transition Assistance Program to help servicemembers 

transition to civilian life. The Committee is concerned about continued obstacles that veterans face in transitioning to the civilian 

workforce, including to the Federal workforce. The Committee 

strongly supports greater coordination between Federal agencies to 

ensure that veterans can successfully transition to the civilian 

workforce, including through the facilitation of the licenses and credentials to translate skills and training from the military to civilian sector jobs. 

Alternative use of education benefits.—With approximately one 

million veterans settling into American communities in the next 

three to five years, the Committee believes that it is important to 

find innovative ways to support veterans in their professional development. The Post-9/11 GI Bill provides post-secondary education 

as the principal option for veterans when they return. However, 

this may not meet the need of every veteran, as each individual 

possesses unique skill sets and experiences from their time in service that may be better suited to pursuing a career as a business 

owner. Therefore, the Committee encourages VA to work closely 

with the Small Business Administration (SBA) to further improve 

entrepreneurial opportunities for veterans. The Committee requests a report from VA analyzing the feasibility of using Post-9/ 

11 GI Bill benefits for business capital formation for qualified veterans, in consultation with the SBA’s recommendations. This report shall be due to the Committee not later than 90 days after enactment of this Act. 

Transition to law enforcement jobs.—The Committee is aware of 

national and State-level recruitment efforts to help veterans transition from military service to careers in civilian law enforcement. 

The Committee requests that the Secretary submit a report not 

later than 90 days after enactment of this Act on the type of training and transition assistance veterans receive to transition from 

military service to law enforcement. 

Intermediate care technician positions.—The Committee encourages VA to establish veterans education connection centers at VA 

medical centers, such as the one established at the Louis Stokes 

Veterans Administration Medical Center (VAMC) in Cleveland, 

Ohio. The Committee is pleased with VA’s decision to expand the 

number of intermediate care technician (ICT) positions at VAMCs, 


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since this program has the ability to augment staffing by utilizing 

the military training, knowledge, skills and experience of former 

DOD medics and corpsmen and Coast Guard corpsmen. The Committee requests VA to report on the impact analysis of the ICT program to guide possible future expansion. This analysis should include the impact of the ICT role on costs, access, and patient satisfaction, and innovative ways clinics are using ICTs to improve the 

coordination of patient care, particularly in the home healthcare 

arena. This report shall be submitted to the Committee not later 

than 180 days after enactment of this Act. 

Reducing fraud against veterans.—The Committee notes that 

only agents or attorneys who have met all qualifications and standards prescribed by VA are allowed to charge a reasonable fee to assist a veteran in filing a claim or appeal with VA. The Committee 

is concerned that financial predators across the country are targeting veterans, offering to help with their cases and charging very 

high fees, and providing them with little or no assistance. The 

Committee recommends that the Secretary be more aggressive in 

referring for criminal prosecution individuals and entities that defraud a veteran of benefits in order to discourage financial predators from continuing to target and defraud veterans. 

State and county veteran service officers receiving access to VA 

records.—The Committee encourages the Secretary to work with 

State and county Veteran Service Officers to explore options for allowing authorized Veteran Service Officers ‘‘read only’’ access to 

VBMS records for the purpose of identifying individuals who may 

be eligible for State or local benefits in addition to Federal VA benefits. 

Service records loss through fire.—The 1973 fire at the National 

Personnel Records Center in Overland, Missouri destroyed millions 

of military service records. This loss has created numerous challenges for some veterans and has prevented them from accessing 

the benefits and decorations they have earned through their service. While VA has an established process for veterans affected by 

this fire, the coordination between VA and DOD could be improved. 

The Committee urges the two Departments to create a clear, coordinated plan to improve the process to address the issue of proving military service when a veteran’s official service record has 

been lost or destroyed while in possession of the Federal government. 

INFORMATION TECHNOLOGY SYSTEMS

(INCLUDING TRANSFER OF FUNDS)

Fiscal year 2016 enacted level ........................................................... $4,133,363,000 

Fiscal year 2017 budget request ....................................................... 4,278,259,000 

Committee recommendation in the bill ............................................ 4,220,869,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... 87,506,000 

Fiscal year 2017 budget request ................................................ (57,390,000) 

The Information Technology Systems account supports information technology (IT) services such as systems development and performance, operations and maintenance, information protection, and 

customer support. The program permits the effective and efficient 

delivery of veterans’ healthcare services and benefits programs. 


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Within the account total, the Committee allocates in bill language $1,247,548,000 for pay and associated costs, which is 

$25,000,000 below the budget request; $2,502,052,000 for operations and maintenance, which is $32,390,000 below the request; 

and $471,269,000 for development, modernization, and enhancement, which is the same as the request. The bill makes available 

$36,300,000 of pay and associated costs and $177,900,000 of operations and maintenance funds until September 30, 2018. All development, modernization, and enhancement funds are available until 

September 30, 2018. 

Although funding constraints require the Committee to provide 

a funding level below the request, the level provided includes a 

$87,506,000, or a 2.1 percent, increase over fiscal year 2016, which 

will permit investment in high priority areas. The Committee identifies in particular as high priorities: $143,000,000 for the Veterans 

Benefits Management System (in addition to $37,356,000 which is 

provided for VBMS in the General Operating Expenses, Veterans 

Benefits Administration account); $19,100,000 for the Board of Veterans Appeals modernization effort; $20,000,000 for Section 508 

compliance efforts; $168,113,000 for VistA Evolution, the modernization of the electronic health record (EHR); and $91,761,000 

for interoperability and Virtual Lifetime Electronic Record (VLER) 

health. 

The Committee has had a longtime interest in assuring that 

DOD and VA health records for servicemembers and veterans can 

be exchanged electronically so that doctors across the street or 

across the world will be able to learn the patient’s health history. 

While disappointed that DOD and VA chose to develop two different health record systems, the Committee has been reassured by 

both agencies that the records will be fully interoperable. Committee members were startled to learn during the recent hearing 

with the Secretary that VA is rethinking the approach it previously 

chose (to modernize its VistA electronic health record) and is now 

considering other options, including purchasing a commercial offthe-shelf product. The Committee is concerned about what implications this detour will have on the completion time for the project 

(previously promised for 2018), its cost, and the usability of the 

VistA modernization products already completed. 

Consistent with previous appropriations bills, the Committee includes language to fence a portion of the funding provided for the 

electronic health record until VA provides requested information 

listed in the bill language. The Committee believes this fencing language is especially important as VA changes direction on development of the electronic health record. The language requires VA to: 

(1) demonstrate it has met the interoperability required in the 

2014 National Defense Authorization Act by December 31, 2016; (2) 

provide the business case for VistA Evolution that is guiding VA’s 

considerations; (3) provide a strategic plan, lifecycle cost estimate 

and master schedule for any system chosen; and (4) describe the 

implementation plan for the transition from the Project Management Accountability System (PMAS) to its new project delivery 

framework, the Veteran-focused Integration Process (VIP). The bill 

language fences the $168,113,000 of funds requested for VistA Evolution until these conditions are met, but does not restrict the funding provided for interoperability or VLER Health. 


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An administrative provision limits the funding for the electronic 

health record provided by the Veterans Health Administration to 

$40,000,000 from the Medical Support and Compliance account. 

The Committee continues to include bill language prohibiting obligation or expenditure of funds for information technology systems 

development, modernization and enhancement until VA submits to 

the Committees a certification of the amounts. In addition, the 

Committee continues bill language permitting the transfer of funding among the three subaccounts upon approval of the Committees. 

The bill contains language which allows for the reprogramming of 

funds among development, modernization and enhancement 

projects upon prior notification to, and approval by, the Committees. The bill continues to include language indicating that funds 

for development, modernization and enhancement are available 

only for the projects and in the amounts specified in the report accompanying the Act. 

The chart below reflects the Administration’s budget request for 

development projects and includes the Committee’s recommendation for each. This chart will serve as the Department’s approved 

list of development projects, and all requested changes are subject 

to the reprogramming guidelines as outlined in the accompanying 

Act. 

INFORMATION TECHNOLOGY DEVELOPMENT PROJECTS

[in thousands of dollars] 

Project Budget Request Committee Recommendation 

Electronic Health Record Interoperability and VLER Health ................... 17,322 17,322 

VistA Evolution ......................................................................................... 63,339 63,339 

Veterans Benefits Management System (VBMS) ..................................... 85,288 85,288 

Virtual Lifetime Electronic Record (VLER) ............................................... 17,857 17,857 

Veteran Customer Experience .................................................................. 73,624 73,624 

VHA Research IT Support Development ................................................... 15,066 15,066 

Other IT Systems Development ................................................................ 198,773 198,773 

Total All Development ..................................................................... 471,269 471,269 

The Committee expects the Office of Information Technology to 

continue to provide an IT expenditure report to the Committees on 

Appropriations on a monthly basis. This report shall include a comparison to the project costs included in the development, modernization, and enhancement project funding chart included in the 

House report, and provide an explanation for any differences in excess of $1,000,000. 

Security concerns.—The Committee continues to be concerned 

about the protection of veterans’ personal and medical data. As 

such, within six months of enactment of this Act, the Committee 

requests the Department to submit a report on VA’s use of cybersecurity best practices as it applies to datacenter security and mobile 

device management. This includes, but is not limited to: data center perimeter security, segmentation to improve lateral security 

within a data center or network, mobile device management protocols, and security protocols and identity management for remote access to data and applications. The Department should also identify 

measures taken to effectively contain and minimize a breach if it 

occurs. 


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Appointment scheduling system.—The Committee is frustrated 

that VA has spent years attempting to modernize its appointment 

scheduling system, investing in two systems and ultimately abandoning them. The consequence of these failures has been abundantly clear in the past several years as many VA facilities were 

found to be manipulating scheduling systems and failing to provide 

timely service to veterans. The Committee understands that VA is 

again considering how to modernize and standardize scheduling. 

The Department is directed to submit a report to the Committee 

not later than 30 days after enactment of this Act describing what 

alternatives VA has considered, including promising private sector 

practices, what functionalities a new system requires, and the anticipated timeframe for installation of a new system nationwide. 

The Department is encouraged to consider private sector scheduling solutions that may include trained patient care managers and 

strategies that have worked in other settings and develop a pilot 

of feasible options. 

OFFICE OF INSPECTOR GENERAL (OIG)

Fiscal year 2016 enacted level ........................................................... $136,766,000 

Fiscal year 2017 budget request ....................................................... 160,106,000 

Committee recommendation in the bill ............................................ 160,106,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... 23,340,000 

Fiscal year 2017 budget request ................................................ – – – 

The OIG was established by the Inspector General Act of 1978 

and is responsible for the audit, investigation, and inspection of all 

VA programs and operations. The overall operational objective is to 

focus available resources on areas which would help improve services to veterans and their beneficiaries, assist managers of Department programs to operate economically in accomplishing program 

goals, and to prevent and deter recurring and potential fraud, 

waste, and inefficiencies. 

The bill makes $14,800,000 of this funding available until September 30, 2018. 

The funding increase provided in the bill above the fiscal year 

2016 level is targeted to the OIG’s increasing workload, as it investigates myriad allegations of possible misconduct, poor patient care, 

and claims processing inaccuracies. The Committee understands 

the additional funding will be used to hire 100 fulltime positions 

at both new and existing locations nationwide, especially in areas 

in the southern and western tiers of the country and areas where 

there is currently no permanent OIG presence and a growing veteran population. 

Transparency.—Due to recent accounts alleging unjustified 

delays in release of reports pertaining to patient wait times and 

criminal investigations to the general public, the Committee believes that all reports prepared by the IG should be released publicly within 30 days of completion. The OIG could be perceived as 

biased by the public, and its effectiveness undermined, when its actions do not fully support transparency. 


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CONSTRUCTION, MAJOR PROJECTS

Fiscal year 2016 enacted level ........................................................... $1,243,800,000 

Fiscal year 2017 budget request ....................................................... 528,110,000 

Committee recommendation in the bill ............................................ 528,110,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... (715,690,000) 

Fiscal year 2017 budget request ................................................ – – – 

The Construction, Major Projects appropriation provides for constructing, altering, extending, and improving any of the facilities 

under the jurisdiction of or for the use of VA, including planning, 

architectural and engineering services, assessments, and site acquisition where the estimated cost of a project is $10,000,000 or more. 

The Committee recommendation makes all but $33,800,000 of 

these funds available for a five-year period. 

Continuing the practice first established in fiscal year 2016, the 

bill restricts the availability of funding for major construction 

projects costing more than $100,000,000 until VA certifies it has 

signed an agreement with an appropriate non-VA government entity to serve as the design and/or construction agent for the project. 

For fiscal year 2017, two major construction projects above the 

$100,000,000 threshold are funded, with restricted funds totaling 

$222,620,000. Within the account, the bill also provides 

$49,490,000 for the contract fees for the outside agent chosen for 

the projects. The Committee has taken this action in hopes that the 

gross mismanagement of the Denver, Colorado VA hospital project 

will never recur. 

The bill funds the following items as requested in the budget 

submission: 

CONSTRUCTION, MAJOR PROJECTS

[in thousands of dollars] 

Location Description Funding 

VHA: 

Long Beach, CA .............................................. Seismic Corrections—Mental Health and Comm. 

Living Center.

30,200 

Reno, NV ......................................................... Upgrade seismic, safety, utilities, and expand 

clinical services.

192,420 

Advance planning and design ........................ Various Stations ..................................................... 65,000 

Major Construction Staff ................................ Various Stations ..................................................... 24,000 

Claims Analysis .............................................. Various Stations ..................................................... 5,000 

Hazardous Waste ............................................ Various Stations ..................................................... 10,000 

Judgment Fund ............................................... Various Stations ..................................................... 9,000 

Non-Dept. Fed Entity Project Management 

Support.

Various Stations ..................................................... 49,490 

Total VHA ............................................... ................................................................................. 385,110 

National Cemetery Admin. (NCA): 

Elmira, NY ....................................................... New National Cemetery—Western NY .................... 36,000 

Las Animas, CO .............................................. New National Cemetery—Southern CO .................. 36,000 

Jacksonville, FL ............................................... Gravesite Expansion ............................................... 24,000 

South Florida, FL ............................................. Gravesite Expansion ............................................... 31,000 

Advance Planning and Design Fund .............. Various Stations ..................................................... 10,000 

Total, NCA .............................................. ................................................................................. 137,000 

Gen. Admin/Staff Offices: 

Dept APDF for Major ....................................... ................................................................................. 6,000 

Total, Staff Offices ................................ ................................................................................. 6,000 

Major Construction Total .............. ................................................................................. 528,110 


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To enhance the Committee’s capacity to conduct oversight on 

VA’s facility construction efforts, several administrative provisions 

are continued in the bill: (1) no funding amount greater than 

$5,000,000 may be reprogrammed between construction projects 

unless approved by the Committees on Appropriations of both 

House of Congress; (2) any change to the scope of a construction 

project is not permitted without the approval of the Committees; 

and (3) VA must report any bid savings of $5,000,000 or more on 

projects as soon as they are identified. 

Budget justification materials.—The Committee was disappointed 

that VA did not comply with the fiscal year 2016 conference report 

directive about additional information to be included in the fiscal 

year 2017 VA budget justification documents describing its major 

construction project requests. The Committee expects that the fiscal year 2018 justifications will include the information described 

in the 2016 conference report. 

Alternative financing.—The Committee is concerned about meeting the need for access to high quality veterans health care facilities, including in rural areas where access to facilities, including 

clinics and hospitals, is more limited. The Committee is pleased 

that VA is considering the creative use of public-private partnerships to meet this need and that the agency has developed the following criteria for possible projects: (1) Congress has provided partial funding; (2) VA has identified a need for the project through 

its long-range capital planning process by listing the project on its 

Strategic Capital Investment Planning (SCIP) priority list; and (3) 

the local community has agreed to provide not less than 25 percent 

of construction costs. The Committee requests that VA provide a 

list of facilities that meet these criteria and provide it to the Committee not later than 30 days after enactment of this Act. Such alternative financing mechanisms could be an important corollary to 

the increasing use of Medical Community Care in the future. 

Research infrastructure.—The Committee notes the Final Report 

on VA Research Infrastructure, completed in 2012, documented significant deficiencies in VA research laboratories across the VA system. The Committee is pleased the VA Office of Research and Development is reviewing the status of those deficiencies and looks 

forward to receiving updated reports on each VISN as they are 

completed. The Committee urges VA to allocate the appropriate resources needed to address the remaining deficiencies identified in 

the reports. 

Training for VA personnel engaged in facility management.—The 

Committee continues to be concerned about the lack of training and 

certification provided to engineering, construction and facility management staff with regard to building operations and maintenance. 

A recent GAO report found that VA has not provided clear guidance to personnel regarding required training from either the Engineering or Construction and Facility Management Divisions. Therefore, the Committee requests a report not later than 90 days after 

enactment of this Act about the number of personnel trained and 

certified in compliance with the Federal Buildings Personnel Training Act and the actions VA is taking to demonstrate clear guidance 

on training requirements for facility managers, building engineers, 

operations and maintenance staff. 


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Use of the Treasury judgment fund.—In the past several years, 

VA has had significant disputes with general contractors managing 

its major construction projects. In some cases, the claims disputes 

have had to be resolved with payments from the Department of 

Treasury Judgment Fund. The Committee requests the OIG to review VA’s claims and settlement practices relating to payment of 

contractors for major medical construction projects and the Department’s reimbursement of Treasury’s Judgment Fund and submit a 

report not later than 60 days after enactment of this Act. The report should include VA’s total required reimbursements to the 

Judgment Fund, the construction projects for which the settlements were required, and whether VA has fully reimbursed the 

Judgment Fund for all VA claims paid through the Fund. 

Construction Oversight.—The Committee is aware that commercial off-the-shelf building information modeling systems are routinely used in the private sector to manage the design and construction of large-scale facilities. These models have been proven to 

facilitate the delivery of large-scale construction projects ahead of 

schedule with significant savings. Therefore, the Committee encourages VA to examine if a fully competitive acquisition and implementation of commercial off-the-shelf building information modeling systems could be used to improve the timeliness and cost of 

VA medical facilities. The Committee requests a report not later 

than 60 days after enactment of this Act that describes: (1) how a 

model project delivery system would be tailored to VA construction 

needs at one or more projects included in the Strategic Capital Investment Plan (SCIP); (2) the acquisition of commercial building information modeling tools necessary to produce or utilize high fidelity project information; and (3) project management, reporting, and 

implementation support for VA construction projects during design, 

construction, and operations using 3D models to identify and mitigate cost, schedule, or technical risk and to better manage engineering change orders. 

CONSTRUCTION, MINOR PROJECTS

Fiscal year 2016 enacted level ........................................................... $406,200,000 

Fiscal year 2017 budget request ....................................................... 372,069,000 

Committee recommendation in the bill ............................................ 372,069,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... (34,131,000) 

Fiscal year 2017 budget request ................................................ – – – 

The Construction, Minor Projects appropriation provides for constructing, altering, extending, and improving any of the facilities 

under the jurisdiction or for the use of the Department, including 

planning, assessment of needs, architectural and engineering services, and site acquisition, where the estimated cost of a project is 

less than $10,000,000. 

As with the Major Construction account, the Committee recommendation makes these funds available for a five-year period. 

Funding identified in the bill is in addition to the anticipated $115,830,000 for minor construction from the Veterans Choice Act 

in fiscal year 2017. 

Mobile surgical units.—In P.L 114–113, the Consolidated and 

Further Continuing Appropriations Act of 2015, Congress directed 

VHA to establish two pilot projects at VA medical centers designed 

to gauge the cost-savings and clinical benefits of using mobile surVerDate Sep 11 2014 03:42 Apr 16, 2016 Jkt 099765 PO 00000 Frm 00068 Fmt 6659 Sfmt 6602 E:\HR\OC\HR497.XXX HR497

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gical units to cover for operating rooms taken out of service for repair or refurbishment. The Committee urges VHA to expedite selection of two pilot projects and report to the Committee not later 

than 90 days after enactment of this Act about the status and preliminary results of the pilots. 

GRANTS FOR CONSTRUCTION OF STATE EXTENDED CARE FACILITIES

Fiscal year 2016 enacted level ........................................................... $120,000,000 

Fiscal year 2017 budget request ....................................................... 80,000,000 

Committee recommendation in the bill ............................................ 80,000,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... (40,000,000) 

Fiscal year 2017 budget request ................................................ – – – 

This appropriation provides grants to assist States to construct 

State home facilities, for furnishing domiciliary or nursing home 

care to veterans, and to expand, remodel, or alter existing buildings 

for furnishing domiciliary, nursing home, or hospital care to veterans in State homes. A grant may not exceed 65 percent of the 

total cost of the project. The bill makes this funding available until 

expended. 

GRANTS FOR CONSTRUCTION OF VETERANS CEMETERIES

Fiscal year 2016 enacted level ........................................................... $46,000,000 

Fiscal year 2017 budget request ....................................................... 45,000,000 

Committee recommendation in the bill ............................................ 45,000,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... (1,000,000) 

Fiscal year 2017 budget request ................................................ – – – 

This program provides grants to assist States and tribal governments with the establishment, expansion, and improvement of veterans cemeteries which are operated and permanently maintained 

by the States and tribal governments. Grants under this program 

fund up to 100 percent of construction costs and the initial equipment expenses when the cemetery is established. The States and 

tribal governments remain responsible for providing the land and 

for paying all costs related to the operation and maintenance of the 

State cemeteries, including the costs for subsequent equipment 

purchases. The bill makes this funding available until expended. 

Public-private partnerships.—In order to provide a burial option 

to those veterans who may not have reasonable access to a national 

cemetery or State cemetery, the Committee encourages VA to 

prioritize funding under the State Veterans Cemetery Grant program for the establishment of veterans cemeteries in rural and 

highly rural areas. Additionally, States and local governments are 

encouraged to utilize public-private partnerships that are currently 

available to help defray the cost of operation and maintenance of 

a State veterans cemetery. 

ADMINISTRATIVE PROVISIONS

The bill includes 38 administrative provisions, 32 of which were 

included in the fiscal year 2016 bill and six of which are new. 


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70 

(INCLUDING TRANSFER OF FUNDS)

The bill includes section 201 allowing for the transfer of funds 

among three mandatory appropriations. The Administration proposal to modify this provision is not adopted. 

(INCLUDING TRANSFER OF FUNDS)

The bill includes section 202 allowing the Department to transfer 

funding among the four medical appropriations accounts in fiscal 

year 2017. The Administration proposal to modify this provision is 

not adopted. 

The bill includes section 203 allowing for salaries and expenses 

funds to be used for hire of passenger vehicles, lease of facilities 

or land, and purchase of uniforms. 

The bill includes section 204 providing that only funding in ‘‘Construction, Major Projects’’ and ‘‘Construction, Minor Projects’’ can 

be used for the purchase of any site for any new hospital or home 

or to construct any new hospital or home. 

The bill includes section 205 requiring the Department to be reimbursed for medical services it provides to any person not defined 

as a beneficiary to ensure the Department is receiving payment for 

all medical services provided. 

The bill includes section 206 allowing for the use of funds appropriated in fiscal year 2017 for ‘‘Compensation and Pensions’’, ‘‘Readjustment Benefits’’, and ‘‘Veterans Insurance and Indemnities’’ 

for payment of accrued obligations recorded in the last quarter of 

fiscal year 2016. 

The bill includes section 207 allowing for the use of fiscal year 

2017 funds to pay prior year obligations resulting from implementation of sections 3328(a), 3334, and 3712(a) of title 31, United 

States Code. 

(INCLUDING TRANSFER OF FUNDS)

The bill includes section 208 allowing the Department to use surplus earnings from the national service life insurance, U.S. Government life insurance, and veterans special life insurance program to 

administer these programs. 

The bill includes section 209 allowing the Department to obligate 

enhanced-use lease proceeds for administrative expenses that were 

incurred in a prior fiscal year during the year funds are received. 

(INCLUDING TRANSFER OF FUNDS)

The bill includes section 210 limiting the amount of reimbursement the Office of Resolution Management and the Office of Employment Discrimination Complaint Adjudication can charge other 

offices and accounts of the Department for services provided. 

The bill includes section 211 requiring the Department to collect 

current and accurate third-party reimbursement information for 

the purposes of third-party insurance collections. If persons receiving care or medical services do not disclose this information, the 

Department is allowed to bill them reasonable charges for services 

provided. 


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(INCLUDING TRANSFER OF FUNDS)

The bill includes section 212 allowing the Department to use enhanced-use lease funds for construction and alteration of medical 

facilities. 

The bill includes section 213 allowing the Department to use the 

Medical Services appropriation for expenses related to the broader 

mission of medical care to veterans. 

(INCLUDING TRANSFER OF FUNDS)

The bill includes section 214 allowing the Department to transfer 

Medical Care Collections to the ‘‘Medical Services’’ and ‘‘Medical 

Community Care’’ accounts to be used for veterans medical care 

and makes those funds available until expended. 

The bill includes section 215 allowing veterans who reside in 

Alaska to obtain medical services from medical facilities supported 

by the Indian Health Service or tribal organizations, and provides 

for reimbursement for those services from VA. 

(INCLUDING TRANSFER OF FUNDS)

The bill includes section 216 allowing the Department to transfer 

the proceeds received from the transfer of real property deposited 

into the VA Capital Asset Fund to the major and minor construction appropriations accounts and makes those funds available until 

expended. 

The bill includes section 217 providing that no funds may be 

used to prohibit Directors of the VISNs from conducting outreach 

or marketing programs. The Administration proposed to delete this 

provision. 

The bill includes section 218 requiring the Secretary to submit 

quarterly reports to the Committees on Appropriations of both 

Houses of Congress on the financial status of the Veterans Health 

Administration. The Administration proposed to delete this provision. 

(INCLUDING TRANSFER OF FUNDS)

The bill includes section 219 prohibiting the Department from 

transferring more than ten percent of the total Information Technology appropriation to or from the Information Technology account and requires the Department to receive approval from the 

Committees on Appropriations before such transfer. The Administration proposal to modify this provision is not adopted. 

(INCLUDING TRANSFER OF FUNDS)

The bill includes section 220 permitting the transfer of 

$274,731,000 appropriated for medical accounts, minor construction, and information technology systems to the Joint Department 

of Defense-Department of Veterans Affairs Medical Facility Demonstration Fund for the operation of facilities designated as combined Federal medical facilities. 

(INCLUDING TRANSFER OF FUNDS)

The bill includes section 221 permitting the transfer of $280,802,000 of fiscal year 2018 advance funding appropriated for 


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medical accounts to the Joint Department of Defense-Department 

of Veterans Affairs Medical Facility Demonstration Fund for the 

operation of facilities designated as combined Federal medical facilities. 

(INCLUDING TRANSFER OF FUNDS)

The bill includes section 222 permitting the transfer of funds deposited in the Medical Care Collections Fund to the Joint Medical 

Facility Demonstration Fund for facilities designated as combined 

Federal medical facilities. 

(INCLUDING TRANSFER OF FUNDS)

The bill includes section 223 directing that a minimum of 

$15,000,000 shall be transferred from the four medical care appropriations to the Department of Defense/Department of Veterans Affairs Health Care Sharing Incentive Fund, to be available until expended. 

The bill includes section 224 requiring the Secretary to notify the 

Committees on Appropriations of both Houses of Congress of all bid 

savings when identified in Major Construction projects that total at 

least $5,000,000 or 5 percent of the programmed amount of the 

project. The Administration proposal to delete this provision is not 

adopted. 

The bill includes section 225 prohibiting the original scope of 

work for a Major Construction project from being increased above 

the scope specified for that project in the original justification data 

provided to the Congress unless approved by the Committees. The 

budget request proposed to delete this provision. 

The bill includes section 226 identifying the maximum funding 

that may be obligated for VHA VistA Evolution and electronic 

health record interoperability activities. The budget request proposed to delete this provision. 

The bill includes section 227 requiring advance written notification to the Committees on Appropriations of both Houses of Congress 15 days prior to organizational changes which result in the 

transfer of 25 or more full-time equivalent staff from one organizational unit to another. The budget request proposed to delete this 

provision. 

The bill includes section 228 requiring the Secretary to provide 

on a quarterly basis to the Committees on Appropriations of both 

Houses of Congress notification of any single national outreach and 

awareness marketing campaign in which obligations exceed 

$2,000,000. The budget request proposed to delete this provision. 

(INCLUDING TRANSFER OF FUNDS)

The bill includes section 229 permitting the transfer to ‘‘Medical 

Services’’ from any discretionary program except ‘‘General Operating Expenses, Veterans Benefits Administration’’ upon approval 

of both Appropriations Committees. This provision is intended to 

give VA flexibility as it administers the changes to its traditional 

health care program and the Choice Act. The budget request to 

modify this provision is not adopted. 


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(INCLUDING TRANSFER OF FUNDS)

The bill includes section 230 permitting the transfer of funds between the ‘‘Board of Veterans Appeals’’ and ‘‘General Operating Expenses, Veterans Benefits Administration’’ upon approval of both 

Appropriations Committees. The budget request to modify this provision is not adopted. 

The bill includes section 231 prohibiting the reprogramming of 

funds exceeding $5,000,000 among the major construction projects 

unless both Appropriations Committees approve the request. The 

budget request proposed to delete this provision. 

(RESCISSION OF FUNDS)

The bill includes section 232 rescinding $30,000,000 of unobligated balances within the ‘‘DOD–VA Health Care Sharing Incentive Fund’’. 

(RESCISSIONS OF FUNDS)

The bill includes section 233 which rescinds Medical Care advance funding and section 234 which reduces funding in current 

year-funded accounts to incorporate assumed absorption of the proposed 1.6 percent payraise. The Department has authority to use 

whatever appropriated funds are available to support the payraise 

if it chooses to do so. 

The bill includes section 235 requiring the Secretary to ensure 

that the toll-free suicide hotline provides immediate assistance 

from a trained professional and adheres to all requirements of the 

American Association of Suicidology. 

The bill includes section 236 requiring the Secretary to treat a 

marriage and family therapist as qualified to serve in VA if the 

therapist meets certain educational and licensing requirements. 

The bill includes section 237 directing that none of the funds in 

the Act may be used to pay a performance award under section 

5384 of title 5, United States Code. 

The bill includes section 238 prohibiting the use of funds to end 

or relocate hospital-based services of a VA healthcare facility that 

is the subject of an environmental impact statement; designated as 

a National Historic Landmark by the National Park Service; and 

located in a highly rural area. 

The bill does not include section 224 as requested to provide additional transfer authority to the Secretary of Veterans Affairs. 

TITLE III 

RELATED AGENCIES 

AMERICAN BATTLE MONUMENTS COMMISSION

SALARIES AND EXPENSES

The recommendation includes $75,100,000 for Salaries and Expenses of the American Battle Monuments Commission (ABMC), as 

requested. The Committee notes that ABMC was provided with $30,000,000 

in the Fiscal Year 2016 Appropriations Act to support large, 

planned projects such as the Manila Visitor Center, adequate and 


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appropriate security at ABMC sites, significant repairs and refurbishing, and interpretive work supporting the World War I centennial. The Committee approves the spend plan for these funds provided by the Secretary and requires regular updates on the 

progress of the projects and a report on obligation of the funds. 

The Committee recognizes the critical work of ABMC to preserve 

commemorative and historical sites, and to educate the public 

about the United States Armed Forces. The Committee further recognizes the critical role that African Americans and other minorities played during World War II. The Committee urges the ABMC 

to partner with Department of Defense historians to ensure that 

these servicemembers and support staff are properly recognized at 

ABMC sites. Further, the Committee directs the ABMC to appropriately incorporate the contributions that African Americans and 

other minorities made into ABMC’s interpretive exhibits and on 

the ABMC website. 

FOREIGN CURRENCY FLUCTUATIONS ACCOUNT

The recommendation includes such sums as necessary for the 

Foreign Currency Fluctuations Account. It is not expected that additional funds will be required for fiscal year 2017 due to favorable 

exchange rates. 

UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS

SALARIES AND EXPENSES

The recommendation includes $30,945,000 for Salaries and Expenses for the United States Court of Appeals for Veterans Claims, 

as requested. 

DEPARTMENT OF DEFENSE—CIVIL CEMETERIAL EXPENSES, ARMY

SALARIES AND EXPENSES

The agreement provides $70,800,000 for Salaries and Expenses 

for Arlington National Cemetery (ANC), as requested. The Committee appreciates ANC’s emphasis on acquisition improvements, 

including training, certification and workforce hiring, to improve 

procurement and accountability. The Committee notes that 

$8,716,000 was provided in the Fiscal Year 2016 Appropriations 

Act to address deferred maintenance and infrastructure repairs at 

Arlington National Cemetery and a spend plan for use of those 

funds was required within 30 days of enactment. The spend plan 

has not been officially submitted and therefore the Committee repeats the requirement so that it can determine if the plan is acceptable. 

ARMED FORCES RETIREMENT HOME TRUST FUND

The recommendation includes $64,300,000 for the Armed Forces 

Retirement Home (AFRH), which is the same as the total amount 

requested, although $22,000,000 of the total is provided from a different source than requested. The Committee notes that there are 

major challenges for the near and long-term sustainability of the 

Trust Fund, which was created to provide all resources required for 

operations and expenses of the two AFRH locations. The Trust 


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Fund is replenished from a variety of sources, including fines and 

forfeitures and Active Duty Withholding. However, the largest 

source of funds, which is derived from fines and forfeitures, is diminishing. Annual outlays for the Fund have exceeded revenues 

since 2011, and in November 2015 the Department of Defense and 

AFRH officials informed the Committee that, counter to the assumptions in the fiscal year 2016 budget request, the Trust Fund 

balances were not sufficient to support the expenses of AFRH; 

therefore, the Fund was projected to be insolvent by April 2016. As 

an emergency measure to assure solvency for AFRH, in the Fiscal 

Year 2016 Appropriations Act, AFRH was provided with 

$20,000,000 from the General Fund. 

Although AFRH and the Department of Defense (DOD) were directed by Congress to develop an approach that will replenish the 

Trust Fund in a sustainable, reliable manner and to present that 

approach to the Congress in the President’s Request for fiscal year 

2017, along with legislative proposals, the Administration did not 

do so. Instead, the budget request for AFRH for Fiscal Year 2017 

includes an indefinite transfer from the Department of Defense Operations and Maintenance account, which the Committee does not 

support. AFRH’s budget request notes that DOD has commissioned 

a study of AFRH operations to include benchmarking and potential 

legislative changes to revise AFRH’s funding model. The Committee requests further information from DOD regarding the study, 

including a report on its cost, scope of work, deliverables, and 

timeline not later than 60 days after enactment of this Act. 

The Committee again asserts that the use of the General Fund 

is a not a long-term solution, and AFRH is directed to work with 

DOD to develop an alternative during fiscal year 2017, to be included in the fiscal year 2018 budget request. In addition, AFRH 

is directed to report quarterly to the Committee on the Trust Fund 

balance, receipts and expenditures, and the progress of its efforts 

to lease property at the Washington, D.C. facility, starting not later 

than 30 days after enactment of this Act. 

ADMINISTRATIVE PROVISIONS

The bill includes two provisions that were in effect in fiscal year 

2016. The administrative provisions included in the bill are as follows: 

The bill includes section 301 permitting Arlington National Cemetery to provide funds to Arlington County to relocate a water 

main. 

The bill includes section 302 permitting funds from concessions 

at Army National Military Cemeteries to be used to support activities at the Cemeteries. 


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TITLE IV 

OVERSEAS CONTINGENCY OPERATIONS 

DEPARTMENT OF DEFENSE

Fiscal year 2016 enacted level ........................................................... $– – – 

Fiscal year 2017 budget request ....................................................... 172,449,000 

Committee recommendation in the bill ............................................ 172,000,000 

Comparison with: 

Fiscal year 2016 enacted level ................................................... 172,000,000 

Fiscal year 2017 budget request ................................................ (449,000) 

The Committee recommendation includes Overseas Contingency 

Operations for military construction projects, unspecified minor 

construction and planning and design related to the Global War on 

Terrorism, Counter-Terrorism Support, and European Reassurance 

Initiative projects as requested in the fiscal year 2017 Overseas 

Contingency Operations budget request. 

Planning and Design.—The Committee is providing the planning 

and design as requested. However, the Committee directs that any 

future planning and design funds in fiscal year 2018 and beyond 

are to be requested as part of the base request. The Committee further directs the Secretary of Defense to submit 10 U.S.C. 2807 notifications to the congressional defense committees prior to obligation 

of the funds. 

Unspecified Minor Construction.—The Committee is providing 

the $5,000,000 as requested by the Joint Staff in Military Construction Defense-Wide. The Committee directs the Chief of the 

Joint Staff to submit to the congressional defense committees a 

spend plan for the $5,000,000 and 10 U.S.C. 2805 notifications 

prior to obligation of any of the funds. 

Counter-Terrorism support.—The Committee is providing the 

$8,551,000 within Military Construction, Air Force for planning 

and design of an undetermined project in the Levant. The Committee is concerned that requesting funding for an undetermined 

project, as well as inadequate planning and design of three percent 

of the expected total cost rather than ten percent, is not an appropriate practice by the Department of Defense. The Committee 

therefore directs the Department of Defense to provide a spend 

plan for the $8,551,000 and 10 U.S.C. 2807 notifications prior to 

obligation of any of the funds. 

Overseas Contingency Operations Future Year Defense Program.—The Committee is concerned that funding requested for 

Overseas Contingency Operations (OCO) does not follow the same 

process as the Department of Defense (DOD) process for planning, 

programming, budgeting and execution of funds required to support 

military operations, readiness, infrastructure and military force 

modernization. Further, the projects requested as part of OCO do 

not have the associated planning and design or future year defense 

program. Therefore, the Committee directs the Secretary of Defense to provide to the congressional defense committee a future 

year defense program for OCO projects beginning with fiscal year 

2015 and each subsequent year in which military construction 

funds have been or are to be requested in an OCO budget submission not later than 60 days after enactment of this Act. 


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MILITARY CONSTRUCTION, ARMY

The Committee recommendation includes $18,900,000 for Army 

military construction planning and design for a European Reassurance Initiative project. 

MILITARY CONSTRUCTION, NAVY AND MARINE CORPS

The Committee recommendation includes $59,809,000 for Navy 

and Marine Corps military construction and planning and design 

for Overseas Contingency Operations and European Reassurance 

Initiative projects. 

MILITARY CONSTRUCTION, AIR FORCE

The Committee recommendation includes $88,291,000 for Air 

Force military construction and planning and design for Overseas 

Contingency Operations, Counter-Terrorism, and European Reassurance Initiative projects. 

MILITARY CONSTRUCTION, DEFENSE-WIDE

The Committee recommendation includes $5,000,000 for DefenseWide unspecified minor construction for the Joint Staff for the European Reassurance Initiative. 

TITLE V 

GENERAL PROVISIONS 

The bill includes 14 provisions—12 provisions that are effective 

in fiscal year 2016 and two new provisions as follows: 

The bill includes section 501 prohibiting the obligation of funds 

beyond the current fiscal year unless expressly so provided. 

The bill includes section 502 prohibiting the use of funds for programs, projects or activities not in compliance with Federal law relating to risk assessment, the protection of private property rights, 

or unfunded mandates. 

The bill includes section 503 encouraging all departments and 

agencies funded in this Act to expand the use of ‘‘E–Commerce’’ 

technologies and procedures. 

The bill includes section 504 specifying the Congressional committees that are to receive all reports and notifications. 

The bill includes section 505 prohibiting the transfer of funds to 

any instrumentality of the United States Government without authority from an appropriations Act. 

The bill includes section 506 prohibiting any funds in this Act to 

be used for a project or program named for an individual serving 

as a Member, Delegate, or Resident Commissioner of the United 

States House of Representatives. 

The bill includes section 507 requiring all reports submitted to 

the Congress to be posted on official websites of the submitting 

agency. 

The bill includes section 508 prohibiting the use of funds to establish or maintain a computer network unless such network 

blocks the viewing, downloading, and exchanging of pornography, 

except for law enforcement investigation, prosecution or adjudication activities. 


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The bill includes section 509 prohibiting the use of funds for payment of first-class travel by an employee of the executive branch. 

The bill includes section 510 prohibiting the use of funds in this 

Act for any contract where the contractor has not complied with E– 

Verify requirements. 

The bill includes section 511 prohibiting the use of funds in this 

Act by the Department of Defense or the Department of Veterans 

Affairs for the purchase or lease of a new vehicle except in accordance with Presidential Memorandum—Federal Fleet Performance, 

dated May 24, 2011. 

The bill includes section 512 prohibiting the use of funds in this 

Act for the renovation, expansion, or construction of any facility in 

the United States, its territories or possessions, for the purpose of 

housing any individual who has been detained at the United States 

Naval Station, Guantanamo Bay, Cuba. 

The bill includes a new provision, section 513, to allow unobligated balances of amounts appropriated for the Ebola outbreak to 

be available to prevent, prepare for, and respond to the Zika virus. 

The bill includes a new provision, section 514 establishing a 

‘‘Spending Reduction Account’’ in the bill. 

HOUSE OF REPRESENTATIVES REPORT REQUIREMENTS

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

STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

Pursuant to clause 3(c)(4) of rule XIII of the Rules of the House 

of Representatives, the following is a statement of general performance goals and objectives for which this measure authorizes funding: 

The Committee on Appropriations considers program performance, including a program’s success in developing and attaining 

outcome-related goals and objectives, in developing funding recommendations. 

RESCISSIONS

Pursuant to clause 3(f)(2) of rule XIII of the Rules of the House 

of Representatives, the following table lists the rescissions in the 

accompanying bill: 

DEPARTMENT/ACTIVITY

AMOUNTS RECOMMENDED FOR RESCISSION

Department of Defense, Military Construction, Army (Sec. 125) ... 25,000,000 

Department of Defense, Military Construction, Navy and Marine 

Corps (Sec. 126) .............................................................................. 51,848,000 

Department of Defense, Defense-Wide (Sec. 127) ............................ 37,377,000 

42 USC 3374 (Sec. 133) ...................................................................... 25,000,000 

NATO Security Investment Program (Sec. 135) .............................. 30,000,000 

DOD–VA Health Care Sharing Incentive Fund (Sec. 232) ............. 30,000,000 

Department of Veterans Affairs, Medical Services (Sec. 233) ........ 266,760,000 

Department of Veterans Affairs, Medical Support and Compliance (Sec. 233) ................................................................................. 52,031,000 

Department of Veterans Affairs, Medical Facilities (Sec. 233) ....... 18,591,000 


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TRANSFER OF FUNDS

Pursuant to clause 3(f)(2) of rule XIII of the Rules of the House 

of Representatives, the following statements are submitted describing the transfer of funds provided in the accompanying bill. 

Language is included to allow for the transfer of funds from 

Family Housing, Construction accounts to the Department of Defense Family Housing Improvement Fund and funds from Military 

Construction accounts to the Department of Defense Military Unaccompanied Housing Improvement Fund. 

Language is included to provide transfer authority from the 

BRAC account to the Homeowners Assistance Program. 

Language is included to allow the transfer of expired funds to the 

‘‘Foreign Currency Fluctuations, Construction, Defense’’ account. 

Language is included to transfer not to exceed $17,224,000 in fiscal year 2018 from Compensation and Pensions to General Operating Expenses, Veterans Benefits Administration and Information 

Technology Systems. These funds are for the administrative costs 

of implementing cost-savings proposals required by the Omnibus 

Budget Reconciliation Act of 1990 and the Veterans’ Benefits Act 

of 1992. Language is also included transferring funds to the medical care collections fund to augment funding of medical facilities 

for nursing home care provided to pensioners. 

Language is included to permit the transfer of funds from General Administration to General Operating Expenses, Veterans Benefits Administration. 

Language is included to permit $7,246,181,000 to be derived from 

the Medical Care accounts to become available for Medical Community Care for fiscal year 2017. 

Language is included to permit the transfer of funds between Information Technology Systems development projects and among the 

three sub-accounts identified in bill language subject to the approval of the Committee. 

Language is included to provide authority for the Department of 

Veterans Affairs for any funds appropriated in 2017 for Compensation and Pensions, Readjustment Benefits, and Veterans Insurance 

and Indemnities to be transferred among those three accounts. 

Language is included to transfer funds among the Medical Services, Medical Support and Compliance, and Medical Facilities accounts. 

Language is included to permit the funds from three life insurance funds to be transferred to General Operating Expenses, Veterans Benefits Administration and Information Technology Systems for the costs of administering such programs. 

Language is included to permit up to $51,200,000 to be transferred to General Administration and Information Technology Systems from any funds appropriated in fiscal year 2017 to reimburse 

the Office of Resolution Management and the Office of Employment 

Discrimination Complaint Adjudication for services provided. 

Language is included to transfer certain funds derived from enhanced-use leasing activities to the Construction, Major Projects 

and Construction, Minor Projects accounts. 

Language is included to transfer funds from the Medical Care 

Collections Fund to the Medical Services account. 


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Language is included to allow the transfer of funds from the Capital Asset Fund to the Construction, Major Projects and Construction, Minor Projects accounts. 

Language is included to allow the transfer of funds from various 

accounts to the Information Technology Systems account in an aggregate amount not to exceed ten percent of the account appropriation, subject to approval by the Committee. 

Language is included to allow the transfer of funds in fiscal years 

2017 and 2018 provided for the Department of Veterans Affairs to 

the Joint Department of Defense-Department of Veterans Affairs 

Medical Facility Demonstration Fund. 

Language is included permitting funds deposited to the Medical 

Care Collections Fund for health care provided at a combined Federal medical facility to be transferred to the Joint Department of 

Defense-Department of Veterans Affairs Medical Facility Demonstration Fund. 

Language is included under the Department of Veterans Affairs 

that would transfer no less than $15,000,000 for the DOD/VA 

Health Care Sharing Incentive Fund as authorized by section 

8111(d) of title 38, United States Code. 

Language is included that permits the transfer from all discretionary accounts except General Operating Expenses, Veterans 

Benefits Administration, to Medical Services, subject to approval by 

the Committee. 

Language is included that permits transfer of funds between 

General Operating Expenses, Veterans Benefits Administration 

and the Board of Veterans Appeals, subject to approval by the 

Committee. 

DISCLOSURE OF EARMARKS AND CONGRESSIONALLY DIRECTED

SPENDING ITEMS

Neither the bill nor the report contains any Congressional earmarks, limited tax benefits, or limited tariff benefits as defined in 

clause 9 of rule XXI. 

CHANGES IN APPLICATION OF EXISTING LAW

Pursuant to clause 3(f)(1)(A) of rule XIII of the Rules of the 

House of Representatives, the following statements are submitted 

describing the effect of provisions in the accompanying bill that directly or indirectly change the application of existing law. 

Language is included in various parts of the bill to continue ongoing activities that require annual authorization or additional legislation, which to date have not been enacted. 

Language is included in various parts of the bill to place limitations on the use of funds in the bill or change existing limitations 

and which might, under some circumstances, be construed as 

changing the application of existing law. 

Language is included in various parts of the bill to allow the Secretary of Defense to exceed certain limitations upon notification to 

the Committee. 

Language is included in various parts of the bill to allow funding 

to be used for official reception and representation expenses. 

Language is included in various parts of the bill to enable various appropriations to remain available for more than one year for 


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some programs for which the basic authority legislation does not 

presently authorize such extended availability. 

Language is included in various parts of the bill to permit the 

transfer of funds to other accounts. 

Language is included under Title I to prohibit payments for costplus-a-fixed-fee contracts under certain circumstances. 

Language is included in various parts of the bill to allow funds 

to be used for the hire of passenger motor vehicles. 

Language is included under Title I to allow advances to the Federal Highway Administration, Department of Transportation under 

certain circumstances. 

Language is included under Title I to prohibit the use of funds 

to begin construction of new bases without specific appropriations. 

Language is included under Title I to prohibit the use of funds 

for purchase of land or land easements under certain circumstances. 

Language is included under Title I to prohibit the use of funds 

for land acquisition, site preparation, and utility installation for 

family housing unless funds have been made available in annual 

appropriations Acts. 

Language is included under Title I to prohibit the use of minor 

construction funds to transfer an activity between installations 

without prior notification. 

Language is included under Title I to prohibit the use of funds 

for the procurement of steel for any activity if American steel producers have been denied the opportunity to compete for such steel 

procurements. 

Language is included under Title I to prohibit the use of funds 

to pay real property taxes in any foreign nation. 

Language is included under Title I to prohibit the use of funds 

to initiate a new installation overseas without prior notification. 

Language is included under Title I to limit the use of funds for 

architect and engineer contracts under certain circumstances. 

Language is included under Title I to limit the use of funds for 

awarding contracts to foreign contractors under certain circumstances. 

Language is included under Title I to require the Department of 

Defense to notify the appropriate committees of Congress of any 

proposed military exercises under certain circumstances. 

Language is included under Title I to allow prior year construction funding to be available for currently authorized projects. 

Language is included under Title I to allow payment for the cost 

associated with supervision, inspection, overhead, engineering and 

design on family housing or military construction projects that are 

being completed with expired or lapsed funds. 

Language is included under Title I to allow funds to be expended 

on military construction projects for four fiscal years after enactment under certain circumstances. 

Language is included under Title I to allow construction funds to 

be transferred to Housing Improvement Funds. 

Language is included under Title I to allow for the transfer of 

BRAC funds to the Homeowners Assistance Program. 

Language is included under Title I to limit funds for the operation and maintenance of family housing to those provided in this 


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appropriation and to limit amounts expended on repairs of general 

and flag officer quarters under certain circumstances. 

Language is included under Title I to allow funds in the Ford Island Improvement Account to be available until expended for certain purposes. 

Language is included under Title I to allow for the transfer of expired funding to the Foreign Currency Fluctuation Account under 

certain circumstances. 

Language is included under Title I limiting movement of an 

Army unit with a testing mission. 

Language is included under Title I to allow for transfer of funds 

among projects and activities in accordance with reprogramming 

guidelines. 

Language is included under Title I to prohibit funds to be used 

for projects at Arlington Cemetery. 

Language is included under Title I defining the congressional defense committees. 

Language is included under Title I to prohibit the closure or realignment of Naval Station Guantanamo Bay. 

Language is included under Title II to require that the Secretary 

of Veterans Affairs establish a priority for treatment of veterans 

who are service-connected disabled, lower income, or have special 

needs. 

Language is included under Title II to require that the Secretary 

of Veterans Affairs give priority funding of basic medical benefits 

to priority groups 1 through 6. 

Language is included under Title II to allow the Secretary of Veterans Affairs to dispense prescription drugs from VHA facilities to 

enrolled veterans with privately written prescriptions. 

Language is included under Title II providing for the reimbursement to the Department of Defense for the costs of overseas employee mail. 

Language is included under Title II to require approval of a 

transfer between development, modernization, and enhancement 

projects in the Information Technology Systems account. 

Language is included under Title II restricting the use of funding 

for VistA Evolution or any successor electronic health record system until the Secretary certifies that the Department has met multiple conditions regarding the development, cost, schedule and 

interoperability of such a system. 

Language is included under Title II restricting the availability of 

funding for Major Construction projects in excess of $100,000,000 

until VA enters into an agreement with an appropriate non-VA 

Federal entity to serve as the design and/or construction agent for 

the project. 

Language is included under Title II establishing time limitations 

and reporting requirements concerning the obligation of Major Construction funds, limiting the use of funds, and allowing the use of 

funds for program costs. 

Language is included under Title II to allow Minor Construction 

funds to be used to repair non-medical facilities damaged by natural disaster or catastrophe. 

Language is included under Title II permitting transfers between 

mandatory and discretionary accounts, limiting and providing for 

the use of certain funds, funding administrative expenses associVerDate Sep 11 2014 03:42 Apr 16, 2016 Jkt 099765 PO 00000 Frm 00082 Fmt 6659 Sfmt 6602 E:\HR\OC\HR497.XXX HR497

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ated with life insurance programs from excess program revenues, 

allowing reimbursement from enhanced-use leases and for certain 

services, requiring notification of construction bid savings, limiting 

reprogramming amount major construction projects, restricting 

changes in the scope of major construction projects, requiring disclosure of insurance and income information, allowing a recovery 

audit collection program, allowing veterans in the State of Alaska 

to use Indian Health Service facilities under certain conditions, allowing medical services funds for recreational and funeral expenses, and requiring notification of organizational changes that 

transfer 25 or more employees from one VA organizational unit to 

another. 

Language is included under Title II requiring the Secretary to 

maintain certain requirements in operating the toll-free suicide 

hotline. 

Language is included under Title II permitting marriage and 

family therapists who meet certain requirements to be eligible for 

VA employment. 

Language is included under Title II prohibiting funds from being 

used to end, suspend, or relocate hospital-based services in a health 

care facility that is the subject of an environmental impact statement, is designated as a national historic landmark, and is in a 

highly rural area. 

Language is included under Title III United States Court of Appeals for Veterans Claims, Salaries and Expenses, to permit the 

use of funds for a pro bono program. 

Language is included under Title III Cemeterial Expenses, Army, 

Salaries and Expenses, to permit the use of funds for parking 

maintenance and repairs. 

Language is included under Title III Armed Forces Retirement 

Home to permit payment from the general fund of the Treasury to 

the Trust Fund. 

Language is included under Title III to permit the use of funds 

to relocate a water main. 

Language is included under Title III to allow for the use of concession fees. 

Language is included under Title V to limit the use of funds for 

Federal entities when they are not in compliance with Federal law 

relating to risk assessment, the protection of private property 

rights, or unfunded mandates. 

Language is included under Title V to limit the use of funds for 

publicity or propaganda designed to support or defeat legislation 

pending before Congress. 

Language is included under Title V to prohibit the use of funds 

for a project or program named for a serving Member of the United 

States Congress. 

Language is included under Title V prohibiting funds from being 

used to maintain or establish a computer network unless such network blocks the viewing, downloading, and exchanging of pornography. 

Language is included under Title V prohibiting funds from being 

used to pay for first class travel in violation of federal regulations. 

Language is included under Title V prohibiting funds from being 

used to execute a contract for goods or services where a contractor 

has not complied with Executive Order 12989. 


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Language is included under Title V prohibiting funds from being 

used by the Department of Defense or the Department of Veterans 

Affairs for the purchase or lease of a new vehicle except in accordance with Presidential Memorandum—Federal Fleet Performance, 

dated May 24, 2011. 

Language is included under Title V prohibiting the use of funds 

for renovation, expansion, or construction of a facility in the United 

States to house any individual who has been detained at the 

United States Naval Station, Guantanamo Bay, Cuba. 

Language is included under Title V allowing unobligated balances of amounts appropriated for the Ebola outbreak to be available to prevent, prepare for, and respond to the Zika virus. 

APPROPRIATIONS NOT AUTHORIZED BY LAW

Pursuant to clause 3(f)(1)(B) of rule XIII of the Rules of the 

House of Representatives, the following table lists the appropriations in the accompanying bill which are not authorized by law for 

the period concerned: 


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PROGRAM DUPLICATION

No provision of this bill establishes or reauthorizes a program of 

the Federal Government known to be duplicative of another Federal program, a program that was included in any report from the 

Government Accountability Office to Congress pursuant to section 

21 of Public Law 111–139, or a program related to a program identified in the most recent Catalog of Federal Domestic Assistance. 

DIRECTED RULE MAKING

The bill does not direct any rule making. 


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

In compliance with clause 3(e) of rule XIII of the Rules of the 

House of Representatives, changes in existing law made by the bill, 

as reported, are shown as follows (existing law proposed to be omitted is enclosed in black brackets): 

SECTION 223 OF THE MILITARY CONSTRUCTION, VETERANS AFFAIRS, AND RELATED AGENCIES APPROPRIATIONS ACT, 2016 

(Public Law 114–113; division J) 

ø(INCLUDING TRANSFER OF FUNDS) 

øSEC. 223. Of the amounts appropriated to the Department of 

Veterans Affairs which become available on October 1, 2016, for 

‘‘Medical Services’’, ‘‘Medical Support and Compliance’’, and ‘‘Medical Facilities’’, up to $265,675,000, plus reimbursements, may be 

transferred to the Joint Department of Defense-Department of Veterans Affairs Medical Facility Demonstration Fund, established by 

section 1704 of the National Defense Authorization Act for Fiscal 

Year 2010 (Public Law 111–84; 123 Stat. 3571) and may be used 

for operation of the facilities designated as combined Federal medical facilities as described by section 706 of the Duncan Hunter National Defense Authorization Act for Fiscal Year 2009 (Public Law 

110–417; 122 Stat. 4500): Provided, That additional funds may be 

transferred from accounts designated in this section to the Joint 

Department of Defense-Department of Veterans Affairs Medical 

Facility Demonstration Fund upon written notification by the Secretary of Veterans Affairs to the Committees on Appropriations of 

both Houses of Congress.¿ 

COMPARISON WITH THE BUDGET RESOLUTION

Pursuant to clause 3(c)(2) of rule XIII of the Rules of the House 

of Representatives and section 308(a)(1)(A) of the Congressional 

Budget Act of 1974, the following table compares the levels of new 

budget authority provided in the bill with the appropriate allocation under section 302(b) of the Budget Act. 

[In millions of dollars] 

302(b) Allocation This bill 

Budget 

authority Outlays Budget authority Outlays 

Mandatory ....................................................................................................... 101,433 101,074 101,433 1 101,074 

Discretionary .................................................................................................. 81,643 82,988 81,643 82,988 

General Purpose .................................................................................... 81,471 82,987 81,471 82,987 

Overseas Contingency Operations ........................................................ 172 1 172 1 

1 Includes outlays from prior-year authority. 

FIVE-YEAR PROJECTION OF OUTLAYS

Pursuant to clause 3(c)(2) of rule XIII of the Rules of the House 

of Representatives and section 308(a)(1)(B) of the Congressional 

Budget Act of 1974, the following table contains five-year projections prepared by the Congressional Budget Office of outlays associated with the budget authority provided in the accompanying bill: 


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[Millions] 

Non-OCO OCO 

Outlays: 

2017 ........................................................................................................................................ 2 109,744 1 

2018 ........................................................................................................................................ 4,762 43 

2019 ........................................................................................................................................ 3,359 66 

2020 ........................................................................................................................................ 2,105 40 

2021 and future years ........................................................................................................... 1,358 10 

2 Excludes outlays from prior-year budget authority. 

ASSISTANCE TO STATE AND LOCAL GOVERNMENTS

Pursuant to clause 3(c)(2) of rule XIII of the Rules of the House 

of Representatives and section 308(a)(1)(C) of the Congressional 

Budget Act of 1974, the amount of financial assistance to State and 

local governments is as follows: 

Millions 

Budget Authority ................................................................................... 3 181 

Fiscal Year 2017 outlays resulting therefrom ..................................... 33 3 Excludes outlays from prior-year budget authority. 

STATE LIST

The following is a complete listing, by title, State and country, 

of the Committee’s recommendations for military construction and 

family housing projects, including Overseas Contingency Operations projects: 


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MINORITY VIEWS 

The fiscal year 2017 Military Construction, Veterans Affairs and 

Related Agencies appropriations bill funds critical military construction, family housing and quality of life improvements and enhancements for our brave men and women in uniform and their 

families. This bill provides $81.6 billion in total discretionary funding. This is $1.8 billion above the 2016 enacted funding level but 

$1.2 billion below the FY 2017 budget request. 

The bill funds military construction at $5.6 billion, which is $120 

million below the FY 2017 request. For Department of Veterans Affairs (VA) programs, the bill provides $73.5 billion in discretionary 

funding, which is $2.1 billion above the FY 2016 enacted level but 

$1.4 billion below the President’s request. The recommendation 

also includes the budget request of $66.3 billion in discretionary 

funds for the FY 2018 advance appropriations for VA medical services. The bill includes $75.1 million for our heroes who have made 

the ultimate sacrifice and are honored in the battle monuments 

and cemeteries funded in this bill. 

We are pleased that the bill continues to build on efforts to end 

the veterans claims backlog that began in fiscal year 2014. First, 

the Committee bill continues both the aggressive monthly reporting 

requirements from each specific regional office on claims processing 

performance as well as quarterly reports on remediation efforts at 

the poorest performing regional offices. Second, the bill provides 

$180 million for the paperless claims processing system, $153 million for digital scanning of health records, and $27 million for centralized mail. Finally, the bill provides $156 million, a $46 million 

increase over the fiscal year 2016 level, for the Board of Veterans 

Appeals to support 242 new staff to tackle claims appeals, which 

have been ballooning as the number of claims decisions has increased. 

The bill continues to closely track the VA’s development of its 

electronic health record (EHR) system and fences off a portion of 

the funding until certain information is provided to the Committee. 

We believe that the fencing language is especially important for FY 

2017 as VA has indicated it will change direction on the development of this platform. In addition, the bill continues the practice 

started in 2013 to require the VA to provide information on the 

VistA Evolution system before funding is released. The Committee 

does not intend to delay the progress of modernizing VistA but believes continuing close oversight is necessary to ensure that the 

modernization effort will have the necessary capabilities to provide 

superior care. 

We are also pleased that the bill provides the full FY 2017 budget request of $7.8 billion for mental health programs, of which $164 

million will be available for suicide prevention outreach. In addition to the robust funding levels, language to address the Veterans 


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Crisis Line will have a meaningful impact on our Nation’s veterans 

when they are most vulnerable. Furthermore, the report addresses 

the mental health needs of female veterans, who are six times 

more likely to commit suicide than women in the general population. This bill takes positive steps to deal with this alarming 

trend. 

While there are numerous measures to praise in the bill, some 

shortcomings will have to be addressed. The inclusion of bill language indiscriminately denying performance awards is one example. This language does not distinguish between high-quality executives and the supervisors and managers at facilities where the Inspector General identified the use of inappropriate scheduling practices. In the long-term, denying SES bonus pay to high-performing 

executives will compound the very problem it attempts to address. 

It will make it significantly harder for the VA to recruit and retain 

quality executive leaders. The talented individuals that the VA 

needs to hire to solve problems for our nation’s veterans will be 

more inclined to take positions where employees in good standing, 

achieving desired results, can be rewarded. 

ADDRESSING THE ZIKA CRISIS

On February 22, 2016, the Administration requested that Con- gress provide nearly $1.9 billion to combat the spread of the Zika 

virus. Nearly seven weeks later, the Republican majority of Congress has not taken up the Administration’s request, even as the 

summer months approach and the threat of Zika infected mosquitoes continue to grow in the continental United States. 

Americans should have confidence their government is doing all 

it can to protect its citizens from the harmful effects of this terrible 

virus. Scientists no longer have doubts that Zika is a cause of 

microcephaly, a serious birth defect that can result in miscarriage 

and disability or death of a child. In addition, scientists continue 

to study the connection of Zika and Guillain-Barre, a neurological 

condition that causes paralysis. Funding is needed to not only respond to this virus, but to fully understand its effects. 

According to the Centers for Disease Control and Prevention 

(CDC), as of April 13, 2016, travel-associated Zika cases stand at 

358 in the United States. Thirty-one of those cases are pregnant 

women. In US territories, there are 471 cases of locally acquired 

virus and four travel-associated cases. Fifty-eight of those cases are 

pregnant women. It is unconscionable to continue to do nothing as 

these numbers continue to grow. 

During the first Committee meeting of the year, Committee 

Democrats attempted to address the threat of the Zika virus by offering an amendment to fund the Administration’s request of nearly $1.9 billion. The amendment offered by full Committee Ranking 

Member Nita Lowey, along with subcommittee ranking members 

Rosa DeLauro and Debbie Wasserman Schultz, would have funded 

prevention, detection, and response to the Zika virus as well as additional research, development, and procurement of vaccines, therapeutics, and diagnostics. The Republican majority blocked that effort through a procedural vote that denied providing additional 

funds for a Zika response and reneged on America’s commitment 

to continue to fight Ebola even as cases have resurfaced in Africa. 


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The Republicans’ logic is to promote an inadequate response to 

both Zika and Ebola by syphoning resources from Ebola response 

to partially fund a Zika response. We must confront Zika immediately with dedicated resources for CDC, the National Institutes 

of Health, and the U.S. Agency for International Development. U.S. 

efforts to keep Ebola at bay in Africa must not be weakened as we 

increase response to the Zika virus in the Americas. 

We must be prepared to respond to both public health crises. 

CONCLUSION

There is much to praise in the Military Construction VA bill 

though several items in the bill weaken our support. Moreover, 

Democrats will find it difficult to support individual FY 2017 appropriations bills such as this one until it is clear that Congress 

will provide needed resources in FY 2016 to respond to the Zika 

virus. 

NITA M. LOWEY. 

SANFORD D. BISHOP, Jr. 


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ADDITIONAL VIEWS 

During consideration of the 2017 Military Construction, Veterans 

Affairs and Related Agencies Appropriations Bill, the Committee 

recklessly adopted the Rogers amendment that redirected the funding Congress provided to respond to Ebola public health emergency 

to the emerging threat posed by the Zika virus. This is unwise and 

places American lives at risk. 

CDC has pledged to use this funding to support up to 30 poor 

and developing countries to improve their public health infrastructure. If we abandon this commitment, which has helped secure billions in funding from other countries, our partners in will certainly 

follow suit. Improving the public health infrastructure around the 

world makes Americans safer by preventing future epidemics like 

Ebola and Zika from spiraling out of control. It is shortsighted and 

irresponsible for us to shift these funds to another crisis. 

Instead Congress should immediately pass an emergency supplemental appropriations bill to support our response to the Zika 

virus. The Administration requested an emergency appropriation of 

$1.9 billion to face the Zika threat. Unfortunately, the administration has already been forced to rob nearly $600 million from Ebola 

to respond to Zika. This is dumbfounding. The Ebola crisis is not 

over. These funds are being directed away from other-critical and 

threatening global health risks and are being repurposed only as 

a last resort—not because it is the right thing to do from a policy 

perspective. 

Democrats offered the Lowey-DeLauro-Wasserman Schultz 

amendment, which would have fully funded the Administration’s 

request. 

We must immediately fund the Administration’s request and invest in stopping the Zika virus. This past month, Dr Anthony 

Fauci, Director of the National Institute of Allergy and Infectious 

Diseases said the following about Zika ‘‘Everything we see is bad. 

Every week, every month it tends to surprise us. There was no reason to think that it would be this bad.’’ 

Just this week Brazilian scientists and researchers uncovered a 

concerning links between the Zika virus and serious brain issues— 

Guillain Barre Syndrome and ADEM. Guillain Barre causes the 

immune system to attack the nerves, and can lead to paralysis. 

ADEM causes swelling in the brain and spinal cord and presents 

such similar symptoms to multiple sclerosis that many doctors cannot distinguish between the two. As Anne Schuchat, principal deputy director of the U.S. Centers for Disease Control and Prevention 

put it, ‘‘Everything we look at with this virus seems to be a bit 

scarier than we initially thought.’’ 

Zika is already infecting travelers returning to the United States, 

and is even being transmitted sexually—so men, as well as women, 

are at risk. We are about to send hundreds of American athletes 


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to Rio for the Olympics, and thousands more will attend as spectators. 

The Zika virus has already wreaked havoc across Latin America. 

In areas affected by Zika, we have seen thousands of babies born 

with microcephaly—a rare neurological condition characterized by 

incomplete brain development and an infant’s head being significantly smaller than the heads of other children. One of the mosquitos that transmits Zika is found in 30 U.S. states where millions 

of babies are born each year. 

In the Gulf Coast states of the U.S.—Texas, Louisiana, Mississippi, Alabama, and Florida—where large concentrations of the 

Aedes aegypti mosquito—the primary carrier of the Zika virus—are 

found, there were 783,000 births in 2014. Along the Gulf Coast, 

temperatures are already reaching the 80s in the afternoon. By 

May and June, these areas will begin to see these mosquitoes in 

larger numbers. 

Even Senator Marco Rubio said this week: ‘‘the Zika virus is impacting Florida, [Puerto Rico, and South America] and we must be 

prepared for what is predicted to be an even more explosive outbreak.’’ 

We need to immediately fund our response effort. What will happen to our blood supply when Zika transmission increases as more 

and more mosquitoes are born in the U.S. this summer? We need 

to reduce the population of Zika-carrying mosquitoes; we need to 

ensure the safety of the blood supply; and we need to enhance laboratory capacity and surveillance data. We need to develop advanced diagnostics to test more rapidly and accurately for Zika, 

and we need to develop a Zika vaccine. 

Congress needs to act immediately to protect millions of pregnant women and newborns from this serious threat. I urge my colleagues to oppose the inclusion of the Rogers Amendment in the 

2017 Military Construction, Veterans Affairs and Related Agencies 

Appropriations Bill. 

ROSA L. DELAURO. 

Æ 


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