28–054 

[COMMITTEE PRINT] 

115TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 2d Session 115–XXX 

MILITARY CONSTRUCTION, VETERANS AFFAIRS, AND 

RELATED AGENCIES APPROPRIATIONS BILL, 2019 

XXX–XX, 2018.—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 VIEWS 

[To accompany H.R. XXX] 

The Committee on Appropriations submits the following report in 

explanation of the accompanying bill making appropriations for 

military construction, the Department of Veterans Affairs, and related agencies for the fiscal year ending September 30, 2019, and 

for other purposes. 

CONTENTS 

Page 

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

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

Management and Oversight Initiatives ................................................................. 4 

Department of Defense: 

Military Construction ....................................................................................... 5 

NATO Security Investment Program .............................................................. 16 

Family Housing Construction and Operation and Maintenance .................. 16 

Department of Defense Family Housing Improvement Fund ....................... 18 

Department of Defense Military Unaccompanied Housing Improvement 

Fund ............................................................................................................... 18 

Department of Defense Base Closure Account ............................................... 18 

Administrative Provisions ................................................................................ 19 

Department of Veterans Affairs: 

Veterans Benefits Administration ................................................................... 21 

Veterans Health Administration ..................................................................... 27 

National Cemetery Administration ................................................................. 52 

Departmental Administration ......................................................................... 53 

Administrative Provisions ................................................................................ 65 


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Related Agencies: 

American Battle Monuments Commission ..................................................... 69 

U.S. Court of Appeals for Veterans Claims .................................................... 69 

Cemeterial Expenses, Army ............................................................................ 69 

Armed Forces Retirement Home ..................................................................... 70 

Administrative Provisions ................................................................................ 70 

Department of Defense: 

Overseas Contingency Operations .................................................................. 70 

Administrative Provisions ................................................................................ 71 

General Provisions ................................................................................................... 71 

House of Representatives Report Requirements ................................................... 72 

Statement of General Performance Goals and Objectives ............................ 72 

Rescissions ........................................................................................................ 72 

Transfer of Funds ............................................................................................. 73 

Disclosure of Earmarks and Congressionally Directed Spending Items ...... 74 

Changes in Application of Existing Law ........................................................ 74 

Appropriations Not Authorized by Law .......................................................... 78 

Program Duplication ........................................................................................ 80 

Directed Rule Making ...................................................................................... 80 

Full Committee Votes ...................................................................................... 80 

Ramseyer Rule .................................................................................................. 80 

Comparison With the Budget Resolution ....................................................... 80 

Five-Year Projection of Outlays ...................................................................... 80 

Assistance to State and Local Governments .................................................. 80 

Comparative Statement of New Budget Authority ........................................ 80 

State Project List .............................................................................................. 80 

Overseas Contingency Operations Project List .............................................. 80 

Minority Views .................................................................................................. 107 

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 because of their service to our Nation. This is accomplished through the programs funded in the bill, which provide the 

facilities and infrastructure needed to house, treat, 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 a wide variety of assistance 

programs for veterans—disability and pension benefits, health care 

in many different settings, educational assistance, and home loan 

and insurance programs. 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 $206,040,134,000 in budget authority for the fiscal year 2019 programs and activities funded in the 

bill. The fiscal year 2019 recommendation is an increase of 

$9,350,699,000 above the fiscal year 2018 enacted level and 

$130,617,000 below the President’s request. Of the increase over 

the fiscal year 2018 enacted level, $5,171,624,000 is in mandatory 

programs. Included in the total budget authority is 

$109,120,059,000 in mandatory budget authority and 

$96,920,075,000 in discretionary budget authority. 

The Committee recommendation highlights the continued commitment to our servicemembers and their families and to our vetVerDate Sep 11 2014 05:48 May 03, 2018 Jkt 028054 PO 00000 Frm 00002 Fmt 6659 Sfmt 6602 E:\HR\OC\B054.XXX B054

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erans. In discretionary budget authority, the bill is 4.5 percent over 

the fiscal year 2018 enacted level. The bill includes an increase in 

military construction, which is 3.8 percent above the fiscal year 

2018 level, and an increase in the Department of Veterans Affairs 

budget, which is 4.8 percent over the fiscal year 2018 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 missioncritical. Where it was prudent, the Committee recommendation rescinds prior year funding that is no longer needed for the purpose 

for which it was originally appropriated while leaving sufficient resources to close out contracts. Finally, the recommendation rescinds unobligated balances in certain military construction accounts. 

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 readiness improvements with new construction, family housing, continued cleanup of military bases closed during previous Base Realignment and Closure rounds, support 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, including the European Reassurance Initiative, is 

$11,253,420,000, which is $412,420,000 above the fiscal year 2018 

enacted level and $130,617,000 below the budget request. The recommendation includes funding for Family Housing, funding for 

necessary construction on our bases, including barracks, health facilities and schools, and support for critical overseas investments. 

The recommendation also includes $837,000,000 for the Services’ 

unfunded priorities. In addition, the recommendation also includes 

$921,420,000 for European Deterrence Initiative to help ensure the 

protection of our allies. 

The total funding level for fiscal year 2019 for the Department 

of Veterans Affairs is $194,469,059,000, an increase of 

$9,045,324,000 over the fiscal year 2018 enacted level. Of the total, 

$109,120,059,000 is provided for mandatory benefit programs and 

$85,349,000,000 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 4.8 percent over the fiscal year 2018 enacted level. 

For fiscal year 2019, $70,699,313,000 for medical care has been appropriated in advance. The recommendation includes 

$2,922,000,000, an increase of $53,091,000 over the President’s 

budget request for the administrative costs of Veterans Benefits 

Administration, including funding for scanning claims and staff 

overtime. The bill also provides $174,748,000 for the Board of Veterans Appeals, a $13,700,000 increase over fiscal year 2018, to target the growing caseload of appeals of initial benefits decisions. In 

addition, the Committee recommendation includes $75,550,600,000 

in advance appropriations for fiscal year 2020 for the four health 

care accounts of the Department and $121,296,429,000 in advance 

appropriations for mandatory benefits programs for fiscal year 

2020. 


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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, 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 2019 appropriations Act and the accompanying 

report address management challenges of the Federal agencies it 

funds, 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 $194,469,059,000 

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 as the 

operating procedures of the VA workforce. The following initiatives 

demonstrate the Committee’s oversight focus: 

VA electronic health record.—After at least a decade of Congressional encouragement to DOD and VA to develop a single electronic 

health record (EHR), VA has completed a contract to acquire the 

same EHR that DOD is adopting. The bill includes $1,207,000,000 

for the EHR contract in 2019, but also includes requirements for 

strict quarterly reporting of timelines, performance milestones, 

costs, implementation, and change management. The bill also requires the Government Accountability Office to conduct an ongoing 

review so that Congress can be informed of any problems at a point 

where they can be promptly and economically addressed. 

Disability claims and appeals.—Thanks to the significant investments Congress has provided over the past seven years, VA has 

been able to hire the staff, acquire the technology, and change work 

processes necessary to reduce the disability claims backlog to an 

‘‘effective’’ zero. But as the number of claims continues to increase 

and the number of appeals skyrockets once claims are decided, VA 

again runs the risk of falling into serious claims and appeals backlogs. The Committee recognizes this threat and provides 

$53,091,000 above the Veterans Benefits Administration request to 

support staff overtime and digital claims scanning. The Committee 

hopes that with this additional investment and the recently passed 

legislation to reform the appeals process, Congress will have taken 


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the necessary management action to prevent veterans from enduring excessive waits to claim the disability benefits they deserve. 

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

for information technology systems development until VA submits 

to the Committees a certification of the amounts. The bill limits the 

amount of funds that can be transferred into the IT account 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 projects upon prior notification to, and approval by, the Committees. 

Financial management system.—The Committee provides 

$83,621,000 for the replacement of VA’s antiquated financial management system. However, the Committee has concerns that VA 

may have problems managing the conversion without the planned 

management by the Department of Agriculture, which developed 

the system but has subsequently withdrawn its participation. Consequently, the Committee requires quarterly reporting by VA comparing actual performance in implementing the system to the 

metrics and timelines established in the initial operating plan required by the fiscal year 2018 appropriations bill. The Committee 

also requires its investigative staff to monitor periodically the system’s development and report to the Committee. 

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

The Committee receives quarterly briefings on the progress and 

cost of each facility managed by an outside entity. Several additional bill language provisions are included to enhance the Committee’s capacity to conduct oversight on VA’s facility construction efforts including: (1) no funding greater than $7,000,000 may be reprogrammed between construction projects unless approved by the 

Committees on Appropriations of both Houses of Congress; (2) any 

change to the scope of a construction project is prohibited without 

the approval of the Committees; and (3) VA must report any bid 

savings of $5,000,000 or more on projects as soon as they are identified. 

TITLE I 

DEPARTMENT OF DEFENSE 

MILITARY CONSTRUCTION OVERVIEW

Fiscal year 2018 enacted level (including rescissions) .................... $10,091,000,000 

Fiscal year 2019 budget request ....................................................... 10,462,617,000 

Committee recommendation in the bill (including rescissions) ...... 10,332,000,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... 241,000,000 

Fiscal year 2018 budget request ................................................ (130,617,000) 

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 

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ply, 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 for a reprogramming request for a project or account has 

been received from the Committees on Appropriations of both 

Houses of Congress, the adjusted amount approved becomes the 

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

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

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

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; 


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(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. 

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, although declining, on previously appropriated military construction projects. The Committee’s recommendation therefore includes rescissions to the Air Force, NATO 

Security Investment Program and HAP 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 Houses of Congress. 

Incremental funding of projects.—In general, the Committee supports full funding for military construction projects if they are executable. However, it continues to be the practice of the Committee 

to provide incremental funding for certain large projects to enable 

the services to more efficiently allocate military construction dolVerDate Sep 11 2014 05:48 May 03, 2018 Jkt 028054 PO 00000 Frm 00007 Fmt 6659 Sfmt 6602 E:\HR\OC\B054.XXX B054

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lars among projects that can be executed in the year of appropriation. Therefore, the Committee recommendation includes 12 

projects that have been incrementally funded; however the full authorization of the projects will be provided in the fiscal year 2019 

National Defense Authorization Act. 

Federally Recognized Tribes.—The Committee notes our nation’s 

commitment to honoring treaty and trust obligations to Federally 

Recognized Tribes. While military operations and facility protection 

are important, upholding our commitments to Indian Country must 

be an equal priority. It has been observed that the Department of 

Defense has struggled to proactively engage with affected Tribes at 

the start of the planning process to ensure meaningful consultation 

can occur. Moreover, the Department does not identify sufficient 

funds to cover mitigation and/or alternatives should they be agreed 

upon. To understand the scale of this problem, the Committee directs the Secretary of Defense to provide the Committee with a list 

of military construction projects where mitigation and/or changes to 

projects within the past five years where consultation with a Federally Recognized Tribe was required, the outcome of each consultation, a list of all project modifications and/or mitigation requests 

made by the Tribe (or Tribes) in question for each project, the cost 

of each measure, and which modifications and or mitigations were 

adopted. 

Impacts of weather and security for Military Installations.—The 

Department of Defense must pay close attention to potential adverse impacts of the weather as a driver of instability. From sea 

level rise to increased drought and flooding across the country and 

the world, proper defense planning must include considerations related to weather impacts. The Committee urges the Secretary of 

Defense to plan infrastructure and other projects using the best 

available data and to mitigate risks to our armed forces serving domestically and abroad. 

Joint Military Bases.—The Committee is concerned that Joint 

Bases lack a full complement of training facilities such as aquatic 

facilities for complete education. This often results in burdening 

local communities to attempt to accommodate training at insufficient facilities. The Department is encouraged to prioritize construction of training facilities that will diminish impacts on surrounding communities and increase readiness. 

Defense Access Roads.—The Committee is concerned about the 

lack of future planning for Defense Access Roads (DAR) and transportation infrastructure needs as continued flooding of vital access 

roads occurs more frequently. The Committee directs the Secretary 

of Defense to work with the Secretary of Transportation to 

prioritize DAR roads and projects specifically examining bases in 

communities that have experienced flooding by both non-storm 

surge flooding and flooding due to storm surge and report to the 

Committee no later than 30 days after enactment of this Act on its 

findings. Further, the Committee is concerned about the increasingly harmful impact of flooding on facilities at DOD’s coastal military installations and on the roads and infrastructure to access 

these installations. In January 2018, the Office of the Assistant 

Secretary of Defense for Energy, Installations and Environment, 

initiated a preliminary Screening Level Vulnerability Assessment 

Survey of DOD installations worldwide. With this report and other 


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similar reports by GAO, the Committee directs the Secretary of Defense to incorporate efforts from the reports to mitigate the effects 

of flooding on roads and infrastructure on domestic installations 

that are vital to military operations. 

Enhancing force protection and security on military installations.—The Committee, in collaboration with the House Armed 

Services Committee, includes section 130 that provides $50,000,000 

to each of the military construction accounts for Army, Navy and 

Marine Corps and the Air Force to alleviate deficiencies in access 

control points, air traffic control towers, fire stations, and AT/FP 

deficiencies across the enterprise. There has been much concern on 

both sides of the aisle that these types of military construction 

projects continually fall short of securing funding in a fiscal year 

due to higher priorities within the Services. Each Service Secretary 

is directed to provide a spend plan for these additional funds no 

later than 30 days after enactment of this Act to the congressional 

defense committees. 

MILITARY CONSTRUCTION, ARMY

Fiscal year 2018 enacted level ........................................................... $923,994,000 

Fiscal year 2019 budget request ....................................................... 1,011,768,000 

Committee recommendation in the bill ............................................ 1,001,768,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... 77,774,000 

Fiscal year 2019 budget request ................................................ (10,000,000) 

The recommendation includes additional funding for the Army in 

section 125 under Administrative Provisions for projects on the 

Services Unfunded Priority lists as provided by the Office of the 

Secretary of Defense and submitted to Congress in priority order. 

Aircraft maintenance hangars.—The Committee is concerned that 

many of our aircraft maintenance hangar facilities are unsafe, antiquated, and do not provide adequate space for storage and maintenance of our aircraft. For example, the current Combat Aviation 

Brigade, at Hunter Army Airfield, utilizes hangars that are outdated and require millions of dollars in funding for maintenance 

yearly. Therefore, the Secretary of the Army is directed to conduct 

a cost analysis on a review of Aircraft Hangars throughout the 

Army enterprise and a plan to update these facilities. This analysis 

shall be submitted to the congressional defense committees no later 

than 60 days after enactment of this Act. 

Rapid deployment requirements.—The Committee is concerned 

that the Army is not adequately prioritizing logistics infrastructure 

on bases with rapid deployment requirements. Therefore, the Secretary of the Army is directed to report to the congressional defense committees no later than 60 days after enactment of this Act 

on the backlog of infrastructure and the plan to eliminate the backlog by fiscal year. 

Army Futures Command.—The Committee is aware that the 

Army is in the process of standing up a new Army Futures Command which is the most significant Army reorganization effort 

since 1973. This will be the fourth Army Command, and its mission 

is to drive the Army into the future to achieve clear overmatch in 

future conflicts. The Army has identified 15 locations where Army 

Futures Command could be located. The Committee is concerned 

that the Army is failing to consider existing locations that could be 


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suitable for this new Command. The Committee directs the Secretary of the Army to provide a report on how the 15 locations were 

selected and identify current Army locations where Futures Command could be established no later than 30 days after enactment 

of this Act. 

Access Control Points.—Since September 11, 2001, the Department has made significant safety improvements at base entry 

points across many installations, but more needs to be done. The 

Committee is concerned that many of the Army’s access control 

points do not provide adequate controls for traffic flow on and off 

the installation. For example, the current access control points at 

Picatinny Arsenal need modernization to maintain its security and 

to enhance commercial and personnel traffic movement. The Committee is aware that the Office of the Secretary of Defense is conducting a risk assessment of certain access control points and developing a plan to update these facilities, including a cost estimate 

for each facility. The Committee looks forward to reviewing the report and the plan in coming weeks. 

MILITARY CONSTRUCTION, NAVY AND MARINE CORPS

Fiscal year 2018 enacted level ........................................................... $1,553,275,000 

Fiscal year 2019 budget request ....................................................... 2,543,189,000 

Committee recommendation in the bill ............................................ 2,100,298,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... 547,023,000 

Fiscal year 2019 budget request ................................................ (442,891,000) 

The recommendation includes additional funding for the Navy 

and Marine Corps in section 125 under Administrative Provisions 

for projects on the Services Unfunded Priority lists as provided by 

the Office of Secretary of Defense and submitted to Congress in priority order. 

Public Law 115–141 provided funding for the TBS Fire Station 

at Quantico, Virginia therefore, the recommendation does not include funding for the project in fiscal year 2019 recommendation. 

F–35 beddown.—The Committee is concerned that there is little 

coordination among the Navy and Marine Corps for the construction of aircraft and support facilities associated with the beddown 

of F–35s. The Committee believes that it would not be prudent to 

have 5th generation air assets like the F–35 housed in inappropriate hangars that fail to protect the aircraft from the elements. 

Therefore, the Committee directs the Navy and Marine Corps to 

provide a detailed timeline by fiscal year and cost of F–35 facilities 

to the congressional defense committees no later than 60 days after 

enactment of this Act. 

Shipyard Infrastructure.—The Committee recognizes the strategic and critical role our public shipyards play in the national security of our nation. However, our shipyards are in direct need of 

maintenance and upgrade. The Fiscal Year 2018 National Defense 

Authorization Act included language directing the Department of 

Defense to create a Shipyard Infrastructure Optimization Plan. 

This plan, included recommendations and future year projects that 

would help to restore our public shipyards in order to help support 

our fleet around the world. The Committee directs that the Secretary of Defense expedite or accelerate the funding of projects listVerDate Sep 11 2014 05:48 May 03, 2018 Jkt 028054 PO 00000 Frm 00010 Fmt 6659 Sfmt 6602 E:\HR\OC\B054.XXX B054

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ed in the Future Years Defense Plan and Shipyard Infrastructure 

Optimization Plan necessary for national security requirements. 

MILITARY CONSTRUCTION, AIR FORCE

Fiscal year 2018 enacted level ........................................................... $1,543,558,000 

Fiscal year 2019 budget request ....................................................... 1,725,707,000 

Committee recommendation in the bill ............................................ 1,454,723,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... (88,835,000) 

Fiscal year 2019 budget request ................................................ (270,984,000) 

The recommendation includes additional funding for the Air 

Force in section 125 under Administrative Provisions for projects 

on the Services Unfunded Priority lists as provided by the Office 

of the Secretary of Defense and submitted to Congress in priority 

order. 

The recommendation includes a rescission of $31,158,000 from 

unobligated balances in section 126 under Administrative Provisions. 

Public Law 115–141 provided additional funding for increment I 

of the Presidential Aircraft Recap Complex. Therefore, the recommendation does not fully fund the Presidential Aircraft Recap 

Complex, Increment II as requested. 

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. 

MILITARY CONSTRUCTION, DEFENSE-WIDE

(INCLUDING TRANSFER OF FUNDS)

Fiscal year 2018 enacted level ........................................................... $2,811,513,000 

Fiscal year 2019 budget request ....................................................... 2,693,324,000 

Committee recommendation in the bill ............................................ 2,465,738,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... (345,775,000) 

Fiscal year 2019 budget request ................................................ (227,586,000) 

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. 

The recommendation includes a reduction of $10,000,000 from 

contingency construction account. 

The recommendation does not include $10,000,000 for the Ambulatory Care Center Addition/Alteration at RAF Croughton due to 


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the construction pause on other projects at the installation by the 

Secretary of Defense and the EUCOM Commander. 

Inadequate roads infrastructure.—The Committee is concerned 

that inadequate local, state, and federal roads and insufficient 

parking accommodations and structures are unable to accommodate the volume of cars and are causing delays for civilians and 

service members working at critical national security mission locations, such as the National Security Agency and United States 

Cyber Command. The Department of Defense is therefore directed 

to submit to the Committee a report detailing the locations in 

which traffic congestion and insufficient parking facilities potentially impact the performance of national security missions, and 

their detailed plans to mitigate these detrimental impacts no later 

than 60 days after enactment of this Act. 

Information Technology Infrastructure for Military Construction 

Projects.—The Committee recognizes that information technology is 

an essential component in constructing modern facilities for military missions as well as planning for future requirements. Technology advancements can lead to increased productivity as well as 

efficiencies on energy and space, which impact military construction and modernization projects. It is essential that military planning keep up with advancements in technology in order to take advantage of these efficiencies and benefits. The mission-sets behind 

numerous military construction projects include requirements for 

access to multiple classified networks. The Committee is aware of 

technology that can streamline historically compartmented classified networks through cross domain solutions. Not only does this 

drastically impact future productivity for the workforce but it could 

also yield substantial savings and efficiencies on space, energy, and 

HVAC requirements. In an effort to ensure these technology advancements are incorporated at the early stages of planning for 

military construction, the Secretary of Defense shall report to the 

Committee no later than 60 days after enactment of this Act on 

how each department is staying apprised of technology advancements, working with industry partners on ways to gain efficiencies 

and savings on military construction projects, and how they plan 

to utilize cross domain solutions early in the planning stages for 

construction projects. 

National Maritime Intelligence Center.—The National Maritime 

Intelligence Center (NMIC) is located on the Suitland Federal Center in Suitland, Maryland. The NMIC is an Intelligence Facility designed and built with NFIP funds completed in 1993. The Office of 

Naval Intelligence (ONI) is the host command of the NMIC. The 

NMIC facility is required to provide safe and adequate parking for 

all tenet commands, which include 3,700 employees. Since 2008, 

parking at the NMIC has been inadequate due to significant facility expansion for 700 new FTEs and the discovery of structural and 

safety deficiencies of the NMIC garage. NAVFAC engineers have 

assessed that useful life of the garage will expire in 2021–2023. 

Therefore, the Secretary of Defense is directed to provide a way forward to correct these deficiencies no later than 60 days after enactment of this Act. 

Rhine Ordnance Barracks Medical Center Replacement.—In Public Law 115–141 the Committee directed the Director of the Defense Health Agency to report to the congressional defense commitVerDate Sep 11 2014 05:48 May 03, 2018 Jkt 028054 PO 00000 Frm 00012 Fmt 6659 Sfmt 6602 E:\HR\OC\B054.XXX B054

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tees: (1) specific changes in German energy law that affected the 

energy study; (2) what U.S. sources of energy the new German energy laws incorporate; (3) what U.S. sources are no longer able to 

be used in Germany; (4) what effect the changes in law have on 

other military construction projects, construction costs and current 

utilities contracts in the region; and (5) what effect this delay may 

have on other aspects of the Rhine Ordnance Barracks Medical 

Center Replacement Project. In addition to this requirement, the 

Committee directs the Director of the Defense Health Agency to 

provide to the congressional defense committees no later than 60 

days after enactment of this Act: (1) an updated 1391 to include a 

WIP curve; (2) the total amount of funding for the utility plant that 

is within the military construction program; and (3) a list of other 

of appropriations, if any, that are being used for utility costs. 

Parking issues at DOD facilities.—The lack of parking is a safety 

issue and a detriment to the well-being of employees, both civilian 

and military. The Committee is concerned that many DOD facilities in the Department’s inventory do not have sufficient parking 

to meet installation requirements. Furthermore, these deficiencies 

can contribute to traffic congestion and are serious problems on 

base. The Committee is concerned that the Department does not 

have a coherent strategy to address the growing parking requirements at installations that have seen significant growth. For example, Fort Meade, which already was home to the National Security 

Agency (NSA), became the headquarters of the newly formed U.S. 

Cyber Command in 2010. By 2011, the Defense Information Systems Agency, which handles the Pentagon’s IT and communications 

needs, had moved onto the base. In 2005, the base had just over 

33,500 employees. Today, it has about 57,000, more than double 

the number of workers at the Pentagon. As a result of this growth, 

parking at Fort Meade has become a serious issue. Therefore, the 

Secretary of Defense is directed to submit to the Committee with 

the fiscal year 2020 military construction budget request: an updated list of unfunded requirements for parking facilities, access 

control points, and road construction at DOD facilities that have 

serious parking, access, and road congestion issues. Finally, the 

Secretary is further directed to submit, with the fiscal year 2020 

military construction budget request, a list of how those requirements will be incorporated into their construction requests for fiscal years 2020 through 2024. 

DOD Installation Energy Policy.—DOD must ramp up its efforts 

to enhance energy security on its installations through a range of 

actions, including investing in renewable energy and smart technology that can shield mission-critical operations from disruptions 

to the power grid. According to a January 2017 report commissioned by the Pew Charitable Trusts (Power Begins at Home: Assured Energy for U.S. Military Bases), DOD could enhance energy 

security on installations and save hundreds of millions of dollars 

annually by investing in microgrids and renewable energy systems, 

and by increasing energy efficiency on military bases. The report 

found that microgrid power systems are more reliable than the 

stand-alone diesel generators typically used for backup power and 

could save $8,000,000 to $20,000,000 over a 20 year period. The report also found that DOD could save as much as $1,000,000,000 a 

year simply by increasing the use of commercially available energy 


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efficiency measures in its facilities. The Committee notes that military installations in Hawaii are among those at the forefront of 

DOD’s efforts to increase energy efficiency and security, including 

projects to develop net-zero energy military housing and installation facilities, upgrade and retrofit systems to improve energy and 

water efficiency, and demonstrate microgrid technology. The Committee supports DOD’s investments in energy efficiency, renewable 

energy systems, and energy security, including projects through the 

Energy Resilience and Conservation Investment Program [ERCIP]. 

The Committee encourages the Department to prioritize funding 

for energy-related projects, including renewable energy projects, to 

mitigate risk to mission-critical assets and promote energy security 

and efficiency at military installations. 

GUARD AND RESERVE ITEM OF INTEREST

Fiscal Year 2018 National Guard Reporting Requirement.—Since 

fiscal year 2012 the Committee has noted the need to bolster National Guard resources and explore public-private partnerships 

with state and local governments. Due to the late passage of the 

fiscal year 2018 bill, the reporting requirement regarding this issue 

remains outstanding. Therefore, the Committee reiterates its interest in this report and looks forward to its submission. 

MILITARY CONSTRUCTION, ARMY NATIONAL GUARD

Fiscal year 2018 enacted level ........................................................... $220,652,000 

Fiscal year 2019 budget request ....................................................... 180,122,000 

Committee recommendation in the bill ............................................ 180,122,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... (40,530,000) 

Fiscal year 2019 budget request ................................................ – – – 

The recommendation includes additional funding for the Army 

National Guard in section 125 under Administrative Provisions for 

projects on the Services Unfunded Priority lists as provided by the 

Office of the Secretary of Defense and submitted to Congress in priority order. 

Army National Guard Readiness Centers Investment.—The Committee remains concerned by the failure of the Army to prioritize 

investment in Army National Guard Readiness Centers. These facilities are critical infrastructure in the protection of the homeland 

and in the responding to domestic emergencies. Their deteriorating 

conditions are detrimental to the readiness of the Army Guard and 

present significant safety concerns. The Committee encourages the 

Army to accelerate investments in Readiness Centers within the 

fiscal year 2020 future years defense program to include the 

$1,200,000,000 for the Army National Guard transformation Plan. 

MILITARY CONSTRUCTION, AIR NATIONAL GUARD

Fiscal year 2018 enacted level ........................................................... $171,491,000 

Fiscal year 2019 budget request ....................................................... 129,126,000 

Committee recommendation in the bill ............................................ 129,126,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... (42,365,000) 

Fiscal year 2019 budget request ................................................ – – – 

The recommendation includes additional funding for the Air National Guard in section 125 under Administrative Provisions for 


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projects on the Services Unfunded Priority lists as provided by the 

Office of the Secretary of Defense and submitted to Congress in priority order. 

MILITARY CONSTRUCTION, ARMY RESERVE

Fiscal year 2018 enacted level ........................................................... $83,712,000 

Fiscal year 2019 budget request ....................................................... 64,919,000 

Committee recommendation in the bill ............................................ 64,919,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... (18,793,000) 

Fiscal year 2019 budget request ................................................ – – – 

The recommendation includes additional funding for the Army 

Reserve in section 125 under Administrative Provisions for projects 

on the Services Unfunded Priority lists as provided by the Office 

of the Secretary of Defense and submitted to Congress in priority 

order. 

MILITARY CONSTRUCTION, NAVY RESERVE

Fiscal year 2018 enacted level ........................................................... $95,271,000 

Fiscal year 2019 budget request ....................................................... 43,065,000 

Committee recommendation in the bill ............................................ 43,065,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... (52,206,000) 

Fiscal year 2019 budget request ................................................ – – – 

MILITARY CONSTRUCTION, AIR FORCE RESERVE

Fiscal year 2018 enacted level ........................................................... $73,535,000 

Fiscal year 2019 budget request ....................................................... 50,163,000 

Committee recommendation in the bill ............................................ 50,163,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... (23,372,000) 

Fiscal year 2019 budget request ................................................ – – – 

The Committee recommendation includes additional funding for 

the Air Force Reserve in section 125 under Administrative Provisions for projects on the Services Unfunded Priority lists as provided by the Office of the Secretary of Defense and submitted to 

Congress in priority order. 

Air Force Reserve Hangars.—The Committee is concerned that 

many of the Air Force Reserve Hangars that have been damaged 

during the record breaking 2017 hurricane season are unsafe, antiquated, and do not provide adequate protection of Air Force Reserve air assets. For example, hangers located at Homestead Air 

Reserve Base have become wholly inadequate due to constrained 

military construction budgets and devastating storm damage and 

are putting equipment and air assets at risk. The Committee is 

concerned that this could be a problem throughout the Air Force 

Reserve enterprise with the recent reductions to the Department of 

Defense’s Construction accounts. Therefore, the Secretary of the 

Air Force is directed to conduct a risk assessment on Air Force Reserve Hangars damaged by natural events throughout the Air 

Force Reserve enterprise and develop a plan to update these facilities in the fiscal years 2020–2024 future years defense plan. This 

assessment shall be submitted to the congressional defense committees no later than 30 days after this report is filed. 


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NORTH ATLANTIC TREATY ORGANIZATION SECURITY INVESTMENT

PROGRAM

Fiscal year 2018 enacted level ........................................................... $177,932,000 

Fiscal year 2019 budget request ....................................................... 171,064,000 

Committee recommendation in the bill ............................................ 171,064,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... (6,868,000) 

Fiscal year 2019 budget request ................................................ – – – 

The recommendation includes a rescission of $25,000,000 from 

unobligated balances under Administrative Provisions. 

The North Atlantic Treaty Organization 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. 

FAMILY HOUSING OVERVIEW

Fiscal year 2018 enacted level ........................................................... $1,409,437,000 

Fiscal year 2019 budget request ....................................................... 1,582,632,000 

Committee recommendation in the bill ............................................ 1,582,632,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... 173,195,000 

Fiscal year 2019 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. 

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 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 within 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. 


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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. 

FAMILY HOUSING CONSTRUCTION, ARMY

Fiscal year 2018 enacted level ........................................................... $182,662,000 

Fiscal year 2019 budget request ....................................................... 330,660,000 

Committee recommendation in the bill ............................................ 330,660,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... 147,998,000 

Fiscal year 2019 budget request ................................................ – – – 

FAMILY HOUSING OPERATION AND MAINTENANCE, ARMY

Fiscal year 2018 enacted level ........................................................... $348,907,000 

Fiscal year 2019 budget request ....................................................... 376,509,000 

Committee recommendation in the bill ............................................ 376,509,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... 27,602,000 

Fiscal year 2019 budget request ................................................ – – – 

FAMILY HOUSING CONSTRUCTION, NAVY AND MARINE CORPS

Fiscal year 2018 enacted level ........................................................... $83,682,000 

Fiscal year 2019 budget request ....................................................... 104,581,000 

Committee recommendation in the bill ............................................ 104,581,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... 20,899,000 

Fiscal year 2019 budget request ................................................ – – – 

FAMILY HOUSING OPERATION AND MAINTENANCE, NAVY AND

MARINE CORPS

Fiscal year 2018 enacted level ........................................................... $328,282,000 

Fiscal year 2019 budget request ....................................................... 314,536,000 

Committee recommendation in the bill ............................................ 314,536,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... (13,746,000) 

Fiscal year 2019 budget request ................................................ – – – 

FAMILY HOUSING CONSTRUCTION, AIR FORCE

Fiscal year 2018 enacted level ........................................................... $85,062,000 

Fiscal year 2019 budget request ....................................................... 78,446,000 

Committee recommendation in the bill ............................................ 78,446,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... (6,616,000) 

Fiscal year 2019 budget request ................................................ – – – 


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FAMILY HOUSING OPERATION AND MAINTENANCE, AIR FORCE

Fiscal year 2018 enacted level ........................................................... $318,324,000 

Fiscal year 2019 budget request ....................................................... 317,274,000 

Committee recommendation in the bill ............................................ 317,274,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... (1,050,000) 

Fiscal year 2019 budget request ................................................ – – – 

FAMILY HOUSING OPERATION AND MAINTENANCE, DEFENSE-WIDE

Fiscal year 2018 enacted level ........................................................... $59,169,000 

Fiscal year 2019 budget request ....................................................... 58,373,000 

Committee recommendation in the bill ............................................ 58,373,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... (796,000) 

Fiscal year 2019 budget request ................................................ – – – 

DEPARTMENT OF DEFENSE FAMILY HOUSING IMPROVEMENT FUND

Fiscal year 2018 enacted level ........................................................... $2,726,000 

Fiscal year 2019 budget request ....................................................... 1,653,000 

Committee recommendation in the bill ............................................ 1,653,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... (1,073,000) 

Fiscal year 2019 budget request ................................................ – – – 

DEPARTMENT OF DEFENSE MILITARY UNACCOMPANIED HOUSING

IMPROVEMENT FUND

Fiscal year 2018 enacted level ........................................................... $623,000 

Fiscal year 2019 budget request ....................................................... 600,000 

Committee recommendation in the bill ............................................ 600,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... (23,000) 

Fiscal year 2019 budget request ................................................ – – – 

DEPARTMENT OF DEFENSE BASE CLOSURE ACCOUNT

Fiscal year 2018 enacted level ........................................................... $310,000,000 

Fiscal year 2019 budget request ....................................................... 267,538,000 

Committee recommendation in the bill ............................................ 322,390,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... 12,390,000 

Fiscal year 2019 budget request ................................................ 54,852,000 

The recommendation provides additional funding for the Navy to 

accelerate environmental remediation at installations closed under 

previous Base Closure and Realignment rounds. Furthermore, the 

Navy shall provide to the Committee a spend plan for these additional funds not later than 60 days after enactment of this Act. 

Perfluorooctane Sulfonate (PFOS) and Perfluorooctanoic Acid 

(PFOA).—The Committee has provided additional funds for the 

continued review of contaminations across the Department of Defense from PFOS and PFOA. This issue not limited to one Service 

nor is to be funded solely out of a single account. DOD has inspected 524 DOD-wide installations and is directed to keep the 

Committee apprised of what contaminated locations are to be funded with the BRAC account only, as that is solely the jurisdiction 

of this bill. 


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ADMINISTRATIVE PROVISIONS

The bill retains 29 provisions that were in effect in fiscal year 

2018 and includes two new administrative provision in fiscal year 

2019. 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. 

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. 


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(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 $15,000 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. 

The bill includes section 124 prohibiting the use of funds for 

projects at Arlington National Cemetery. 

The bill includes section 125 providing additional funds for various military construction accounts and requires a spend plan for 

each. 

(RESCISSIONS OF FUNDS)

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

The bill includes section 127 defining the congressional defense 

committees. 

The bill includes section 128 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 includes section 129 prohibiting the relocation of any element of REDHORSE until certain conditions are met. 

The bill includes section 130 directing all amounts appropriated 

to Military Construction (all accounts) be immediately available 

and allotted for the full scope of the authorized project. 

The bill includes section 131 providing additional funds for various military construction accounts for enhancing force protection 

and safety at military installations. 


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TITLE II 

DEPARTMENT OF VETERANS AFFAIRS 

Fiscal year 2018 enacted level1 ..................................................... $185,423,735,000 

Fiscal year 2019 budget request1 .................................................. 194,469,059,000 

Committee recommendation in the bill1 ....................................... 194,469,059,000 

Comparison with: 

Fiscal year 2018 enacted ........................................................ $9,045,324,000 

Fiscal year 2019 budget request ............................................ – – – 

Fiscal year 2020 advance budget request ............................. 196,847,029,000 

Fiscal year 2020 Committee recommendation in the bill .... 196,847,029,000 1 All funding cited excludes amounts in the Medical Care Collections Fund. 

The Department of Veterans Affairs (VA) serves approximately 

43,500,000 people—20,000,000 veterans and 23,500,000 family 

members and dependents who may be eligible for certain VA benefits. To serve adequately the nation’s veterans, VA employs more 

than 385,000 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 2019 enacted level ....................................................... $95,768,462,000 

Fiscal year 2019 current year request .......................................... 1,410,332,000 

Fiscal year 2019 current year Committee recommendation in 

the bill .......................................................................................... 1,410,332,000 

Fiscal year 2020 advance budget request ..................................... 107,119,807,000 

Fiscal year 2020 Committee recommendation in the bill ........... 107,119,807,000 

Comparison with: 

Fiscal year 2019 enacted level ............................................... 11,351,345,000 

Fiscal year 2020 budget request ............................................ – – – 

This appropriation will provide funds for service-connected compensation payments to an estimated 5,283,000 veterans, survivors, 

and dependents in 2019. In addition, pension payments will be 

funded for 469,000 veterans and their survivors. The average cost 

per compensation case for veterans in 2019 is estimated at $17,553 

and pension payments are projected at $13,345. 

The appropriation includes authority to transfer funding not to 

exceed $18,047,000 in 2020 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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Financial hardship and bankruptcy.—The Committee continues 

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

dependent financial hardship, which is a known contributory factor 

to negative outcomes such as mental health issues, substance use 

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

only honor the service and sacrifice of the veterans who receive 

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

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

inequity in current bankruptcy law that results in the inclusion of 

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

disability benefits for non-veterans. The Department, therefore, is 

directed to submit to the Committee a report, no later than 90 days 

after enactment of this Act, outlining the legislative authority 

needed to end this inequity. 

READJUSTMENT BENEFITS

Fiscal year 2019 enacted level ........................................................... $11,832,175,000 

Fiscal year 2020 advance budget request ......................................... 14,065,282,000 

Fiscal year 2020 Committee recommendation in the bill ............... 14,065,282,000 

Comparison with: 

Fiscal year 2019 enacted level ................................................... 2,233,107,000 

Fiscal year 2020 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 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. Almost 80 percent of the funds in the account support the Post-9/11 

GI Bill. 

VetSuccess on Campus (VSOC).—The Committee recognizes the 

tremendous value of counseling in assisting the transition of veterans from military service to academic life. Therefore, the Committee encourages VBA to expand the availability of services 

through the VSOC program to additional sites, with particular attention to geographic regions without current access to VSOC programs. 

VETERANS INSURANCE AND INDEMNITIES

Fiscal year 2019 enacted level ........................................................... $109,090,000 

Fiscal year 2020 advance budget request ......................................... 111,340,000 

Fiscal year 2020 Committee recommendation in the bill ............... 111,340,000 

Comparison with: 

Fiscal year 2019 enacted level ................................................... 2,250,000 

Fiscal year 2020 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 


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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. 

VETERANS HOUSING BENEFIT PROGRAM FUND PROGRAM ACCOUNT

Program account 

Limitation on 

direct loans for 

specially adapted 

housing loans 

Administrative 

expenses 

Fiscal year 2018 enacted level ........................................................ – – – ($500,000) $178,626,000 

Fiscal year 2019 budget request est. .............................................. – – – (500,000) 200,612,000 

Committee recommendation est. in the bill .................................... – – – (500,000) 200,612,000 

Comparison with: 

Fiscal year 2018 enacted level ............................................... – – – – – – 21,986,000 

Fiscal year 2019 budget request ............................................ – – – – – – – – – 

The purpose of the home loan guaranty program is to facilitate 

the extension of mortgage credit on favorable terms by private 

lenders to eligible veterans. This appropriation provides for all 

costs, with the exception of the Native American veterans housing 

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

resources to be available prior to incurring a direct loan obligation 

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

administrative expenses of a direct or guaranteed loan program to 

be funded through a program account. Loan guaranties are made 

to servicemembers, veterans, reservists, and single surviving 

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

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

payment be made for a manufactured home. With a Department 

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

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

Access problems.—The Committee remains concerned with the 

ability of veterans to benefit from the VA Home Loan Program 

given the shortage of appraisers approved by VA and program requirements that may deter prospective sellers from accepting applicants with VA loans. The Committee therefore directs the Secretary to provide a report to the Committee, no later than 180 days 

of enactment of this Act, which reviews the program’s requirements 

and determines if viable options exist for improving VA home loan 

utilization rates. The report should include, if possible, a comparison of utilization rates between VA home loans and non-VA home 

loans. Additionally, the report should assess the impact of aligning 

VA’s appraiser qualifications with those of the Appraisal Foundation, which is authorized by Congress as a source of appraisal 

standards and qualifications. This assessment should include the 


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estimated change, if any, in the number of available appraisers and 

loan utilization rates that would result from such an alignment. 

VOCATIONAL REHABILITATION LOANS PROGRAM ACCOUNT

Program account Limitation on 

direct loans 

Administrative 

expenses 

Fiscal year 2018 enacted level ........................................................ $30,000 ($2,356,000) $395,000 

Fiscal year 2019 budget request ..................................................... 39,000 (2,037,000) 396,000 

Committee recommendation in the bill ............................................ 39,000 (2,037,000) 396,000 

Comparison with: 

Fiscal year 2018 enacted level ............................................... 9,000 (319,000) 1,000 

Fiscal year 2019 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 $1,235 (based on indexed chapter 31 subsistence allowance 

rate) are available to service-connected disabled veterans enrolled 

in vocational rehabilitation programs when the veteran is temporarily in need of additional assistance. 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 2,039 loans in fiscal year 2019, with an average amount of $999. 

NATIVE AMERICAN VETERAN HOUSING LOAN PROGRAM

Administrative expenses: 

Fiscal year 2018 enacted level ........................................................... $1,163,000 

Fiscal year 2019 budget request ....................................................... 1,149,000 

Committee recommendation in the bill ............................................ 1,149,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... (14,000) 

Fiscal year 2019 budget request ................................................ – – – 

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

Native American veterans for the purpose of purchasing, constructing, or improving dwellings on trust lands, including Hawaiian Home Lands. Native Hawaiians, Alaska Natives, and Native 

Americans enroll in the military at higher rates than non-Natives. 

These loans are available to purchase, construct, or improve homes 

to be occupied as veterans’ residences. 

GENERAL OPERATING EXPENSES, VETERANS BENEFITS

ADMINISTRATION

Fiscal year 2018 enacted level ........................................................... $2,910,000,000 

Fiscal year 2019 budget request ....................................................... 2,869,909,000 

Committee recommendation in the bill ............................................ 2,922,000,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... 12,000,000 

Fiscal year 2019 budget request ................................................ 53,091,000 

The General Operating Expenses, Veterans Benefits Administration account provides funding for VBA to administer entitlement 


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programs such as service-connected disability compensation, education benefits, and vocational rehabilitation services. 

The bill makes available through September 30, 2020, up to five 

percent of these funds. The Committee provides $2,922,000,000 for the General Oper- ating Expenses, VBA account, which is $53,091,000 above the Administration request. The Committee intends that VA use these additional funds for the Veterans Claims Intake Program (VCIP) to 

scan paper claims and convert them into digital format. In addition, the Committee intends that VA use a portion of the additional 

funding to hire additional staff and finance overtime payments if 

that becomes necessary to manage disability claims and appeals 

backlogs. 

Equitable relief.—The Committee understands that VA is continuing work on implementing new systems and protocols to eliminate instances of administrative error. As the Committee noted 

previously, if VA, during implementation of these system-wide reforms, erroneously ended equitable relief to eligible veterans initially deemed eligible, it would be placing an unfair burden on veterans and their families. The Secretary is, therefore, directed to 

continue to grant or extend equitable relief to eligible veterans initially deemed eligible in instances of administrative error. No later 

than April 1, 2019, the Secretary shall submit to the Committee 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 

during the preceding calendar year. 

Military sexual trauma (MST) claims.—The Committee is 

pleased with the increased focus on MST and encourages VA to 

continue to build on the strides that have been made and to include 

intensive training and specialized claims employees for MST-related claims. As the Committee has noted previously, like 

posttraumatic stress disorder (PTSD), MST can lead to other mental health disorders, such as anxiety and depression. Therefore, the 

Committee applauds VA’s use of a relaxed evidentiary standard, 

such as that available to PTSD claimants. The Committee also 

urges VA to continue veteran outreach initiatives and publicize 

benefits veterans may be entitled to as a result of MST. Additionally, since MST is not gender-specific, the Committee encourages 

VA to provide equal treatment and assistance to all veterans affected by MST. 

Outreach to remote locations.—The Committee urges VBA to 

renew efforts to increase 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 these areas 

on a regular basis. Veterans living in these areas, particularly elderly and disabled veterans who may have difficulty accessing VBA 

services via the internet or phone, should have an opportunity to 

speak, in-person, with VBA staff. 

Claims prioritization.—The Committee is very concerned about 

ensuring the prioritization of the most vulnerable veterans in regard to initial claims processing and claims appeals. The Committee, therefore, urges VA to prioritize claims processing and appeals for veterans that are elderly, or in poor health, so that they 

may receive their benefits while those benefits are still able to assist them. Further, the Committee directs VA to provide a report 


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within 30 days of the enactment of this Act. The report should detail VA’s prioritization process, if any, in regard to initial claims 

and appeals by age, health status, and income. The report should 

also include information on any triggers that are used in such a 

process, or any triggers that VA assesses may be useful to achieve 

the objective of prioritizing these subgroups of veterans. 

Veterans who participated in nuclear clean-up activities in 

Palomares, Spain and on Enewetak Atoll.—The Committee is concerned about the adjudication of service-connected disability claims 

for veterans who participated in nuclear clean-up activities in 

Palomares, Spain and on Enewetak Atoll in the Marshall Islands. 

The Committee understands that some of these veterans’ claims 

are not subject to the presumption of radiation exposure under 38 

CFR 3.309(d), but rather are adjudicated on a case-by-case basis 

under the more burdensome requirements of 38 CFR 3.311. To understand the justification for this variation in claims adjudication, 

the Committee directs VA to submit a report no later than 90 days 

of the enactment of this Act. The report should assess the requirements in 38 CFR 3.309(d) and determine, based on scientific and 

medical data, whether the regulation should be modified to apply 

to the group of veterans currently subject to 38 CFR 3.311. 

Cholangiocarcinoma.—The Committee understands that some 

Vietnam veterans have been diagnosed with cholangiocarcinoma, a 

rare cancer, and that VA is currently conducting research to determine whether this disease occurs at a higher rate in such veterans 

than in the general population. The Committee also notes that less 

than one-third of claims for service connected disabilities related to 

this disease have been granted by VA. To better understand this 

affliction and the adjudication of these claims, the Committee directs VA to submit a report no later than 90 days of enactment of 

this Act. The report should include a status update of current research efforts and an assessment of how service-connected disability claim adjudication rates for this disease compare with other 

cancers. 

Tactical Communication and Protective Systems (TCAPS).—The 

Committee understands that VA’s Remote Order Entry System 

(ROES) is designed to allow VA and DOD audiologists to order 

hearing aids and related items for veterans and military personnel. 

However, it is not currently possible for clinicians to order devices 

that help prevent hearing loss, such as the U.S. Army’s TCAPS, 

through ROES due to a lack of a contract vehicle. Based on information provided by VA, the lack of such a contract vehicle is due 

solely to an assessment by VA’s Audiology and Speech Pathology 

Service (ASPS) of insufficient need. While the Committee understands that there may be minimal need among veterans, the same 

may not be true for military personnel given the environments to 

which they are routinely exposed. Further, preventing hearing loss 

for military personnel today, may reduce the number of veterans 

with hearing loss tomorrow. This, in turn, may reduce VA’s future 

costs. Therefore, the Committee urges VA to work with DOD to determine if they have a need for a contract vehicle in ROES to allow 

the ordering of hearing loss prevention devices and to report to the 

Committee, within 90 days of the enactment of this Act, their decision and whether they plan to add these devices to ROES. 


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Transition assistance.—The Committee is aware of VA’s effort to 

expand veterans education connection centers at medical centers 

and outpatient clinics, such as the one established at the Louis 

Stokes Veterans Medical Center in Cleveland, Ohio. The Committee continues to encourage VA to explore opportunities for education connection centers at VA medical centers with a high need. 

Furthermore, the Committee directs VA to provide the Committee 

with a report detailing: 1) the current education connection centers 

project, 2) explanation of how the center currently benefits veterans it serves, and 3) its potential plans to expand the number of 

education connection centers. In addition, this report should include an action plan with a detailed timeline for possible further 

expansion to one education connection center in at least 10 of the 

21 Veterans Integration Service Networks (VISNs) within the next 

3 years, projected timelines for implementation of this expansion 

effort, an analysis of projected added benefits to veterans under the 

expansion, as well as potential funding costs and needs. This report 

shall be submitted to the Committee no later than 90 days after 

enactment of this Act. 

Veterans service data.—The Committee continues to note employers’ enduring interest in minimizing the barriers to veteran employment. Often, businesses seeking to hire veterans and take advantage of the Work Opportunity Tax Credit are faced with difficulty in verifying veterans’ disabilities and service data. While the 

Committee recognizes the multiple means for veterans to obtain access to their DD 214 and medical records, the Committee also recognizes the benefits of making these documents available to prospective employers electronically in controlled settings. Unfortunately, data sharing agreements between VA, DOD, and States, 

which have addressed this concern, have not been maintained. The 

Committee therefore directs the Secretary to work with the Secretary of Defense and State governors to identify and implement 

opportunities to improve use of the Work Opportunity Tax Credit 

and support the employment of veterans. 

VETERANS HEALTH ADMINISTRATION (VHA) 

The Department operates the largest Federal medical care delivery system in the country, with 145 hospitals, 112 residential rehabilitation treatment programs, 133 nursing homes, 300 Vet Centers, 80 mobile Vet Centers, and 743 outpatient clinics. About 

7,000,000 patients will be treated in 2019. 

The Veterans Health Administration budget 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 2020 of $75,550,600,000 in 

direct appropriations to fund the four advance appropriations of the 

VHA. In addition, VA will receive an estimated $3,443,000,000 in 

Medical Care Collections Fund in fiscal year 2019. The Committee 

also provides $732,262,000 for medical and prosthetic research. 

CHOICE PROGRAM AND NON-VA CARE

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cause of distance from VA facilities or the lack of capacity to provide care in a timely way at certain facilities. Indeed, VA has operated some non-VA care programs for years. The Choice program 

was created in 2014 to address continuing patient access issues. 

While the program has resulted in significant increases in the 

number of patients treated, the Committee has been concerned 

about budgetary and management challenges that have developed 

with the Choice program. The Committee is pleased that the authorizing committees are in the midst of negotiating legislation to 

create one consolidated non-VA medical care program that includes 

both Choice and the multiple other non-VA care programs VA operates. Further, the authorizers plan to convert the program’s budget 

to regular discretionary funding subject to annual appropriations 

once the new program has been implemented and regulations finalized. This change will bring greater stability and oversight of the 

program, although it presents a significant new funding requirement for the Committee. Additional mandatory funding is now expected to be required after May, 2018 and throughout the period 

of implementation of the new program. The Committee is ready to 

meet its responsibility of funding the new discretionary program, 

which may not be implemented until the end of fiscal year 2019. 

The Committee will continue to use the budget structure first 

proposed by the Administration—to provide two separate accounts 

for Medical Services and Medical Community Care for non-VA care. 

That structure provides the most transparency for the Committee 

to monitor and control spending in these two areas. The Committee 

does not accept the more recent Administration proposal to combine both these funding streams into one account. Anticipating that 

there may be circumstances where the Department needs to transfer funding from one of these accounts to the other, the Committee 

continues to provide authority in section 228 to transfer funding 

from any VA account, except the administrative account for VBA, 

to the Medical Services account as well as section 202 allowing the 

transfer of funding between the four medical care accounts. 

MEDICAL SERVICES

Fiscal year 2018 enacted level ........................................................... $46,098,538,000 

Fiscal year 2019 enacted level ........................................................... 49,161,165,000 

Fiscal year 2020 advance budget request ......................................... 48,747,988,000 

Committee 2020 recommendation in the bill ................................... 48,747,988,000 

Comparison with: 

Fiscal year 2019 enacted level ................................................... (413,177,000) 

Fiscal year 2020 budget request.

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

clinic facilities, contract hospitals, State homes, and outpatient programs on a fee basis. 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 provides the request of $48,747,988,000 for advance fiscal year 2020 funding. The Committee has included bill language 

to make available through September 30, 2021, $1,400,000,000 of 

the Medical Services advance appropriation for fiscal year 2020. 

The Committee is skeptical that this advance appropriation will be 

adequate to support full needs in fiscal year 2020. A year-to-year 

reduction in funding is highly unusual in this account. 


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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. 

Caregivers program.—The caregivers program provides an unprecedented level of benefits to families with veterans seriously injured in the line of duty in post-9/11 service. These benefits include 

stipends paid directly to the family caregiver, enrollment for the 

family member in the VA Civilian Health and Medical Program 

(CHAMPVA), an expanded respite benefit, and mental health treatment. The Committee provides the request of $496,032,000 for 

caregivers, but is concerned that the funding levels estimated for 

the program have decreased significantly in the past two years. 

The Committee requests a report, no later than 60 days after enactment of this Act, explaining the reasons for the decrease in program funding estimates. It also continues the requirement from the 

fiscal year 2018 conference report on quarterly reporting on obligations for the caregivers program. 

Allocation of health funding.—The Committee continues to be 

concerned that the process VA uses to allocate the health services 

appropriation through the 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, no later than 30 days after 

VA allocates the medical services appropriation to the VISNs, that 

identifies: (1) the amount of general purpose funding that is allocated to each VISN; (2) the amount of funding that is retained by 

central headquarters for specific purposes, with amounts identified 

for each purpose; and (3) the amount of funding that is retained 

by each VISN before allocating it to the medical centers, identifying 

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

Mental health issues 

The Committee provides $8,608,500,000 for mental health programs, which is $6,000,000 above the budget request. Of the 

amounts provided for mental health programs in fiscal year 2019, 

$196,128,000 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. 

Skill-based interventions.—The Committee remains very concerned about the suicide rate for veterans and applauds VA for developing novel and innovative approaches for suicide prevention, 

such as the Department’s Recovery Engagement and Coordination 

for Health—Veterans Enhanced Treatment (REACH VET) program. The Committee encourages VA to continue its efforts in this 

area and to prioritize the deployment of such technologies. The 

Committee also requests a report, within 90 days of enactment of 

this Act, which details the innovative application of technology to 

reduce the risk of suicide among veterans. 


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Posttraumatic growth programs.—To improve the mental health 

of veterans, the Committee directs VA to conduct a study regarding 

the potential effectiveness and benefits of nonprofit posttraumatic 

growth programs. The study should compare the effectiveness of 

these programs to traditional models of mental health care, assess 

the possible integration of such nonprofit programs into traditional 

mental health care programs, and estimate the budgetary impact 

of such integration. The Committee directs VA to complete the 

study within 90 days of the enactment of this Act and report back 

to the Committee within 30 days of the study’s completion. The report should provide the study results, define post-traumatic growth 

programs, and assess the feasibility, requirements, and cost of conducting a pilot program to further assess their value. 

Improving the Veterans Crisis Line (VCL).—The Committee continues to monitor the VCL to ensure veterans are receiving appropriate clinical care. To support this critical care, the Committee instructs the Secretary to ensure that Federal funding for the VCL 

is utilized to make any necessary improvements to VCL’s operations in order to best meet the needs of veterans seeking assistance. This includes, but is not limited to, ensuring appropriate 

staffing for call centers and back-up centers, providing necessary 

training for VCL staff, and ensuring that staff are able to appropriately and effectively respond to the needs of veterans needing 

assistance through the VCL. In addition, the Committee requests 

that the Secretary provide the Committee a report, no later than 

90 days after enactment of this Act, which contains an update detailing findings on the outcomes and efficacy of the VCL from the 

Veterans Crisis Line Study Act of 2017. 

The Committee has repeated bill language included in the fiscal 

year 2018 Act requiring the VCL to: (1) provide to individuals who 

contact the hotline immediate assistance from a trained professional; and (2) to adhere to all requirements of the American Association of Suicidology. 

Community clinic mental health services.—While the Committee 

is awaiting a briefing to learn more about how VA establishes mental health care in individual community-based outpatient clinics, 

the Committee remains concerned that in-person mental health is 

not available to veterans who require this care. The VA is encouraged to ensure critical in-person mental health services are available at facilities that currently are not served, even on a temporary 

basis. 

PTSD service dogs.—The Committee recognizes the positive role 

that service, guide, and hearing dogs have played in mitigating veterans’ disabilities and providing therapy, assistance, and rehabilitation. As such, the Committee urges VA to prioritize support of 

veterinary health care and other benefits for service dogs for 

wounded warriors. The Committee also notes that VA is currently 

engaged in a study to assess the potential therapeutic effectiveness 

of service dogs in the treatment of PTSD and that the study will 

be completed in June 2019. The Committee requests a copy of the 

results of this study as soon as it is completed. 

Telehealth for mental health.—The Committee recognizes the 

strides made by the Department to reach rural communities with 

telehealth solutions. The Committee encourages further development and implementation of telemedicine to treat veterans with 


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mental health issues in rural communities. Telemedicine should be 

used to its maximum capabilities by VA. The Committee requests 

VA to submit a report, no later than 90 days after enactment of 

this Act, providing an update on the VA plans to further expand 

the use of telemedicine for mental health care. 

Inpatient substance abuse care.—While veterans are able to access inpatient substance abuse care through VA, the Committee remains concerned that veterans still wait weeks to actually receive 

the inpatient support they need. In fact, the Committee understands from VA that the median time between screening and admission for Substance Use Disorder (SUD) Residential Rehabilitation Treatment Programs (RRTP) increased from 15 days to 21 

days between fiscal years 2017 and 2018. This is very concerning 

and the Committee urges VA to focus on reducing this burdensome 

wait time for substance abuse treatment. In addition, the Committee requests a report, no later than 90 days after enactment of 

this Act, which shows the trends in program wait times over the 

last five years and any proposed solutions to reduce such wait 

times. 

Public-private partnerships.—The Committee continues to recommend that VA actively seek out public-private partnerships, in 

particular with research universities, teaching hospitals, and other 

partners, to expand upon its existing efforts related to suicide prevention, PTSD, traumatic brain injury (TBI), and substance use 

disorders. Additionally, the Committee directs VA to provide a report, within 90 days of enactment of this Act, regarding the feasibility of expanding public-private partnerships related to suicide 

prevention, PTSD, TBI, and substance use disorders. 

Law enforcement liaison.—The Committee appreciates VHA’s 

past efforts in working to educate the law enforcement community 

regarding the unique issues facing veterans, especially those returning from combat operations. Such education is invaluable in 

cases where veterans are determined to be an immediate threat to 

themselves or others. In such instances, it is imperative that the 

veteran’s needs be addressed in an expeditious, humane, and respectful manner. The Committee, therefore, encourages VA to implement a program that would designate a VA liaison to work with 

local law enforcement to address such circumstances. 

Non-citizen veteran outreach.—The Committee is concerned about 

the level of awareness regarding mental health services by at-risk, 

non-citizen veterans. It urges VA, therefore, to conduct more aggressive outreach targeting this group of veterans to offer mental 

health and other early intervention services, drug and alcohol services, and mental health counseling. 

Cultural competency training.—The Committee recognizes the 

role that the National Center for Posttraumatic Stress Disorder 

(NCPTSD) plays in promoting better prevention, diagnoses, and 

treatment of PTSD. Consistent with findings from the Center, the 

Committee recognizes that minority groups of veterans, including 

African Americans and Latinos, are more likely than their white 

counterparts to develop PTSD. As such, the Committee directs 

VHA, in coordination with NCPTSD, to provide a report within 180 

days of enactment of this Act detailing whether cultural competency training is provided to health care professionals serving 

veterans of color, and at what stage(s) in their career, and anaVerDate Sep 11 2014 05:48 May 03, 2018 Jkt 028054 PO 00000 Frm 00031 Fmt 6659 Sfmt 6602 E:\HR\OC\B054.XXX B054

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lyzing whether minority veterans receive quality and culturally appropriate care. This report shall also include recommendations on 

how to address the unique mental health needs of minority veterans, as well as the disparities in the care they receive. 

Homeless assistance 

The Committee provides $1,773,534,000 for VA homeless assist- ance programs, in addition to an estimated $5,633,442,000 for 

homeless veterans treatment costs. These programs include the 

Homeless Providers Grant and Per Diem, the Domiciliary Care for 

Homeless Veterans, the Supportive Services for Low Income Veterans and Families, and the Department of Housing and Urban 

Development Department of Veterans Affairs Supported Housing 

(HUD–VASH) programs. Within this total, the bill includes 

$340,000,000 for the Supportive Services to Veteran Families program, which is the same as the fiscal year 2018 funding level and 

$20,000,000 above the request. 

Allocation of funding for homeless programs.—The Committee 

has been concerned about the Department’s tentative decision last 

fall to convert almost $1,000,000,000 of funding for homeless programs from Special Purpose funding to General Purpose funding. 

This proposal would have potentially risked funding for important 

programs such as the Supportive Services to Veteran Families program. While the Committee is pleased that the Department decided not to move forward with the proposal for fiscal year 2018, 

it expects VA to consult with the Committee before any attempt is 

made to change the manner in which funding allocations are made 

to the field for fiscal year 2019. 

Grant and per diem (GPD) rate.—The Committee is concerned 

that the cost incurred by nonprofit organizations, who are providing clinical services as part of their GPD program, are not covered by the current GPD rate. VA is required to report back to the 

Committee, within 30 days of the enactment of this Act, on whether the current GPD rate is effectively covering the costs of clinical 

services and, if not, options for adjusting the GPD rate to ensure 

these nonprofit organizations have the necessary resources to cover 

the cost of providing the lifesaving clinical care our homeless veterans deserve. 

Construction assistance for nonprofit organizations.—The Committee strongly supports innovative approaches and public-private 

partnerships that can help reduce homelessness among our veterans. As such, the Committee urges VA to assess the possibility 

of assisting nonprofit organizations with capital costs related to the 

construction of new housing units for homeless veterans on non-VA 

property, particularly those utilizing HUD–VASH vouchers. When 

considering assistance to such organizations, VA should limit its 

consideration to those that have secured over 50 percent of the 

needed financing so as to reduce the federal burden for establishing 

new housing. 

HUD–VASH program.—The Committee continues to support the 

HUD–VASH program and reminds the Department to continue to 

provide the annual report on distribution of HUD–VASH vouchers 

as requested in House Report 115–118. 

Legal assistance for the Supportive Services for Veteran Families 

Program.—The Committee notes that university law schools may 


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be willing to work with veterans on a pro-bono basis to provide 

legal assistance. This can result in additional benefits, such as 

training law students in veteran disability law and legal skills critical to providing advocacy within the VA system, as well as inspiring the next generation of lawyers to serve veterans. The Committee encourages the Supportive Services for Veteran Families 

(SSVF) program to work with grantees to expand their legal service 

offerings, particularly in rural areas where access to private legal 

assistance can be limited. The Committee further encourages VA to 

establish one or more pilot projects to partner SSVF grantees with 

university law schools in rural areas to enhance legal assistance to 

veterans. 

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 veterans with 

minor children. These veterans may be faced with additional challenges when trying to obtain homeless services from VA. The Committee urges the Department to address the challenges facing 

homeless female veterans. 

Homeless veterans near the U.S.-Mexico border.—The Committee 

notes that there may be homeless veterans living near the U.S.- 

Mexico border who, historically, may not have been counted in 

point-in-time homeless surveys. The Committee encourages VA to 

work with HUD to develop strategies and recommendations for addressing U.S. veteran homelessness near the U.S.-Mexico border 

and to take into account these undercounted veterans when awarding HUD–VASH vouchers. VA shall report on these strategies and 

recommendations within 90 days of enactment of this Act. 

Related needs of homeless veterans.—With significant help from 

the Committee, VA has made great strides in reducing veteran 

homelessness. The Committee believes that more could be done to 

address veterans’ homelessness and remains interested in the feasibility, advisability, and cost of VA conducting a pilot program 

that would 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 looks forward to the report requested in House Report 115– 

118 on this concept and expects the deadline for the report to be 

met. 

Staffing issues 

Medical staff retention.—The Committee expects VA to continue 

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

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 

data should be aggregated at the VISN level and should also include the percentage of staff in primary care versus specialty care 

and mental health care, and the percentage of medical staff at each 

facility who complete an exit survey upon their departure. Exit surveys should be conducted anonymously, including through the use 

of a location that allows for privacy, is not directly visible by another employee, and does not require the departing employee to 


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input any personally identifiable data. In addition, the Committee 

directs VA to submit a separate report, within 90 days after enactment of this Act, on efforts to recruit and hire medical officers and 

nurses at each VA medical facility, as well as any impediments to 

such efforts. The report should include the resources provided for 

these efforts and recommendations for relevant legislation. 

Advanced practice registered nurses.—The Committee is concerned that some VA facilities have failed to implement VA’s final 

rule granting full practice authority to advanced practice registered 

nurses. While the Committee understands that implementation 

must be voted on and approved by each facility’s organized medical 

staff, the Committee urges the Secretary to work with the remaining facilities to ensure quick implementation of this directive. 

Psychology internships.—The Committee understands that VHA 

each year uses the services of the Association of Psychological 

Postdoctoral and Internship Centers (APPIC), a nonprofit organization, to help select and match clinical psychologists for available 

VA internships. The Committee is concerned, however, that APPIC 

has repeatedly decided to not include psychologists from programs 

accredited only by the Psychological Clinical Science Accreditation 

System (PCSAS) in the match, even though VHA regulations recognize PCSAS-accredited programs. The Committee is also concerned 

with the lack of progress by VHA to require APPIC to address this 

issue and therefore urges VHA to request that APPIC modify its 

policy within 90 days of enactment of this Act. 

Access for rural veterans 

Office of Rural Health.—The Committee provides $270,000,000 to 

improve access and quality of care for the more than 3,000,000 enrolled veterans residing in rural and highly rural areas. The VA 

Office of Rural Health (ORH) improves access and quality of care 

for enrolled veterans residing in geographically rural areas. Developing evidence-based policies and innovative practices to bring 

health care to rural areas is key to serving veterans in geographically remote areas, including remote facilities in Hawaii, many of 

whom would otherwise need to fly to reach their nearest VA facility. In addition to providing health care services, ORH’s important 

work includes identifying barriers to health care delivery in rural 

areas and implementing new ways to deliver health care and services to veterans in these locations. 

Operating plan.—The Committee directs ORH to submit to the 

Committee not later than 30 days after enactment of this Act an 

operating plan for fiscal year 2019 funding, as well as the fiscal 

year 2020 funding provided in advance by this Act. 

Rural Health Resource Centers.—Given the important role ORH’s 

Rural Health Resource Centers play in expanding access to care, 

the Committee encourages VA to continue considering expanding 

these centers. ORH has played a major role in VA’s overall strategy 

to combat opioid abuse by funding pilot programs through the 

Rural Health Initiative focused on pain coaching and modalities 

which increase veterans’ access to alternatives to opioid-centered 

pain management. The Committee recommends that as ORH considers expansion, combatting the opioid epidemic and non-opioid 

pain management in rural areas remain key components of its 

focus. 


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Lack of rural health providers.—The Committee notes persistent 

issues for VA health facilities in rural areas in recruiting and retaining health providers in the face of national provider shortages 

and a highly competitive environment. The Committee encourages 

VA to continue to consider expanded use of doctors of osteopathic 

medicine and physician assistants, through both physical facilities 

and expanded access to telehealth services, to address the rural 

health provider gap. 

Telehealth in rural areas.—The Committee is encouraged with 

recent efforts by VA with regard to investment in telehealth programs. Additionally, the Committee acknowledges the recent report 

submitted by VA outlining their collaboration efforts with several 

other Federal agencies on this issue. However, the report fails to 

provide an adequate explanation of the specific plan/strategy which 

VA will pursue to provide telehealth access to the 33 percent of veterans that reside in rural areas nationwide. The Committee remains concerned that not enough is being done to expand access 

to those veterans in rural areas with limited broadband internet 

access. The Committee directs the Secretary, and the VHA Office 

of Rural Health, to elaborate with specificity on measures to expand capabilities of telehealth to these regions, and continue collaboration with the Department of Agriculture, which has dedicated programs specifically for rural broadband access, as well as 

continued participation with the President’s Rural prosperity Task 

Force. The Committee directs the department to submit a report to 

the Committee, no later than 90 days after enactment of this Act. 

Women’s issues 

As the number of female veterans increases, VA needs to 

prioritize the expansion of health care services to accommodate 

women. This means more gender-specific services and the availability of appropriate infrastructure facilities to safeguard the privacy needs and proper gender-specific care and treatment of female 

veterans. The bill provides $511,352,000 for VA to continue redesigning its women’s health care delivery system and facilities to ensure women receive equitable, timely, and high-quality health care. 

Women’s access to medical services.—While the Committee is currently awaiting a report from VA on its plan to implement standards of care for female veterans, the Committee remains concerned 

that female veterans face remarkably different experiences than 

their male counterparts when transitioning in and out of combat 

roles, in between services, or back to civilian life and that VA is 

not adequately addressing the health needs of female veterans. 

These include obstetrics and gynecological care, treatment for gender-specific conditions and diseases, and female veteran suicide. 

The VA must ensure an improved quality of life for female veterans 

with gender-specific health care to meet their needs. Therefore, the 

Committee urges VA to continue its efforts to expand access to care 

in these areas and ensure the gender-specific health needs of female veterans are met. 

Female medical staff.—The Committee supports the hiring of 

more female health care professionals in order to provide female 

veterans greater opportunities to choose the gender of their health 

care provider. To enhance the Committee’s understanding of VHA’s 

staff demographic, the Committee requests a report, no later than 


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90 days after enactment of this Act, on the number of female 

health care professionals hired by VHA each year over the past five 

years. The report should include information pertaining to job type 

and employment location. 

Breast cancer screening guidelines.—The Committee commends 

the VA decision to offer breast cancer screening and mammography 

to eligible female veterans beginning at age 40, yearly mammograms at age 45, and then every other year from age 55. The Committee supports this effort to ensure that the care female veterans 

receive is consistent with the private sector, and the Committee 

will continue to monitor the Department’s implementation of this 

policy. Bill language is included to ensure VA maintains this policy 

through January 1, 2024. 

Pharmacy issues 

Vaccines.—To improve the health of veterans and to reduce 

health care costs due to avoidable hospitalizations and complications, the Committee directs VHA to incorporate, when available, 

peer-reviewed and published randomized and other high-quality, 

well-controlled clinical trials and economic data, particularly from 

the VA population, into its influenza vaccine procurement decisions 

and educational efforts to enable better informed decision making 

to positively impact the health of senior veterans. 

Prescription drug abuse 

Opioid abuse.—As the reports of increasing numbers of opioid 

overdoses roil the nation, the Committee is pleased that VA has 

taken an aggressive posture in reducing the volume of opioid prescriptions it dispenses and is turning to alternative approaches to 

pain relief, including the use of complementary medicine tools. The 

VA Opioid Safety Initiative, begun in 2013, has resulted in a 25 

percent reduction in the number of veterans prescribed opioids for 

pain relief and the rate of overdose among veterans prescribed a 

prescription opioid has been cut in half. The Committee encourages 

VA to continue the challenging effort to reduce opioid use among 

veterans, half of whom suffer from chronic pain. The bill provides 

$386,530,000 for opioid treatment and prevention efforts, of which 

$52,025,000 is provided for activities authorized by the Comprehensive Addiction and Recovery Act of 2016 (CARA). 

Opioid Therapy Risk Report.—The Committee urges VA to ensure that all VA providers who prescribe opioids use VA’s Opioid 

Therapy Risk Report tool consistently, including prior to initiating 

opioid therapy, to ensure safe prescribing and to help prevent diversion, abuse, and double-prescribing. The Committee also urges 

VA to further improve the timeliness of data available in the tool 

to allow a provider to have real-time access to data. It is critical 

that VA clinicians have access to a patient’s opioid therapy history 

from outside providers to ensure safe pain management care, as 

many veterans also seek care from providers in the community who 

may prescribe them medication. 

State prescription drug monitoring programs.—The Committee 

notes that, with the problem of opioid use disorders escalating 

among veterans, it is very 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 unVerDate Sep 11 2014 05:48 May 03, 2018 Jkt 028054 PO 00000 Frm 00036 Fmt 6659 Sfmt 6602 E:\HR\OC\B054.XXX B054

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derstands that two States currently have not installed the technology to exchange data from their State prescription drug monitoring boards with VA. VA is urged to assist these States to speed 

their exchange. 

Opioid addiction treatment.—The Committee appreciates VA’s 

submittal of a report to the Committee on VA’s ongoing review of 

prescription practices and addiction treatment protocols for opioids. 

The Committee requests an update of this report, not later than 90 

days after enactment of this Act, that describes VA’s commitment 

to the goal of enabling veterans to become free of all opioids and 

having access to non-opioid alternative medications and recovery 

supports. In conjunction with its overall efforts to address opioid 

abuse, the Committee also encourages VA to explore the use of advanced data analytics to detect and deter abuse and to treat addiction. 

Naloxone.—United States public health agencies have appropriately highlighted the risk of overdose from doses of opioids 

greater than 90 morphine milligram equivalents (MME) per day. 

However, the vast majority of patients, including the vast majority 

who die from overdose, are below 90 MME, making broad education about opioid-related risks essential for all patients prescribed opioids, regardless of dose or formulation. Hundreds of millions of patients receive prescriptions each year of immediate release (IR) lower MME opioids, such as hydrocodone and oxycodone. 

These opioids are commonly associated with abuse, are a common 

pathway to addiction, and present a risk of overdose. Some States 

have limited the prescribing of these IR opioids. An alternative approach may be to assess the benefit of providing Opioid Overdose 

Education and Naloxone Distribution (OEND), regarding how to 

prevent, recognize, and respond to an opioid overdose, including responding with naloxone, to patients prescribed opioids. Prescribers 

including dentists and other primary care providers have an opportunity to become more attuned to the risks of all opioids through 

the consideration of broad Opioid Overdose Education and co-prescribing naloxone to those with an opioid prescription. The Committee requests that VHA develop a strategy to test this hypothesis 

and consider executing a pilot program to assess the benefit for veteran patients. 

Complementary and integrative health (CIH).—The Committee 

supports VA’s work in developing a plan to expand the scope of research, education, delivery, and integration of CIH into the health 

care services provided to veterans and urges its robust implementation. The Committee supports the progress being made to reduce 

misuse and abuse of opioids and to improve pain care and encourages VHA to accord priority for CIH to VISNs or VA medical centers with a history of opioid prescription rates, or current opioid 

prescription rates, inconsistent with the standards of appropriate 

and safe care. 

Opioid treatment alternatives.—The Committee notes that the 

United States is grappling with an opioid epidemic. Some areas, 

such as Appalachia, are disproportionately hard-hit by this crisis. 

The Committee, therefore, encourages VA to ensure pain treatment 

alternatives to opioids, such as chiropractic care, are available to 

veterans where they are most needed. Further, the Committee encourages VA to integrate such treatments into VA’s medical centers 


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or clinics to be provided by VA staff, or on a contract basis where 

needed. 

Pain University.—The Committee recognizes the excellent and 

inspiring work from the Tomah VA facility in Tomah, Wisconsin, 

which has successfully implemented a program called Pain University. The program seeks to incorporate alternative medicine, such 

as acupuncture and meditation, to reduce veterans’ reliance on prescription pain medications, which have a higher likelihood of addiction leading to substance abuse. The Pain University program was 

recognized as a gold status program by VHA in 2016 for its work. 

The Committee encourages VHA to continue to expand implementation of the Pain University program to other VA clinics so more 

veterans have access to non-addictive pain management therapies. 

Other health issues 

Hepatitis C Virus (HCV) outreach and testing.—The Committee 

is pleased with VA’s significant progress in reaching and treating 

veterans who have lived with HCV for years and that it continues 

to dedicate resources towards the goal of screening and treating 

veterans who are disproportionately impacted by the disease. Now 

that the easiest to identify and treat HCV caseload has been largely addressed, it is important for VA to use other tools to reach the 

remaining caseload. Participating in community events, with onsite HCV testing, that are organized by veterans services organizations is an excellent way to reach veterans, both those who may be 

enrolled for VA services, but are not actively using them, or veterans who don’t know their eligibility status. Therefore, VA is encouraged to explore innovative partnerships with stakeholder organizations to effectively engage and test additional veterans with 

rapid HCV screening outside of traditional sites of care. The Department is also encouraged to make available, at community 

events involving on-site screening, department staff who have the 

capacity to check a veteran’s status on-site so that eligibility for VA 

reimbursement for testing is known instantly. 

Lung cancer screening.—The Committee continues to note with 

concern that veterans at risk for lung cancer are not afforded the 

same access to lung cancer screening programs that are offered to 

Medicare beneficiaries. The Committee looks forward to receiving 

the report from VA, as requested in House Report 115–188, presenting the steps the VHA is taking to make lung cancer screening 

broadly available to veterans at high risk for lung cancer. 

Colorectal cancer screening.—The Committee reminds VA of the 

direction in the Statement of Managers accompanying Public Law 

115–141 that directed the Department to offer all seven colorectal 

cancer screening strategies recommended by the United States Preventive Services Task Force or to notify the Committee if it is not 

using all seven approaches. 

Prostate cancer.—Prostate cancer is the most frequently detected 

cancer among veterans, with an estimated 10,000 new cases diagnosed annually. Unfortunately, early detection is not yet an exact 

science. Although prostate biopsies are the standard of care, they 

often miss detecting cancer. This fear of missed cancer often leads 

to multiple, invasive biopsies, many of which may be unnecessary. 

Recent biotechnology advancements within the emerging field of 

prostate cancer biomarkers have hastened the detection of prostate 


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cancer and curbed the financial costs associated with unnecessary 

repeat diagnostic procedures. The Committee encourages VA to accelerate the adoption of such technologies within VHA, particularly 

for biomarker tests on the federal supply schedule, to help rule out 

false-negative biopsy concerns and alleviate financial and mental 

anguish for veterans. 

Rare cancers.—The Committee is pleased to learn of the December 2017 signing of a collaboration agreement between the VA, the 

John P. Murtha Cancer Center at Walter Reed National Military 

Medical Center, and the National Cancer Institute (NCI) focused 

on improving cancer care for common cancers affecting military 

personnel and veterans. However, the Committee remains concerned about the need for a better understanding of, and treatment 

options for, rare cancers that may disproportionately impact veterans. Military personnel are uniquely exposed to carcinogens including asbestos, industrial solvents, nuclear radiation, depleted 

uranium, lead, fuels, PCBs, and components of Chemical Agent Resistance Coating. Each of these hazards may increase the risk of 

certain cancers for both military personnel and veterans. Therefore, 

the Committee directs VA to assess options for modifying the December 2017 agreement to include collaboration on rare cancers. 

Further, the Committee seeks clarification regarding VA’s authorities to provide funding to commercial firms for the development of 

treatments for rare cancers. The Committee directs VA to provide 

a report on these topics within 90 days of the enactment of this 

Act. 

Sepsis.—Sepsis is a leading cause of mortality for veterans with 

spinal cord injuries. The Committee believes that VA, through its 

Center for Clinical Management Research and its Spinal Cord Injuries and Disorders Centers, can help improve the diagnosis and 

management of sepsis. The Committee, therefore, directs the Department to provide a report, within 90 days of the enactment of 

this Act, on its costs related to sepsis management and how it has 

incorporated the latest improvements in sepsis screening and 

diagnostics, including biomarker testing, across its health care facilities. 

Diabetes treatment.—The Committee is concerned about the incidence of diabetes impacting veterans and seeks approaches to reduce both the prevalence of this disease and any wait times associated with treatment. Therefore, the Committee requests that VA 

provide a report, no later than 90 days after the enactment of this 

Act, on the feasibility and potential cost of building a fullyequipped diabetes center that would be open 24 hours per day, 7 

days a week, and 365 days a year. In describing in the report suitable locations for such a facility, VA should consider areas with the 

highest prevalence of diabetes, a large concentration of veterans, 

and a system of established VA medical centers and clinics. Any 

willingness of medical providers to defray the expense of such a facility by paying the capital costs of construction, if permitted in 

law, should also be taken into account in considering potential locations. 

Pressure ulcer prevention.—The Committee is concerned about facility-acquired pressure ulcers (PU) and the associated costs for the 

treatment of hospitalized patients with PUs in VHA facilities. The 

Committee, therefore, commends VA for its current studies on the 


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VA Smart Modular Adaptive Electrotherapy Delivery System 

(SmartMAEDS), the use of smartphone technology for PU screening, and the prevention of community-acquired PU in individuals 

living with a spinal cord injury. Given the importance of this research, the Committee encourages VA to prioritize clinical care and 

research focused on wound care, particularly in locations with higher incidence rates of PUs, such as sites that serve patient populations with limited mobility and spinal-cord injury. Furthermore, 

the Committee encourages VA to explore the feasibility of including 

military treatment facilities in this care and research to increase 

the cost-effectiveness of the health care provided by the Military 

Health System and VA, as authorized under Joint DOD/VA Sharing Incentive Funds, 38 USC 8111. To assess VA’s progress in this 

area, the Committee requests a report, no later than one year after 

the enactment of this Act, regarding the status and preliminary results of these studies, as well as any other innovative technologies 

VA has assessed, particularly those involving biometric sensor 

technologies. 

Antimicrobial stewardship.—The Committee continues to be 

pleased with VA’s efforts to reduce antibiotic use so as to avoid development of resistance to important drugs, without increasing 30- 

day readmission and mortality rates. Per VHA Directive 1031, the 

VA has focused on the implementation and effectiveness of the VA 

Antimicrobial Stewardship Program. This program establishes 

stewardship programs in all VA facilities and fosters the judicious 

use of antimicrobials through education, direct provider-to-provider 

stewardship, and surveillance. It also supports and expands ongoing efforts to prevent the emergence of multidrug-resistant organisms. The Committee encourages VA to continue improvements in 

the effectiveness and implementation of its Antimicrobial Stewardship Program. 

Wheelchairs.—The Committee is extremely concerned by the 

March 2018 report from VA’s Office of Inspector General regarding 

the repair times and policies for powered wheelchairs and scooters. 

The report noted that, due to VA staff failures, some veterans waited an average of 69 days to have their powered wheelchair or scooter repaired and were provided manual wheelchairs or scooters in 

the interim jeopardizing their quality of life. Therefore, the Committee requests a report, no later than 60 days after enactment of 

this Act, explaining VA’s policy in regard to the types of wheelchairs or scooters issued as replacements when powered wheelchairs or scooters are turned in for repair. It should also provide 

the estimated cost of maintaining sufficient powered wheelchairs 

and scooters on hand to enable veterans to receive one as a replacement, instead of a manual wheelchair or scooter, while awaiting repair of their powered wheelchair or scooter. The report should also 

include a description of VA’s authority to provide wheelchairs that 

restore an ability that relates exclusively to participation in a recreational activity. 

Non-invasive cardiac artery disease diagnosis.—The Committee 

understands that significant health advantages and cost savings 

may be possible through non-invasive diagnosis of cardiac artery 

disease. Therefore, the Committee commends VA on having conducted such diagnoses through cardiac CT angiography (CTA) on 

approximately 2,300 veterans in the past year. The Committee is 


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also interested in newly-developed CTA-related technologies that 

may provide even greater benefits to veterans. The Committee directs VA to conduct a study on such technologies assessing their capabilities, the anticipated annual net cost impact (the estimated 

annual cost of the testing and the estimated cost savings and offsets that would result from avoidance of invasive CTA and other 

non-invasive cardiac testing), and any issues that might impact 

their incorporation into clinical practice guidelines, such as privacy 

and information technology issues, if such technologies are proprietary. The Committee requests that VA submit the results of this 

study within 180 days after enactment of this Act. 

Mobile magnetic resonance imaging (MRI).—The Committee is 

concerned about MRI wait times for veterans. Delays in MRI use 

have the potential to keep veterans in pain or cause injuries to heal 

incorrectly without proper diagnosis. Therefore, the Committee requests a report from VA, no later than 90 days after the enactment 

of this Act, on any MRI backlog that may exist. The report should 

include data on average wait times by location, an assessment as 

to whether a mobile MRI service would help reduce any existing 

backlog, and an estimate of the cost for implementing such a service. 

Wellness.—Public Law 115–141 included funding for a veteran 

services organizations (VSOs) wellness pilot program to upgrade, 

through construction and repair, veteran service organization facilities to expand access to wellness programs and expanded complementary and integrative health promotion. The Committee 

strongly supports this program and directs VA to report the 

progress of this pilot no later than 15 days after enactment of this 

Act and then provide quarterly status updates. 

Tobacco.—In a 2018 Centers for Disease Control and Prevention 

study, 56.8 percent of servicemembers and veterans between the 

ages of 18–25 reported being current smokers. Interventions for active duty and veteran servicemembers are important to reduce tobacco use and could lead to improved health outcomes. The Committee encourages VA to implement evidence-based tobacco interventions to support servicemembers now and in the future. 

Nutrition.—The Committee recognizes the value of proper nutrition and food’s impact on health. Patients with three or more 

chronic conditions represent 35 percent of veterans receiving VA 

care and account for 65 percent of VHA costs. Additionally, 79 percent of veterans receiving VA care are overweight and 43 percent 

are obese. The Committee urges VHA to be proactive in promoting 

wellness and disease prevention by providing evidence-based nutritional services and requests to be briefed on current practices, as 

well as on a plan to expand nutritional education and means to increase access to nutritional foods for veterans. 

Long-term care.—The Committee is aware of the aging veteran 

population and supports long-term care that focuses on facilitating 

veteran independence, enhancing quality of life, and supporting the 

family members of veterans. 

Veterans’ end-of-life care.—Public Law 115–141 directed VA to 

undertake a study on the feasibility of implementing hospice care 

protocols tailored to the unique needs of combat veterans, including 

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erans. The Vietnam Veterans End of Life Care report submitted to 

the Committee is woefully inadequate, failed to meet any of the reporting requirements, and is frankly of no use to the Committee. 

Furthermore, the report stated that there are over 4,000 community hospice care providers who all maintain their own resources 

and training materials which leads the Committee to believe there 

is no clear standard being provided by VA for veterans hospice care 

and veterans facing unique end-of-life challenges are failing to receive proper care. Due to the lack of information provided in the 

report, VA is again directed to provide a detailed report outlining 

the techniques, best practices, and support mechanisms for end-oflife care. The Committee strongly reiterates that such an approach 

could be beneficial to Iraq, Afghanistan, and Syria combat veterans 

in the future. This report shall be submitted to the Committee 

within 30 days after the enactment of this Act. 

Patients rights.—The statement of managers for Public Law 115– 

141 contained a VA patients rights reporting requirement. However, due to the late passage of the fiscal year 2018 bill, the reporting requirement remains outstanding. The Committee strongly supports veterans making decisions regarding their medical care and 

having the right to accept or refuse treatment, and the right to formulate advance directives. The Committee remains interested in 

this report and looks forward to its submission. 

Teague-Cranston medical schools.—The Committee recognizes 

that the 1972 Teague-Cranston Act, also known as the Medical 

School Assistance and Health Manpower Training Act, established 

five medical schools to be built on VA campuses in conjunction with 

these universities: Wright State University, the University of South 

Carolina, Texas A&M University, Marshall University, and East 

Tennessee State University. These schools were built on VA campuses for the express purpose of training physicians for service in 

underserved areas and benefitting veterans. The Committee also 

understands that VA maintains a robust academic affiliation with 

these schools. Given congressional intent regarding the establishment of these schools, and the critical role they play in caring for 

veterans, the Committee directs VA to notify Congress in advance 

of any plan to move resources or assets from these schools, if such 

a move would have a negative impact on them. 

Hispanic-Serving Institution (HSI) 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. The Committee looks forward 

to the report mandated by Public Law 115–141. 

Historically Black Colleges and Universities medical research programs.—Over the past five years the Committee has urged VA to 

increase its efforts to improve its academic affiliation activities 

with minority medical schools and institutions for the purposes of 

enhancing training initiatives, improving patient care, and providing educational opportunities. At one point the Committee directed VA to have a symposium in order to achieve these goals. The 

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ment to, and partnership with, minority health professions schools 

and report back to the Committee, no later than 30 days after the 

enactment of this Act, regarding the actions it will take to address 

this issue. Thereafter, the Committee directs a quarterly report on 

this issue be submitted to the Committee explaining how each action has been fulfilled. 

Minority veteran care.—The Committee acknowledges VA’s efforts to streamline data collection practices via a working group 

and other initiatives. The Committee also notes that the veteran 

population is becoming increasingly diverse. Accordingly, the Committee directs VA to provide a report within 180 days of enactment 

of this Act, which details how it can restructure its data collection 

practices to more accurately and consistently capture data on the 

race and ethnicity of veterans across its various systems. This report shall take into consideration that the Department is in the 

midst of the acquisition of a new electronic health record program, 

which will combine the Department’s current data collecting programs, and make recommendations on how implementation of this 

new program can help improve data collection on veterans. 

Freely Associated States (FAS) veterans’ access.—The Committee 

is concerned about impediments to VA health care access for FAS 

veterans. Veterans in the FAS must travel hundreds to thousands 

of miles to the nearest VA medical center in Guam or Hawaii, in 

some circumstances at their own expense, to get health care. For 

those who are able to travel to seek care, the collective costs are 

magnified by lost wages resulting from missed days at work and 

childcare costs, as well as time away from families. Given the significant time, resources, and high costs for travel for some veterans, including airfare, transportation, and lodging, many FAS 

veterans are never able to access the VA health services they have 

earned through their military service. As the VA works to transform its Community Care programs, the Committee directs VA, no 

later than 90 days after enactment of this Act, to provide the Committee a report that assesses options for improving access to VA 

health care for FAS veterans. The report should include the number of veterans residing in the FAS who have utilized services in 

VA Pacific Islands Health Care System (VAPIHCS) facilities over 

the last three fiscal years, the extent of travel benefits offered to 

veterans and eligibility requirements for the benefits, an average 

estimated personal cost for an FAS veteran to access VA care, the 

estimated costs for providing telehealth services in FAS through a 

pilot program, and recommendations for how VA can reduce burdensome restrictions under the Foreign Medical Program using existing authorities. Furthermore, the Committee encourages VA to 

work with Federal and non-Federal partners, including the Departments of Defense, Interior, and Health and Human Services, as 

well as non-VA health care facilities and educational institutions, 

to leverage shared resources and improve access for delivery of care 

through collaboration. 

Volunteer physicians.—The Committee continues to be encouraged by the success of the Physician Ambassadors Helping Veterans Pilot Program to date and encourages VA to expand this program to additional facilities throughout the country, prioritizing 

VHA sites that serve the largest veteran populations as well as 

those which experience the longest wait times. 


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National Veterans Sport Program.—The bill includes $17,825,000 

for the National Veterans Sports Program, which is $1,000,000 

above the request and $860,000 above the fiscal year 2018 funding. 

Within the total, $6,825,000 is provided for the support of national 

veterans’ sports and special events programs; $2,000,000 is designated for veterans’ monthly assistance allowances; and 

$9,000,000 is provided for the Adaptive Sports Grants Program. 

The Adaptive Sports Grants Program currently awards a limited 

number of grants for equine therapy, mostly related to physical disabilities. The Committee provides $1,000,000 above the request to 

encourage VA to increase its use of these grants for the purpose of 

equine therapy targeted to mental health issues. 

MEDICAL COMMUNITY CARE

Fiscal year 2018 enacted level ........................................................... $9,828,294,000 

Fiscal year 2019 enacted level ........................................................... 8,384,704,000 

Fiscal year 2019 additional request .................................................. 500,000,000 

Committee 2019 additional recommendation ................................... 500,000,000 

Fiscal year 2020 advance appropriation request ............................. 14,419,786,000 

Committee 2020 advance appropriation recommendation .............. 14,419,786,000 

Comparison with: 

Fiscal year 2019 enacted level ................................................... 6,035,082,000 

Fiscal year 2020 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 2020, the bill provides 

$14,419,786,000, of which $2,000,000,000 is available until September 30, 2021. 

The Committee provides $500,000,000 as requested in the April 

13 Administration budget amendment for this activity. 

Peer support services.—The Committee understands that private 

nonprofit peer-to-peer organizations have provided important services for veterans in areas such as crisis interventions, services to 

improve community integration such as rehabilitation, mental 

health assessments, referral services, and treatment plan development. The Committee encourages VA to review the types of services provided by peer-to-peer organizations and determine whether 

the Department is permitted to contract for their services under 

current law. The Committee requests a report, no later than 60 

days after enactment of this Act, describing whether VA is permitted to reimburse peer-to-peer organizations and whether these 

providers could be a useful component in the Department’s comprehensive strategy for health care services for veterans. 

Problems with network administrators.—The Committee recognizes the massive undertaking to develop and implement the Veterans Choice Program and the difficulties that patients and providers have experienced in dealing with the third party administrators of the program. As such, the Committee is interested in ensuring that, going forward, the Veterans Choice Program is providing 

maximum benefit to veterans, attracting top quality providers, and 

meeting program goals. To this end, the Committee requests VHA 

to submit a report, within 90 days of enactment of this Act, on the 

effectiveness of the program’s third party administrators with regard to patients and providers and the challenges this program has 

created for them. 


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CHOICE FUND

Fiscal year 2018 enacted .................................................................... – – – 

Fiscal year 2019 enacted .................................................................... – – – 

Fiscal year 2019 additional request .................................................. $1,900,000,000 

Committee recommendation in the bill ............................................ – – – 

Comparison with: 

Fiscal year 2018 enacted level ................................................... – – – 

Fiscal year 2019 additional request ........................................... (1,900,000,000) 

The Choice Fund was created in P.L. 113-146, the legislation establishing the Choice program and providing mandatory funding 

for it. Since its inception, the authorizers have provided nearly 

$20,000,000,000 in emergency mandatory funding to support the 

Choice program. The account has never received discretionary 

funding. It was anticipated that the funding would last until the 

authorizing committees created a program to consolidate the 

Choice program with other non-VA care programs. However, the 

new program has not yet been passed into law. The Administration 

proposes a budget amendment of $1,900,000,000 in discretionary 

funding as a patch until a consolidated non-VA care program is in 

place. The Committee is reluctant to provide discretionary funding 

for a mandatory program, but is ready to meet its responsibility to 

provide funding after the new discretionary program is implemented. 

MEDICAL SUPPORT AND COMPLIANCE

Fiscal year 2018 enacted level ........................................................... $6,754,480,000 

Fiscal year 2019 enacted level ........................................................... 7,239,156,000 

Fiscal year 2020 advance budget request ......................................... 7,106,150,000 

Committee 2020 recommendation in the bill ................................... 7,106,150,000 

Comparison with: 

Fiscal year 2019 enacted level ................................................... (133,006,000) 

Fiscal year 2020 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 bill provides $7,106,150,000 in advance fiscal year 2020 

funding. The Committee has included bill language to make available through September 30, 2021, $100,000,000 of the Medical Support and Compliance appropriation for fiscal year 2020. 

MEDICAL FACILITIES

Fiscal year 2018 enacted level ........................................................... $6,141,880,000 

Fiscal year 2019 enacted level ........................................................... 5,914,288,000 

Fiscal year 2020 advance budget request ......................................... 5,276,676,000 

Committee 2020 recommendation in the bill ................................... 5,276,676,000 

Comparison with: 

Fiscal year 2019 enacted level ................................................... (637,612,000) 

Fiscal year 2020 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, 


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

repair, and property disposition and acquisition. The bill provides $5,276,676,000 in advance fiscal year 2020 

funding. The Committee has included bill language to make available through September 30, 2021, $250,000,000 of the advance 

Medical Facilities appropriation for fiscal year 2020. In addition to funding provided in this account, $800,000,000 is 

provided in sec. 238 for non-recurring maintenance as part of a 

$2,000,000,000 infrastructure initiative. A similar initiative provided $1,000,000,000 for this account for non-recurring maintenance in fiscal year 2018. 

Spending plan.—The Committee expects VA to provide, no later 

than 30 days after enactment of this Act, an expenditure plan detailing the planned use of the funds provided. The Committee understands that some of the projects planned for fiscal year 2019 

may not be ready within that timeframe, requiring an adjustment 

to the spending plan. The Committee requests a quarterly update 

of the plan if the funding for any single project changes by more 

than $3,000,000 during that time period. 

Facility expansion.—The Committee continues to support an expansion of the number of clinics available to veterans. To help accomplish this, the Committee encourages VA to identify Community Based Outpatient Clinic (CBOC) facilities, with a priority in 

rural areas, for facility expansion opportunities in order to accommodate additional patients and provide enhanced services, thereby 

reducing the need for veterans to travel long distances for care. 

The VA is encouraged to look at existing CBOCs which are operating at full capacity, have a proven record of delivering services, 

and have community support to expand the facility. Additionally, 

VA is directed to complete a study, within 120 days after enactment of this Act, on the potential benefits of placing VA clinics on 

military installations located in areas with high veteran populations and where nearby VA infrastructure is overburdened. The 

study should emphasize locations with readily available, unused 

medical facilities on military installations. The report should identify potential cost savings and determine if increased quality and 

improved timeliness of care can be provided to veterans in these 

communities through on-post VA medical care. The results of the 

study are to be provided to the Committee once available. 

Bakersfield outpatient clinic.—The Committee remains concerned 

that VA has not yet established a new outpatient clinic in Bakersfield, California as authorized in Public Law 111–82. Based on information provided by VA, the Committee expects the lease for this 

facility to be awarded in the summer of 2018 and that clinic activation will occur in the fall of 2020. Furthermore, the Committee directs the Secretary to continue to provide regular updates to Congress as directed in House Report 114–497. 

Center of Excellence for Research on Returning War Veterans.— 

The Committee understands that VA is planning to move the 

Posttraumatic-stress Residential Rehabilitation Program (PRRP) 

that is currently co-located with the Center of Excellence (COE) for 

Research on Returning War Veterans on the campus of the VA 

Medical Center in Waco, Texas. The Committee is concerned that 

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fering from PTSD. Therefore, the Committee directs VA to provide 

a report, within 30 days of the enactment of this Act, which details 

the mission of the COE, the mission of the PRRP, and the relationship between these two programs. The report should include an assessment of the research benefits of having in-patient programs colocated with mental health centers of excellence in general, an assessment specific to benefits resulting from the current co-location 

of the COE with the PRRP on the Waco campus, and any costs associated with VA’s planned move of the PRRP. Further, the Committee reminds VA that the conference report accompanying Public 

Law 109–114, House Report 109–305, expressly designated the establishment of three VA ‘‘centers of excellence to focus on mental 

health/PTSD needs,’’ with one of these being at the VA Medical 

Center in Waco, Texas. The Committee expects VA to adhere to 

congressional intent, as expressed in the report, regarding the location of this center of excellence. 

Medical imaging equipment.—The Committee remains committed 

to helping VA in its efforts to ensure a timely process for VA medical centers to receive medical imaging equipment to effectively and 

efficiently deliver care to veterans. The Committee urges VA to 

strive to maintain a 120-day turnaround for these equipment orders during their three, annual consolidated purchase periods for 

high tech medical equipment. The Committee requests that VA 

consider more education for contracting officers and 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 make 

public information regarding current requirements and regulations 

and any changes or revisions to procurement processes in the area 

of high tech medical equipment. In addition, the Committee urges 

VA to coordinate between capital equipment purchases, facilities 

funding for site readiness, and clinical staff training to ensure that 

facilities are prepared to install and operate equipment as quickly 

as possible after purchase. 

Operating room patient safety and fire prevention.—Given the importance of patient safety, the Committee requests that VA provide 

a report, within 90 days of enactment of this Act, that provides information regarding incidents of operating room fires at VA medical facilities over the last ten years. The report should include the 

Department’s policies and procedures for tracking and evaluating 

patient burn and fire risk exposures in live operating room environments and data that shows the total number of tort claims, the 

amount per claim, and the total amount of these claims, paid by 

the Department of the Treasury’s Judgement Fund or any other 

taxpayer-funded sources as a result of VA operating room fires and 

related safety issues. The report should also include information on 

the Department’s public reporting of patient outcome measures 

based on Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSI). 


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MEDICAL AND PROSTHETIC RESEARCH

Fiscal year 2019 enacted level ........................................................... $722,262,000 

Fiscal year 2019 budget request ....................................................... 727,369,000 

Committee recommendation in the bill ............................................ 732,262,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... 10,000,000 

Fiscal year 2019 budget request ................................................ 4,893,000 

This appropriation provides for medical, rehabilitative, and health services research. The bill makes $705,262,000 of this funding available through September 30, 2020. The Committee recognizes the importance of the research conducted by VA for veterans’ 

quality of life and health and provides $4,893,000 above the request and $10,000,000 above last year for these activities. Of the 

funding provided, $27,000,000 supports VA’s collaboration with the 

Department of Energy (DOE) via a long-term inter-agency agreement to leverage DOE’s next generation artificial intelligence, big 

data, and high-performance computing technologies, as well as 

multi-modal diagnostics and data integration, in order to develop 

specific precision medicine applications. This funding is made available through September 30, 2023. 

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 2019 research 

resources beyond the research account are $1,188,000,000. 

PTSD research.—The National Center for PTSD 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 the Center in fiscal 

year 2019, compared to the budget request of $19,680,000. 

Modeling and simulation treatment of PTSD.—As a mechanism 

to explore treatments for PTSD, the Committee is aware that the 

use of modeling and simulation technology has enabled the development of innovative and immersive therapies, which can extend 

trauma management therapy protocol. The Committee encourages 

VA to continue its research into therapeutic virtual environments 

using real-time modeling and simulation training to treat PTSD. 

Identifying at-risk veterans through social media algorithms.— 

The committee encourages VA to investigate the use of technology, 

specifically social media database algorithms, to detect and identify, via indirect contact such as on social media, veterans who are 

at risk of harming themselves or others. Once an individual is 

identified, the Department would use indirect means of communication to interact with the troubled individual to provide help 

and support in the hope of preventing tragedy. 


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Dystonia.—The Committee is concerned that there may be a connection between traumatic brain injury (TBI) and the onset of 

dystonia and that this may disproportionately impact veterans. The 

Committee, therefore, urges the VA to pursue collaboration with 

stakeholders to advance critical research on dystonia. 

Cannabis research.—The Committee recognizes that continued 

focus on the discovery of treatment alternatives for veterans diagnosed with various conditions such as chronic pain and PTSD are 

essential to reducing the number of veteran suicides. For this reason, the Committee urges VA to utilize funds, in an amount 

deemed appropriate by the Secretary, to prioritize investments in 

research on the efficacy and safety of cannabis usage among the 

veteran population for medicinal purposes. The Committee also requests a report, within 180 days after the enactment of this Act, 

by the Secretary containing a detailed plan on how the Department 

expects to pursue this research. The Committee also urges VA to 

ensure any research conducted or supported by VA on cannabis 

therapy is preserved in a manner that will facilitate further research. 

Comprehensive cancer centers.—The Committee seeks to ensure 

that veterans have access to the highest quality cancer care available. The Committee, therefore, applauds the ongoing collaborative 

efforts between VA medical centers and NCI-designated comprehensive cancer centers. The Committee supports these efforts, 

especially as they relate to providing veterans access to 

groundbreaking new treatments through clinical trials led by academic cancer centers, as well as the linking of VA oncology care 

with national research databases involving patients at multiple 

academic cancer centers. The Committee is also pleased that VA is 

engaged with the NCI and VA Interagency Group to Accelerate 

Trials Enrollment (NAVIGATE) partnership. The Committee encourages VA to continue and expand such partnerships so that veterans have greater access to clinical trials and VA medical staff 

have greater opportunities to engage in collaborative cancer care to 

enhance outcomes. 

Respiratory disease.—The Committee notes the high burden of 

respiratory illnesses, such as lung cancer, on the veteran population. The Committee urges VA to provide support for respiratory 

research proposals commensurate with the burden of respiratory 

disease in this population. 

Exposure to herbicide-related toxins.—Veterans have frequently 

expressed long-held concerns that toxic exposure during their military service is related to adverse health conditions. The Committee 

is committed to understanding the residual impacts of Agent Orange/Dioxin and other herbicide-related toxic exposures among veterans who served in Vietnam, Thailand, and all other geographic 

areas where these toxic substances were dispersed. The Committee 

urges VA to reference data from existing medical records of veterans to determine the percentage of veterans from the above referenced subgroup that have more frequent or unexplained diseases 

compared to the civilian population. This body of data could be 

helpful in clarifying the extent and specifics of the medical issues 

suffered by veterans from exposure to herbicides. 

Female prosthetics research.—The Committee strongly supports 

robust funding for medical and prosthetic research. Recognizing 


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that approximately six percent of wounded veterans returning from 

Iraq and Afghanistan are amputees, and the number of veterans 

accessing VA health care for prosthetics and sensory aids continues 

to increase, this funding greatly enhances veterans’ quality of life. 

However, there is an acute need for research specializing in female 

prosthetics, as most prostheses are designed to fit male veterans. 

Since three percent of military amputees are female, the Committee urges that a proportionate amount of prosthetics research 

should be focused on prosthetics meant for female 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. Furthermore, the Committee directs VA to submit this report on an annual 

basis that coincides with the annual VA budget submission as its 

own chapter in the relevant budget documents. 

Hydraulic prosthetic technology.—The Committee is aware of recent developments in hydraulic prosthetic technology. Hydraulic 

designs fill the gap between standard myoelectric grippers and premium, bionic-like hand prostheses, offering cost-effective solutions 

with advanced motion control and flexibility. The Committee also 

understands that VA is limited to providing prosthetic devices that 

have been approved by the Food and Drug Administration (FDA). 

Therefore, the Committee encourages the Department to monitor 

the development of this technology and, if approved by the FDA, 

to implement pilot programs that assess its benefits for veterans. 

Specialized and modular prosthetics research.—As referenced in 

the Statement of Managers accompanying Public Law 115–141, the 

field of specialized and modular prosthetics is evolving at a faster 

pace than VA has been able to match. The Statement of Managers 

directed VA to provide a report on this issue; however, due to the 

late passage of the fiscal year 2018 Omnibus the report remains 

outstanding. The Committee reiterates its interest in this report 

and urges the Department to complete the report as soon as possible. 

Neuromuscular junction (NMJ) regeneration research.—The Committee applauds VHA for its support of cutting edge research into 

the molecular mechanisms that govern NMJ. This knowledge is essential to making improvements in the re-innervation of 

denervated muscles. Progress in this area is critical to reducing the 

incidence of long-term disability among military personnel as a result of combat-related extremity injuries and other non-combat related incidents. It is also crucial to mitigating the disproportionate 

incidence of neurodegenerative disorders among the veteran population. Consequently, the Committee strongly encourages VHA to 

dedicate additional research resources to efforts to better understand the underlying mechanisms of NMJ regeneration. 

Gulf War illness studies.—The Committee recommends the Department continue to conduct epidemiological studies regarding the 

prevalence of Gulf War illness, morbidity, and mortality in Persian 

Gulf War veterans, and the development of effective treatments, 

preventions, and cures. The Committee also urges VA to make public all of its available research data on Gulf War illness, particularly disease-specific mortality data related specifically to Gulf War 

veterans. 


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Gulf War illness.—The Committee encourages VA to continue inclusion of research on functional gastrointestinal (GI) disorders in 

its research related to Gulf War Illness. 

Post-deployment integrated care.—Each new generation of veteran faces unique service-related conditions. Historically, it has 

been a challenge, when large-scale deployments occur, to identify 

signature wounds and develop and implement appropriate care 

models for returning combat veterans in a timely way. Given the 

evolving responsibilities for current and future military service personnel, the Committee directs VA, through the War Related Illness 

and Injury Study Center (WRIISC) and the Offices of Patient Care 

Services and Post-Deployment Health Services, to provide to Congress, no later than 120 days after enactment of this Act, an assessment of the process by which VA develops and improves its approaches to post-deployment integrated care for returning combat 

veterans. The report shall build on lessons learned from previous 

veteran cohorts and care models, including the Post-Deployment 

Integrated Care Initiative (PDICI). The report shall include recommendations to ensure VA has the capabilities and agility to 

identify and meet the needs of the next generation of combat veterans. 

The Million Veteran Program (MVP) Computational Health Analytics for Medical Precision to Improve Outcomes Now (CHAMPION) project.—The Committee supports the MVP–CHAMPION 

project, and encourages VA to continue leveraging the high performance computer facilities available through its partnership with 

the Department of Energy to focus on the secure analysis of large 

digital health and genomic data. The Committee also encourages 

VA to provide principal investigators at VA sites across the country 

for participation in the project. Further, the Committee recognizes 

that VA may benefit from the help of academic institutions across 

the country regarding sample collecting, contributions to relevant 

research, precision medicine, and health informatics. The Committee, therefore, encourages VA to consider a small number of 

pilot programs with academic health institutions that have biorepositories, existing clinical partnerships with VA, data security 

programs, and clinical care strengths in at least one of the following three identified areas of priority: suicide prevention, prostate cancer, and cardiovascular disease. Priority may be given to 

institutions that also have existing partnerships with the Department of Energy. 

Canine research.—The Committee understands there may be 

times that research involving canines leads to advances that benefit the health of our veterans. However, the Committee remains 

concerned about the extent of such experimentation and continues 

the language in the Consolidated Appropriations Act, 2018 limiting 

canine research to those studies in which the scientific objectives 

of the study can only be met by research with canines, the study 

has been directly approved by the Secretary, and the study is consistent with the revised VA canine research policy document released on December 18, 2017. Additionally, the Committee is aware 

that on March 13, 2018, the VA publicly announced that VHA’s Office of Research and Development would be conducting a ‘‘rapid, indepth internal review of existing canine research projects.’’ The 


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Committee directs VA to provide the results of this review to the 

Committee as soon as it is completed. 

Public access to scientific data.—The Committee commends VA 

on issuing its Policy and Implementation Plan for Public Access to 

Scientific Publications and Digital Data from Research Funded by 

the Department of Veterans Affairs on July 23, 2015. The Committee urges VA to continue its efforts towards full implementation 

of the plan, and requests a status report be submitted in conjunction with the fiscal year 2020 VA budget. 

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 2019 is $3,590,000,000. 

NATIONAL CEMETERY ADMINISTRATION

Fiscal year 2018 enacted level ........................................................... $306,193,000 

Fiscal year 2019 budget request ....................................................... 315,836,000 

Committee recommendation in the bill ............................................ 315,836,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... 9,643,000 

Fiscal year 2019 budget request ................................................ – – –

The National Cemetery Administration (NCA) 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 

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 135 operational national cemeteries and 33 other cemeterial installations. 

The bill includes language making ten percent of the total available until September 30, 2020. 

Unclaimed remains of veterans.—Throughout the country, there 

are reports of unclaimed remains of veterans being stored due to 

the absence of someone to claim these remains and begin the process for proper interment. The Committee was pleased to learn that 

NCA has recently taken steps to establish a process to address unclaimed remains of veterans at various locations. As VA establishes 

a process for unclaimed remains the Committee urges VA, in consultation with the National Park Service, to also consider including 

in this process ways to deal with remains of veterans that are left 

at National Memorials. 


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Rural cemetery access.—In House Report 112–94 and House Report 115–188 the Committee expressed concern that NCA is not 

adequately serving the nation’s veterans in rural areas. In five 

years, VA has only reduced this number to eight percent while receiving generous funding increases in a tight budget environment. 

As a result, the Committee continues to be concerned that there 

are geographic pockets in the country that are not being served, 

and VA has failed to meet its goal of having access for all veterans 

to a burial option within 75 miles of a veteran’s home. The Committee has previously requested a report on this issue and in fiscal 

year 2018 requested that GAO examine this issue as well. The 

Committee remains interested and looks forward to this report. 

DEPARTMENTAL ADMINISTRATION

GENERAL ADMINISTRATION

(INCLUDING TRANSFER OF FUNDS)

Fiscal year 2018 enacted level ........................................................... $335,891,000 

Fiscal year 2019 budget request ....................................................... 367,629,000 

Committee recommendation in the bill ............................................ 346,091,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... 10,200,000 

Fiscal year 2019 budget request ................................................ (21,538,000) 

The General Administration account provides funds for the Office 

of the Secretary, seven Assistant Secretaries, and three independent staff offices. The Committee has included bill language to 

make available through September 30, 2020, up to five percent of 

these funds and to permit the transfer of funds in this account to 

the General Operating Expenses, Veterans Benefits Administration 

account. 

Five year development plan.—The Committee is very pleased that 

the Department has provided a Five Year Development Plan 

(FYDP) in its fiscal year 2019 budget. The Committee has asked 

for such a document for years, but has faced resistance in the past. 

The FYPD has proved very useful in analysis of Military Construction budgets and the Committee looks forward to annual review of 

the FYDP in VA budget submissions. 

Quarterly financial information reports.—The bill includes an administrative provision which extends the requirement for submission of the quarterly financial information required in the fiscal 

year 2018 bill and conference report. 

Additional budgetary information.—The Committee continues its 

request that items described in the fiscal year 2015, 2016 and 2017 

House reports continue to be included in the budget justifications 

submitted each year. Further, the Committee directs VA to include 

in its budget justification materials a table for each account that 

shows a five-year funding history, for requested and enacted levels. 

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. 

Financial Management System (FMS) replacement.—The agreement includes $10,800,000 in this account as well as $72,821,000 

in the Information Technology Systems account for development of 


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a new financial management system. The current legacy financial 

management system is 30 years old, and its imminent failure presents significant risks to VA. Unfortunately, the VA agreement to 

use the Department of Agriculture’s (USDA) Federal Shared Services financial management system to develop its FMS has collapsed, and VA is trying to use the contracts established by USDA 

to reconstruct the financial management system it had anticipated 

acquiring through USDA. The Committee continues to be concerned with VA moving forward alone, given the disastrous outcomes of its two previous attempts to create a modern financial 

management system. In the fiscal year 2018 conference report, VA 

was directed to provide a report to the Committee, within 60 days 

of enactment of that Act, which described the components to be included in its planned financial management system, such as acquisition, the cost of the contracts and staffing that VA has acquired 

from USDA, the annual and total costs of the project, and its 

timeline and performance benchmarks. In addition, VA was directed to provide the Committee, on a quarterly basis, a report that 

compares actual progress on the financial management system to 

the performance benchmarks and timeline provided in the first report. The Committee continues to expect the Department to continue this quarterly report throughout fiscal year 2019. The Committee has also assigned its own investigative staff to review the 

system VA plans to develop and to provide the Committee periodic 

reports on the project. 

Management reforms.—In House Report 115–188 the Committee 

was concerned that the Department had not yet implemented hundreds of recommendations that would address ongoing management challenges and directed VA to provide recommendations for 

legislation regarding the roles, responsibilities, and accountability 

of elements and individuals of the Department of Veterans Affairs. 

The Committee looks forward to the submission of this report. 

Implementing the VA Accountability and Whistleblower Protection Act.—To ensure that the authorities granted in the Department of Veterans Affairs Accountability and Whistleblower Protection Act of 2017 are being applied consistently and as intended, the 

Committee directs VA to provide a report no later than 120 days 

after the enactment of this Act. The report should include data on 

the application of such authorities to employees organized by wage 

grade, an assessment of whether such authorities are being disproportionately applied to lower wage grades, and data regarding 

the frequency of appeals when such authorities are applied. The report should also include any available demographic data on overall 

VA workforce terminations since fiscal year 2016. 

Small, minority- and women-owned businesses.—The Committee 

recognizes the need for VA to continue to meet its goals for contracting with minority, disadvantaged, and women-owned businesses. The Committee is concerned that in fiscal year 2016 and 

2017, the Department missed its prime contracting goals for 

women-owned businesses and businesses in HUBZones. In fiscal 

year 2016, the Department missed all of its subcontracting goals 

for women-owned businesses, small disadvantaged businesses, 

service disabled veteran-owned businesses and businesses in 

HUBZones. Therefore, the Committee encourages the Department 

to prioritize awarding contracts to contractors that consistently 


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execute approved small business subcontracting plans. The Committee further urges the Department to prioritize minority-owned 

and disadvantaged contractors and subcontractors. The Committee 

requests a report, within 180 days of enactment of this Act and annually thereafter, detailing the number of contractors which submitted a small business subcontracting plan during the fiscal year. 

This report shall include an analysis detailing which contractors 

successfully implemented subcontracting plans and recommendations on how the Department could better achieve its prime and 

subcontracting goals for small businesses. 

Data on women and minority veterans.—The Committee recognizes the lack of data specific to women and minority veterans 

made available to Congress by VA. The Committee continues to 

recommend, when applicable, that VA display information separately for female and minority veterans in its annual report(s) to 

Congress. 

BOARD OF VETERANS APPEALS

Fiscal year 2018 enacted level ........................................................... $161,048,000 

Fiscal year 2019 budget request ....................................................... 174,748,000 

Committee recommendation in the bill ............................................ 174,748,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... 13,700,000 

Fiscal year 2019 budget request ................................................ – – – 

The bill makes ten percent of this funding available through September 30, 2020. 

The bill also provides the $9,505,000 requested in the Information Technology Systems budget to support the Appeals Modernization initiative. The initiative will convert the Board’s 1980’s-era 

case control and locator system to a new, automated integrated 

community developed suite that is used to process initial disability 

claims. 

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 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 31 percent from 153,513 at the end of 2017 

to 201,816 by the end of 2019. 

Appeals reform.—The Committee is relieved that the historic 

Veterans Appeals Improvement and Modernization Act of 2017, 

signed into law in August, 2017 will provide both VBA and BVA 

with the tools they need to reduce the troubling backlog of appeals. 

Although implementation of the new law will not be complete until 

March, 2019, the Committee is encouraged that both agencies are 

taking steps now to implement some of the Act’s new authorities 

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peals Modernization Program (RAMP), which provides veterans 

with pending disability claims the option to participate in the new 

‘‘three lane’’ appeals process authorized by RAMP during the implementation period. BVA is also testing a process to outsource a large 

majority of the case review process to reduce the administrative 

work currently done by decision-writing attorneys, which pulls 

them from their primary role of writing draft decisions. With the 

appeals received by VBA and BVA increasing dramatically each 

year as the backlog of initial disability claims is reduced, these efforts are vital to containing the volume of pending appeals and 

serving veterans who have waited years, in some cases, for adjudication of their claims. The Committee urges BVA to commit the 

necessary resources to reduce this backlog of appeals. 

Appeals modernization.—The Committee concurs with the recommendations in GAO report 18–352 regarding modernizing and 

improving VA’s appeals process. The VA should articulate a more 

complete and balanced set of goals and measures for monitoring 

and assessing performance on a range of dimensions of success; include key planned activities; articulate interim goals and needed 

resources for, and inter-dependencies among, activities; and identify and mitigate key risks associated with implementing the new 

processes. The Committee directs the Secretary to fully implement 

the GAO’s recommendations to ensure successful implementation of 

the new appeals process. 

Service-connected disability appeals.—The Committee continues 

to remain concerned about the excessive wait times that veterans 

must endure to receive appeals decisions, particularly appeals of 

service-connected disability claims. To assist the Committee in its 

oversight responsibilities, VA is directed to provide an analysis of 

appeals wait times related to service-connected disability claims 

since fiscal year 2014. The analysis should determine the average 

time, by fiscal year, for these appeals to be resolved and highlight 

VA’s efforts to accelerate this appeals resolution process. 

Tele-appeals.—The Committee seeks to reduce the logistical burden for veterans during the claims appeals process. Current law, 

as stipulated in 38 USC 7107, requires that appeals made using 

video teleconferencing equipment be conducted at VA facilities. The 

Committee is interested in understanding the feasibility and cost 

of allowing veterans to conduct such appeals from locations of their 

own choosing, such as their homes. Therefore, the Committee requests a report, no later than 90 days after the enactment of this 

Act, that assesses the statutory, technological, and security issues 

that would need to be addressed to implement such a program. The 

report should include an assessment of currently available technologies and the cost associated with such technologies in the context of implementing such a program. The report should also include recommendations on legislative changes that would be needed to implement such a program. 


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INFORMATION TECHNOLOGY SYSTEMS

(INCLUDING TRANSFER OF FUNDS)

Fiscal year 2018 enacted level ........................................................... $4,055,500,000 

Fiscal year 2019 budget request ....................................................... 4,184,571,000 

Committee recommendation in the bill ............................................ 4,105,500,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... 50,000,000 

Fiscal year 2019 budget request ................................................ (79,071,000) 

The Information Technology Systems account supports 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’ 

health care services and benefits programs. 

Within the account total, the Committee allocates in bill language $1,235,320,000 for pay and associated costs, which is 

$7,900,000 below the budget request; $2,521,650,000 for operations 

and maintenance, which is $39,130,000 below the request; and 

$348,530,000 for development, which is $32,041,000 below the request. The bill makes available five percent of pay and associated 

costs and of operations and maintenance funds until September 30, 

2020. All development funds are available until September 30, 

2020. 

The bill provides $32,013,000 for the Veterans Benefits Management System (in addition to the $36,212,000 which is provided for 

VBMS in the General Operating Expenses, Veterans Benefits Administration account); $72,821,000 for the replacement of the Financial Management System, in addition to the $10,800,000 provided in General Administration; $22,081,000 for replacement of 

the NCA burial operations support system; and $9,505,000 for the 

Board of Veterans Appeals modernization effort. 

The Committee continues to include bill language prohibiting obligation or expenditure of funds for information technology systems 

development 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 projects 

upon prior notification to, and approval by, the Committees. The 

bill continues to include language indicating that funds for development 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. 


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INFORMATION TECHNOLOGY DEVELOPMENT PROJECTS 

(in thousands of dollars) 

Project Fiscal year 2019 

Budget request 

Committee Recommendation 

Clinical Applications .................................................................................................... $32,479 $27,479 

Health Management Platforms .................................................................................... 70,391 60,391 

Benefits Systems ......................................................................................................... 129,615 112,574 

Memorial Affairs .......................................................................................................... 18,800 18,800 

Other IT Systems ......................................................................................................... 78,571 78,571 

Cybersecurity ................................................................................................................ 17,000 17,000 

Information/Infrastructure Management ..................................................................... 33,715 33,715 

Total, Development ............................................................................................. 380,571 348,530 

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 funding 

chart above and provide an explanation for any differences in excess of $1,000,000. 

Appointment scheduling system.—The Committee remains concerned about patient scheduling challenges and seeks to understand the Department’s plan for a solution that will improve veteran access to care, shorten veteran wait times, allow the VA to 

track and manage patient progress throughout the care continuum, 

and improve resource utilization across the VA health care system. 

The Committee understands that a scheduling system will be a 

component of the new EHR program and that VA plans to deploy 

this new system to its first facilities within 18 months of the EHR 

program’s contract award and to all its facilities within 10 years of 

contract award. The Committee also understands that VA is conducting pilot programs involving commercial off-the-shelf solutions 

scheduling systems to assess if they provide substantial value over 

its current interim systems. To ensure that the immediate and 

long-term scheduling needs of our veterans are addressed, the 

Committee directs VA to provide the results of its evaluation of the 

pilot programs as soon as those evaluations are complete. Further, 

the Committee requests a report, within 90 days of enactment of 

this Act, that evaluates the cost and benefits of its interim scheduling systems, the commercial solutions considered in its pilot programs, and the EHR scheduling system, based on current contract 

requirements. 

Cybersecurity implementation.—The Committee is concerned 

about the pace at which implementation of cybersecurity best practices are occurring at the Department, especially as VA and DOD 

continue to integrate VA electronic health information. The Committee directs the Department to identify for the Committee steps 

it has taken to protect data and patient records across physical, 

virtual, and mobile networks and the devices and systems attached 

to these networks. If such review warrants, the Department should 

consider a layered defensive strategy that includes perimeter security, segmentation within the data center to increase lateral security, and data and application protections. The Committee also 

urges VA to ensure that patient records being transferred from 

DOD to VA have the same level of security and data-level protections as provided by DOD. 


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Information technology solutions.—The Committee is encouraged 

by VA’s efforts to modernize its electronic health record, but remains concerned about the use of critical resources on the development of internal Information Technology (IT) applications. To improve patient health outcomes and ensure the best possible care for 

veterans, the Committee urges VA to complete its review of its inventory of IT solutions and standardize best practices and proven 

technologies across the continuum of care for veterans. The Committee directs the Secretary to provide a report, no later than 90 

days after enactment of this Act, outlining the Department’s plan 

to evaluate and incorporate these IT applications to improve and 

promote veteran-centered care. 

VETERANS ELECTRONIC HEALTH RECORD

Fiscal year 2018 enacted level ........................................................... $782,000,000 

Fiscal year 2019 budget request ....................................................... 1,207,000,000 

Committee recommendation in the bill ............................................ 1,207,000,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... 425,000,000 

Fiscal year 2019 budget request ................................................ – – – 

The Veterans Electronic Health Record is a unified account designed to manage the effort to develop an electronic health record 

that will access seamlessly the records of veterans in the VA system and those of DOD and of community providers. The VA system 

is the same as the one chosen by DOD and is planned to be rolled 

out with the same timeline and geographic areas as DOD in order 

to realize cost efficiency savings. Within the total funding, the bill provides $675,000,000 for the electronic health record contract, $120,000,000 for program management, and $412,000,000 for infrastructure support. Funding is 

made available for three years because of the uncertainty of the 

timing of obligations in this substantial new effort. 

The Department has committed in future years to provide about 

30 percent of the total cost of this ten-year project. The Committee 

expects that this pledge will be maintained throughout Department 

leadership changes. 

The bill does not include the transfer language requested by the 

Administration. This account is intended to be the single source of 

funding within VA for the electronic health record effort. No authority is provided for funds from other VA accounts to be transferred to this account or for funds from this account to be transferred to other accounts. Consistent with the effort to centralize financial management of the development of the electronic health 

record, the Committee continues to direct the Department to place 

top management of the project at the headquarters level above either the VHA or the Office of Information Technology, in the Office 

of the Deputy Secretary. 

The bill language for this account continues to require the Secretary to submit a report quarterly to the Committees detailing obligations, expenditures, and deployment strategy by facility. In addition, the Committee repeats the fiscal year 2018 directive for 

GAO to perform quarterly performance reviews of the VA electronic 

health record deployment so that the Committees are kept abreast 

of important issues such as cost and operational capability. It is expected that this quarterly reporting will avail the Committees and 


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VA with timely information to properly oversee this effort and address important issues. 

The Committee remains concerned that the effort to deploy a different type of electronic record than the VistA system that VA physicians are accustomed to could run into major resistance. Other 

major electronic health record system start-ups have failed in the 

face of internal resistance. The Committee urges VA to focus sufficient resources and attention to this change management challenge, which could be more difficult than the technical issues of implementing the new record. 

Delays in contract finalization.—The Committee was encouraged 

that VA finally decided to use the same EHR system as DOD, since 

it is vital that the two systems be interoperable. Last July, the Secretary announced that Cerner Corporation, which had participated 

in the DOD EHR contract, had received the sole source contract to 

develop the VA EHR. The Committee had a hearing last November 

in closed session to learn the details of the contract, its cost, design 

features, and anticipated project rollout across the VA network. 

Subsequently, the Committee provided the initial $782,000,000 

funding for the project, with the expectation that the Cerner contract would be signed soon after that funding became available. 

However, the contract may not be signed until the new Secretary 

is confirmed. The Committee is concerned that further delays could 

jeopardize VA’s plans to roll out the EHR in the same regions and 

under the same timeframe as DOD is using for its new EHR system, as well as increase the program’s cost. With a decade of futile 

effort and billions of dollars spent to develop the VA EHR, the 

agency needs to complete its contract as soon as possible. The Committee will continue to monitor VA expenditures for the new EHR, 

and if it is clear that delays in project management are slowing obligations, funding levels may be revisited during conference. 

Medical records portability.—The Committee supports veterans 

having real-time, seamless, and portable access to all of their medical records. As such, the Committee urges VA to develop, as part 

of its new EHR system, the means by which veterans can have secure, portable access to their own medical records. 

OFFICE OF INSPECTOR GENERAL

Fiscal year 2018 enacted level ........................................................... $164,000,000 

Fiscal year 2019 budget request ....................................................... 172,054,000 

Committee recommendation in the bill ............................................ 172,054,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... 8,054,000 

Fiscal year 2019 budget request ................................................ – – – 

The Office of Inspector General (OIG) was established by the Inspector General Act of 1978 and is responsible for the audit, investigation, and inspection of all 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 up to ten percent of this funding available until 

September 30, 2020. 


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CONSTRUCTION, MAJOR PROJECTS

Fiscal year 2018 enacted level ........................................................... $512,430,000 

Fiscal year 2019 budget request ....................................................... 1,127,486,000 

Committee recommendation in the bill ............................................ 1,127,486,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... 615,056,000 

Fiscal year 2019 budget request ................................................ (– – –) 

The Construction, Major Projects appropriation provides for constructing, altering, extending, and improving any of the facilities 

under the jurisdiction 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 $480,000,000 of 

these funds available for a five-year period. In addition, Sec. 238 provides a total of $850,000,000 in additional funding for this account as part of the infrastructure initiative—$750,000,000 for seismic corrections and $100,000,000 for 

cemetery Major Construction. 

In past years, this appropriations bill repeated language that is 

in permanent law requiring that all major construction projects 

costing more than $100,000,000 be managed by a non-VA government entity such as the Army Corps of Engineers. Because this 

policy is now well-established, the Committee no longer feels a 

need to duplicate the language. However, the Committee intends to 

continue its oversight of the quality of the outside entity management and will continue to receive quarterly briefings on each of the 

large construction projects. 

The chart below reflects the Administration’s budget request for 

Major Construction projects and includes the Committee’s recommendation for each. 

CONSTRUCTION, MAJOR PROJECTS 

(in thousands of dollars) 

Location and description Request Recommended 

Veterans Health Admin. (VHA): 

St. Louis, MO, medical facility improvements and cemetery expansion ........... 34,400 34,400 

Canandaigua, NY, construction and renovation ................................................ 190,000 190,000 

Dallas, TX, spinal cord injury facility ................................................................ 135,686 135,686 

North Chicago, IL, renovate building #4 ............................................................ 6,000 6,000 

Oklahoma, OK new surgical intensive care unit ............................................... 10,800 10,800 

Advance Planning and Design Fund: various locations .................................... 95,000 95,000 

Asbestos: various locations ................................................................................ 15,000 15,000 

Major Construction Staff: various locations ...................................................... 27,500 27,500 

Hazardous Waste: various locations .................................................................. 26,200 26,200 

Judgment Fund: various locations ..................................................................... 25,000 25,000 

Non-Dept. Fed. Entity Project Management Support ......................................... 38,700 38,700 

Seismic Corrections: various location ................................................................ 400,000 400,000 

Total, VHA ........................................................................................................... 1,004,286 1,004,286 

National Cemetery Admin. (NCA): 

Ohio Western Reserve: gravesite expansion ....................................................... 29,000 29,000 

Great Lakes, MI: gravesite expansion ................................................................ 35,200 35,200 

Cape Canaveral, FL: gravesite expansion .......................................................... 38,000 38,000 

Advance Planning and Design Fund .................................................................. 10,000 10,000 

NCA Land Acquisition ......................................................................................... 5,000 5,000 

Total, NCA ........................................................................................................... 117,200 117,200 

General Admin.: 

Staff Offices Advance Planning Fund ................................................................ 6,000 6,000 

Total, Construction Major Projects ............................................................ $1,127,486 $1,127,486 


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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 

$7,000,000 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 documents.—The Committee reminds the Department of the requirement in Sec. 258 of Division A of P.L. 114– 

223 regarding specific materials to be included in Major Construction budget justification documents for fiscal year 2017 and each 

fiscal year thereafter. 

Joint VA and U.S. Army Corps of Engineers projects.—While the 

Committee has strongly endorsed the management of large VA construction projects by the U.S. Army Corps of Engineers (‘‘the 

Corps’’), as required by section 502 of Public Law 114–58, it recognizes that the transition to this new process has created some unavoidable delays in construction schedules. To better understand 

the timetable and construction issues associated with each VA 

project managed by the Corps, the Committee requests, within 60 

days of enactment of this Act, the initiation of quarterly reports on 

each VA project managed by the Corps. 

Market assessment.—The Committee supports VA’s efforts to obtain analysis that provides a more holistic view of VA facilities and 

thereby allows the Department to make more informed, data driven decisions about its facilities and buildings. The Committee recognizes that annual analysis and benchmarking across the Department’s facilities will provide an invaluable tool for long-term system-wide planning, needs identification, and cost management for 

the Department. The Committee, therefore, encourages the Department to utilize an independent, third-party to provide facilities 

analysis, benchmarking and recommendations for all VHA hospitals, nursing homes, domiciliary facilities, and other necessary facilities. 

Training for VA personnel engaged in facility management.—The 

Committee continues to be concerned by the lack of training and 

certification provided to engineering, construction and facility management staff with regard to building operations and maintenance. 

The Committee looks forward to receiving the report from VA on 

this topic as requested in House Report 115–188. 

Parking facilities.—In H. Rpt. 115–188, the Committee noted 

that numerous parking facility projects throughout the Strategic 

Capital Investment Planning (SCIP) list are often skipped for more 

traditional VA construction projects, which has caused a backlog in 

parking facilities. In response, the Committee directed VA to provide information regarding how parking facility projects are rated, 

a timeline for completion of these projects, their cost, and any notable actions taken by VA medical centers to address parking issues. 

However due to the late passage of the fiscal year 2018 bill, this 

reporting requirement remains incomplete. The Committee reiterates its interest in this issue and looks forward to the final report. 

Public-private partnerships.—The Committee applauds VA for 

engaging in partnerships with academic institutions to facilitate 


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closer scientific collaboration, while increasing the research space 

available to VA. Such partnerships are important in expanding the 

Department’s research investment to leverage non-federal initiatives, which provide the opportunity for strong co-location of VA 

and university biomedical scientists for translational investigation. 

Such co-location and collaboration may enable precision medicine 

outcomes for wounded warriors and other high-at-risk veteran populations. Therefore, the Committee encourages VA to expedite consideration of proposals for the Department to co-locate its research 

facilities with academic institutions that are engaged in the conduct of multi-disciplinary investigations related to veterans and 

wounded warriors, including those related to medicine, engineering, and veterinary science. 

CONSTRUCTION, MINOR PROJECTS

Fiscal year 2018 enacted level ........................................................... $342,570,000 

Fiscal year 2019 budget request ....................................................... 706,889,000 

Committee recommendation in the bill ............................................ 649,514,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... 306,944,000 

Fiscal year 2019 budget request ................................................ (57,375,000) 

The Construction, Minor Projects appropriation provides for constructing, altering, extending, and improving any of the facilities 

under the jurisdiction of, 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. 

In addition to this funding, $350,000,000 is provided in Sec. 238 for VHA Minor Construction projects as part of a $2,000,000,000 

infrastructure initiative. A similar initiative provided $425,000,000 

in additional funds for this account in fiscal year 2018. 

As with the Major Construction account, the Committee recommendation makes these funds available for a five-year period. 

Ambulatory surgical centers (ASC).—The Committee is concerned 

about VA’s ambulatory surgical capacity and believes a focus on 

ambulatory surgical services, as provided by ASCs, has the potential to provide substantial cost savings and improve health outcomes for veterans. However, the Committee understands that 

VHA does not consider ASCs to be one of its foundational services 

and, therefore, does not place any special priority on construction 

of ASCs during the SCIP process. To better understand the role of 

ASCs, the Committee directs VHA to provide a report, no later 

than 60 days after enactment of this Act, which assesses whether 

assigning a specific prioritization to ASCs during the SCIP process 

would provide substantial cost savings and improve health outcomes for veterans by increasing VHA’s ambulatory surgical capacity. The report should also include a timeline for completion of 

pending ambulatory surgical center projects, their costs, and any 

notable actions taken by VA medical centers to address ambulatory 

surgical needs. 

Construction of housing for rural homeless veterans.—The Department has made great efforts to find suitable housing for homeless veterans and their families. However, more non-traditional efforts should be made to eliminate this problem. For example, some 

cities and towns have started pilot programs using Micro or ‘‘Tiny 


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Homes’’ to help deal with homelessness. However, due to the lack 

of legislative authority the VA is unable to utilize tiny homes for 

homeless veterans. The Committee is interested in what statutory 

changes would be needed for VA to be able purchase and construct, 

single unit, Micro or ‘‘Tiny Homes’’ for homeless veterans. This approach could provide a pathway to stable housing for veterans. The 

Committee directs VA to identify the necessary statutory changes 

in a report no later than 60 days after enactment of this Act. 

Impact of changes to Historic Preservation Tax Credit to historic 

VA facilities.—The Committee encourages VA to work with Enhanced-Use Lease (EUL) project sponsors, the Internal Revenue 

Service, local VA, and any other relevant officials to address the 

adverse impacts that changes to the Historic Preservation Tax 

Credit made by Public Law 115–97, are having on EUL projects to 

renovate and rehabilitate historic VA facilities. The Committee is 

aware that some of the recent tax law changes have made it harder 

to complete longstanding projects because they reduced the value 

of tax credits needed to bring the projects to fruition, resulting in 

a funding gap. For example, VA selected a Preferred Developer to 

carry out a EUL to renovate historic VA buildings in July 2016 but 

still has not yet formally signed the lease. Without action by VA, 

this critical project to provide permanent supportive housing for 

veterans and their families that are homeless, or at risk of homelessness, is now at risk due to additional and unanticipated costs 

directly related to how the historic preservation tax credit can be 

used for the project. Therefore, the Committee urges VA to work 

with interested parties to find a solution, including developing options to directly provide capital funding, technical, and other assistance to prevent the loss of benefits to veterans should these 

projects stall as a direct result of changes beyond the sponsor’s control that were unforeseen when these projects were put out to bid. 

GRANTS FOR CONSTRUCTION OF STATE EXTENDED CARE FACILITIES

Fiscal year 2018 enacted level ........................................................... $110,000,000 

Fiscal year 2019 budget request ....................................................... 150,000,000 

Committee recommendation in the bill ............................................ 150,000,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... 40,000,000 

Fiscal year 2019 budget request ................................................ – – – 

In addition to funding provided in this account, as part of a 

$2,000,000,000 VA infrastructure initiative, the fiscal year 2018 appropriations bill provided $575,000,000 for State homes. This funding, in conjunction with the regular fiscal year 2018 appropriation, 

was sufficient to clear the longstanding backlog of approved State 

applications. 

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. 


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GRANTS FOR CONSTRUCTION OF VETERANS CEMETERIES

Fiscal year 2018 enacted level ........................................................... $45,000,000 

Fiscal year 2019 budget request ....................................................... 45,000,000 

Committee recommendation in the bill ............................................ 45,000,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... – – – 

Fiscal year 2019 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. 

ADMINISTRATIVE PROVISIONS

The bill includes 38 administrative provisions, all of which were 

included in the fiscal year 2018 bill in some form. 

(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 2018. 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 2018 for ‘‘Compensation and Pensions’’, ‘‘Readjustment Benefits’’, and ‘‘Veterans Insurance and Indemnities’’ 

for payment of accrued obligations recorded in the last quarter of 

fiscal year 2018. 

The bill includes section 207 allowing for the use of fiscal year 

2019 funds to pay prior year obligations resulting from implementation of sections 3328(a), 3334, and 3712(a) of title 31, United 

States Code. 


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(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, the Office of Employment Discrimination Complaint Adjudication, the Office of Accountability and Whistleblower Protection, and the Office of Diversity 

and Inclusion can charge other offices and accounts of the Department for services provided. 

The bill includes section 211 requiring the Department to collect 

current and accurate third-party reimbursement information for 

the purposes of third-party insurance collections. If persons receiving care or medical services do not disclose this information, the 

Department is allowed to bill them reasonable charges for services 

provided. 

(INCLUDING TRANSFER OF FUNDS)

The bill includes section 212 allowing the Department to use enhanced-use lease funds for construction and alteration of medical 

facilities. 

The bill includes section 213 allowing the Department to use the 

Medical Services appropriation for expenses related to the broader 

mission of medical care to veterans. 

(INCLUDING TRANSFER OF FUNDS)

The bill includes section 214 allowing the Department to transfer 

Medical Care Collections to the ‘‘Medical Services’’ and ‘‘Medical 

Community Care’’ accounts to be used for veterans medical care 

and makes those funds available until expended. 

The bill includes section 215 allowing veterans who reside in 

Alaska to obtain medical services from medical facilities supported 

by the Indian Health Service or tribal organizations, and provides 

for reimbursement for those services from VA. 

(INCLUDING TRANSFER OF FUNDS)

The bill includes section 216 allowing the Department to transfer 

the proceeds received from the transfer of real property deposited 

into the VA Capital Asset Fund to the major and minor construction appropriations accounts and makes those funds available until 

expended. 

The bill includes section 217 requiring the Secretary to submit 

quarterly reports to the Committees on Appropriations of both 

Houses of Congress on the financial status of the Veterans Health 

Administration. The Administration proposed to delete this provision. 


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(INCLUDING TRANSFER OF FUNDS)

The bill includes section 218 prohibiting the Department from increasing total resources of the Information Technology appropriation by more than ten percent by transferring funding from the 

other VA accounts and requires the Department to receive approval 

from the Committees on Appropriations before such transfer. The 

Administration proposal to modify this provision is not adopted. 

(INCLUDING TRANSFER OF FUNDS)

The bill includes section 219 permitting the transfer of 

$307,609,000 of fiscal year 2020 funding appropriated for 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 220 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 221 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 222 prohibiting funds from being used 

to replace the current system by which VISNs select and contract 

for diabetes monitoring supplies and equipment. The administration proposal to delete this provision is not adopted. 

The bill includes section 223 requiring the Secretary to notify the 

Committees on Appropriations of both Houses of Congress of all bid 

savings when identified in Major Construction projects that total at 

least $5,000,000 or 5 percent of the programmed amount of the 

project. The Administration proposal to delete this provision is not 

adopted. 

The bill includes section 224 prohibiting the original scope of 

work for a Major Construction project from being increased above 

the scope specified for that project in the original justification data 

provided to Congress unless approved by the Committees. The Administration proposal to delete this provision is not adopted. 

The bill includes section 225 requiring a quarterly report from 

each VBA regional office on pending disability claims, both initial 

and supplemental; error rates; the number of claims processing 

personnel; corrective actions taken; training programs; and review 

team audit results. In addition, the bill requires quarterly reporting on pending appeals at VBA, as well as BVA. The Administration proposal to delete this provision is not adopted. 

The bill includes section 226 requiring advance written notification to the Committees on Appropriations of both Houses of Congress 15 days prior to organizational changes which result in the 

transfer of 25 or more full-time equivalent staff from one organizaVerDate Sep 11 2014 05:48 May 03, 2018 Jkt 028054 PO 00000 Frm 00067 Fmt 6659 Sfmt 6602 E:\HR\OC\B054.XXX B054

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tional unit to another. The Administration proposal to delete this 

provision is not adopted. 

The bill includes section 227 requiring the Secretary to provide, 

on a quarterly basis to the Committees on Appropriations of both 

Houses of Congress, notification of any single national outreach 

and awareness marketing campaign in which obligations exceed 

$2,000,000. The Administration proposal to delete this provision is 

not adopted. 

(INCLUDING TRANSFER OF FUNDS)

The bill includes section 228 permitting the transfer to ‘‘Medical 

Services’’ from any discretionary program except ‘‘General Operating Expenses, Veterans Benefits Administration’’ upon approval 

of 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. 

(INCLUDING TRANSFER OF FUNDS)

The bill includes section 229 permitting the transfer of funds between the ‘‘Board of Veterans Appeals’’ and ‘‘General Operating Expenses, Veterans Benefits Administration’’ upon approval of both 

Appropriations Committees. The budget request to modify this provision is not adopted. 

The bill includes section 230 prohibiting the reprogramming of 

funds exceeding $7,000,000 among the major construction projects 

unless both Appropriations Committees approve the request. The 

Administration proposal to delete this provision is not adopted. 

The bill includes section 231 requiring the Secretary to ensure 

that the toll-free suicide hotline provides immediate assistance 

from a trained professional and adheres to all requirements of the 

American Association of Suicidology. The administration request to 

delete this provision is not adopted. 

The bill includes section 232 restricting funds from being used to 

close certain medical facilities in the absence of a national realignment strategy. The budget request to delete this provision is not 

adopted. 

The bill includes section 233 requiring VA to use the mammography screening guidelines announced by the Secretary on May 10, 

2017 through January 1, 2024. The administration request to delete this provision is not adopted. 

The bill includes section 234 allowing the use of Medical Services 

funding for assisted reproductive technology treatment and adoption reimbursement for veterans and their spouses if the veteran 

has a service-connected disability that results in being unable to 

procreate without such fertility treatment. The bill retains the language for this provision included in the 2018 bill rather than returning to the 2017 language, as the Administration proposed. 

The bill includes section 235 prohibiting any funds being used in 

a manner that is inconsistent with statutory limitations on outsourcing. 

The bill includes section 236 which prohibits funds from being 

used to transfer funding from the Filipino Veterans Equity Compensation Fund to any other VA account. 


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The bill includes section 237 prohibiting the use of canines in VA 

research unless: the scientific objectives of the study can only be 

met by using canines; the study has been directly approved by the 

Secretary; and the study is consistent with the revised VA canine 

research policy document released in December, 2017. The bill includes section 238 providing $2,000,000,000 for infra- structure improvements, allocated between $750,000,000 for seismic corrections, $800,000,000 for non-recurring maintenance, 

$100,000,000 in Major Construction for National Cemetery Administration projects, and $350,000,000 in Minor Construction for Veterans Health Administration projects. 

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. 

FOREIGN CURRENCY FLUCTUATIONS ACCOUNT

The recommendation includes such sums as necessary for the 

Foreign Currency Fluctuations Account. 

UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS

SALARIES AND EXPENSES

The recommendation includes $33,600,000 for Salaries and Expenses for the United States Court of Appeals for Veterans Claims. 

The fiscal year 2018 omnibus included bill language requiring a 

feasibility study prior to the purchase of a new courthouse. The 

study has not been completed, therefore the recommendation does 

not include the funds requested for a new courthouse. 

DEPARTMENT OF DEFENSE—CIVIL CEMETERIAL EXPENSES, ARMY

SALARIES AND EXPENSES

The recommendation includes $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, to improve 

procurement and accountability. 

CONSTRUCTION

The recommendation includes $73,855,000 for planning and design and construction of Southern Expansion to remain available 

until expended. 

Southern Expansion.—The recommendation includes $73,855,000 

for planning and design and construction of Southern Expansion to 

remain available until expended. The Committee notes that Public 

law 115–141 included $167,000,000 above the budget request for 

the Southern Expansion and road realignments to extend the life 


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of the cemetery. For fiscal year 2019 the bill again includes additional funds for Southern Expansion which brings the total funds 

available for this project to $240,855,000, well short of the projected $300,000,000 plus that will be needed to complete this 

project. The Committee notes that the Office of Management and 

Budget will need to dedicate resources in future budget submissions to ensure that the life of our Nation’s most prestigious cemetery is extended into the 2050 timeframe. 

ARMED FORCES RETIREMENT HOME

TRUST FUND

The recommendation includes $64,300,000 for the Armed Forces 

Retirement Home (AFRH), which is the same as requested, although $22,000,000 of the total is provided from the general fund 

of the Treasury, and not the Trust Fund. 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 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. 

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. The Committee again asserts that the use of the General Fund is not a long-term solution, 

and AFRH is directed to work with DOD to continue to develop alternatives during fiscal year 2019, to be included in the fiscal year 

2020 budget request. In addition, AFRH is directed to report to the 

Committee quarterly, on the Trust Fund balance, receipts and expenditures, and the progress of its efforts to lease property at the 

Washington, D.C. facility. Further, AFRH is directed to submit a 

report to the Committee on business practice reforms, revised funding models, and long-term plan to stabilize the Armed Forces Retirement Home Trust Fund. 

ADMINISTRATIVE PROVISION

The bill includes one provision that was in effect in fiscal year 

2018. The administrative provision included in the bill as follows: 

The bill includes section 301 permitting funds from concessions 

at Army National Military Cemeteries to be used to support activities at the Cemeteries. 

TITLE IV 

OVERSEAS CONTINGENCY OPERATIONS 

DEPARTMENT OF DEFENSE

Fiscal year 2018 enacted level ........................................................... $750,000,000 

Fiscal year 2019 budget request ....................................................... 921,420,000 

Committee recommendation in the bill ............................................ 921,420,000 

Comparison with: 

Fiscal year 2018 enacted level ................................................... 171,420,000 

Fiscal year 2019 budget request ................................................ – – – 


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The Committee recommendation includes Overseas Contingency 

Operations, for military construction projects and planning and design related to the European Deterrence Initiative (EDI). 

MILITARY CONSTRUCTION, ARMY

The recommendation includes $261,250,000 for Army military 

construction and planning and design for European Deterrence Initiative projects. 

MILITARY CONSTRUCTION, NAVY AND MARINE CORPS

The recommendation includes $227,320,000 for Navy and Marine 

Corps military construction and planning and design for European 

Deterrence Initiative projects. 

MILITARY CONSTRUCTION, AIR FORCE

The recommendation includes $345,800,000 for Air Force military construction and planning and design for European Deterrence 

Initiative projects. 

MILITARY CONSTRUCTION, DEFENSE-WIDE

The recommendation includes $87,050,000 for Defense-Wide 

Overseas Contingency Operations and planning and design for Special Operations Command and European Deterrence Initiative 

projects. 

ADMINISTRATIVE PROVISIONS

The bill includes one provision that was in effect in fiscal year 

2018 and includes one new administrative provision. The administrative provisions included in the bill are as follows: 

The bill includes section 401 that designates that funding shall 

be available only if the President so designates all amounts and 

transmits such designations to Congress. 

The bill includes section 402 prohibiting obligation or expenditure of planning and design funds for any project associated with 

European Deterrence Initiative in this title until a list of projects 

is submitted to the congressional defense committees. 

TITLE V 

GENERAL PROVISIONS 

The bill includes a total of 13 provisions: 12 provisions that are 

effective in fiscal year 2018 and a new provision 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. 


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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. 

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 continental United States for the purpose of housing any individual who has been detained at the United States Naval Station, 

Guantanamo Bay, Cuba. 

The bill includes section 513 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: 


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DEPARTMENT/ACTIVITY

AMOUNTS RECOMMENDED FOR RESCISSION

Department of Defense, Military Construction, Air Force (Sec. 

126) .................................................................................................. $31,158,000 

Department of Defense, NATO Security Investment Program 

(Sec. 126) ......................................................................................... 25,000,000 

Department of Defense, Home Owners Assistance Program (Sec. 

126) .................................................................................................. 15,000,000 

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 that allows transfer of funds from ‘‘Military 

Construction, Defense-Wide’’ to other military construction accounts and family housing. 

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 $18,047,000 in fiscal year 2020 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 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 2019 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 Community Care, 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 funding up to $73,694,000 to be 

transferred to General Administration and Information Technology 


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Systems from any funds appropriated in fiscal year 2019 to reimburse four headquarters offices 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 and Medical Community 

Care accounts. 

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 year 

2020 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 


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and which might, under some circumstances, be construed as 

changing the application of existing law. 

Language is included in various parts of the bill to allow the Secretary of Defense to exceed certain limitations upon notification to 

the Committee. 

Language is included in various parts of the bill to allow funding 

to be used for official reception and representation expenses. 

Language is included in various parts of the bill to enable various appropriations to remain available for more than one year for 

some programs for which the basic authority legislation does not 

presently authorize such extended availability. 

Language is included in various parts of the bill to permit the 

transfer of funds to other accounts. 

Language is included under Title I to prohibit payments for 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. 


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Language is included under Title I to allow funds to be expended 

on military construction projects for four fiscal years after enactment under certain circumstances. 

Language is included under Title I to allow construction funds to 

be transferred to Housing Improvement Funds. 

Language is included under Title I to allow for the transfer of 

BRAC funds to the Homeowners Assistance Program. 

Language is included under Title I to limit funds for the operation and maintenance of family housing to those provided in this 

appropriation and to limit amounts expended on repairs of general 

and flag officer quarters under certain circumstances. 

Language is included under Title I to allow funds in the Ford Island Improvement Account to be available until expended for certain purposes. 

Language is included under Title I to allow for the transfer of expired funding to the Foreign Currency Fluctuation Account under 

certain circumstances. 

Language is included under Title I 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 providing additional funds for 

Military Construction, Army. 

Language is included under Title I providing additional funds for 

Military Construction, Navy and Marine Corps. 

Language is included under Title I providing additional funds for 

Military Construction, Air Force. 

Language is included under Title I providing additional funds for 

Military Construction, Army National Guard. 

Language is included under Title I providing additional funds for 

Military Construction, Air National Guard. 

Language is included under Title I providing additional funds for 

Military Construction, Army Reserve. 

Language is included under Title I providing additional funds for 

Military Construction, Air Force Reserve. 

Language is included under Title I that rescinds funds from prior 

year appropriations Acts. 

Language is included under Title I defining the congressional defense committees. 

Language is included under Title I to prohibit closure or realignment of Naval Station, Guantanamo Bay, Cuba. 

Language is included under Title I limiting the movement of any 

element of the Rapid Engineer Deployable Heavy Operational Repair Squadron Engineer outside the United States. 

Language is included under Title I to require funds appropriated 

shall be immediately available and allotted to contract for the full 

scope of authorized projects. 

Language is included under Title I providing additional funds for 

enhancing force protection and safety at Military Installations. 

Language is included under Title II to require that the Secretary 

of Veterans Affairs establish a priority for treatment of veterans 


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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 projects in the Information Technology Systems account. 

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 associated with life insurance programs from excess program revenues, 

allowing reimbursement from enhanced-use leases and for certain 

services, requiring notification of construction bid savings, limiting 

reprogramming amount of major construction projects, restricting 

changes in the scope of major construction projects, requiring disclosure of insurance and income information, allowing a recovery 

audit collection program, allowing veterans in the State of Alaska 

to use Indian Health Service facilities under certain conditions, 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 prohibiting funds from being 

used to close hospitals, domiciliaries, or clinics, or conduct environmental assessment or diminish services in the Veterans Integrated 

Service Network 23 as part of a realignment of VA services until 

the Secretary provides a report that includes a national realignment strategy, a cost benefit analysis, and an inventory of buildings with historic designation. 

Language is included under title II to allow covered veterans and 

their spouses, under certain conditions, to receive assisted reproductive technology services and adoption reimbursement. 

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. 


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Language is included under Title III Armed Forces Retirement 

Home to permit payment from the general fund of the Treasury to 

the Trust Fund. 

Language is included under Title III to allow for the use of concession fees. 

Language is included under Title IV providing Overseas Contingency Operations funding with an emergency designation. 

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 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. 

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. 

APPROPRIATIONS NOT AUTHORIZED BY LAW


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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. 

FULL COMMITTEE VOTES

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

In compliance with clause 3(e) of rule XIII of the Rules of the 

House of Representatives, changes in existing law made by the bill, 

as reported, are shown as follows (existing law proposed to be omitted is enclosed in black brackets, new matter is printed in italics, 

existing law in which no change is proposed is shown in roman): 

None. 

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. 

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: 

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: 

COMPARATIVE STATEMENT OF NEW BUDGET AUTHORITY AND 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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(107) 

MINORITY VIEWS 


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