department of veterans affairs - the white … · the department of veterans affairs [: provided...

DEPARTMENT OF VETERANS AFFAIRS

VETERANS HEALTH ADMINISTRATIONFederal Funds

MEDICAL SERVICES

For necessary expenses for furnishing, as authorized by law, inpatient and outpatientcare and treatment to beneficiaries of the Department of Veterans Affairs and veteransdescribed in section 1705(a) of title 38, United States Code, including care andtreatment in facilities not under the jurisdiction of the Department, and includingmedical supplies and equipment, bioengineering services, food services, and salariesand expenses of healthcare employees hired under title 38, United States Code, aidto State homes as authorized by section 1741 of title 38, United States Code, assist-ance and support services for caregivers as authorized by section 1720G of title 38,United States Code, loan repayments authorized by section 604 of the Caregiversand Veterans Omnibus Health Services Act of 2010 (Public Law 111–163; 124 Stat.1174; 38 U.S.C. 7681 note), and hospital care and medical services authorized bysection 1787 of title 38, United States Code; [$1,078,993,000] $1,031,808,000,which shall be in addition to funds previously appropriated under this heading thatbecome available on October 1, [2016] 2017; and, in addition, [$44,886,554,000]$49,161,165,000, plus reimbursements, shall become available on October 1, [2017]2018, and shall remain available until September 30, [2018] 2019: Provided, That,of the amount made available on October 1, [2017] 2018, under this heading,$1,400,000,000 shall remain available until September 30, [2019] 2020: Providedfurther, That, notwithstanding any other provision of law, the Secretary of VeteransAffairs shall establish a priority for the provision of medical treatment for veteranswho have service-connected disabilities, lower income, or have special needs:Provided further, That, notwithstanding any other provision of law, the Secretaryof Veterans Affairs shall give priority funding for the provision of basic medicalbenefits to veterans in enrollment priority groups 1 through 6: Provided further,That, notwithstanding any other provision of law, the Secretary of Veterans Affairsmay authorize the dispensing of prescription drugs from Veterans Health Adminis-tration facilities to enrolled veterans with privately written prescriptions based onrequirements established by the Secretary: Provided further, That the implementationof the program described in the previous proviso shall incur no additional cost tothe Department of Veterans Affairs[: Provided further, That the Secretary of Veter-ans Affairs shall ensure that sufficient amounts appropriated under this heading formedical supplies and equipment are available for the acquisition of prosthetics de-signed specifically for female veterans: Provided further, That the Secretary ofVeterans Affairs shall provide access to therapeutic listening devices to veteransstruggling with mental health related problems, substance abuse, or traumatic braininjury]. (Military Construction, Veterans Affairs, and Related Agencies Appropri-ations Act, 2017.)

Special and Trust Fund Receipts (in millions of dollars)

2018 est.2017 est.2016 actualIdentification code 036–0160–0–1–703

9,3051,723292Balance, start of year ....................................................................0100Receipts:

Current law:456535631Pharmaceutical Co-payments, MCCF ....................................1130

115109100Medical Care Collections Fund, Third Party Prescription

Claims ..............................................................................1130

.................21Enhanced-use Lease Proceeds, MCCF ...................................1130204205190First Party Collections, MCCF ................................................1130

2,4312,4022,544Third Party Collections, MCCF ...............................................1130444Parking Fees, MCCF ...............................................................1130

636161Compensated Work Therapy, MCCF ........................................1130232MCCF, Long-term Care Copayments ......................................1130221Payments from Compensation and Pension, MCCF ...............1140

3,2773,3233,534Total current law receipts ..................................................1199

3,2773,3233,534Total receipts .............................................................................1999

12,5825,0463,826Total: Balances and receipts .....................................................2000Appropriations:

Current law:–3,271–3,322–3,503Medical Care Collections Fund ..............................................2101

...................................................Medical Services ...................................................................2172

...................................................Medical Services ...................................................................2172

.................1341,400Medical Services ...................................................................2174

.................7,246.................Medical Services ...................................................................2174

–3,0574,259–2,103Total current law appropriations .......................................2199

–3,0574,259–2,103Total appropriations ..................................................................2999

9,5259,3051,723Balance, end of year ..................................................................5099

Program and Financing (in millions of dollars)


Obligations by program activity:17,07315,47215,216Outpatient care .........................................................................00018,7478,1687,565Inpatient care ............................................................................00026,2965,7935,361Mental health care ....................................................................00043,6123,3413,149Long-term care ..........................................................................00056,9746,6486,256Pharmacy ..................................................................................00063,6893,4142,908Prosthetics care ........................................................................0007808752614Dental care ................................................................................0008815779201Rehabilitation ...........................................................................0009196195203Readjustment Counseling .........................................................0011571494487Caregivers (Title I) P.L. 111–163 ...............................................0012

..................................246Prior-Year Recoveries ................................................................0013

..................................9,089Non-VA Care (Payments) ...........................................................0014353343.................CHAMPVA (VA Portion) ...............................................................0015

.................7131,270P.L. 113–146, Hires ...................................................................0022321713P.L. 113–146, Sec. 301 ..............................................................0023

.................2316P.L. 113–146, Supplies/Equipment ...........................................0024

.................311P.L. 113–146, Mobile Clinic Video ..............................................0025

..................................41P.L. 113–146, Activations ..........................................................0026

..................................1P.L. 113–146, Prior Year Recoveries ..........................................0029

..................................149Audit Adjustment ......................................................................0030

49,16646,15552,796Total operating expenses ...............................................................0091777933810Outpatient care .........................................................................0101250300261Inpatient care ............................................................................0102384640Mental health care ....................................................................0103667969Long-term care ..........................................................................0104242925Pharmacy ..................................................................................0105273228Prosthetics care ........................................................................0106242925Dental care ................................................................................0107898Rehabilitation ...........................................................................0108898Readjustment Counseling .........................................................0109

..................................1P.L. 113–146, Hires ...................................................................0113

.................2626P.L. 113–146, Supplies/Equipment ...........................................0114

1,2221,4921,301Total Capital Investment ...............................................................0191

50,38847,64754,097Total direct obligations ..................................................................0799153153119Medical Services (Reimbursable) ..............................................0801

50,54147,80054,216Total new obligations, unexpired accounts ....................................0900

Budgetary resources:Unobligated balance:

1,7421,5391,882Unobligated balance brought forward, Oct 1 .........................1000.................667.................Discretionary unobligated balance brought fwd, Oct 1 ......1001..................................195Unobligated balance transfer from other acct [036–0111] ....1011..................................330Unobligated balance transfer from other acct [036–0162] ....1011..................................9Unobligated balance transfer from other acct [036–0152] ....1011.................223.................Adjustment of unobligated bal brought forward, Oct 1 .........1020..................................237Recoveries of prior year unpaid obligations ...........................1021..................................9Recoveries of prior year paid obligations ...............................1033

1,7421,7622,662Unobligated balance (total) ......................................................1050Budget authority:

Appropriations, discretionary:1,0321,0793,769Appropriation ....................................................................1100

..................................–196Appropriations transferred to other accts [036–0169] .......1120


..................................–39Appropriations transferred to other acct [036–0110] ........1120

..................................–20Appropriations transferred to other acct [036–0181] ........11202,9992,4563,485Appropriations transferred from other acct [036–5287] ....1121

..................................10Appropriations transferred from other acct [036–0169] ....1121

4,0313,5356,994Appropriation, discretionary (total) .......................................1160Advance appropriations, discretionary:

44,88751,67347,603Advance appropriation ..................................................1170

–15–15.................Advance appropriations transferred to other accounts[036–0165] ..................................................................

1172


1172

.................–134–1,400Advance appropriations permanently reduced ..............1174

.................–7,246.................Advance appropriations permanently reduced ..............1174

44,67344,09246,203Advanced appropriation, discretionary (total) ...................1180Spending authority from offsetting collections, discretionary:

150150116Collected ...........................................................................1700333Change in uncollected payments, Federal sources ............1701

153153119Spending auth from offsetting collections, disc (total) .........1750

961

MEDICAL SERVICES—Continued

Program and Financing—Continued


48,85747,78053,316Budget authority (total) .............................................................190050,59949,54255,978Total budgetary resources available ..............................................1930

Memorandum (non-add) entries:..................................–223Unobligated balance expiring ................................................1940

581,7421,539Unexpired unobligated balance, end of year ..........................1941

Change in obligated balance:Unpaid obligations:

7,3307,9317,089Unpaid obligations, brought forward, Oct 1 ..........................3000

..................................–868Adjustments to unpaid obligations, brought forward, Oct

1 .......................................................................................3001

50,54147,80054,216New obligations, unexpired accounts ....................................3010..................................957Obligations ("upward adjustments"), expired accounts ........3011

–48,326–48,401–52,453Outlays (gross) ......................................................................3020..................................–237Recoveries of prior year unpaid obligations, unexpired .........3040..................................–773Recoveries of prior year unpaid obligations, expired .............3041

9,5457,3307,931Unpaid obligations, end of year .................................................3050Uncollected payments:

–9–6–6Uncollected pymts, Fed sources, brought forward, Oct 1 ........3060–3–3–3Change in uncollected pymts, Fed sources, unexpired ..........3070

..................................3Change in uncollected pymts, Fed sources, expired ..............3071

–12–9–6Uncollected pymts, Fed sources, end of year .............................3090Memorandum (non-add) entries:

7,3217,9256,215Obligated balance, start of year ............................................31009,5337,3217,925Obligated balance, end of year ..............................................3200

Budget authority and outlays, net:Discretionary:

48,85747,78053,316Budget authority, gross .........................................................4000Outlays, gross:

42,16841,39445,651Outlays from new discretionary authority ..........................40105,7436,5785,437Outlays from discretionary balances .................................4011

47,91147,97251,088Outlays, gross (total) .............................................................4020Offsets against gross budget authority and outlays:

Offsetting collections (collected) from:–40–50–65Federal sources .................................................................4030

–110–100–244Non-Federal sources .........................................................4033

–150–150–309Offsets against gross budget authority and outlays (total) ....4040Additional offsets against gross budget authority only:

–3–3–3Change in uncollected pymts, Fed sources, unexpired .......4050..................................184Offsetting collections credited to expired accounts ...........4052

..................................9Recoveries of prior year paid obligations, unexpired

accounts .......................................................................4053

–3–3190Additional offsets against budget authority only (total) ........4060

48,70447,62753,197Budget authority, net (discretionary) .........................................407047,76147,82250,779Outlays, net (discretionary) .......................................................4080

Mandatory:Outlays, gross:

4154291,365Outlays from mandatory balances ....................................410148,70447,62753,197Budget authority, net (total) ..........................................................418048,17648,25152,144Outlays, net (total) ........................................................................4190

For 2019, the Budget requests $70.7 billion in advance appropriationsfor the four medical care appropriations: Medical Services, Medical Com-munity Care, Medical Support and Compliance, and Medical Facilities.This request for advance appropriations fulfills the Administration's com-mitment to provide reliable and timely resources to support the deliveryof accessible and high-quality medical services for veterans. This fundingenables timely and predictable funding for VA's medical care to preventour Nation's veterans from being adversely affected by budget delays, andprovides opportunities to more effectively use resources in a constrainedfiscal environment.

For 2018, Medical Care appropriations are increased by $2.7 billion overthe 2018 enacted advance appropriations of $66.4 billion. Each year, VAupdates its budget estimates to incorporate the most recent data on healthcare utilization rates, actual program experience, and other factors, suchas economic trends in unemployment and inflation. As a result of theseupdates, the adjusted budget estimates more accurately reflect the projectedmedical demands of veterans enrolled in the VA health care system.

The Veterans Access, Choice, and Accountability Act of 2014 ("VeteransChoice Act"), Public Law 113–146, provided $5 billion in mandatoryfunding to increase veterans' access to health care by hiring more physiciansand staff and improving VA's physical infrastructure. It also provided $10billion in mandatory funding through 2017 to establish a temporary program("Veterans Choice Program") to improve veterans' access to health careby allowing eligible veterans who meet certain wait-time or distancestandards to use eligible health care providers outside the VA system.Public Law 115–26, enacted April 19, 2017, amended the Veterans ChoiceAct to eliminate the August 7, 2017 sunset date for the Veterans ChoiceProgram, thus allowing the program to operate until all of the money inthe Veterans Choice Fund is expended. To further continue the program,the Budget requests $2.9 billion in mandatory budget authority in 2018and $3.5 billion in 2019.

With the resources requested for 2018 and 2019, VA will provide thehighest quality health care services for veterans. VA estimates it will treat7.0 million patients in 2018 and 7.1 million patients in 2019. OperationEnduring Freedom, Operation Iraqi Freedom, and Operation New Dawn(OEF/OIF/OND) veterans are expected to be 858,552 in 2018 (12.2 percentof the total) and 887,098 in 2019 (12.4 percent of the total).

Medical Care Collections Fund (MCCF).—VA estimates collections ofnearly $3.3 billion in both 2018 and 2019, representing nearly five percentof available Medical Care resources in both years. VA has the authority tocollect inpatient and outpatient co-payments, medication co-payments, andnursing home co-payments; authority for certain income verification; au-thority to recover third-party insurance payments from veterans for nonser-vice-connected conditions; and authority to collect revenue from enhanceduse leases. These collections also include those collected from the Com-pensated Work Therapy Program, Compensation and Living ExpensesProgram, and the Parking Program.

Medical Services.—For Medical Services, the Budget reflects the follow-ing discretionary appropriation funding: the 2017 enacted advance appro-priation of $51.7 billion, augmented with $1.1 billion (as provided inPublic Law 114–223); the 2018 enacted advance appropriation of $44.9billion, together with an additional $1.0 billion as requested in this Budget;and the 2019 advance appropriation request of $49.2 billion. This appropri-ation provides for a comprehensive, integrated health care delivery systemthat addresses the needs of eligible veterans and beneficiaries in VA med-ical centers, outpatient clinic facilities, contract hospitals, State homes, andoutpatient programs on a fee basis. Hospital and outpatient care is alsoprovided by the private sector for certain dependents and survivors of vet-erans under the Civilian Health and Medical Programs for the Departmentof Veterans Affairs (CHAMPVA). In addition to this funding, the Budgetreflects mandatory funding provided in section 801 of the Veterans ChoiceAct (Public Law 113–146): $874 million in unobligated balances remainedavailable at the start of 2017.

WORKLOAD

Estimated obligations and workload for six categories of health care ser-vices are shown below: outpatient care, inpatient care, mental health care,long term services and supports, prosthetics care, and dental care. In addi-tion, estimated obligations and workload are also shown for three programs:CHAMPVA and other dependent programs, readjustment counseling, andCaregivers. In each of the six categories of health care services, the oblig-ations and workload shown reflect only the provision of care by VA pro-viders; obligations and workload for all types of non-VA care are displayedseparately in VA's Congressional Justification materials. Finally, the oblig-ations for each of the six categories of health care services do not includethe funding provided by section 801 of the Veterans Choice Act, but theestimated workload levels do include the additional workload associatedwith this funding.

Outpatient care.—Obligations in the Medical Services account for 2018are estimated to be $18,003 million for this health service category, whichincludes funding for ambulatory care in VA hospital-based and community-based clinics.

THE BUDGET FOR FISCAL YEAR 2018962 Veterans Health Administration—ContinuedFederal Funds—Continued

Estimated operating levels are:2018 est.2017 est.2016 actualOutpatient Visits (excludes Mental Health):

77,155,87375,117,59772,664,723Staff .....................................................................................................

Inpatient care.—Obligations in the Medical Services account for 2018are estimated to be $8,997 million, which includes funding for inpatientcare in VA medical centers.

Estimated operating levels are:2018 est.2017 est.2016 actual437,635445,464453,293Patients Treated .......................................................................................

Mental health care.—Obligations in the Medical Services account for2018 are estimated to be $6,334 million for the inpatient, residential, andoutpatient care of veterans with conditions related to mental illness, includ-ing alcohol and drug problems. Mental health services and operations ensurethe availability of a range of services, from treatment of a variety of com-mon mental health conditions in primary care to more intensive interven-tions in specialty mental health programs for more severe and persistingmental health conditions. Specialty services such as evidence-based psy-chotherapies, intensive outpatient programs, residential rehabilitationtreatment, and inpatient care are available to meet the range of veterans'needs.

Estimated operating levels are:2018 est.2017 est.2016 actual

8,1338,2608,341Average daily census (ADC) ......................................................................14,503,77813,965,96513,397,001Outpatient Visits/Encounters ....................................................................

Long term services and supports.—Obligations in the Medical Servicesaccount for 2018 are estimated to be $3,678 million for the care of veteranresidents in VA-operated long-term care programs. VA offers a spectrumof geriatric and extended care services to veterans enrolled in its healthcare system. The spectrum of long-term care services includes non-institu-tional and institutional services. All VA medical centers provide home-and community-based long-term care programs. The patient-focused ap-proach supports veterans who wish to live safely at home in their owncommunities for as long as possible. In addition, veterans receive institu-tional long-term care through one of four venues: VA Community LivingCenters (CLCs); Community Nursing Homes; State Veterans NursingHomes; and State Veterans Home Domiciliaries. The operating levels forinstitutional care below represent only VA CLCs.


8,6458,8899,084Institutional (ADC) ...............................................................................2,895,9402,790,0722,633,814Non-Institutional Visits/Procedures ......................................................

Prosthetics care.—Obligations in the Medical Services account for 2018are estimated to be $3,716 million for veterans. Prosthetic and SensoryAids Service is an integrated delivery system designed to provide medicallyprescribed prosthetic and sensory aids, medical devices, assistive aids, re-pairs and services to eligible disabled veterans to maximize their independ-ence and enhance their quality of life. This includes, but is not limited to,artificial limbs, hearing aids, and home oxygen; items that improve access-ibility such as ramps and vehicle modifications, wheelchairs and mobilityaids; and devices surgically placed in the veteran, such as stents.

Dental care.—Obligations in the Medical Services account for 2018 areestimated to be $832 million for the treatment of veterans who requiredental care. Dental care services are provided to eligible veterans with a"medical condition negatively impacted by poor dentition." These patientsmay include poorly controlled diabetic patients, patients with head or neckcancer, organ transplant patients, and others. Veterans with a 100 percentservice-connected disability are eligible for comprehensive dental care asneeded. In addition, homeless veterans enrolled in certain residentialtreatment programs are also eligible for dental treatment.

Estimated operating levels are:2018 est.2017 est.2016 actual4,904,9454,728,6504,544,714Dental Procedures ................................................................................

Rehabilitation.—Obligations in the Medical Services account for 2018are estimated to be $823 million for the provision of rehabilitative care,including Blind Rehabilitation and Spinal Cord Injury programs. These

services include inpatient and outpatient blind and vision rehabilitationprograms, adjustment to blindness counseling, patient and family education,and assistive technology. The mission of Spinal Cord Injury and Disorders(SCI/D) Services is to promote the health, independence, quality of lifeand productivity of individuals with spinal cord injury and disorders throughefficient delivery of acute rehabilitation, psychological, social, vocational,medical and surgical care, professional training, as well as patient andfamily education.

Estimated operating levels are:

2018 est.2017 est.2016

actual1,1621,1651,163ADC ..........................................................................................................

Civilian Health and Medical Program of the Department of VeteransAffairs (CHAMPVA) Programs.—Obligations in the Medical Services ac-count for 2018 are estimated to be $353 million (excludes care in thecommunity portion found under the new Medical Community Care appro-priation) for pharmacy and medical service personnel dealing withCHAMPVA matters.

Readjustment Counseling.—Obligations in the Medical Services accountfor 2018 are estimated to be $204 million. This program provides readjust-ment counseling services at VA Vet Centers. Vet Centers are community-based counseling centers that provide a wide range of social and psycholo-gical services to include: professional readjustment counseling to veteranswho have served in a combat zone, military sexual trauma counseling, be-reavement counseling for families who experience an active duty death,substance abuse assessments and referral, medical referral, VBA benefitsexplanation and referral, and employment counseling. Services are alsoextended to the family members of eligible veterans for issues related tomilitary service and the readjustment of those veterans.

Estimated operating levels are:2018 est.2017 est.2016 actual1,981,9231,887,5461,797,663Visits ....................................................................................................

Caregivers (Title I) Programs.—Obligations in the Medical Servicesaccount for 2018 are estimated to be $571 million. The Caregivers andVeterans Omnibus Health Services Act of 2010, Public Law 111–163, au-thorized VA to provide assistance and support services for Caregivers ofeligible veterans. This program provides a wide range of services forprimary caregivers to include: a monthly personal caregiver stipend, respitecare, access to mental health services, beneficiary travel, and health carebenefits through the existing CHAMPVA Program.


489,244,000424,618,000421,839,000Caregiver Stipend (dollars) .......................................................................37,14433,34526,989Caregiver Caseload ..................................................................................

Pharmacy.—Obligations in the Medical Services account for 2018 areestimated to be $6,998 million for pharmacy costs. VA's use of medicationtherapies is a fundamental underpinning of how VA delivers health caretoday. VA's primary focus is on diagnosis and treatment in an ambulatoryenvironment and home environment basis with institutional care as themodality of last resort.


294283278Number of 30-day Prescriptions (millions) ...............................................

Public Law 113–146, Veterans Choice Act, Section 801.— The VeteransAccess, Choice, and Accountability Act of 2014 (Public Law 113–146)("Veterans Choice Act") was enacted on August 7, 2014. The 2018 Budgetsupports implementation of the Veterans Choice Act and the Administra-tion's goal of providing timely, high-quality health care for our Nation'sveterans. The Veterans Choice Act provided $5 billion in mandatoryfunding in Section 801 to increase veterans' access to health care by hiringmore physicians and staff and improving the VA's physical infrastructure.Obligations in the Medical Services account for 2018 are estimated to be$32 million for Section 301/302, hiring medical staff, and supplies andmaterials.

963DEPARTMENT OF VETERANS AFFAIRSVeterans Health Administration—Continued

Federal Funds—Continued

MEDICAL SERVICES—Continued

Estimated obligations in the Medical Services account are:2018 est.2017 est.2016 actualDollars in Millions

$0$782$1,325FTE & Other Costs .....................................................................................$32$0$13Section 301/302 Activities ........................................................................$0$0$41Activations ...............................................................................................

$32$782$1,379Total .........................................................................................................

Object Classification (in millions of dollars)


Direct obligations:Personnel compensation:

19,25017,75816,738Full-time permanent .............................................................11.1.................5541,020Full-time permanent - P.L. 113–146, Sec. 801 ......................11.1

406374353Other than full-time permanent ............................................11.3.................1222Other than full-time permanent - P.L. 113–146, Sec. 801 ......11.3

2,2162,0451,926Other personnel compensation ..............................................11.5.................64117Other personnel compensation - P.L. 113–146, Sec. 801 .......11.5

21,87220,80720,176Total personnel compensation ...........................................11.97,6446,9166,414Civilian personnel benefits ........................................................12.1

.................84155Civilian personnel benefits - P.L. 113–146, Sec. 801 ................12.1999Benefits for former personnel ....................................................13.0

1,0661,025975Travel & Transportation of Persons ............................................21.0181817Transportation of things ............................................................22.0

487450417Rent, Communications & Utilities .............................................23.2..................................1Rent, Communications & Utilities - P.L. 113–146, Sec. 801 .......23.2

999Printing and reproduction .........................................................24.05,2294,92511,840Other contractual services ........................................................25.2

322122Other contractual serv. - P.L. 113–146, Sec. 801 ......................25.212,22811,27510,639Supplies & Materials .................................................................26.0

.................2315Supplies & Materials - P.L. 113–146, Sec. 801 .........................26.01,2221,4661,272Equipment .................................................................................31.0

.................2426Equipment - P.L. 113–146, Sec. 801 .........................................31.0

..................................2Land and structures ..................................................................32.05725951,712Grants, Subsidies & Contributions ............................................41.0

..................................246Prior-year Recoveries .................................................................44.0

..................................1Prior Year Recoveries - P.L. 113–146, Sec. 801 .........................44.0

..................................149Audit Adjustment ......................................................................92.0

50,38847,64754,097Direct obligations ..................................................................99.0153153119Reimbursable obligations .....................................................99.0

50,54147,80054,216Total new obligations, unexpired accounts ............................99.9

Employment Summary


234,668228,966222,974Direct civilian full-time equivalent employment ............................10011,8721,8721,872Reimbursable civilian full-time equivalent employment ...............2001

✦

MEDICAL COMMUNITY CARE

For necessary expenses for furnishing health care to individuals pursuant to chapter17 of title 38, United States Code, at non-Department facilities, [$7,246,181,000,plus reimbursements, of which $2,000,000,000 shall remain available untilSeptember 30, 2020; ] $254,000,000, which shall be in addition to funds previouslyappropriated under this heading that become available on October 1, 2017; and,in addition, [$9,409,118,000] $8,384,704,000, plus reimbursements, shall becomeavailable on October 1, [2017] 2018, and shall remain available until September30, [2018] 2019: Provided, That of the amount made available on October 1,[2017] 2018, under this heading, [$1,500,000,000] $2,000,000,000 shall remainavailable until September 30, [2021] 2022. (Military Construction, Veterans Affairs,and Related Agencies Appropriations Act, 2017.)



Obligations by program activity:2,3212,338.................Ambulatory ................................................................................000110167.................Dental .......................................................................................0002

1,552774.................Inpatient ...................................................................................00031,032956.................LTSS: Facility Based Services ....................................................0004806695.................LTSS: Home & Community Based Services .................................0005315274.................Mental Health ............................................................................0006

1,6101,653.................CHAMPVA & Other Dependent Programs ....................................00071,3461,312.................State Home Programs ................................................................0008

76.................Camp Lejeune, Veterans Families ..............................................0009

24..................................Indian Health Services ..............................................................001029..................................Caregiver ...................................................................................0011

9,1438,075.................Total new obligations, unexpired accounts ....................................0900

Budgetary resources:Budget authority:

Appropriations, discretionary:2547,246.................Appropriation ....................................................................1100

.................–21.................Appropriations transferred to other acct [036–0169] ........1120256850.................Appropriations transferred from other acct [036–5287] ....1121

5108,075.................Appropriation, discretionary (total) .......................................1160Advance appropriations, discretionary:

9,409..................................Advance appropriation ..................................................1170

–26..................................Advance appropriations transferred to other accounts[036–0169] ..................................................................

1172

9,383..................................Advanced appropriation, discretionary (total) ...................11809,8938,075.................Budget authority (total) .............................................................19009,8938,075.................Total budgetary resources available ..............................................1930

Memorandum (non-add) entries:750..................................Unexpired unobligated balance, end of year ..........................1941


1,672..................................Unpaid obligations, brought forward, Oct 1 ..........................30009,1438,075.................New obligations, unexpired accounts ....................................3010

–9,822–6,403.................Outlays (gross) ......................................................................3020

9931,672.................Unpaid obligations, end of year .................................................3050Memorandum (non-add) entries:

1,672..................................Obligated balance, start of year ............................................31009931,672.................Obligated balance, end of year ..............................................3200


9,8938,075.................Budget authority, gross .........................................................4000Outlays, gross:

8,3516,403.................Outlays from new discretionary authority ..........................40101,471..................................Outlays from discretionary balances .................................4011

9,8226,403.................Outlays, gross (total) .............................................................40209,8938,075.................Budget authority, net (total) ..........................................................41809,8226,403.................Outlays, net (total) ........................................................................4190

For 2019, the Budget requests $8.4 billion in advance appropriations forMedical Community Care. This request for advance appropriations fulfillsthe Administration's commitment to provide reliable and timely resourcesto support the delivery of accessible and high-quality medical services forveterans. The Medical Community Care appropriation provides for thefurnishing of hospital care and medical services to eligible veterans throughagreements with certain eligible entities that have an agreement to providesuch care and services for VA. Medical Community Care will be the sourceof funding for care that VA provides to veterans through community pro-viders that is not provided through the Veterans Choice Program.



Direct obligations:7,7976,755.................Other Contractual Services ........................................................25.21,3461,320.................State Homes ..............................................................................41.0

9,1438,075.................Total new obligations, unexpired accounts ............................99.9

✦

MEDICAL SUPPORT AND COMPLIANCE

For necessary expenses in the administration of the medical, hospital, nursinghome, domiciliary, construction, supply, and research activities, as authorized bylaw; administrative expenses in support of capital policy activities; and administrativeand legal expenses of the Department for collecting and recovering amounts owedthe Department as authorized under chapter 17 of title 38, United States Code, andthe Federal Medical Care Recovery Act (42 U.S.C. 2651 et seq.), $284,397,000,which shall be in addition to funds previously appropriated under this heading thatbecome available on October 1, 2017; and, in addition, [$6,654,480,000]$7,239,156,000, plus reimbursements, shall become available on October 1, [2017]2018, and shall remain available until September 30, [2018] 2019: Provided, That,


of the amount made available on October 1, [2017] 2018, under this heading,$100,000,000 shall remain available until September 30, [2019] 2020. (MilitaryConstruction, Veterans Affairs, and Related Agencies Appropriations Act, 2017.)



Obligations by program activity:4,5264,1673,868VA Medical Centers & Other Field Activities ..............................0001227223166VISN Headquarters ....................................................................0002666653608VHA Central Office .....................................................................0003232236240Office of Informatics & Analytics ...............................................0005848262Employee Education Service Center ...........................................0008

250245257VHA Service Center ....................................................................0009201917Consolidated Mail Outpatient Pharmacies ................................0013997National Center for Patient Safety .............................................0014

796724707Community Care ........................................................................001611611488VHA Member Services ................................................................0017

..................................5P.L. 113–146, Activations ..........................................................002514.................2P.L. 113–146, Section 301/302 Activities ..................................0026

6,9406,4726,027Total operating expenses ...............................................................0091323124VAMCs & Other Field Activities ..................................................0102111VHA Service Center ....................................................................0109222Community Care ........................................................................0116111VHA Member Services ................................................................0117

363528Total Capital Investment ...............................................................0191

6,9766,5076,055Total direct program ......................................................................0293

6,9766,5076,055Total direct obligations ..................................................................0799191913Medical Support and Compliance (Reimbursable) ....................0801



69104126Unobligated balance brought forward, Oct 1 .........................1000.................85.................Discretionary unobligated balance brought fwd, Oct 1 ......1001..................................–9Unobligated balance transfer to other accts [036–0160] ......1010..................................9Unobligated balance transfer from other acct [036–0162] ....1011

69104126Unobligated balance (total) ......................................................1050Budget authority:

Appropriations, discretionary:284.................100Appropriation ....................................................................1100




284.................–11Appropriation, discretionary (total) .......................................1160Advance appropriations, discretionary:



1172

.................–26–100Advance appropriations permanently reduced ..............1174


191913Collected ...........................................................................17006,9306,4916,046Budget authority (total) .............................................................19006,9996,5956,172Total budgetary resources available ..............................................1930

Memorandum (non-add) entries:469104Unexpired unobligated balance, end of year ..........................1941


1,049883791Unpaid obligations, brought forward, Oct 1 ..........................3000


1 .......................................................................................3001


–6,790–6,360–5,898Outlays (gross) ......................................................................3020..................................–57Recoveries of prior year unpaid obligations, expired .............3041

1,2541,049883Unpaid obligations, end of year .................................................3050Uncollected payments:

–1–1–1Uncollected pymts, Fed sources, brought forward, Oct 1 ........3060


1,048882729Obligated balance, start of year ............................................31001,2531,048882Obligated balance, end of year ..............................................3200


6,9306,4916,046Budget authority, gross .........................................................4000

Outlays, gross:6,1515,7605,285Outlays from new discretionary authority ..........................4010632593607Outlays from discretionary balances .................................4011



..................................–10Non-Federal sources .........................................................4033


..................................10Offsetting collections credited to expired accounts ...........4052

..................................10Additional offsets against budget authority only (total) ........4060



776Outlays from mandatory balances ....................................41016,9116,4726,033Budget authority, net (total) ..........................................................41806,7716,3415,875Outlays, net (total) ........................................................................4190

For 2019, the Budget requests $7.2 billion in advance appropriations forMedical Support and Compliance. This request for advance appropriationsfulfills the Administration's commitment to provide reliable and timelyresources to support the delivery of accessible and high-quality medicalservices for veterans.

For Medical Support and Compliance, the Budget reflects the followingdiscretionary appropriation funding from 2017 through 2019: the 2017enacted advance appropriation of $6.5 billion; the 2018 enacted advanceappropriation of $6.7 billion, together with an additional $284 million asrequested in this Budget; and the 2019 advance appropriation request of$7.2 billion. In addition to this funding, the Budget reflects mandatoryfunding provided in section 801 of the Veterans Access, Choice, and Ac-countability Act of 2014 (Public Law 113–146): $20 million in unobligatedbalances remained available at the start of 2017.

Medical Support and Compliance appropriation finances the expensesof management, security, and administration of the VA health care systemthrough the operation of VA medical centers, other facilities, Veterans In-tegrated Service Network offices and facility director offices, chief of staffoperations, quality of care oversight, legal services, billing and codingactivities, procurement, financial management, and human resource man-agement.




3,3843,2503,085Full-time permanent .............................................................11.1..................................4Full-time permanent - Choice Act, P.L. 113–146, Sec. 801 ....11.1

726966Other than full-time permanent ............................................11.3389374355Other personnel compensation ..............................................11.5

3,8453,6933,510Total personnel compensation ...........................................11.91,3521,2881,217Civilian personnel benefits ........................................................12.1

..................................1Civilian personnel benefits - Choice Act, P.L. 113–146, Sec.

801 ........................................................................................12.1

222Benefits for former personnel ....................................................13.0605352Travel & Transportation of Persons ............................................21.0121211Transportation of things ............................................................22.0

133130126Communications, utilities, and miscellaneous charges ............23.3181817Printing and reproduction .........................................................24.0

1,4211,1951,004Other contractual services ........................................................25.2

14.................2Other contractual services - Choice Act, P.L. 113–146, Section

801 ........................................................................................25.2

838186Medical supplies and materials ................................................26.0363527Equipment .................................................................................31.0



Employment Summary


52,23051,35349,685Direct civilian full-time equivalent employment ............................1001



MEDICAL SUPPORT AND COMPLIANCE—Continued

Employment Summary—Continued


869869869Reimbursable civilian full-time equivalent employment ...............2001

✦

DOD-VA HEALTH CARE SHARING INCENTIVE FUND



Obligations by program activity:665663DOD-VA health care sharing incentive fund ..............................0001


2382138Unobligated balance brought forward, Oct 1 .........................10001377Recoveries of prior year unpaid obligations ...........................1021


Appropriations, discretionary:151515Transferred from DOD account [097–0130] ......................1121

..................................15Appropriations transferred from VA account

[036–0160] ..................................................................1121

.................–40–30Unobligated balance of appropriations permanently

reduced .........................................................................1131

15–25.................Appropriation, discretionary (total) .......................................1160Advance appropriations, discretionary:

1515.................Advance appropriations transferred from VA account[036–0160] ..................................................................

1173

30–10.................Budget authority (total) .............................................................19006679145Total budgetary resources available ..............................................1930

Memorandum (non-add) entries:.................2382Unexpired unobligated balance, end of year ..........................1941


1005970Unpaid obligations, brought forward, Oct 1 ..........................3000665663New obligations, unexpired accounts ....................................3010

–16–8–67Outlays (gross) ......................................................................3020–13–7–7Recoveries of prior year unpaid obligations, unexpired .........3040

13710059Unpaid obligations, end of year .................................................3050Memorandum (non-add) entries:

1005970Obligated balance, start of year ............................................310013710059Obligated balance, end of year ..............................................3200


30–10.................Budget authority, gross .........................................................4000Outlays, gross:

16867Outlays from discretionary balances .................................401130–10.................Budget authority, net (total) ..........................................................418016867Outlays, net (total) ........................................................................4190

The purpose of the Department of Defense-Veterans Affairs Health CareSharing Incentive Fund, often referred to as the Joint Incentive Fund (JIF),is to enable the Departments to carry out a program to identify and provideincentives to implement creative sharing initiatives at the facility, intra-regional and nationwide levels. The JIF promotes collaboration and newapproaches to problem solving to enable the Departments to improve thecoordination of health care services. The Departments have established thefund and developed processes and criteria to solicit and select projects.Section 721 of the 2003 National Defense Authorization Act, Public Law107–314, established the fund and requires VA and Department of Defenseto establish a joint incentive program. In 2018, each Secretary shall contrib-ute a minimum of $15 million to the fund after the appropriation is enacted.



Direct obligations:555Personnel compensation: Full-time permanent .........................11.1

524249Advisory and assistance services ..............................................25.1

111Supplies and materials .............................................................26.0888Equipment .................................................................................31.0

665663Total new obligations, unexpired accounts ............................99.9

Employment Summary


574747Direct civilian full-time equivalent employment ............................1001

✦

MEDICAL FACILITIES

For necessary expenses for the maintenance and operation of hospitals, nursinghomes, domiciliary facilities, and other necessary facilities of the Veterans HealthAdministration; for administrative expenses in support of planning, design, projectmanagement, real property acquisition and disposition, construction, and renovationof any facility under the jurisdiction or for the use of the Department; for oversight,engineering, and architectural activities not charged to project costs; for repairing,altering, improving, or providing facilities in the several hospitals and homes underthe jurisdiction of the Department, not otherwise provided for, either by contract orby the hire of temporary employees and purchase of materials; for leases of facilities;and for laundry services; [$247,668,000] $1,079,795,000, which shall be in additionto funds previously appropriated under this heading that become available on October1, [2016] 2017; and, in addition, [$5,434,880,000 ]$5,914,288,000, plus reimburse-ments, shall become available on October 1, [2017] 2018, and shall remain availableuntil September 30, [2018] 2019: Provided, That, of the amount made availableon October 1, [2017] 2018, under this heading, $250,000,000 shall remain availableuntil September 30, [2019] 2020. (Military Construction, Veterans Affairs, andRelated Agencies Appropriations Act, 2017.)



Obligations by program activity:12393Energy & Green Management ....................................................0001

651613578Engineering & Environmental Management Services ................0002859811797Engineering Service ...................................................................00031009491Grounds Maintenance & Fire Protection ....................................0004710658346Leases .......................................................................................0005225213207Operating Equipment Maintenance & Repair ............................0008327231Other Facilities Operation Support ............................................0009

734666723Plant Operation .........................................................................0011517488489Recurring Maintenance & Repair ..............................................0012198187155Textile Care Processing & Management .....................................0013176166170Transportation ...........................................................................0014

..................................16Prior-Year Recoveries ................................................................0023

..................................2P.L. 113–146, Activations ..........................................................0025

.................24169P.L. 113–146, Leases ................................................................0026

..................................4P.L. 113–146, Non-Recurring Maintenance ...............................0028412.................P.L. 113–146, Sec. 301 ..............................................................0029

..................................30P.L. 113–146, Prior year Recoveries ...........................................0030

4,2184,0433,811Total operating expenses ...............................................................0091..................................18Energy & Green Management ....................................................0101

181561Engineering & Environmental Management Services ................010221189Engineering Service ...................................................................0103334Grounds Maintenance & Fire Protection ....................................0104

2448347Leases .......................................................................................01051,8701,060867Non-Recurring Maintenance ......................................................0106

141216Operating Equipment Maintenance & Repair ............................010754.................Other Facilities Operation Support ............................................0108

574913Plant Operation .........................................................................0109211812Recurring Maintenance & Repair ..............................................01108737Textile Care Processing & Management .....................................0111871Transportation ...........................................................................0122

..................................1P.L. 113–146, Activations ..........................................................0124

..................................33P.L. 113–146, Leases ................................................................0125

.................9331P.L. 113–146, Legionella ...........................................................0126

.................10504P.L. 113–146, Non-Recurring Maintenance ...............................0127

2,2691,3791,654Total capital investment ................................................................0191

6,4875,4225,465Total direct obligations ..................................................................0799171713Medical Facilities (Reimbursable) .............................................0801



111551,239Unobligated balance brought forward, Oct 1 .........................1000


.................10.................Discretionary unobligated balance brought fwd, Oct 1 ......1001

..................................–330Unobligated balance transfer to other accts [036–0160] ......1010

..................................–9Unobligated balance transfer to other accts [036–0152] ......1010

..................................46Recoveries of prior year unpaid obligations ...........................1021

..................................1Recoveries of prior year paid obligations ...............................1033


Appropriations, discretionary:1,080248355Appropriation ....................................................................1100




1,0802487Appropriation, discretionary (total) .......................................1160Advance appropriations, discretionary:



1172

.................–9–250Advance appropriations permanently reduced ..............1174


171713Collected ...........................................................................1700..................................1Change in uncollected payments, Federal sources ............1701

171714Spending auth from offsetting collections, disc (total) .........17506,4955,2954,686Budget authority (total) .............................................................19006,5065,4505,633Total budgetary resources available ..............................................1930



2,9352,9962,927Unpaid obligations, brought forward, Oct 1 ..........................3000


1 .......................................................................................3001


–6,257–5,500–5,256Outlays (gross) ......................................................................3020..................................–46Recoveries of prior year unpaid obligations, unexpired .........3040..................................–177Recoveries of prior year unpaid obligations, expired .............3041


–1–1–1Uncollected pymts, Fed sources, brought forward, Oct 1 ........3060..................................–1Change in uncollected pymts, Fed sources, unexpired ..........3070..................................1Change in uncollected pymts, Fed sources, expired ..............3071







Offsetting collections (collected) from:–10–10–10Federal sources .................................................................4030–7–7–39Non-Federal sources .........................................................4033


..................................–1Change in uncollected pymts, Fed sources, unexpired .......4050





215473468Outlays from mandatory balances ....................................4101Offsets against gross budget authority and outlays:

Offsetting collections (collected) from:..................................–1Non-Federal sources .........................................................4123

Additional offsets against gross budget authority only:


accounts .......................................................................4143

215473467Outlays, net (mandatory) ...........................................................41706,4785,2784,672Budget authority, net (total) ..........................................................41806,2405,4835,206Outlays, net (total) ........................................................................4190

For 2019, the Budget requests advance appropriations of $5.9 billion forMedical Facilities. This request for advance appropriations fulfills theAdministration's commitment to provide reliable and timely resources tosupport the delivery of accessible and high-quality medical services forveterans.

For Medical Facilities, the Budget reflects the following discretionaryappropriation funding from 2017 through 2019: the 2017 enacted advanceappropriation of $5.1 billion, together with an additional $248 million (asdirected in Public Law 114–223); the 2018 enacted advance appropriationof $5.4 billion, together with an additional $1.1 billion as requested in thisBudget; and the 2019 advance appropriation request of $5.9 billion. Inaddition to this funding, the Budget reflects mandatory funding providedin section 801 of the Veterans Access, Choice, and Accountability Act of2014 (Public Law 113–146): $144 million in unobligated balances remainedavailable at the start of2017.

Medical Facilities provides for the operations and maintenance of thecapital infrastructure required to provide health care to the Nation's veterans.These costs include utilities, engineering, capital planning, leases, laundryservices, grounds maintenance, trash removal, housekeeping, fire protection,pest management, facility repair and maintenance, and property dispositionand acquisition.




1,2061,1631,112Full-time permanent .............................................................11.1252423Other than full-time permanent ............................................11.3

139134128Other personnel compensation ..............................................11.5

1,3701,3211,263Total personnel compensation ...........................................11.9503480452Civilian personnel benefits ........................................................12.1

111Benefits for former personnel ....................................................13.0393837Travel & Transportation of Persons ............................................21.0151514Transportation of things ............................................................22.0

1,2391,172876Rent, Communications & Utilities .............................................23.2.................24169Rent, Communications & Utilities - P.L. 113–146, Sec. 801 .......23.2

11.................Printing and reproduction .........................................................24.0719661637Other Contractual Services ........................................................25.2

4125Other Contractual Services - P.L. 113–146, Sec. 801 ................25.2327318310Supplies & Materials .................................................................26.0

..................................1Supplies & Materials - P.L. 113–146, Sec. 801 .........................26.011068104Equipment .................................................................................31.0

..................................1Equipment - P.L. 113–146, Sec. 801 .........................................31.02,1591,208981Lands & Structures ...................................................................32.0

.................103568Lands & Structures - P.L. 113–146, Sec. 801 ............................32.0

..................................16P.L. 113–146, Non Section 801 - Prior Year Recoveries .............44.0

..................................30P.L. 113–146, Section 801 - Prior Year Recoveries ....................44.0



Employment Summary


24,69924,25323,434Direct civilian full-time equivalent employment ............................1001490490490Reimbursable civilian full-time equivalent employment ...............2001

✦

MEDICAL AND PROSTHETIC RESEARCH

For necessary expenses in carrying out programs of medical and prosthetic researchand development as authorized by chapter 73 of title 38, United States Code,[$675,366,000] $640,000,000, plus reimbursements, shall remain available untilSeptember 30, [2018: Provided, That the Secretary of Veterans Affairs shall ensurethat sufficient amounts appropriated under this heading are available for prostheticresearch specifically for female veterans, and for toxic exposure research] 2019.(Military Construction, Veterans Affairs, and Related Agencies Appropriations Act,2017.)



MEDICAL AND PROSTHETIC RESEARCH—Continued



Obligations by program activity:186198211Bio-medical laboratory science research ...................................0001102109112Rehabilitation research .............................................................0002102109112Health services research ...........................................................0003250266225Clinical science research ..........................................................0004

640682660Total operating expenses ...............................................................0091

640682660Total direct obligations ..................................................................0799404035Medical and Prosthetic Research (Reimbursable) .....................0801

680722695Total new obligations, unexpired accounts ....................................0900


536275Unobligated balance brought forward, Oct 1 .........................1000..................................35Recoveries of prior year unpaid obligations ...........................1021


Appropriations, discretionary:640675631Appropriation ....................................................................1100


.................–2.................Appropriations permanently reduced ................................1130

640673611Appropriation, discretionary (total) .......................................1160Spending authority from offsetting collections, discretionary:

404036Collected ...........................................................................1700680713647Budget authority (total) .............................................................1900733775757Total budgetary resources available ..............................................1930




..................................3Obligations ("upward adjustments"), expired accounts ........3011–677–685–620Outlays (gross) ......................................................................3020

..................................–35Recoveries of prior year unpaid obligations, unexpired .........3040

..................................–15Recoveries of prior year unpaid obligations, expired .............3041

287284247Unpaid obligations, end of year .................................................3050Uncollected payments:





680713647Budget authority, gross .........................................................4000Outlays, gross:

484508378Outlays from new discretionary authority ..........................4010193177242Outlays from discretionary balances .................................4011

677685620Outlays, gross (total) .............................................................4020Offsets against gross budget authority and outlays:





640673611Budget authority, net (discretionary) .........................................4070637645583Outlays, net (discretionary) .......................................................4080640673611Budget authority, net (total) ..........................................................4180637645583Outlays, net (total) ........................................................................4190

For 2018, the total budgetary resources of $ 1.8 billion is comprised of$640 million in direct appropriations, $544 million in medical care supportsuch as physicians' pay, utilities and other overhead, $400 million in Fed-eral grants, and $170 million in other non-federal resources. The researchprogram will support 3,040 full time equivalents through direct appropri-ation.

This account is an intramural research program that has had outstandingsuccess that has led to critical clinical achievements that improve the healthand quality of life for Veterans and the Nation. As a health research programfocused exclusively on the needs of Veterans, VA Research continues toplay a vital role in the care and rehabilitation of our men and women whohave served in uniform. Building on more than 90 years of discovery andinnovation engaging Veterans as research volunteers, VA Research has aproud track record of transforming VA health care by bringing new evid-ence-based treatments and technologies into everyday clinical care.

In 2018, VA will invest in research that expands prevention and treatmentpossibilities for Veterans at risk for suicide. VA is currently undertakingand awaiting the results of a cooperative study on Lithium (an oral medic-ation), the largest such trial on suicide prevention to date. Other interven-tions must also be evaluated and those first studies will be starting earlyin 2018.

A particular goal for VA Research in 2018 is to use the Million VeteranProgram (MVP) to advance precision medicine. MVP is a groundbreakinggenomic research program that is collecting genetic samples and generalhealth information from 1 million Veterans. MVP will use genetic analysisto improve treatments, thus improving care for Veterans and all Americans.Currently, MVP has enrolled more than 544,000 Veterans. Investigatorshave already completed initial analyses of MVP genetic data in studies onPost Traumatic Stress Disorder (PTSD), schizophrenia, bipolar disorder,and Gulf War Illness, and further analyses are underway.

Research to benefit Gulf War Veterans remains a priority. As directedby Senate Report 111–40, the VA research program ensures that no lessthan $15 million is available for Gulf War research each year; the actualamount spent on such research depends on the quantity and quality of re-search proposals. VA has worked to develop Gulf War researchers to ensurethat research proposals of high scientific merit are submitted. Funding for2017 is estimated at $15 million.

The opioid addiction epidemic is a major clinical and public healthproblem. Opioids are used to treat chronic pain, but they are associatedwith dangerous side effects including depressed breathing, cognitiveimpairment, and the potential for addiction. In 2018, VA will expand painmanagement research in two areas, one nearer term and the other longerterm: testing and implementing complementary approaches, and workingother drug models and current drugs in the market to test their efficacy fortreating pain.

VA is expanding research efforts to improve women Veterans health, bystudying how VA provides for women Veterans general and gender-specifichealth care needs, and understanding military experiences of women Vet-erans as well as later health risk factors.

VA works closely with other federal agencies to assure effective use ofscarce taxpayer resources in executing its research mission. VA conductsjoint programmatic reviews with the Department of Defense (DoD) andNational Institutes of Health (NIH) to ensure that research efforts are wellcoordinated, benefiting Veterans and the American public.

Veterans' health issues are addressed comprehensively in the followingfour program divisions and the medical care research support required forthese programs:

Biomedical laboratory.—Supports preclinical research to understand lifeprocesses from a molecular, genomic, and physiological level in regard todiseases affecting veterans.

Clinical science.—Administers investigations (i.e., human subject researchsuch as drug, surgical, single subject, pilot, and multi-center cooperativestudies as well as feasibility trials) aimed at instituting new, more effectiveclinical care.

Health services.—Supports studies to identify and promote effective andefficient strategies to improve the delivery of health care to veterans.

Rehabilitation.—Develops novel approaches to restoring veterans withtraumatic amputation, central nervous system injuries, loss of sight and/orhearing, or other physical and cognitive impairments to full and productivelives.


VA's Medical and Prosthetic Research programs are included in theFederal Research and Development (R&D) budget.

SUMMARY OF PROGRAM RESOURCES

[in millions of dollars]2018 est.2017 est.2016 actual

640673631Medical and prosthetic research appropriation ........................................544572526VA Medical Care Support ..........................................................................570595581Other Federal and Non-Federal Resources ................................................404036Reimbursements ......................................................................................

1,7941,8801,774Total program resources ...............................................................




248249248Full-time permanent .............................................................11.1211Other than full-time permanent ............................................11.3455Other personnel compensation ..............................................11.5

254255254Total personnel compensation ...........................................11.9879089Civilian personnel benefits ........................................................12.1465Employee travel .........................................................................21.0223Communications, utilities, and miscellaneous charges ............23.3111Printing and reproduction .........................................................24.0

229254234Other services from non-Federal sources ..................................25.2333937Supplies and materials .............................................................26.0303537Equipment .................................................................................31.0

640682660Direct obligations ..................................................................99.0404035Reimbursable obligations .....................................................99.0


Employment Summary



✦

JOINT DEPARTMENT OF DEFENSE-DEPARTMENT OF VETERANS AFFAIRS MEDICAL

FACILITY DEMONSTRATION FUND



Obligations by program activity:428412391Joint DOD-VA Medical Facility Demonstration Fund (Direct) .......0001

1697Joint DOD-VA Medical Facility Demonstration Fund

(Reimbursable) .....................................................................0801



568Unobligated balance brought forward, Oct 1 .........................1000Budget authority:

Appropriations, discretionary:..................................–10Appropriations transferred to other acct [036–0160] ........1120..................................–1Appropriations transferred to other acct [036–0152] ........1120..................................–2Appropriations transferred to other acct [036–0162] ........1120..................................37Appropriations transferred from other acct [036–0162] ....1121..................................27Appropriations transferred from other acct [036–0152] ....1121..................................196Appropriations transferred from other acct [036–0160] ....1121

877Appropriations transferred from other acct [036–0167] ....1121116120120Appropriations transferred from other acct [097–0130] ....1121161618Appropriations transferred from other acct [036–5287] ....1121

.................21.................Appropriations transferred from other acct [036–0140] ....1121

140164392Appropriation, discretionary (total) .......................................1160Advance appropriations, discretionary:

26..................................Advance appropriations transferred from other accounts[036–0140] ..................................................................

1173

2826.................Advance appropriations transferred from other accounts[036–0152] ..................................................................

1173


1173


1173

290247.................Advanced appropriation, discretionary (total) ...................1180Spending authority from offsetting collections, discretionary:



756Unexpired unobligated balance, end of year ..........................1941














430411392Budget authority, net (discretionary) .........................................4070427409388Outlays, net (discretionary) .......................................................4080430411392Budget authority, net (total) ..........................................................4180427409388Outlays, net (total) ........................................................................4190

The Department of Veterans Affairs (VA) and the Department of Defense(DOD) will each contribute funding to the Joint Department of Defense-Department of Veterans Affairs Medical Facility Demonstration Fund,established by section 1704 of Public Law 111–84, the National DefenseAuthorization Act for Fiscal Year 2010. This funding will support thecontinuing operations of the Captain James A. Lovell Federal Health CareCenter (FHCC), which opened on December 20, 2010. In 2017 and 2018,VA expects to transfer funds from the Medical Services, Medical Com-munity Care, Medical Support and Compliance, Medical Facilities, andInformation Technology Systems accounts, while DOD expects to transferfunds from the Defense Health Program account.



Direct obligations:184177171Personnel compensation: Full-time permanent .........................11.1636156Civilian personnel benefits ........................................................12.1828078Advisory and assistance services ..............................................25.1656258Supplies and materials .............................................................26.0171614Equipment .................................................................................31.0171614Land and structures ..................................................................32.0



Employment Summary



✦



MEDICAL CARE COLLECTIONS FUND




Appropriations, discretionary:3,2713,3223,503Appropriation (special or trust fund) .................................1101

–2,999–2,456–3,485Appropriations transferred to other accts [036–0160] .......1120–16–16–18Appropriations transferred to other accts [036–0169] .......1120

–256–850.................Appropriations transferred to other acct [036–0140] ........1120...................................................Budget authority, net (total) ..........................................................4180...................................................Outlays, net (total) ........................................................................4190

VA has the authority to collect co-payments, which are deposited intothe Medical Care Collections Fund (MCCF) receipt account. As allowedby the provisions of the appropriations Act, these receipts are transferredto Medical Services, Medical Community Care, and the Joint Departmentof Defense-Department of Veterans Affairs Medical Facility DemonstrationFund (Joint Demonstration Fund) appropriations where they remain avail-able until expended for the purposes of this account. In 2016, over $3.5billion was collected in the MCCF receipt account and transferred to theMedical Services appropriation and Joint Demonstration Fund to providehealth care to our veterans. These collections consist of co-payments fromveterans for inpatient, outpatient, and nursing home care, and prescribedmedications; third-party insurance payments from veterans for nonservice-connected conditions; and collections from enhanced-use leases, theCompensated Work Therapy Program, Compensation and Living ExpensedProgram, and the Parking Program.

✦

CANTEEN SERVICE REVOLVING FUND



Obligations by program activity:275257260Reimbursable operating expenses .............................................0801173173164Reimbursable direct operations ................................................0802

20209Reimbursable capital investment: Sales program: Purchase of

equipment and leasehold ......................................................0810





Spending authority from offsetting collections, mandatory:477458441Collected ...........................................................................1800

111Change in uncollected payments, Federal sources ............1801

478459442Spending auth from offsetting collections, mand (total) .......1850512484458Total budgetary resources available ..............................................1930




–481–462–445Outlays (gross) ......................................................................3020..................................–1Recoveries of prior year unpaid obligations, unexpired .........3040


–6–5–4Uncollected pymts, Fed sources, brought forward, Oct 1 ........3060–1–1–1Change in uncollected pymts, Fed sources, unexpired ..........3070



Budget authority and outlays, net:Mandatory:


467449368Outlays from new mandatory authority .............................4100141377Outlays from mandatory balances ....................................4101


Offsetting collections (collected) from:–1–1.................Federal sources .................................................................4120

–476–457–441Non-Federal sources .........................................................4123


–1–1–1Change in uncollected pymts, Fed sources, unexpired .......4140444Outlays, net (mandatory) ...........................................................4170

...................................................Budget authority, net (total) ..........................................................4180444Outlays, net (total) ........................................................................4190

The Veterans Canteen Service was established to furnish, at reasonableprices, meals, merchandise, and services necessary for the comfort andwell-being of veterans in VA medical facilities.

Financing.— Operations will be financed from current revenues.



Reimbursable obligations:Personnel compensation:

143133133Full-time permanent .............................................................11.1333Other than full-time permanent ............................................11.3

146136136Total personnel compensation ...........................................11.9454545Civilian personnel benefits ........................................................12.1333Travel and transportation of persons .........................................21.0666Other services from non-Federal sources ..................................25.2



Employment Summary


3,5003,4503,410Reimbursable civilian full-time equivalent employment ...............2001

✦

VETERANS CHOICE FUND



Obligations by program activity:.................406117Veterans Choice Fund - Administrative .....................................0001

6263,4412,645Veterans Choice Fund - Program ...............................................0002..................................1Emergency Hep-C ......................................................................0003..................................470Emergency Non-VA Care ............................................................0004

6263,8473,233Direct program activities, subtotal ................................................0091.................30.................Capital Investment ....................................................................0109

6263,8773,233Total new obligations, unexpired accounts ....................................0900


6264,5038,201Unobligated balance brought forward, Oct 1 .........................1000..................................–1,100Adjustment of unobligated bal brought forward, Oct 1 .........1020..................................635Recoveries of prior year unpaid obligations ...........................1021

6264,5037,736Unobligated balance (total) ......................................................10506264,5037,736Total budgetary resources available ..............................................1930

Memorandum (non-add) entries:.................6264,503Unexpired unobligated balance, end of year ..........................1941


3,1051,745564Unpaid obligations, brought forward, Oct 1 ..........................3000

..................................1,100Adjustments to unpaid obligations, brought forward, Oct

1 .......................................................................................3001

6263,8773,233New obligations, unexpired accounts ....................................3010


–1,900–2,517–2,517Outlays (gross) ......................................................................3020..................................–635Recoveries of prior year unpaid obligations, unexpired .........3040

1,8313,1051,745Unpaid obligations, end of year .................................................3050Memorandum (non-add) entries:



Outlays, gross:1,9002,5172,517Outlays from mandatory balances ....................................4101

...................................................Budget authority, net (total) ..........................................................41801,9002,5172,517Outlays, net (total) ........................................................................4190

Summary of Budget Authority and Outlays (in millions of dollars)

2018 est.2017 est.2016 actual

Enacted/requested:1,9002,5172,517Outlays ......................................................................................

Legislative proposal, subject to PAYGO:2,874..................................Budget Authority .......................................................................718..................................Outlays ......................................................................................

Total:2,874..................................Budget Authority .......................................................................2,6182,5172,517Outlays ......................................................................................

The Veterans Access, Choice, and Accountability Act of 2014 ("VeteransChoice Act"), Public Law 113–146, provided $10 billion in mandatoryfunding through 2017 to establish a temporary program ("Veterans ChoiceProgram") improving veterans' access to health care by allowing eligibleveterans who meet certain wait-time or distance standards to use eligiblehealth care providers outside the VA system. The law directed that thisfunding be deposited in the Veterans Choice Fund. In July 2015, Congressprovided emergency funding for Hepatitis C ($500,000,000) and Care inthe Community ($2,848,500,000) by passing Public Law 114–41, theSurface Transportation and Veterans Health Care Choice ImprovementAct of 2015, which gave VA temporary authority to use Veterans ChoiceFund dollars on other programs. This authority ended on October 1, 2015and did not extend into fiscal year 2016.

Public Law 115–26 amended the Veterans Choice Act to eliminate theAugust 7, 2017 sunset date for the Veterans Choice Program, thus allowingthe program to operate until all of the money in the Veterans Choice Fundis expended.




.................94Full-time permanent .............................................................11.1

.................1.................Other than full-time permanent ............................................11.3

.................104Total personnel compensation ...........................................11.9

.................21Civilian personnel benefits ........................................................12.1

.................10.................Travel and transportation of persons .........................................21.06263,8552,535Other contract services .............................................................25.2

..................................693Audit Adjustment ......................................................................25.2

6263,8773,233Total new obligations, unexpired accounts ............................99.9

Employment Summary


.................13158Direct civilian full-time equivalent employment ............................1001

VETERANS CHOICE FUND

(Legislative proposal, subject to PAYGO)



Obligations by program activity:31..................................Veterans Choice Fund - Adminstrative ......................................0001

2,843..................................Veterans Choice Fund - Program ...............................................0002

2,874..................................Direct program activities, subtotal ................................................0091

2,874..................................Total new obligations, unexpired accounts ....................................0900


Appropriations, mandatory:2,874..................................Appropriation ....................................................................12002,874..................................Total budgetary resources available ..............................................1930


2,874..................................New obligations, unexpired accounts ....................................3010–718..................................Outlays (gross) ......................................................................3020

2,156..................................Unpaid obligations, end of year .................................................3050Memorandum (non-add) entries:

2,156..................................Obligated balance, end of year ..............................................3200


2,874..................................Budget authority, gross .........................................................4090Outlays, gross:

718..................................Outlays from new mandatory authority .............................41002,874..................................Budget authority, net (total) ..........................................................4180718..................................Outlays, net (total) ........................................................................4190

To continue the Veterans Choice Program, the Budget requests $2.9 bil-lion in mandatory budget authority in 2018 and $3.5 billion in 2019 andeach subsequent outyear.




9..................................Full-time permanent .............................................................11.11..................................Other than full-time permanent ............................................11.3

10..................................Total personnel compensation ...........................................11.92..................................Civilian personnel benefits ........................................................12.1

12..................................Travel and transportation of persons .........................................21.02,814..................................Other contract services .............................................................25.2

36..................................Supplies and materials .............................................................26.0

2,874..................................Total new obligations, unexpired accounts ............................99.9

Employment Summary


131..................................Direct civilian full-time equivalent employment ............................1001

✦

Trust Funds

GENERAL POST FUND, NATIONAL HOMES



9..................................Balance, start of year ....................................................................0100Receipts:

Current law:313121General Post Fund, National Homes, Deposits .......................1130

222General Post Fund, National Homes, Interest on

Investments ......................................................................1140

333323Total current law receipts ..................................................1199

333323Total receipts .............................................................................1999

423323Total: Balances and receipts .....................................................2000Appropriations:

Current law:–25–24–23General Post Fund, National Homes ......................................2101

179.................Balance, end of year ..................................................................5099


Trust Funds

GENERAL POST FUND, NATIONAL HOMES—Continued



Obligations by program activity:232221Religious, recreational, and entertainment activities ................0001111Therapeutic residence maintenance ..........................................0003




Appropriations, mandatory:252423Appropriation (special or trust fund) .................................1201

133131129Total budgetary resources available ..............................................1930Memorandum (non-add) entries:




–24–23–22Outlays (gross) ......................................................................3020





2120.................Outlays from new mandatory authority .............................41003322Outlays from mandatory balances ....................................4101

242322Outlays, gross (total) .............................................................4110252423Budget authority, net (total) ..........................................................4180242322Outlays, net (total) ........................................................................4190

Memorandum (non-add) entries:107106106Total investments, SOY: Federal securities: Par value ...............5000108107106Total investments, EOY: Federal securities: Par value ...............5001

This fund consists of gifts, bequests, and proceeds from the sale ofproperty left in the care of the facilities by former beneficiaries; patients'fund balances; and proceeds from the sale of effects of beneficiaries whodie leaving no heirs or without having otherwise disposed of their estate.Such funds are used to promote the comfort and welfare of veterans athospitals, nursing homes, and domiciliaries where no general appropriationis available. Public Law 102–54 authorizes compensation work therapyand therapeutic transitional housing and loan programs to be funded fromthe General Post Fund. (38 U.S.C. chs. 83 and 85.)



Direct obligations:887Other services from non-Federal sources ..................................25.2

141313Supplies and materials .............................................................26.0111Equipment .................................................................................31.0111Land and structures ..................................................................32.0


✦

BENEFITS PROGRAMSFederal Funds

VETERANS BENEFITS ADMINISTRATION

COMPENSATION AND PENSIONS

(INCLUDING TRANSFER OF FUNDS)

For the payment of compensation benefits to or on behalf of veterans and a pilotprogram for disability examinations as authorized by section 107 and chapters 11,

13, 18, 51, 53, 55, and 61 of title 38, United States Code; pension benefits to or onbehalf of veterans as authorized by chapters 15, 51, 53, 55, and 61 of title 38, UnitedStates Code; and burial benefits, the Reinstated Entitlement Program for Survivors,emergency and other officers' retirement pay, adjusted-service credits and certificates,payment of premiums due on commercial life insurance policies guaranteed underthe provisions of title IV of the Servicemembers Civil Relief Act (50 U.S.C. App.541 et seq.) and for other benefits as authorized by sections 107, 1312, 1977, and2106, and chapters 23, 51, 53, 55, and 61 of title 38, United States Code,[$90,119,449,000] $95,768,462,000, to remain available until expended and tobecome available on October 1, [2017] 2018: Provided, That not to exceed[$17,224,000] $17,882,000 of the amount made available for fiscal year [2018]2019 under this heading shall be reimbursed to "General Operating Expenses, Vet-erans Benefits Administration", and "Information Technology Systems" for necessaryexpenses in implementing the provisions of chapters 51, 53, and 55 of title 38, UnitedStates Code, the funding source for which is specifically provided as the "Compens-ation and Pensions" appropriation: Provided further, That such sums as may beearned on an actual qualifying patient basis, shall be reimbursed to "Medical CareCollections Fund" to augment the funding of individual medical facilities for nursinghome care provided to pensioners as authorized: Provided further, That, of the fundsmade available under this heading in this Act and in Public Law 114–223, suchsums as may be necessary shall be reimbursed to "General Operating Expenses,Veterans Benefits Administration" and "Information Technology Systems" for neces-sary expenses in carrying out the pilot program for disability examinations authorizedby section 504 of Public Law 104–275, as amended (38 U.S.C. § 5101 note), to in-clude associated expenses authorized by section 111 of title 38, United States Code.(Military Construction, Veterans Affairs, and Related Agencies Appropriations Act,2017.)



Obligations by program activity:77,48571,44067,483Veterans ....................................................................................01017,1136,7676,443Survivors ...................................................................................0102

84,59878,20773,926Compensation sub-total ................................................................0191

84,59878,20773,926Other compensation expenses .......................................................0200212020Chapter 18 ................................................................................0201

115107103Clothing allowance ....................................................................0202131313Misc assistance (EAJ, SAFD) ......................................................0203

778765308Medical exam pilot program ......................................................0204433OBRA payment to VBA and IT ....................................................0205111Reinstated entitlement program for survivors ...........................0206

932909448Total other compensation expenses ...............................................0291

85,53079,11674,374Total compensation .......................................................................02933,9013,7433,645Veterans ....................................................................................03022,0891,9381,808Survivors ...................................................................................0303

5,9905,6815,453Pensions sub total .........................................................................0391141315Reimbursements to GOE, IT and VHA .........................................0401

6,0045,6945,468Total pensions ...............................................................................0492111Caskets and Urns ......................................................................0501

292827Burial allowance .......................................................................0502212020Burial plots ...............................................................................0503656261Service-connected deaths .........................................................0504242319Burial flags ...............................................................................0505778081Headstones and markers ...........................................................0506466Graveliners ................................................................................0508

221616Pre-Place Crypts ........................................................................0509

243236231Total burial program ......................................................................0591

91,77785,04680,073Total new obligations (object class 42.0) ......................................0900


3,8792,8425,818Unobligated balance brought forward, Oct 1 .........................1000..................................9Recoveries of prior year unpaid obligations ...........................1021..................................222Recoveries of prior year paid obligations ...............................1033


Appropriations, mandatory:..................................76,866Appropriation ....................................................................1200

Advance appropriations, mandatory:90,11986,083.................Advance appropriation ..................................................127090,11986,08376,866Budget authority (total) .............................................................190093,99888,92582,915Total budgetary resources available ..............................................1930

THE BUDGET FOR FISCAL YEAR 2018972 Veterans Health Administration—ContinuedTrust Funds—Continued

Memorandum (non-add) entries:2,2213,8792,842Unexpired unobligated balance, end of year ..........................1941


1,0081436,038Unpaid obligations, brought forward, Oct 1 ..........................300091,77785,04680,073New obligations, unexpired accounts ....................................3010


8,6121,008143Unpaid obligations, end of year .................................................3050Memorandum (non-add) entries:

1,0081436,038Obligated balance, start of year ............................................31008,6121,008143Obligated balance, end of year ..............................................3200



79,28581,19674,103Outlays from new mandatory authority .............................41004,8882,98511,856Outlays from mandatory balances ....................................4101





accounts .......................................................................4143

90,11986,08376,866Budget authority, net (mandatory) ............................................416084,17384,18185,737Outlays, net (mandatory) ...........................................................417090,11986,08376,866Budget authority, net (total) ..........................................................418084,17384,18185,737Outlays, net (total) ........................................................................4190



Enacted/requested:90,11986,08376,866Budget Authority .......................................................................84,17384,18185,737Outlays ......................................................................................

Legislative proposal, subject to PAYGO:–3,225..................................Budget Authority .......................................................................–3,225..................................Outlays ......................................................................................

Total:86,89486,08376,866Budget Authority .......................................................................80,94884,18185,737Outlays ......................................................................................

WORKLOAD2018 est.2017 est2016 actual

Compensation Completed Claims:1,208,6991,165,7591,122,718Rating ......................................................................................................2,500,4582,488,2512,367,585Other Claims ............................................................................................

Pension Completed Claims:161,583155,843150,089Rating ......................................................................................................425,762434,776394,467Other Non-Rating Claims .........................................................................

For 2019, the Budget requests $95,768,462,000 in advance appropriationsfor Compensation and Pensions. This request satisfies the requirementcreated by the Consolidated and Further Continuing Appropriations Act,2015 (Public Law 113–235) and prevents our Nation's veterans from beingadversely affected by budget delays.

This appropriation provides for the payment of compensation, pension,and burial benefits to veterans and survivors.

Compensation is paid to veterans for disabilities incurred in or aggravatedduring active military service. Dependency and Indemnity Compensationis paid to survivors of servicepersons or veterans whose death occurredwhile on active duty or as a result of service-connected disabilities. Com-pensation and vocational rehabilitation is provided to the children of Viet-nam veterans who were born with certain birth defects. The Secretary maypay a clothing allowance to each veteran who uses a prescribed medicationfor a service-connected skin condition or wears a prosthetic or orthopedicappliance (including a wheelchair) which, in the judgment of the Secretary,tends to damage or tear the clothing of such veteran.

Miscellaneous benefits provided for are:(a) payments for claims made pursuant to the provision of the World War

Adjusted Compensation Act of 1924, as amended;

(b) a special allowance (38 U.S.C. 1312) to dependents of certain veteranswho died after December 31, 1956, but who were not fully and currentlyinsured under the Social Security Act; and

(c) payments authorized by the Equal Access to Justice Act.The appropriation also provides for a program to allow VA to perform

income matches for certain compensation recipients.In accordance with Public Law 97–377, the Reinstated Entitlement Pro-

gram for Survivors (REPS) program restores Social Security benefits tocertain surviving spouses or children of veterans who died of service-con-nected causes.

Legislation is proposed to provide a cost-of-living adjustment comparableto the annual social security increase to recipients of disability compensa-tion, dependency and indemnity compensation, and clothing allowances.The increase, effective with payments made on January 1, 2018, is expectedto be 2.8 percent.

AVERAGE NUMBER OF COMPENSATION CASES AND PAYMENTS2018 est.2017 est2016 actual

Veterans:4,616,7644,446,3474,269,523Cases .......................................................................................................$16,784$16,067$15,805Average payment per case, per year .........................................................$77,486$71,439$67,482Total obligations (in millions) ...................................................................

Survivors:419,948408,013394,813Cases .......................................................................................................$16,938$16,586$16,320Average payment per case, per year .........................................................$7,113$6,767$6,443Total obligations (in millions) ...................................................................

Chapter 18:1,1371,1461,155Children ....................................................................................................

$18,254$17,757$17,704Average payment per case, per year .........................................................$21$20$20Total obligations (in millions) ...................................................................

Clothing allowance:143,070137,858132,575Number of veterans ..................................................................................

$801$780$777Average payment per case, per year .........................................................$115$107$103Total obligations (in millions) ...................................................................

Special Allowance for Dependents:313437Cases .......................................................................................................

$2,468$2,401$2,394Average benefit ........................................................................................$0$0$0Total obligations (in millions) ...................................................................

Equal Access to Justice Act:2,7402,7992,858Cases .......................................................................................................

$4,820$4,702$4,688Average benefit ........................................................................................$13$13$13Total Obligations (in millions) ..................................................................

REPS:111418Cases .......................................................................................................

$54,505$48,448$38,564Average benefit ........................................................................................$1$1$1Total Obligations (in millions) ..................................................................

Pension benefits may be paid to veterans or their survivors. A veteran'sentitlement is based on active duty service of a specific length (normally90 days or more) during a designated war period, disabilities consideredpermanent and total, and countable income below established levels. Thereis no disability requirement for survivor cases or veterans age 65 or older.Income support is provided at established benefit levels.

An automatic annual cost-of-living increase comparable to the annualsocial security increase is provided for those pensioners in the improvedprogram and to parents receiving dependency and indemnity compensation.The increase, effective with payments made on January 1, 2018, is expectedto be 2.8 percent.

AVERAGE NUMBER OF PENSION CASES AND PAYMENTS2018 est.2017 est.2016 actual

Veterans:289,178288,630291,904Cases .......................................................................................................$13,488$12,970$12,485Average payment per case, per year .........................................................$3,901$3,743$3,644Total obligations (in millions) ...................................................................

Survivors:204,006203,194203,771Cases .......................................................................................................$10,241$9,536$8,874Average payment per case, per year .........................................................$2,089$1,938$1,808Total obligations (in millions) ...................................................................

Burial benefits in 2017 provide for: (a) the payment of an allowance of$749 (plus transportation charges where death occurs under VA care) toreimburse, in part, the burial and funeral expense of an eligible deceasedveteran; (b) the payment of $749 for a plot allowance where an eligibleveteran is not buried in a national cemetery or other cemetery under thejurisdiction of the United States; (c) the payment of a burial allowance ofup to $2,000 when a veteran dies as a result of a service-connected disabil-

973DEPARTMENT OF VETERANS AFFAIRSBenefits Programs—Continued


COMPENSATION AND PENSIONS—Continued

ity; (d) furnishing a flag to drape the casket of each deceased veteran entitledthereto; (e) furnishing a headstone or marker for the grave of a veteran and,in certain cases, eligible dependents; and (f) authority to provide outerburial receptacles in the National Cemetery Administration.

NUMBER OF BURIAL BENEFITS2018 est.2017 est.2016 actual

37,21236,05734,993Burial allowance .......................................................................................26,73725,90725,142Burial plot ................................................................................................21,22220,29419,147Service-connected deaths ........................................................................

497,644497,644481,164Burial flags ..............................................................................................373,895369,511365,179Headstones and markers ..........................................................................11,47811,34311,210Graveliners ...............................................................................................30,28129,92629,575Preplaced crypts .......................................................................................

305302298Caskets and Urns .....................................................................................

COMPENSATION AND PENSIONS




Obligations by program activity:–20..................................COLA Round Down .....................................................................0101

–3,205..................................Individual Unemployability (IU) Program Modernization ............0102

–3,225..................................Total new obligations (object class 42.0) ......................................0900


Appropriations, mandatory:Advance appropriations, mandatory:

–3,225..................................Advance appropriation ..................................................1270–3,225..................................Budget authority (total) .............................................................1900–3,225..................................Total budgetary resources available ..............................................1930


–3,225..................................New obligations, unexpired accounts ....................................30103,225..................................Outlays (gross) ......................................................................3020


–3,225..................................Budget authority, gross .........................................................4090Outlays, gross:

–3,225..................................Outlays from new mandatory authority .............................4100–3,225..................................Budget authority, net (total) ..........................................................4180–3,225..................................Outlays, net (total) ........................................................................4190

Round-Down of the Computation of the Cost of Living Adjustment (COLA)for Service-Connected Compensation and Dependency and IndemnityCompensation (DIC) for Ten Years.—VA proposes to amend title 38, U.S.Code (U.S.C.), sections 1104(a) and 1303(a) to provide a ten-year round-down provision of the computation of the COLA for service-connectedcompensation and DIC. Public Law 108–183 extended the ending date ofthis provision from 2011 to 2013, but the provision has now expired. TheCOLA round-down provision for ten years, beginning in 2018, results incost savings. Benefit savings to the Compensation and Pensions accountare estimated to be $19.8 million in 2018, $65.5 million in 2019, $627.2million over five years, and $2.7 billion over ten years.

Modernization of the Individual Unemployability (IU) Program.—VAcurrently provides additional disability compensation benefits to Veterans,irrespective of age, who it deems unable to obtain or maintain gainful em-ployment due to their service-connected disabilities through a programcalled Individual Unemployability (IU). The IU program is a part of VA'sdisability compensation program that allows VA to pay certain Veteransdisability compensation at the 100 percent rate, even though VA has notrated their service-connected disabilities at the total level. These Veteranshave typically received an original disability ratings between 60 and 100percent. Under this proposal, Veterans eligible for Social Security retirementbenefits would have their IU terminated upon reaching the minimum retire-ment age for Social Security purposes, or upon enactment of the proposalif the Veteran is already in receipt of Social Security retirement benefits.

These Veterans would continue to receive VA disability benefits based ontheir original disability rating, at the scheduler evaluation level. IU benefitswould not be terminated for Veterans who are ineligible for Social Securityretirement benefits, thus allowing them to continue to receive IU pastminimum retirement age. Savings to the Compensation and Pensions ac-count are estimated to be $3.2 billion in 2018, $17.9 billion over five years,and $40.8 billion over ten years.

✦

READJUSTMENT BENEFITS

For the payment of readjustment and rehabilitation benefits to or on behalf ofveterans as authorized by chapters 21, 30, 31, 33, 34, 35, 36, 39, 41, 51, 53, 55, and61 of title 38, United States Code, [$13,708,648,000] $11,832,175,000, to remainavailable until expended and to become available on October 1, [2017] 2018:Provided, That expenses for rehabilitation program services and assistance whichthe Secretary is authorized to provide under subsection (a) of section 3104 of title38, United States Code, other than under paragraphs (1), (2), (5), and (11) of thatsubsection, shall be charged to this account. (Military Construction, Veterans Affairs,and Related Agencies Appropriations Act, 2017.)



Obligations by program activity:478459441Sons and daughters ..................................................................0101817879Spouses .....................................................................................0102

559537520Total education and training .........................................................0191842783742Vocational rehabilitation training ..............................................0201752722573Subsistence allowance ..............................................................0202185177135Automobiles and adaptive equipment .......................................0203116111103Housing Grants .........................................................................0204

.................11Housing Technology Grants .......................................................0205

1,8951,7941,554Total special assistance to disabled veterans ...............................0291504842Work study .................................................................................0301191919Payments to States ...................................................................0302

12,31312,06411,810All-volunteer assistance: Basic benefits and all other ..............0303556Tuition Assistance .....................................................................0305332Licensing and Certification .......................................................0306

10910Reporting fees ...........................................................................030711.................Reimbursement to GOE .............................................................0308664Contract Counseling ..................................................................0309

12,40712,15511,893Total All-volunteer assistance and other .......................................0391

14,86114,48613,967Total direct obligations ..................................................................0799191817Veterans and servicepersons supplementary benefits ...............0802

101106110Chapter 1606 reservists benefits ..............................................0803282930Chapter 1606 reservists supplementary benefits ......................0804212121Chapter 1607 reservists benefits ..............................................0805

133128120Chapter 33 DoD Reimbursements .............................................0807

302302298Total reimbursable obligations ......................................................0899



4,7692,9142,320Unobligated balance brought forward, Oct 1 .........................1000..................................4Recoveries of prior year unpaid obligations ...........................1021..................................244Recoveries of prior year paid obligations ...............................1033


Appropriations, mandatory:..................................14,313Appropriation ....................................................................1200

Advance appropriations, mandatory:13,70916,341.................Advance appropriation ..................................................1270


14,01116,64314,611Budget authority (total) .............................................................190018,78019,55717,179Total budgetary resources available ..............................................1930



245183714Unpaid obligations, brought forward, Oct 1 ..........................300015,16314,78814,265New obligations, unexpired accounts ....................................3010

–14,872–14,726–14,792Outlays (gross) ......................................................................3020

THE BUDGET FOR FISCAL YEAR 2018974 Benefits Programs—ContinuedFederal Funds—Continued








9,85811,63011,758Outlays from new mandatory authority .............................41005,0143,0963,034Outlays from mandatory balances ....................................4101






accounts .......................................................................4143

13,70916,34114,313Budget authority, net (mandatory) ............................................416014,57014,42414,250Outlays, net (mandatory) ...........................................................417013,70916,34114,313Budget authority, net (total) ..........................................................418014,57014,42414,250Outlays, net (total) ........................................................................4190



Enacted/requested:13,70916,34114,313Budget Authority .......................................................................14,57014,42414,250Outlays ......................................................................................

Legislative proposal, subject to PAYGO:–42..................................Budget Authority .......................................................................–42..................................Outlays ......................................................................................

Total:13,66716,34114,313Budget Authority .......................................................................14,52814,42414,250Outlays ......................................................................................

WORKLOAD - Vocational Rehabilitation and Employment2018 est.2017 est.2016 actual

81,84281,03180,229Evaluation and planning ..........................................................................122,547121,333120,112Rehabilitation services .............................................................................25,08924,84124,595Employment services status .....................................................................15,54515,39115,239Vocational/educational counseling ...........................................................

WORKLOAD - Education2018 est.2017 est.2016 actual338,152347,893358,001Original claims .........................................................................................

3,548,6543,650,8783,756,960Adjustments/supplemental claims ...........................................................

For 2019, the Budget requests $11,832,175,000 in advance appropriationsfor Readjustment Benefits. This request satisfies the requirement createdby the Consolidated and Further Continuing Appropriations Act, 2015(Public Law 113–235) and prevents our Nation's Veterans from being ad-versely affected by budget delays.

This appropriation finances educational assistance allowances for certainservicemembers, veterans, and for eligible dependents of those: (a) veteranswho died from service-connected causes or have a total and permanentrated service-connected disability; and (b) servicemembers who werecaptured or missing in action. In addition, certain disabled veterans areprovided with vocational rehabilitation, specially adapted housing grants,and automobile grants with the associated approved adaptive equipment.Voluntary contributions by eligible servicemembers and matching contri-butions provided by the Department of Defense are included in the Post-Vietnam Era Veterans Education Account.

The Post 9–11 GI Bill (Chapter 33).—Public Law 110–252 greatly ex-panded education benefits beginning on August 1, 2009. Based on lengthof active duty service and training rate, trainees may be entitled to benefitsincluding: tuition and fees, housing allowance, books and supplies stipend,kickers, and Yellow Ribbon matching payments. Certain active dutymembers of the Armed Forces may transfer benefits to a spouse or children.

All volunteer force educational assistance (Montgomery GI Bill).—PublicLaw 98–525, enacted October 19, 1984, established two new educationalprograms: an assistance program for veterans who enter active duty duringthe period beginning July 1, 1985; and an assistance program for certainmembers of the Selected Reserve. Public Law 108–375 established a pro-gram to provide educational assistance to members of the reserve compon-ents called or ordered to active service in response to a war or nationalemergency declared by the President or the Congress, in recognition of thesacrifices that those members make in answering the call to duty. The Re-adjustment Benefit appropriation pays the basic benefit allowance for vet-erans, except for certain Post-Vietnam Era Veterans Education participantswho transferred to the Montgomery GI Bill program. Supplementary edu-cational assistance, Post-Vietnam Era Veterans Education converters, re-servists, and the National Call to Service Program are financed by paymentsfrom Department of Defense.

Survivors and Dependents Educational Assistance (Chapter 35).—Bene-fits are provided to children and spouses of veterans who died of a service-connected disability or whose service-connected disability is rated perman-ent and total. In addition, dependents of servicemembers missing in actionor interred by a hostile foreign government for more than 90 days are alsoeligible. The following table provides a comparison of trainees and costsfor the Dependents Educational Assistance.

The Veterans Retraining Assistance Program.—Established under PublicLaw 112–56, is a program that, from July 1, 2012 through March 31, 2014,provides up to 12 months of retraining assistance to veterans at least 35years of age but not more than 60 years of age, who are unemployed, re-ceived an honorable discharge and have no eligibility remaining for othereducation benefits. Veterans participating in this program would receivemonthly payments equal to the three-year payment rate under the Mont-gomery GI Bill (MGIB) chapter 30.

The following table shows a caseload and cost comparison for these be-neficiaries under existing legislation.

CASELOAD AND AVERAGE COST DATA2018 est.2017 est.2016 actual

Chapter 33:796,389793,235790,090Number of trainees ...............................................................................$15,292$14,984$14,661Average cost per trainee .......................................................................

$12,178$11,886$11,583Total cost (in millions) .................................................................


$286$324$365Total cost (in millions) .................................................................



Chapter 1607:4,5384,5384,538Number of trainees ...............................................................................

$4,611$4,588$4,561Average cost per trainee .......................................................................


Chapter 35 Sons and Daughters:86,84783,93281,118Number of trainees ...............................................................................$5,498$5,471$5,439Average cost per trainee (in dollars) ....................................................


Chapter 35 Wives and Widow(ers):15,72315,33215,644Number of trainees ...............................................................................$5,123$5,097$5,067Average cost per trainee (in dollars) ....................................................


Veterans Retraining Assistance Program:0Number of trainees ...............................................................................

$0Average cost per trainee .......................................................................

$0$0$0.1Total cost (in millions) ......................................................................



READJUSTMENT BENEFITS—Continued

Vocational Rehabilitation and Employment (Chapter 31).—Servicemem-bers and veterans with service-connected disabilities receive the assistancenecessary to help them prepare for, obtain, and maintain suitable employ-ment. Comprehensive assessments may include interest and aptitude testingas well as specialized assessments such as functional capacity examinations.During the training phase of the program, eligible servicemembers andveterans are provided assistance for necessary training such as tuition, fees,books and supplies at colleges, technical schools and other training pro-grams. A veteran enrolled in training receives a monthly subsistence allow-ance. Eligible veterans may also receive specialized or adaptive equipmentto help them overcome a disability or enable them to compete with non-disabled individuals. At the completion of training, veterans are providedwith employment and placement services, including supplies and equipmentneeded to enter employment, adaptive equipment and workplace accom-modations, incentives to employers to reimburse them for hiring andtraining veterans with disabilities, and two final months of subsistence al-lowance.


Chapter 31:22,58521,79621,418Rehabilitation, Evaluation, Planning and Service cases ......................

122,009117,742115,703Number of trainees ...............................................................................$13,065$12,782$11,363Average cost per trainee (in dollars) ....................................................

$1,594$1,504$1,314Total cost (in millions) .................................................................

Specially Adapted Housing Grants.—Specially adapted housing grantsare provided to certain severely disabled veterans. In 2017, the maximumgrant amount was $77,307. Veterans who suffer service-connected blindnessor who have lost the use of both upper extremities can receive up to$15,462.

Specially Adapted Housing Assistive Technology Grants.—Under theVeterans Benefits Act of 2010, (Public Law 111–275), VA may providegrants of up to $200,000 per fiscal year to individuals or entities for thedevelopment of specially adapted housing assistive technologies and limitsto $1 million the aggregate amount of such grants VA may award in anyfiscal year.

Automobile Grants and Adaptive Equipment.—Certain disabled veteransare provided with automobile grants with the associated approved adaptiveequipment. An allowance is provided to certain service-disabled veteransand servicemembers toward the purchase price of an automobile. Themaximum allowance increased to $20,235 in 2017, under The VeteransBenefits Act of 2010, (Public Law 111–275) and will continue to increasebased on the CPI-U. Adaptive equipment and the maintenance and replace-ment of such equipment is also provided.


Housing grants:2,7322,7352,678Number of housing grants ....................................................................

$42,347$40,617$38,559Average cost per grant .........................................................................


054Number of housing technology grants ..................................................$0$200,000$195,855Average cost per grant .........................................................................

$0$1$.8Total cost (in millions) .................................................................

Automobiles or other conveyances:2,6753,1472,413Number of conveyances ........................................................................

$17,790$18,401$19,034Average benefit ....................................................................................

$48$58$46Obligations (in millions) ..............................................................

Adaptive equipment (including maintenance, repair, and installation forautomobiles):

8,2368,3227,323Number of items ...................................................................................$16,741$14,284$12,187Average benefit ....................................................................................

$138$119$89Obligations (in millions) ..............................................................

Tuition Assistance.—Public Law 106–398, enacted October 30, 2000,allows the military services to pay up to 100 percent of tuition and expensescharged by a school for servicemembers. If a service department pays lessthan 100 percent, a servicemember eligible for the Montgomery GI BillActive-duty (MGIB) or the Post 9–11 GI Bill (Chapter 33) can elect to re-ceive VA benefits for all or a portion of the remaining expenses. PublicLaw 108–454 established a program that provides availability of educationbenefits for payment for national admissions exams and national examsfor credit at institutions of higher education.

The National Exams.—The benefit allows VA to reimburse for the feecharged for national tests for admission to institutions of higher learningand national tests providing an opportunity for course credit at institutionsof higher learning.

Licensing and Certification Test Payments.—Under Public Law 106–419,veterans and other eligible persons may receive up to $2,000 to pay feesrequired for civilian occupational licensing and certification examinationsneeded to enter, maintain, or advance in employment in a vocation or pro-fession, effective March 1, 2001.

National Call to Service.—The 2003 National Defense AuthorizationAct directs the Department of Defense to offer an active duty enlistmentoption of 15 months plus training time to facilitate interest in NationalService. Program participants will be given the opportunity to select oneof the following incentives: a $5,000 enlistment bonus, repayment of studentloans up to $18,000, or one of two education allowances.

Work-Study.—Certain veterans, reservists, and dependents pursuing aprogram of rehabilitation, education or training, who are enrolled as full-time students, can work up to 250 hours per semester, receiving the Federal($7.25 as of July 24, 2009) or state minimum wage rate, whichever ishigher.

Payments to States.—State approving agencies are reimbursed for thecosts of inspecting, approving, and supervising programs of education andtraining offered by educational institutions and training establishments inwhich veterans, dependents, and reservists are enrolled or are about toenter.

Reporting Fees.—Reporting fees are paid to education and training insti-tutions to help defray the costs of certifying education enrollment for vet-erans enrolled in training during a calendar year.



14,86114,48613,967Direct obligations: Grants, subsidies, and contributions ...............41.0302302298Reimbursable obligations .....................................................99.0


READJUSTMENT BENEFITS




Obligations by program activity:–42..................................VA Cap for Flight Training at Public Schools ..............................0102

–42..................................Total new obligations, unexpired accounts (object class 41.0) .......0900


Appropriations, mandatory:Advance appropriations, mandatory:

–42..................................Advance appropriation ..................................................1270–42..................................Budget authority (total) .............................................................1900–42..................................Total budgetary resources available ..............................................1930


–42..................................New obligations, unexpired accounts ....................................301042..................................Outlays (gross) ......................................................................3020



–42..................................Budget authority, gross .........................................................4090Outlays, gross:

–42..................................Outlays from new mandatory authority .............................4100–42..................................Budget authority, net (total) ..........................................................4180–42..................................Outlays, net (total) ........................................................................4190

Rounding Down of Certain Cost-of-Living Adjustments.—VA proposesto amend title 38 U.S.C. sections 3015(h) and 3564 to round-down benefitrates from 2018 to 2027. P.L. 108–183, the Veteran Benefits Act of 2003,last extended a previous authority in title 38 that authorized VA to round-down the yearly cost-of-living adjustments for basic educational assistanceto the next lower whole dollar amount through fiscal year 2013. Previously,under chapter 30 and 35, the yearly increase in educational assistance wasrounded-down to the next lower dollar. When this legislation expired, thesemonthly rate increases for educational assistance were rounded to thenearest whole dollar. Savings to VA are estimated to be $0 in 2018, $2.7million for five years, and $21.4 million over ten years.

Prevent VA from Providing Unlimited Amounts of Payments for FlightTraining at Public Schools.—VA proposes to amend title 38 U.S.C. section3313(c) and add new section (j) to impose tuition and fee payment caps atInstitutions of Higher Learning (IHLs) with flight training programs andestablish a maximum allowable fee structure for all VA-funded flight pro-grams. Savings are estimated to be $42.0 million in 2018, $228.8 millionfor five years, and $511.2 million over ten years.

✦

VETERANS INSURANCE AND INDEMNITIES

For military and naval insurance, national service life insurance, servicemen's in-demnities, service-disabled veterans insurance, and veterans mortgage life insuranceas authorized by chapters 19 and 21, title 38, United States Code, [$124,504,000]$121,529,000, to remain available until expended, which shall be in addition tofunds previously appropriated under this heading that became available on October1, 2017, of which [$107,899,000] $109,090,000 shall become available on October1, [2017] 2018. (Military Construction, Veterans Affairs, and Related AgenciesAppropriations Act, 2017.)



Obligations by program activity:424139VMLI Death Claims ....................................................................0011867344Payment to Service-Disabled Veterans Insurance ......................0012

12811483Total direct expenses .....................................................................0100




Appropriations, mandatory:..................................77Appropriation ....................................................................1200

Advance appropriations, mandatory:120109.................Advance appropriation ..................................................1270


12611583Budget authority (total) .............................................................190012911785Total budgetary resources available ..............................................1930



.................11Unpaid obligations, brought forward, Oct 1 ..........................300012811483New obligations, unexpired accounts ....................................3010

–128–115–83Outlays (gross) ......................................................................3020

..................................1Unpaid obligations, end of year .................................................3050Memorandum (non-add) entries:

.................11Obligated balance, start of year ............................................3100

..................................1Obligated balance, end of year ..............................................3200





Offsetting collections (collected) from:–6–6–6Non-Federal sources .........................................................412312010977Budget authority, net (total) ..........................................................418012210977Outlays, net (total) ........................................................................4190

WORKLOAD2018 est.2017 est.2016 actual823,900867,107899,790Policy service actions ...............................................................................405,000471,000541,120Collections ................................................................................................42,04043,79035,600Disability claims .......................................................................................

173,980186,530178,479Insurance awards .....................................................................................

For military and naval insurance, national service life insurance, service-men's indemnities, service-disabled veterans insurance, and veteransmortgage life insurance as authorized by chapters 19 and 21, title 38, UnitedStates Code $121,529,000, to remain available until expended, of which$109,090,000 shall become available on October 1, 2018. Public Law114–113, Consolidated Appropriations Act, 2016 on December 18, 2015,enacted associated advance 2018 appropriations of $107,899,000 that shallbecome available on October 1, 2017.

Note.—Department of Veterans Affairs insurance policy loans are notan extension of Federal credit. Credit schedules previously shown for thisaccount have been discontinued.

The insurance business line administers six life insurance programs, in-cluding two trust funds, two public enterprise funds, a trust revolving fund,and Veterans' Mortgage Life Insurance (VMLI), and supervises four addi-tional programs for the benefit of servicepersons, veterans, and their bene-ficiaries through contracts with a commercial company. All programs areoperated on a commercial basis, to the extent possible, consistent with allapplicable statutes. The insurance appropriation is the supplemental fundingmechanism for the following Government life insurance activities: NationalService Life Insurance (NSLI); Service-Disabled Veterans Insurance Fund(S-DVI); and Veterans' Mortgage Life Insurance.

National Service Life Insurance.—Payments are made to the NSLI fundfor certain World War II veterans for: (a) extra hazards of service; (b)gratuitous insurance granted to certain persons unable to apply for NationalService Life Insurance; and (c) death claims on policies under the waiverof a premium while the insured was on active duty.

Payment to Service-Disabled Veterans Insurance Fund.—Payments aremade to the S-DVI fund to supplement the premiums and other receipts ofthe fund in amounts necessary to pay claims on insurance policies issuedto veterans with service-connected disabilities.

Veterans' Mortgage Life Insurance.—Payments are made to mortgageholders under this program, which provides mortgage protection life insur-ance to veterans who have received a grant for specially adapted housingdue to severe disabilities. The trend in the number and amount of insurancepolicies in force appears in the following table.

POLICIES AND INSURANCE IN FORCE2018 est.2017 est.2016 actualVMLI Policies

2,8702,7902,654Number of Policies ...........................................................................$401$382$345Amount of Insurance (dollars in millions) ........................................



12611179Direct obligations: Insurance claims and indemnities ...................42.0234Reimbursable obligations .....................................................99.0


✦



FILIPINO VETERANS EQUITY COMPENSATION FUND




565656Unobligated balance brought forward, Oct 1 .........................1000565656Total budgetary resources available ..............................................1930


...................................................Budget authority, net (total) ..........................................................4180

...................................................Outlays, net (total) ........................................................................4190

This fund was established under the Consolidated Security, Disaster As-sistance, and Continuing Appropriations Act of 2009 (Public Law 110–329),to make payments to eligible persons who served in the Philippines duringWorld War II. Payments were subsequently authorized by Congress in theAmerican Recovery and Reinvestment Act of 2009 (Public Law 111–5).Original funding of $198,000,000 was supplemented by a transfer of$67,000,000 authorized by Public Law 111–212 that remains availableuntil expended. Payments to citizens of the United States are $15,000.Payments to non-U.S. citizens are $9,000.

✦

SERVICE-DISABLED VETERANS INSURANCE FUND



Obligations by program activity:272626Capital investment ....................................................................0801

119116107Death claims .............................................................................0802665All other .....................................................................................0803

161513Payments to GOE and IT ............................................................0804




Spending authority from offsetting collections, mandatory:182166131Collected ...........................................................................1800195176161Total budgetary resources available ..............................................1930




–151–178–151Outlays (gross) ......................................................................3020





16816387Outlays from new mandatory authority .............................4100–171564Outlays from mandatory balances ....................................4101



–69–67–62Non-Federal sources .........................................................4123–22–21–21Non-Federal sources .........................................................4123

–182–166–131Offsets against gross budget authority and outlays (total) ....4130–311220Outlays, net (mandatory) ...........................................................4170

...................................................Budget authority, net (total) ..........................................................4180–311220Outlays, net (total) ........................................................................4190

The Insurance Act of 1951 established the Service-Disabled VeteransInsurance (S-DVI) program for veterans with service-connected disabilities.S-DVI is open to veterans who separated from the service on or after April25, 1951. This fund finances the payment of claims on existing life insur-ance policies and remains open for new issues at standard rates to veteranshaving service-connected disabilities.

OPERATING COSTS

Death claims.—Represents payments to designated beneficiaries.All other.—Represents payments to policyholders who surrender their

policies for their cash value and hold endowment policies which havematured.

Capital investment.—A policyholder may borrow up to 94 percent of thevalue of his or her policy.

Administration.—Represents the administrative costs of claims processingand account maintenance.

The trend in the number and amount of policies in force is indicated inthe following table.

POLICIES AND INSURANCE IN FORCE2018 est.2017 est.2016 actual280,752276,682272,112Number of policies (EOY) ..........................................................................$2,975$2,923$2,854Insurance in force (dollars in millions) (EOY) ...........................................

Financing.—Operations are financed from premiums and other receipts.Additional funds are received by transfer from the Veterans Insurance andIndemnities appropriation, instead of direct appropriations to this fund.

Operating results and financial condition.—Since premium and otherreceipts are insufficient to cover operations, the fund continues to projectliabilities in excess of assets. The deficit is expected to reach an estimated$1,448 million by September 30, 2018. The expected deficit is financedby additional funds from the above-mentioned Veterans Insurance and In-demnities appropriations.



Reimbursable obligations:272626Investments and loans ..............................................................33.0

141137125Insurance claims and indemnities ............................................42.0


✦

VETERANS REOPENED INSURANCE FUND



Obligations by program activity:192323Death claims .............................................................................0801222Dividends ..................................................................................0802443All other .....................................................................................0803111Capital investment: policy loans ...............................................0804





101125147Total budgetary resources available ..............................................1930Memorandum (non-add) entries:




–29–34–34Outlays (gross) ......................................................................3020

212428Unpaid obligations, end of year .................................................3050


Uncollected payments:–2–2–2Uncollected pymts, Fed sources, brought forward, Oct 1 ........3060







Offsetting collections (collected) from:..................................–1Federal sources .................................................................4120

–4–5–7Interest on Federal securities ............................................4121–2–2.................Non-Federal sources .........................................................4123

–6–7–8Offsets against gross budget authority and outlays (total) ....4130232726Outlays, net (mandatory) ...........................................................4170




This fund pays claims and administrative costs on participating life insur-ance policies issued during the period May 1, 1965, through May 2, 1966,under three life insurance programs: 1) service-disabled standard insurance;2) service-disabled rated insurance; and 3) nonservice-disabled insuranceavailing disabled World War II and Korean conflict veterans an opportunityto acquire life insurance coverage who were no longer eligible for othergovernment insurance.

Budget program:Death claims.—Represents payments to designated beneficiaries.Dividends.—Policyholders participate in the distribution of annual di-

vidends.All other.—This represents resources for the administrative costs of

processing claims and maintaining the accounts, and to those policyhold-ers who: (a) surrender their policies for cash value; (b) hold endowmentpolicies which have matured; and (c) have purchased total disability in-come coverage and subsequently become disabled.

Policy loans made.—A policyholder may borrow up to 94 percent ofthe cash value of his policy at an interest rate adjusted to reflect privatesector borrowing costs.The following table reflects the decrease in the number of policies and

the amount of insurance in force:

POLICIES AND INSURANCE IN FORCE2018 est.2017 est.2016 actual

7,6989,68512,015Number of policies ...............................................................................$73$90$127Insurance in force (dollars in millions) .................................................

Financing.—Operations are financed from premiums collected frompolicyholders and interest on investments. Excess earnings of the fund aredistributed to the policyholders in the form of an annual dividend.




222625Insurance claims and indemnities ............................................42.0333Interest and dividends ..............................................................43.0


✦

SERVICEMEMBERS' GROUP LIFE INSURANCE FUND



Obligations by program activity:793793784Premium payments ...................................................................0801

333Payment to GOE .........................................................................0803

796796787Total new obligations (object class 41.0) ......................................0900






796796787New obligations, unexpired accounts ....................................3010–796–796–787Outlays (gross) ......................................................................3020





Offsetting collections (collected) from:–796–796–787Non-Federal sources .........................................................4123




This fund finances the payment of group life insurance premiums toprivate insurance companies under the Servicemembers' Group Life Insur-ance (SGLI) Act of 1965, as amended. SGLI is a program for Servicemem-bers on active duty, ready reservists, members of the National Guard,members of the Commissioned Corps of the National Oceanic and Atmo-spheric Administration and the Public Health Service, cadets and midship-men of the four service academies, and members of the Reserve OfficerTraining Corps. SGLI coverage is available in $50,000 increments up tothe maximum of $400,000. Veterans' Group Life Insurance (VGLI) is aprogram of post-separation insurance which allows Servicemembers toconvert their SGLI coverage to renewable term insurance. Family Service-members' Group Life Insurance (FSGLI) is a program extended to thespouses and dependent children of members insured under the SGLI pro-gram. FSGLI provides up to a maximum of $100,000 of insurance coveragefor spouses, not to exceed the amount of SGLI the insured member has inforce, and $10,000 of free coverage for dependent children. Spousal cover-age is issued in increments of $10,000.

The Servicemembers' Group Life Insurance Traumatic Injury ProtectionProgram (TSGLI) became effective December 1, 2005. TSGLI providesfor payment between $25,000 and $100,000 (depending on the type of in-jury) to any member of the uniformed services covered by SGLI who sus-tains a traumatic injury that results in certain serious losses.

✦

VETERANS HOUSING BENEFIT PROGRAM FUND

For the cost of direct and guaranteed loans, such sums as may be necessary tocarry out the program, as authorized by subchapters I through III of chapter 37 oftitle 38, United States Code: Provided, That such costs, including the cost of modi-fying such loans, shall be as defined in section 502 of the Congressional Budget Actof 1974: Provided further, That, during fiscal year [2017] 2018, within the resources



VETERANS HOUSING BENEFIT PROGRAM FUND—Continued

available, not to exceed $500,000 in gross obligations for direct loans are authorizedfor specially adapted housing loans.

In addition, for administrative expenses to carry out the direct and guaranteed loanprograms, [$198,856,000] $178,626,365. (Military Construction, Veterans Affairs,and Related Agencies Appropriations Act, 2017.)



Obligations by program activity:Credit program obligations:

384802455Loan guarantee subsidy ........................................................0702.................524Reestimates of direct loan subsidy .......................................0705.................612Interest on reestimates of direct loan subsidy .......................0706.................54382Reestimates of loan guarantee subsidy ................................0707.................1691Interest on reestimates of loan guarantee subsidy ................0708

179199162Administrative expenses .......................................................0709




Appropriations, mandatory:384883964Appropriation ....................................................................12005631,0821,129Budget authority (total) .............................................................19005631,0821,129Total budgetary resources available ..............................................1930



5631,0821,126New obligations, unexpired accounts ....................................3010–563–1,082–1,126Outlays (gross) ......................................................................3020



179199162Outlays from new discretionary authority ..........................4010Mandatory:


384883964Outlays from new mandatory authority .............................41005631,0821,129Budget authority, net (total) ..........................................................41805631,0821,126Outlays, net (total) ........................................................................4190

Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars)


Direct loan levels supportable by subsidy budget authority:12108Acquired Direct Loans ...............................................................115001

442378.................Vendee Direct Loans ..................................................................115004

4543888Total direct loan levels ..............................................................115999Direct loan subsidy (in percent):

7.941.921.71Acquired Direct Loans ...............................................................132001–26.49–23.58–25.58Vendee Direct Loans ..................................................................132004

–25.58–22.921.71Weighted average subsidy rate ..................................................132999Direct loan subsidy budget authority:

1..................................Acquired Direct Loans ...............................................................133001–117–89.................Vendee Direct Loans ..................................................................133004

–116–89.................Total subsidy budget authority ..................................................133999Direct loan subsidy outlays:

1..................................Acquired Direct Loans ...............................................................134001–117–89.................Vendee Direct Loans ..................................................................134004

–116–89.................Total subsidy outlays .................................................................134999Direct loan reestimates:

.................111Acquired Direct Loans ...............................................................135001

.................29Vendee Direct Loans ..................................................................135004

.................516Acquired and Vendee Loan Reestimates ....................................135005

.................836Total direct loan reestimates .....................................................135999

Guaranteed loan levels supportable by subsidy budget authority:141,929157,226181,786Housing Guaranteed Loans .......................................................215001

141,929157,226181,786Total loan guarantee levels .......................................................215999

Guaranteed loan subsidy (in percent):0.270.510.25Housing Guaranteed Loans .......................................................232001

0.270.510.25Weighted average subsidy rate ..................................................232999Guaranteed loan subsidy budget authority:

383802454Housing Guaranteed Loans .......................................................233001

383802454Total subsidy budget authority ..................................................233999Guaranteed loan subsidy outlays:

383802455Housing Guaranteed Loans .......................................................234001

383802455Total subsidy outlays .................................................................234999Guaranteed loan reestimates:

.................–1,624186Housing Guaranteed Loans .......................................................235001

.................–4–24Guaranteed Loan Sale Securities—Vendee ...............................235002

.................–1,628162Total guaranteed loan reestimates ............................................235999

Administrative expense data:179199165Budget authority .......................................................................3510179199161Outlays from new authority .......................................................3590

Veterans Affairs (VA) Housing Program Account.—The housing programhelps eligible veterans, active duty personnel, surviving spouses, andmembers of the Reserves and National Guard purchase, retain, and adapthomes in recognition of their service to the Nation. When a borrower pur-chases a home, the program operates by substituting the Federal Govern-ment's guaranty for a down payment that might otherwise be required.

Under 38 U.S.C. 3703, the guaranty amount for a borrower with full en-titlement (first-time users of the program or users whose entitlement isfully restored) is as follows:

(a) 50 percent for loans of $45,000 or less;(b) $22,500 for loans greater than $45,000, but no more than $56,250;(c) The lesser of $36,000 or 40 percent of the loan amount for loans

greater than $56,250, but not more than $144,000;(d) 25 percent of the loan amount for loans of $144,001 to $417,000;

or(e) For certain loans in excess of $417,000, the guaranty will be the

lesser of: 25 percent of the county loan limit, or 25 percent of the loan.This appropriation provides for the corporate leadership and operational

support to VA's Housing business line. The Housing Program facilitatesthe extension of private capital, on more liberal terms than generallyavailable to nonveterans, to assist veterans and servicemembers in obtaininghousing credit, and assist veterans in retaining their homes during periodsof temporary economic difficulty through intensive supplemental mortgageloan servicing.

Guaranteed transitional housing loans for homeless veterans.—Estab-lished as a pilot project by the Veterans Benefits Improvement Act of 1998,Public Law 105–368, this program does not require any new loan subsidyfunding. The program has originated no new loans since 2009. The programwas canceled in 2012. The existing loan will continue to be servicedwithin the program's financing account.

WORKLOAD

[In thousands]2018 est.2017 est.2016 actual

446450623Construction and valuation ..................................................................1,0711,0501,095Loan processing ...................................................................................254235214Loan service and claims .......................................................................



Direct obligations:179199162Other services from non-Federal sources ..................................25.2384883964Grants, subsidies, and contributions ........................................41.0


✦


HOUSING DIRECT LOAN FINANCING ACCOUNT



Obligations by program activity:..................................1Property sales expense ..............................................................0003

233Property management/other expense ........................................0004

234Direct program activities, subtotal ................................................0091Credit program obligations:

4543888Direct loan obligations ..........................................................071028624823Payment of interest to Treasury .............................................071311789.................Negative subsidy obligations ................................................0740

.................1.................Downward reestimates paid to receipt accounts ...................0742

.................21Interest on downward reestimates ........................................0743

85772832Direct program activities, subtotal ................................................0791



.................6094Unobligated balance brought forward, Oct 1 .........................1000

.................–60–88Unobligated balances applied to repay debt .........................1023

..................................6Unobligated balance (total) ......................................................1050Financing authority:

Borrowing authority, mandatory:85973157Borrowing authority ...........................................................1400

..................................–49Borrowing authority applied to repay debt ........................1422

8597318Borrowing authority, mandatory (total) .................................1440Spending authority from offsetting collections, mandatory:

7460108Collected ...........................................................................1800

–74–60–26Spending authority from offsetting collections applied to

repay debt .....................................................................1825

..................................82Spending auth from offsetting collections, mand (total) .......185085973190Budget authority (total) .............................................................190085973196Total budgetary resources available ..............................................1930

Memorandum (non-add) entries:..................................60Unexpired unobligated balance, end of year ..........................1941


7.................1Unpaid obligations, brought forward, Oct 1 ..........................300085973136New obligations, unexpired accounts ....................................3010

–857–724–37Outlays (gross) ......................................................................3020

97.................Unpaid obligations, end of year .................................................3050Memorandum (non-add) entries:

7.................1Obligated balance, start of year ............................................310097.................Obligated balance, end of year ..............................................3200

Financing authority and disbursements, net:Mandatory:

85973190Budget authority, gross .........................................................4090Financing disbursements:

85772437Outlays, gross (total) .............................................................4110Offsets against gross financing authority and disbursements:

Offsetting collections (collected) from:–1–11–36Federal sources: Payments from program account ............4120

..................................–6Interest on uninvested funds ............................................4122–70–45–66Interest and principal received on loans ...........................4123–3–4.................Cash sale of properties .....................................................4123

–74–60–108Offsets against gross budget authority and outlays (total) ....4130

785671–18Budget authority, net (mandatory) ............................................4160783664–71Outlays, net (mandatory) ...........................................................4170785671–18Budget authority, net (total) ..........................................................4180783664–71Outlays, net (total) ........................................................................4190

Status of Direct Loans (in millions of dollars)


Position with respect to appropriations act limitation on obligations:4543888Direct loan obligations from current-year authority ...................1111

4543888Total direct loan obligations ..................................................1150

Cumulative balance of direct loans outstanding:743377409Outstanding, start of year .........................................................12104543888Disbursements: Direct loan disbursements ...............................1231–25–19–39Repayments: Repayments and prepayments .............................1251

–2–3–1Write-offs for default: Direct loans ............................................1263

1,170743377Outstanding, end of year .......................................................1290

Balance Sheet (in millions of dollars)

2016 actual2015 actualIdentification code 036–4127–0–3–704

ASSETS:Federal assets:

5994Fund balances with Treasury .....................................................1101Investments in US securities:

916Receivables, net ....................................................................110664Non-Federal assets: Receivables, net ............................................1206

Net value of assets related to post-1991 direct loans receivable:377409Direct loans receivable, gross ....................................................14012019Interest receivable .....................................................................14021525Foreclosed property ....................................................................14042357Allowance for subsidy cost .........................................................1405

435510Net present value of assets related to direct loans ................149911Other Federal assets: Other assets ................................................1901

510625Total assets ...............................................................................1999LIABILITIES:

Federal liabilities:500605Debt ...........................................................................................21031013Other ..........................................................................................2105

Non-Federal liabilities:...........................1Accounts payable .......................................................................2201...........................6Other ..........................................................................................2207

510625Total liabilities ...........................................................................2999

510625Total liabilities and net position .....................................................4999

✦

HOUSING GUARANTEED LOAN FINANCING ACCOUNT



Obligations by program activity:1,691968756Losses on defaulted loans .........................................................0002

171917Payment to trustee reserve ........................................................0005195112123Property sales expense ..............................................................000916092121Property management expense ..................................................0010

533Property improvement expense ..................................................001113129Loans acquired ..........................................................................0012

2,0811,2061,029Direct program activities, subtotal ................................................0091Credit program obligations:

2,7911,6011,589Default claim payments on principal ....................................0711.................1,526252Downward reestimates paid to receipt accounts ...................0742.................17358Interest on downward reestimates ........................................0743

2,7913,3001,899Direct program activities, subtotal ................................................0791



10,47810,4698,727Unobligated balance brought forward, Oct 1 .........................1000..................................8Recoveries of prior year paid obligations ...............................1033

10,47810,4698,735Unobligated balance (total) ......................................................1050Financing authority:

Spending authority from offsetting collections, mandatory:5,3424,5154,662Collected ...........................................................................1800

15,82014,98413,397Total budgetary resources available ..............................................1930Memorandum (non-add) entries:

10,94810,47810,469Unexpired unobligated balance, end of year ..........................1941



–4,831–4,810–2,883Outlays (gross) ......................................................................3020





HOUSING GUARANTEED LOAN FINANCING ACCOUNT—Continued




5,3424,5154,662Budget authority, gross .........................................................4090Financing disbursements:

4,8314,8102,883Outlays, gross (total) .............................................................4110Offsets against gross financing authority and disbursements:

Offsetting collections (collected) from:–383–872–927Payments from program account ......................................4120–456–266–9Recoveries from DLFA ........................................................4120–22–20–213Interest on uninvested funds ............................................4122

–1,974–1,921–2,039Funding fees .....................................................................4123–2,507–1,436–1,502Cash sale of properties .....................................................4123

..................................–12Redemption of Properties/Other income and

receivables ...................................................................4123

..................................32Transferred Collections to the U.S. Treasury ......................4123

–5,342–4,515–4,670Offsets against gross budget authority and outlays (total) ....4130Additional offsets against financing authority only (total):


accounts .......................................................................4143

–511295–1,787Outlays, net (mandatory) ...........................................................4170...................................................Budget authority, net (total) ..........................................................4180

–511295–1,787Outlays, net (total) ........................................................................4190

Status of Guaranteed Loans (in millions of dollars)


Position with respect to appropriations act limitation oncommitments:

141,928157,226181,786Guaranteed loan commitments from current-year authority .......2111

141,928157,226181,786Total guaranteed loan commitments .....................................215039,17343,39550,173Guaranteed amount of guaranteed loan commitments .................2199

Cumulative balance of guaranteed loans outstanding:630,573524,913462,079Outstanding, start of year .........................................................2210141,928157,226181,786Disbursements of new guaranteed loans ..................................2231–56,720–48,968–116,581Repayments and prepayments ..................................................2251

Adjustments:

–2,790–1,601–1,589Terminations for default that result in acquisition of

property .............................................................................2262

–1,721–997–782Terminations for default that result in claim payments ........2263

711,270630,573524,913Outstanding, end of year .......................................................2290

Memorandum:

187,517167,257140,561Guaranteed amount of guaranteed loans outstanding, end of

year .......................................................................................2299




10,8309,043Fund balances with Treasury .....................................................1101Investments in US securities:

27406Receivables, net ....................................................................1106Net value of assets related to post-1991 acquired defaulted

guaranteed loans receivable:1314Accounts receivable from foreclosed property ............................1504

845866Foreclosed property ....................................................................1504

858880Net present value of assets related to defaulted guaranteedloans .................................................................................

1599

11,71510,329Total assets ...............................................................................1999LIABILITIES:

Federal liabilities:......................................................Debt ...........................................................................................2103

1,586333Other liabilities ..........................................................................2105Non-Federal liabilities:

361317Accounts payable .......................................................................22019,7689,679Non-federal liabilities for loan guarantees ................................2204

11,71510,329Total liabilities ...........................................................................2999

11,71510,329Total liabilities and net position .....................................................4999

✦

HOUSING LIQUIDATING ACCOUNT



Obligations by program activity:

121Capital investments, guaranteed claims payment and other

operating expenses ...............................................................0105



.................–2–1Capital transfer of unobligated balances to general fund ......1022

.................1–1Recoveries of prior year paid obligations ...............................1033

..................................–1Unobligated balance (total) ......................................................1050Budget authority:


–6–8–10Capital transfer of spending authority from offsetting

collections to general fund ...........................................1820

123Spending auth from offsetting collections, mand (total) .......1850122Total budgetary resources available ..............................................1930

Memorandum (non-add) entries:..................................1Unexpired unobligated balance, end of year ..........................1941


.................22Unpaid obligations, brought forward, Oct 1 ..........................3000121New obligations, unexpired accounts ....................................3010

–1–4–1Outlays (gross) ......................................................................3020






12.................Outlays from new mandatory authority .............................4100.................21Outlays from mandatory balances ....................................4101


Offsetting collections (collected) from:–1–1–1Loan repayments and prepayments ..................................4123–1–1–1Sale of homes, cash ..........................................................4123

..................................–1Interest on loans ...............................................................4123–2–3–3Interest collection on Veteran liability debts .....................4123–3–6–7Principal collection on Veteran liability debts ...................4123


.................1–1Recoveries of prior year paid obligations, unexpired

accounts .......................................................................4143

–6–8–11Budget authority, net (mandatory) ............................................4160–6–7–12Outlays, net (mandatory) ...........................................................4170–6–8–11Budget authority, net (total) ..........................................................4180–6–7–12Outlays, net (total) ........................................................................4190

Memorandum (non-add) entries:140140140Total investments, SOY: non-Fed securities: Market value .........5010140140140Total investments, EOY: non-Fed securities: Market value .........5011



Cumulative balance of direct loans outstanding:234Outstanding, start of year .........................................................1210

–1–1–1Repayments: Repayments and prepayments .............................1251

123Outstanding, end of year .......................................................1290

Status of Guaranteed Loans (in millions of dollars)


Cumulative balance of guaranteed loans outstanding:4481148Outstanding, start of year .........................................................2210

–19–36–66Repayments and prepayments ..................................................2251


–1–1–1Adjustments: Terminations for default that result in acquisition

of property .............................................................................2262


Memorandum:

91833Guaranteed amount of guaranteed loans outstanding, end of

year .......................................................................................2299

Addendum:Cumulative balance of defaulted guaranteed loans that result

in loans receivable:172322Outstanding, start of year .....................................................2310

..................................2Disbursements for guaranteed loan claims ...........................2331–4–6–1Repayments of loans receivable ............................................2351

...................................................Other adjustments, net .........................................................2364

131723Outstanding, end of year ...................................................2390



ASSETS:33Federal assets: Fund balances with Treasury .................................1101

Non-Federal assets:140140Investments in non-Federal securities, net ................................1201

11Receivables, net ........................................................................120634Direct loans, gross .........................................................................1601938Interest receivable .........................................................................1602

–31–26Allowance for estimated uncollectible loans and interest (-) .........1603

–1916Value of assets related to direct loans .......................................16992322Defaulted guaranteed loans, gross ................................................1701–1–1Allowance for estimated uncollectible loans and interest (-) .........1703

2221Defaulted guaranteed loans and interest receivable, net ..........170412Foreclosed property ........................................................................1706

2323Value of assets related to loan guarantees ................................1799


Non-Federal liabilities:22Accounts payable .......................................................................2201

146181Liabilities for loan guarantees ...................................................2204





Direct obligations:111Land and structures ..................................................................32.0

.................1.................Investments and loans ..............................................................33.0


✦

NATIVE AMERICAN VETERAN HOUSING LOAN PROGRAM ACCOUNT

For administrative expenses to carry out the direct loan program authorized bysubchapter V of chapter 37 of title 38, United States Code, $1,163,000. (MilitaryConstruction, Veterans Affairs, and Related Agencies Appropriations Act, 2017.)

VOCATIONAL REHABILITATION LOANS PROGRAM ACCOUNT

For the cost of direct loans, [$36,000]$29,680, as authorized by chapter 31 oftitle 38, United States Code: Provided, That such costs, including the cost of modi-fying such loans, shall be as defined in section 502 of the Congressional Budget Actof 1974: Provided further, That funds made available under this heading are availableto subsidize gross obligations for the principal amount of direct loans not to exceed[$2,517,000]$2,355,547.

In addition, for administrative expenses necessary to carry out the direct loanprogram, [$389,000]$395,000, which may be paid to the appropriation for "GeneralOperating Expenses, Veterans Benefits Administration". (Military Construction,Veterans Affairs, and Related Agencies Appropriations Act, 2017.)




.................11Reestimates of direct loan subsidy .......................................0705222Administrative expenses .......................................................0709





Appropriations, mandatory:.................21Appropriation ....................................................................1200







212Outlays from new discretionary authority ..........................4010Mandatory:

.................21Budget authority, gross .........................................................4090Outlays, gross:

.................21Outlays from new mandatory authority .............................4100233Budget authority, net (total) ..........................................................4180233Outlays, net (total) ........................................................................4190

Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in millions of dollars)


Direct loan levels supportable by subsidy budget authority:992Native American Direct Loans ...................................................115002332Vocational Rehabilitation ..........................................................115003

12124Total direct loan levels ..............................................................115999Direct loan subsidy (in percent):

–20.22–18.62–18.08Native American Direct Loans ...................................................1320021.261.431.05Vocational Rehabilitation ..........................................................132003

–14.85–13.61–8.51Weighted average subsidy rate ..................................................132999Direct loan subsidy budget authority:

–2–2–1Native American Direct Loans ...................................................133002

–2–2–1Total subsidy budget authority ..................................................133999Direct loan subsidy outlays:

–1–2–1Native American Direct Loans ...................................................134002

–1–2–1Total subsidy outlays .................................................................134999Direct loan reestimates:

.................11Native American Direct Loans ...................................................135002

.................11Total direct loan reestimates .....................................................135999

Administrative expense data:222Budget authority .......................................................................3510222Outlays from new authority .......................................................3590

The Native American Veterans Housing Loan program provides directloans to veterans living on trust lands under 38 U.S.C. chapter 37, section3761. These loans are available to purchase, construct, or improve homesto be occupied as the veteran's residence. This program began as a pilot in1993 and was made permanent on June 15, 2006, through Public Law109–233.

The Vocational Rehabilitation Loan Program provides temporary loansto cover the costs of subsistence, tuition, books, supplies, and equipmentin conjunction with service-connected disability benefits provided to veter-ans participating in VA's Vocational Rehabilitation and Counseling Programas authorized by chapter 31 of title 38, United States Code. Repayment of



NATIVE AMERICAN VETERAN HOUSING LOAN PROGRAM ACCOUNT—Continued

these loans is made in monthly installments, without interest, through de-ductions from future payments of compensation, pension, subsistence al-lowance, educational assistance allowance, or retired pay.



Direct obligations:222Other services from non-Federal sources ..................................25.2

.................11Grants, subsidies, and contributions ........................................41.0


✦

NATIVE AMERICAN DIRECT LOAN FINANCING ACCOUNT




992Direct loan obligations ..........................................................0710432Payment of interest to Treasury .............................................0713221Negative subsidy obligations ................................................0740



124Unobligated balance brought forward, Oct 1 .........................1000..................................–3Unobligated balances applied to repay debt .........................1023

121Unobligated balance (total) ......................................................1050Financing authority:

Borrowing authority, mandatory:13125Borrowing authority ...........................................................1400



996Collected ...........................................................................1800


repay debt .....................................................................1825

215Spending auth from offsetting collections, mand (total) .......185015136Budget authority (total) .............................................................190016157Total budgetary resources available ..............................................1930




–15–14–5Outlays (gross) ......................................................................3020






Offsetting collections (collected) from:.................–1–1Federal sources .................................................................4120

–6–5–4Non-federal sources - Repayments and prepayments of

principal .......................................................................4123

–3–3–1Non-Federal sources - Interest received on loans ..............4123

–9–9–6Offsets against gross budget authority and outlays (total) ....4130

64.................Budget authority, net (mandatory) ............................................416065–1Outlays, net (mandatory) ...........................................................417064.................Budget authority, net (total) ..........................................................418065–1Outlays, net (total) ........................................................................4190





Cumulative balance of direct loans outstanding:646060Outstanding, start of year .........................................................1210993Disbursements: Direct loan disbursements ...............................1231

–5–5–3Repayments: Repayments and prepayments .............................1251





35Fund balances with Treasury .....................................................1101Investments in US securities:

11Receivables, net ....................................................................1106Net value of assets related to post-1991 direct loans receivable:

6060Direct loans receivable, gross ....................................................140122Interest receivable .....................................................................140233Other assets ..............................................................................1405

6565Net present value of assets related to direct loans ................1499


Federal liabilities:6770Federal liabilities debt ...............................................................210321Other liabilities ..........................................................................2105



✦

TRANSITIONAL HOUSING DIRECT LOAN FINANCING ACCOUNT



Obligations by program activity:111Direct program activity ..............................................................0001



555Unobligated balance brought forward, Oct 1 .........................1000Financing authority:





–1–1–1Outlays (gross) ......................................................................3020






Offsetting collections (collected) from:–1–1–1Non-Federal sources .........................................................4123






Position with respect to appropriations act limitation on obligations:959595Limitation available from carry-forward ....................................1121

–95–95–95Unobligated limitation carried forward .....................................1143





ASSETS:55Federal assets: Fund balances with Treasury .................................1101

55Net value of assets related to post-1991 direct loans receivable:Direct loans receivable, gross ....................................................

1401


Federal liabilities:55Debt ...........................................................................................210355Loan Guaranty/Other Liabilities .................................................2105



✦

VOCATIONAL REHABILITATION DIRECT LOAN FINANCING ACCOUNT




332Direct loan obligations ..........................................................0710


Budgetary resources:Financing authority:

Borrowing authority, mandatory:333Authority to borrow (indefinite) .........................................1400



332Collected ...........................................................................1800


repay debt .....................................................................1825







Offsetting collections (collected) from:–3–3–2Repayments and prepayments of principal .......................4123








222Disbursements: Direct loan disbursements ...............................1231–2–3–2Repayments: Repayments and prepayments .............................1251





Investments in US securities:...........................1Investments US Securities .....................................................1104

22Net value of assets related to post-1991 direct loans receivable:Direct loans receivable, gross ....................................................

1401


23Federal liabilities: Debt ..................................................................2103


✦

Trust Funds

POST-VIETNAM ERA VETERANS EDUCATION ACCOUNT




626262Unobligated balance brought forward, Oct 1 .........................1000626262Total budgetary resources available ..............................................1930



111Unpaid obligations, brought forward, Oct 1 ..........................3000





This account was established under Public Law 94–502, Veterans' Edu-cation and Employment Assistance Act, 1976. This program consists ofvoluntary contributions by eligible servicemembers and matching contri-butions provided by the Department of Defense and provides educationalassistance payments to participants who entered the service after December31, 1976. Chapter 32, title 38, U.S.C. Section 901 is a non-contributoryprogram with educational assistance provided by the Department of De-fense. Public Law 99–576, enacted October 28, 1986, closed the programpermanently for new enrollments effective March 31, 1987. The estimatedactivity in the fund follows:

CONTRIBUTIONS, PARTICIPANTS, DISENROLLMENTS, REFUNDS AND TRAINEES2018 est.2017 est.2016 actual

$201$212$223Total program obligations (in thousands) .................................................838792Number of disenrollments ........................................................................

$181$191$201Total refunds (in thousands) ....................................................................$2,180$2,180$2,180Average Refund ........................................................................................

788Total trainees ............................................................................................$13$13$14Total trainee cost (in thousands) ..............................................................

$1,825$1,791$1,767Average trainee cost .................................................................................222Section 901 trainees .................................................................................

$7$8$8Total Section 901 trainee cost (in thousands) ..........................................$3,500$3,925$4,132Average Section 901 trainee cost .............................................................

✦

NATIONAL SERVICE LIFE INSURANCE FUND



2,8333,4003,964Balance, start of year ....................................................................0100


Trust Funds

NATIONAL SERVICE LIFE INSURANCE FUND—Continued

Special and Trust Fund Receipts—Continued


Receipts:Current law:

455569NSLI Fund, Premium and Other Receipts ...............................1130129153188NSLI Fund, Interest ................................................................1140

174208257Total current law receipts ..................................................1199

174208257Total receipts .............................................................................1999

3,0073,6084,221Total: Balances and receipts .....................................................2000Appropriations:

Current law:–175–208–257National Service Life Insurance Fund ....................................2101–506–567–564National Service Life Insurance Fund ....................................2103

–681–775–821Total current law appropriations .......................................2199

–681–775–821Total appropriations ..................................................................2999

2,3262,8333,400Balance, end of year ..................................................................5099



Obligations by program activity:461535603Death claims .............................................................................0001

233Disability claims .......................................................................000211211688Matured endowments ................................................................0003182024Cash surrenders ........................................................................0004414855Dividends ..................................................................................0005202420Interest paid on dividend credits and deposits .........................0006131514Payment to general operating expenses ....................................0007

667761807Total operating expenses ...............................................................0091141414Capital investment: Policy loans ...............................................0201

681775821Total direct obligations ..................................................................0799435119Death claims .............................................................................080110113Matured endowments ................................................................0803221Cash surrenders ........................................................................0804452Dividends ..................................................................................0805221Interest paid on dividend credits and deposits .........................080611.................Payment to general operating expenses ....................................0807




Appropriations, mandatory:175208257Appropriation (special or trust fund) .................................1201506567564Appropriation (previously unavailable) .............................1203

681775821Appropriations, mandatory (total) .........................................1260Spending authority from offsetting collections, mandatory:




–826–926–941Outlays (gross) ......................................................................3020







Offsetting collections (collected) from:–62–72–26Non-Federal sources .........................................................4123681775821Budget authority, net (total) ..........................................................4180

764854915Outlays, net (total) ........................................................................4190

Memorandum (non-add) entries:3,5994,2464,903Total investments, SOY: Federal securities: Par value ...............50003,0103,5994,246Total investments, EOY: Federal securities: Par value ...............5001


This fund was established in 1940. It is for the World War II servicemem-bers' and veterans' insurance program. Over 22 million policies were issuedunder this program. Activity of the fund reflects a declining claim workload.The trend in the number and amount of policies in force is shown as follows:

POLICIES AND INSURANCE IN FORCE2018 est.2017 est.2016 actual206,647254,707309,658Number of policies ....................................................................................$2,577$3,181$3,914Insurance in force (dollars in millions) .....................................................

This fund is operated on a commercial basis to the extent possible. Theincome of the fund is derived from premium receipts, interest on invest-ments, and payments which are made to the fund from the Veterans Insur-ance and Indemnities appropriation.

Assets of the fund, which are largely invested in special interest-bearingTreasury securities and in policy loans, are expected to decrease from anestimated $3,687 million as of September 30, 2017 to $3,059 million as ofSeptember 30, 2018. The actuarial estimate of policy obligations as ofSeptember 30, 2018, totals $2,992 million, leaving a balance of $67 millionfor contingency reserves.

Status of Funds (in millions of dollars)


Unexpended balance, start of year:3,6084,2544,912Balance, start of year ................................................................0100

3,6084,2544,912Total balance, start of year ........................................................0999Cash income during the year:

Current law:Receipts:

455569NSLI Fund, Premium and Other Receipts ...........................1130627226National Service Life Insurance Fund ................................1130

129153188NSLI Fund, Interest ............................................................1150

236280283Income under present law .............................................1199

236280283Total cash income .................................................................1999Cash outgo during year:

Current law:–826–926–941National Service Life Insurance Fund [029–25–8132–0] .......2100

–826–926–941Outgo under current law ...................................................2199

–826–926–941Total cash outgo (-) ...................................................................2999Surplus or deficit::

–719–799–846Excluding interest .....................................................................3110129153188Interest ......................................................................................3120

–590–646–658Subtotal, surplus or deficit ....................................................3199

–590–646–658Total change in fund balance ....................................................3999Unexpended balance, end of year::

898Uninvested balance (net), end of year .......................................41003,0103,5994,246National Service Life Insurance Fund ........................................4200

3,0183,6084,254Total balance, end of year .........................................................4999



Direct obligations:141414Investments and loans ..............................................................33.0



THE BUDGET FOR FISCAL YEAR 2018986 Benefits Programs—ContinuedTrust Funds—Continued


✦

UNITED STATES GOVERNMENT LIFE INSURANCE FUND



233Balance, start of year ....................................................................0100..................................1Rounding adjustment ....................................................................0198

234Balance, start of year ................................................................0199

234Total: Balances and receipts .....................................................2000Appropriations:

Current law:.................–1–1United States Government Life Insurance Fund .....................2103

223Balance, end of year ..................................................................5099



Obligations by program activity:..................................1Death claims .............................................................................0001.................1.................Other costs ................................................................................0007

.................11Total new obligations, unexpired accounts ....................................0900


Appropriations, mandatory:.................11Appropriation (previously unavailable) .............................1203.................11Budget authority (total) .............................................................1900.................11Total budgetary resources available ..............................................1930


.................12Unpaid obligations, brought forward, Oct 1 ..........................3000

.................11New obligations, unexpired accounts ....................................3010

.................–2–2Outlays (gross) ......................................................................3020





.................11Budget authority, gross .........................................................4090Outlays, gross:

.................22Outlays from mandatory balances ....................................4101

.................11Budget authority, net (total) ..........................................................4180

.................22Outlays, net (total) ........................................................................4190



This fund was established in 1919 to receive premiums and pay claimson insurance issued under the provisions of the War Risk Insurance Act.The general decline in the activity of the fund is indicated in the followingtable:


14151348Number of policies ....................................................................................$.04$.2$.7Insurance in force (dollars in millions) .....................................................

The fund is operated on a commercial basis to the extent possible. Theincome of the fund is derived from interest on investments. EffectiveJanuary 1, 1983, premiums were discontinued because reserves held in thefund were adequate to meet future liabilities of the program.

Assets of the fund, which are largely invested in interest-bearing securitiesand policy loans, are estimated to decrease from $2.9 million as of

September 30, 2017, to $2.2 million as of September 30, 2018, as an in-creasing number of policies mature through death or disability. The actuarialevaluation of policy obligations as of September 30, 2018, totals $1.8million, leaving a balance of $.04 million for contingency reserves.

Status of Funds (in millions of dollars)


Unexpended balance, start of year:246Balance, start of year ................................................................0100

246Total balance, start of year ........................................................0999Cash outgo during year:

Current law:

.................–2–2United States Government Life Insurance Fund

[029–25–8150–0] ............................................................2100

.................–2–2Outgo under current law ...................................................2199

.................–2–2Total cash outgo (-) ...................................................................2999Surplus or deficit::

.................–2–2Excluding interest .....................................................................3110

.................–2–2Subtotal, surplus or deficit ....................................................3199

.................–2–2Total change in fund balance ....................................................3999Unexpended balance, end of year::

.................–1.................Uninvested balance (net), end of year .......................................4100234United States Government Life Insurance Fund .........................4200

224Total balance, end of year .........................................................4999



Direct obligations:..................................1Insurance claims and indemnities ............................................42.0.................1.................Interest and dividends ..............................................................43.0

.................11Total new obligations, unexpired accounts ............................99.9

✦

VETERANS SPECIAL LIFE INSURANCE FUND



Obligations by program activity:141139124Death claims .............................................................................0801

666Cash surrenders ........................................................................0802243034Dividends ..................................................................................0803182021All other .....................................................................................0804786Payments to insurance account ................................................0805887Capital investment ....................................................................0806



1,1961,2931,367Unobligated balance brought forward, Oct 1 .........................1000Budget authority:


..................................–2Change in uncollected payments, Federal sources ............1801

102114124Spending auth from offsetting collections, mand (total) .......18501,2981,4071,491Total budgetary resources available ..............................................1930




–246–237–211Outlays (gross) ......................................................................3020


–20–20–22Uncollected pymts, Fed sources, brought forward, Oct 1 ........3060..................................2Change in uncollected pymts, Fed sources, unexpired ..........3070

–20–20–20Uncollected pymts, Fed sources, end of year .............................3090


Trust Funds—Continued

VETERANS SPECIAL LIFE INSURANCE FUND—Continued



Memorandum (non-add) entries:383409420Obligated balance, start of year ............................................3100341383409Obligated balance, end of year ..............................................3200





Offsetting collections (collected) from:–67–75–86Interest on Federal securities ............................................4121–12–14–14Non-Federal sources .........................................................4123–20–22–23Non-Federal sources .........................................................4123–3–3–3Non-Federal sources .........................................................4123


..................................2Change in uncollected pymts, Fed sources, unexpired .......414014412385Outlays, net (mandatory) ...........................................................4170


Memorandum (non-add) entries:1,5771,7001,785Total investments, SOY: Federal securities: Par value ...............50001,4331,5771,700Total investments, EOY: Federal securities: Par value ...............5001


This fund finances the payment of claims on life insurance policies issuedbefore January 3, 1957, to veterans who served in the Armed Forces sub-sequent to April 1, 1951. No new policies can be issued.

Benefit program:Death claims.—Represents payments to designated beneficiaries.Cash surrenders.—A policyholder may terminate his or her insurance

by cashing in the policy for its cash value.Dividends.—Policyholders participate in the distribution of annual di-

vidends.All other.—Classified in this category are payments to policyholders

who: (a) hold endowment policies which have matured; (b) have pur-chased total disability income coverage and subsequently become dis-abled; and (c) are paid interest on dividend credits and deposits.The following table reflects the decrease in the number of policies and

the amounts of insurance in force:


90,788100,880110,943Number of policies ....................................................................................$1,340$1,475$1,608Insurance in force (dollars in millions) .....................................................

Financing.—Payments from this fund are financed primarily frompremium receipts and interest on investments.






✦

DEPARTMENTAL ADMINISTRATIONFederal Funds

CONSTRUCTION, MAJOR PROJECTS

For constructing, altering, extending, and improving any of the facilities, includingparking projects, under the jurisdiction or for the use of the Department of VeteransAffairs, or for any of the purposes set forth in sections 316, 2404, 2406 and chapter81 of title 38, United States Code, not otherwise provided for, including planning,architectural and engineering services, construction management services, mainten-ance or guarantee period services costs associated with equipment guaranteesprovided under the project, services of claims analysts, offsite utility and stormdrainage system construction costs, and site acquisition, where the estimated costof a project is more than the amount set forth in section 8104(a)(3)(A) of title 38,United States Code, or where funds for a project were made available in a previousmajor project appropriation, [$528,110,000] $512,430,000, of which[$478,110,000] $432,430,000 shall remain available until September 30, [2021]2022, and of which [$50,000,000] $80,000,000 shall remain available until expen-ded: Provided, That except for advance planning activities, including needs assess-ments which may or may not lead to capital investments, and other capital assetmanagement related activities, including portfolio development and managementactivities, and investment strategy studies funded through the advance planning fundand the planning and design activities funded through the design fund, includingneeds assessments which may or may not lead to capital investments, and salariesand associated costs of the resident engineers who oversee those capital investmentsfunded through this account and contracting officers who manage specific majorconstruction projects, and funds provided for the purchase, security, and maintenanceof land for the National Cemetery Administration through the land acquisition lineitem, none of the funds made available under this heading shall be used for anyproject that has not been notified to Congress through the budgetary process or thathas not been approved by the Congress through statute, joint resolution, or in theexplanatory statement accompanying such Act and presented to the President at thetime of enrollment: Provided further, That funds made available under this headingfor fiscal year [2017] 2018, for each approved project shall be obligated: (1) bythe awarding of a construction documents contract by September 30, [2017] 2018;and (2) by the awarding of a construction contract by September 30, [2018] 2019:Provided further, That the Secretary of Veterans Affairs shall promptly submit tothe Committees on Appropriations of both Houses of Congress a written report onany approved major construction project for which obligations are not incurredwithin the time limitations established above: Provided further, That, of the amountmade available under this heading, [$222,620,000] $117,300,000 for VeteransHealth Administration major construction projects shall not be available until theDepartment of Veterans Affairs—

(1) enters into an agreement with an appropriate non-Department of VeteransAffairs Federal entity to serve as the design and/or construction agent for anyVeterans Health Administration major construction project with a Total EstimatedCost of $100,000,000 or above by providing full project management services,including management of the project design, acquisition, construction, and contractchanges, consistent with section 502 of Public Law 114–58; and

(2) certifies in writing that such an agreement is executed and intended to min-imize or prevent subsequent major construction project cost overruns and providesa copy of the agreement entered into and any required supplementary informationto the Committees on Appropriations of both Houses of Congress. (MilitaryConstruction, Veterans Affairs, and Related Agencies Appropriations Act, 2017.)



Obligations by program activity:9886791,312Medical programs .....................................................................000118316720National cemeteries ..................................................................0002

888Staff offices ..............................................................................0005

1,1798541,340Total direct obligations ..................................................................0799



1,7382,0642,145Unobligated balance brought forward, Oct 1 .........................1000..................................38Recoveries of prior year unpaid obligations ...........................1021



THE BUDGET FOR FISCAL YEAR 2018988 Benefits Programs—ContinuedTrust Funds—Continued









5125281,221Appropriation, discretionary (total) .......................................11605125281,221Budget authority (total) .............................................................1900

2,2502,5923,404Total budgetary resources available ..............................................1930Memorandum (non-add) entries:

1,0711,7382,064Unexpired unobligated balance, end of year ..........................1941


1,020880930Unpaid obligations, brought forward, Oct 1 ..........................30001,1798541,340New obligations, unexpired accounts ....................................3010–847–714–1,352Outlays (gross) ......................................................................3020


1,3521,020880Unpaid obligations, end of year .................................................3050Memorandum (non-add) entries:

1,020880930Obligated balance, start of year ............................................31001,3521,020880Obligated balance, end of year ..............................................3200


5125281,221Budget authority, gross .........................................................4000Outlays, gross:


8477141,352Outlays, gross (total) .............................................................40205125281,221Budget authority, net (total) ..........................................................41808477141,352Outlays, net (total) ........................................................................4190

The Construction, Major Projects appropriation funds construction pro-jects costing more than $10 million. Funding is to complete a new outpatientclinic for the realignment and closure of a campus project in Livermore,CA, as well as gravesite expansions at six national cemeteries in Sacra-mento, CA; Bushnell, FL; Ellwood, IL; Calverton, NY; Phoenix, AZ; andBridgeville, PA. Additional funds are provided to fund salaries and associ-ated expenses of resident engineers and contracting officers who overseethe Department's capital investments and to support advance planning anddesign activities, and also fund asbestos and hazardous waste abatementprojects.

$649 million of funds appropriated in 2016 are not reflected in theavailable balance in the tables. These funds will become available for useonce VA meets the specific conditions required by law (P.L. 114–113) andthe funds are apportioned.



Direct obligations:333Travel and transportation of persons .........................................21.0111Other services from non-Federal sources ..................................25.2

393939Other goods and services from Federal sources ........................25.3111Supplies and materials .............................................................26.0222Equipment .................................................................................31.0

1,1338081,293Land and structures ..................................................................32.0

1,1798541,339Direct obligations ..................................................................99.0..................................1Reimbursable obligations .....................................................99.0


✦

CONSTRUCTION, MINOR PROJECTS

For constructing, altering, extending, and improving any of the facilities, includingparking projects, under the jurisdiction or for the use of the Department of VeteransAffairs, including planning and assessments of needs which may lead to capital in-vestments, architectural and engineering services, maintenance or guarantee periodservices costs associated with equipment guarantees provided under the project,services of claims analysts, offsite utility and storm drainage system constructioncosts, and site acquisition, or for any of the purposes set forth in sections 316, 2404,

2406 and chapter 81 of title 38, United States Code, not otherwise provided for,where the estimated cost of a project is equal to or less than the amount set forth insection 8104(a)(3)(A) of title 38, United States Code, [$372,069,000]$342,570,000,to remain available until September 30, [2021]2022, along with unobligated balancesof previous "Construction, Minor Projects" appropriations which are hereby madeavailable for any project where the estimated cost is equal to or less than the amountset forth in such section: Provided, That funds made available under this headingshall be for: (1) repairs to any of the nonmedical facilities under the jurisdiction orfor the use of the Department which are necessary because of loss or damage causedby any natural disaster or catastrophe; and (2) temporary measures necessary toprevent or to minimize further loss by such causes. (Military Construction, VeteransAffairs, and Related Agencies Appropriations Act, 2017.)



Obligations by program activity:358600385Medical programs .....................................................................0001908772National cemeteries ..................................................................0002404715Regional offices ........................................................................0003232718Staff offices ..............................................................................0004

.................116101Choice Act, P.L. 113–146, Sec. 801 ...........................................0005



1686731,033Unobligated balance brought forward, Oct 1 .........................1000..................................–195Unobligated balance transfer to other accts [036–0160] ......1010..................................95Recoveries of prior year unpaid obligations ...........................1021..................................10Recoveries of prior year paid obligations ...............................1033




343372321Appropriation, discretionary (total) .......................................1160343372321Budget authority (total) .............................................................19005111,0451,264Total budgetary resources available ..............................................1930

Memorandum (non-add) entries:.................168673Unexpired unobligated balance, end of year ..........................1941


1,4141,0001,087Unpaid obligations, brought forward, Oct 1 ..........................3000511877591New obligations, unexpired accounts ....................................3010


1,4741,4141,000Unpaid obligations, end of year .................................................3050Memorandum (non-add) entries:









accounts .......................................................................4053

343372321Budget authority, net (discretionary) .........................................4070413425525Outlays, net (discretionary) .......................................................4080


383848Outlays from mandatory balances ....................................4101343372321Budget authority, net (total) ..........................................................4180451463573Outlays, net (total) ........................................................................4190

The Construction, Minor Projects appropriation, which funds constructionprojects costing equal to or less than $10 million, is used to improve theinfrastructure of medical facilities and other Department-owned facilities

989DEPARTMENT OF VETERANS AFFAIRSDepartmental Administration—Continued


CONSTRUCTION, MINOR PROJECTS—Continued

to reduce the risk to patient life and safety, correct code deficiencies, andimprove national cemeteries and regional and staff offices.



Direct obligations:181818Other services from non-Federal sources ..................................25.2111Equipment .................................................................................31.0

492858572Land and structures ..................................................................32.0


✦

GRANTS FOR CONSTRUCTION OF STATE EXTENDED CARE FACILITIES

For grants to assist States to acquire or construct State nursing home and domicil-iary facilities and to remodel, modify, or alter existing hospital, nursing home, anddomiciliary facilities in State homes, for furnishing care to veterans as authorizedby sections 8131 through 8137 of title 38, United States Code, $90,000,000, to remainavailable until expended. (Military Construction, Veterans Affairs, and RelatedAgencies Appropriations Act, 2017.)



Obligations by program activity:100106130Grants for construction of state extended care facilities ...........0001



92311Unobligated balance brought forward, Oct 1 .........................10001822Recoveries of prior year unpaid obligations ...........................1021




9090140Appropriation, discretionary (total) .......................................1160117115153Total budgetary resources available ..............................................1930




–109–93–77Outlays (gross) ......................................................................3020–18–2–2Recoveries of prior year unpaid obligations, unexpired .........3040





22.................Outlays from new discretionary authority ..........................40101079177Outlays from discretionary balances .................................4011

1099377Outlays, gross (total) .............................................................40209090140Budget authority, net (total) ..........................................................4180

1099377Outlays, net (total) ........................................................................4190

The Grants for Construction of State Extended Care Facilities programis authorized by sections 8131 through 8137 of title 38, United States Code.It is a shared program between states and the VA, whereby VA provides65 percent of the funding for new construction of State home facilities,furnishing of domiciliary or nursing home care to veterans, and expansion,

remodeling, or alteration of existing State home facilities. The State is re-sponsible for providing the remaining 35 percent of funding.

✦

GRANTS FOR CONSTRUCTION OF VETERANS CEMETERIES

For grants to assist States and tribal organizations in establishing, expanding, orimproving veterans cemeteries as authorized by section 2408 of title 38, UnitedStates Code, $45,000,000, to remain available until expended. (Military Construction,Veterans Affairs, and Related Agencies Appropriations Act, 2017.)



Obligations by program activity:454549Grants for construction of state veterans cemeteries ................0001





Appropriations, discretionary:454546Appropriation ....................................................................1100545458Total budgetary resources available ..............................................1930









2424.................Outlays from new discretionary authority ..........................4010204040Outlays from discretionary balances .................................4011


✦

GENERAL ADMINISTRATION


For necessary operating expenses of the Department of Veterans Affairs, not oth-erwise provided for, including administrative expenses in support of Department-wide capital planning, management and policy activities, uniforms, or allowancestherefor; not to exceed $25,000 for official reception and representation expenses;hire of passenger motor vehicles; and reimbursement of the General Services Ad-ministration for security guard services, [$345,391,000]$346,891,000, of whichnot to exceed 5 percent shall remain available until September 30, [2018]2019:Provided, That funds provided under this heading may be transferred to "GeneralOperating Expenses, Veterans Benefits Administration". (Military Construction,Veterans Affairs, and Related Agencies Appropriations Act, 2017.)



Obligations by program activity:347355326General administration .............................................................0014421326391General administration, reimbursable program ........................0806


THE BUDGET FOR FISCAL YEAR 2018990 Departmental Administration—ContinuedFederal Funds—Continued



.................35Unobligated balance transfers between expired and unexpired

accounts ...........................................................................1012

.................1010Unobligated balance (total) ......................................................1050Budget authority:



347345333Appropriation, discretionary (total) .......................................1160Spending authority from offsetting collections, discretionary:


Memorandum (non-add) entries:..................................–11Unobligated balance expiring ................................................1940..................................7Unexpired unobligated balance, end of year ..........................1941














–421–326–392Offsets against gross budget authority and outlays (total) ....4040347345333Budget authority, net (total) ..........................................................4180330486282Outlays, net (total) ........................................................................4190

General Administration.—Includes departmental executive direction,departmental support offices and the General Counsel. The Pershing HallRevolving Fund was created to operate and manage Pershing Hall, an assetof the United States, located in Paris, France. All operating expenses forPershing Hall are borne by the revolving fund and all receipts generatedby the operation of Pershing Hall are deposited in the revolving fund.




203198180Full-time permanent .............................................................11.1343Other personnel compensation ..............................................11.5

206202183Total personnel compensation ...........................................11.9656463Civilian personnel benefits ........................................................12.1673Travel and transportation of persons .........................................21.0

..................................1Rent ..........................................................................................23.121205Rental payments to others ........................................................23.2583Communications, utilities, and miscellaneous charges ............23.3

..................................1Printing and reproduction .........................................................24.0415263Other services from non-Federal sources ..................................25.2111Supplies and materials .............................................................26.0213Equipment .................................................................................31.0



Employment Summary


1,8281,7031,632Direct civilian full-time equivalent employment ............................10011,188941927Reimbursable civilian full-time equivalent employment ...............2001

✦

BOARD OF VETERANS APPEALS

For necessary operating expenses of the Board of Veterans Appeals,[$156,096,000]$155,596,000, of which not to exceed 10 percent shall remainavailable until September 30, [2018]2019. (Military Construction, Veterans Affairs,and Related Agencies Appropriations Act, 2017.)



Obligations by program activity:171143110Board of Veterans' Appeals .......................................................0014







–151–146–106Outlays (gross) ......................................................................3020..................................–1Recoveries of prior year unpaid obligations, expired .............3041







The mission of the Board of Veterans' Appeals (Board or BVA), as setforth in 38 U.S.C. § 7101(a) is to conduct hearings and consider and disposeof appeals properly before the Board in a timely manner. The Board's goalis to issue quality decisions in compliance with the requirements of thelaw, including the precedential decisions of the United States Court ofAppeals for Veterans Claims (CAVC) and other federal courts. The Boardmakes final decisions on behalf of the Secretary on appeals from decisionsof the agencies of original jurisdiction with the Department of VeteransAffairs (VA) Offices. The Board reviews all appeals for entitlement toVeterans' benefits, including claims for service connection, increased dis-ability ratings, total disability ratings, pension, insurance benefits, educa-tional benefits, home loan guaranties, vocational rehabilitation, dependencyand indemnity compensation, and healthcare delivery.





1169572Total personnel compensation ...........................................11.9362922Civilian personnel benefits ........................................................12.1



BOARD OF VETERANS APPEALS—Continued

Object Classification—Continued


91110Rental payments to others ........................................................23.21086Other services from non-Federal sources ..................................25.2


Employment Summary


1,050886660Direct civilian full-time equivalent employment ............................1001

✦

GENERAL OPERATING EXPENSES, VETERANS BENEFITS ADMINISTRATION

For necessary operating expenses of the Veterans Benefits Administration, nototherwise provided for, including hire of passenger motor vehicles, reimbursementof the General Services Administration for security guard services, and reimburse-ment of the Department of Defense for the cost of overseas employee mail,[$2,856,160,000]$2,844,000,000: Provided, That expenses for services and assist-ance authorized under paragraphs (1), (2), (5), and (11) of section 3104(a) of title38, United States Code, that the Secretary of Veterans Affairs determines are neces-sary to enable entitled veterans: (1) to the maximum extent feasible, to becomeemployable and to obtain and maintain suitable employment; or (2) to achievemaximum independence in daily living, shall be charged to this account: Providedfurther, That, of the funds made available under this heading, not to exceed 5 percentshall remain available until September 30, [2018]2019. (Military Construction,Veterans Affairs, and Related Agencies Appropriations Act, 2017.)



Obligations by program activity:2,2912,3062,197Compensation and pensions .....................................................0010201203213Education ..................................................................................0011333331217Vocational rehabilitation and counseling ..................................0012

111Insurance ..................................................................................00131815.................Housing .....................................................................................0014

2,8442,8562,628Total direct obligations ..................................................................0799796782331Compensation and pensions .....................................................0801

11.................Education ..................................................................................0802333529Insurance ..................................................................................0804

155170139Housing .....................................................................................0805




8910110Unobligated balance brought forward, Oct 1 .........................1000

..................................38Unobligated balance transfers between expired and unexpired

accounts ...........................................................................1012




.................–12.................Appropriations permanently reduced ................................1130

2,8442,8442,704Appropriation, discretionary (total) .......................................1160Spending authority from offsetting collections, discretionary:

988988499Collected ...........................................................................17003,8323,8323,203Budget authority (total) .............................................................19003,9213,9333,251Total budgetary resources available ..............................................1930





..................................36Obligations ("upward adjustments"), expired accounts ........3011–3,767–3,719–2,953Outlays (gross) ......................................................................3020






3,2633,2402,645Outlays from new discretionary authority ..........................4010504479308Outlays from discretionary balances .................................4011






2,8442,8442,704Budget authority, net (discretionary) .........................................40702,7792,7312,453Outlays, net (discretionary) .......................................................40802,8442,8442,704Budget authority, net (total) ..........................................................41802,7792,7312,453Outlays, net (total) ........................................................................4190

General Operating Expenses, Veterans Benefits Administration.—Thetotal cost of administering veterans insurance programs is funded throughdirect appropriations to this account and through reimbursements from theinsurance trust fund. This appropriation provides for the Department's topmanagement direction and administrative support, including fiscal, person-nel, and legal services, as well as for the administration of veteran benefits.

Note.—Reflects FTE treated as reimbursements in all years and the effectsof Credit Reform, per P.L. 101–508.




1,4811,4141,394Full-time permanent .............................................................11.1130125117Other personnel compensation ..............................................11.5

1,6111,5391,511Total personnel compensation ...........................................11.9520515505Civilian personnel benefits ........................................................12.1

111Benefits for former personnel ....................................................13.0324222Travel and transportation of persons .........................................21.0222Transportation of things ............................................................22.0

124125115Rent ..........................................................................................23.1191918Rental payments to others ........................................................23.2181817Communications, utilities, and miscellaneous charges ............23.3443Printing and reproduction .........................................................24.0

490563415Other services from non-Federal sources ..................................25.2787Supplies and materials .............................................................26.0

141810Equipment .................................................................................31.0222Insurance claims and indemnities ............................................42.0



Employment Summary


21,39921,31020,227Direct civilian full-time equivalent employment ............................10011,3221,4111,331Reimbursable civilian full-time equivalent employment ...............2001

✦

OFFICE OF INSPECTOR GENERAL

For necessary expenses of the Office of Inspector General, to include informationtechnology, in carrying out the provisions of the Inspector General Act of 1978 (5U.S.C. App.), [$160,106,000] $159,606,000, of which not to exceed 10 percentshall remain available until September 30, [2018] 2019. (Military Construction,Veterans Affairs, and Related Agencies Appropriations Act, 2017.)




Obligations by program activity:170158128Office of Inspector General (Direct) ...........................................0101

170158128Total direct program ......................................................................0192.................34Office of Inspector General (Reimbursable) ...............................0801





Spending authority from offsetting collections, discretionary:.................34Collected ...........................................................................1700


Memorandum (non-add) entries:.................–1–1Unobligated balance expiring ................................................1940.................109Unexpired unobligated balance, end of year ..........................1941



–155–138–138Outlays (gross) ......................................................................3020..................................–3Recoveries of prior year unpaid obligations, expired .............3041







Offsetting collections (collected) from:.................–3–4Federal sources .................................................................4030

160160137Budget authority, net (total) ..........................................................4180155135134Outlays, net (total) ........................................................................4190

This appropriation provides for carrying out the independent oversightresponsibilities of the Inspector General Act of 1978. This oversight in-cludes VA-wide audit, investigation, health care inspection, and manage-ment support functions to identify and report weaknesses and deficienciesthat create conditions for actual or potential fraud and other criminalactivity, mismanagement, and waste in VA programs and operations. Theaudit function plans and conducts internal programmatic and financialaudits and evaluations of all facets of VA operations. The health care in-spection function performs legislatively mandated medical care qualityassurance reviews and oversight of VA health care programs. The invest-igative function performs criminal and administrative investigations ofimproper and illegal activities involving VA operations, personnel, benefi-ciaries, and other parties.





998979Total personnel compensation ...........................................11.9383530Civilian personnel benefits ........................................................12.1665Employee Travel .........................................................................21.066.................Rental payments to GSA ............................................................23.1322Communications, utilities, and miscellaneous charges ............23.3

141610Other services from non-Federal sources ..................................25.2442Equipment .................................................................................31.0

170158128Direct obligations ..................................................................99.0.................34Reimbursable obligations .....................................................99.0


Employment Summary


820760680Direct civilian full-time equivalent employment ............................1001.................1326Reimbursable civilian full-time equivalent employment ...............2001

✦

INFORMATION TECHNOLOGY SYSTEMS


For necessary expenses for information technology systems and telecommunica-tions support, including developmental information systems and operational inform-ation systems; for pay and associated costs; and for the capital asset acquisition ofinformation technology systems, including management and related contractualcosts of said acquisitions, including contractual costs associated with operationsauthorized by section 3109 of title 5, United States Code, [$4,278,259,000]$4,055,500,000, plus reimbursements: Provided, That [$1,272,548,000]$1,230,320,000 shall be for pay and associated costs, of which not to exceed[$37,100,000] $35,869,000 shall remain available until September 30, [2018]2019: Provided further, That [$2,534,442,000] $2,466,650,000 shall be for opera-tions and maintenance, of which not to exceed [$180,200,000 ] $172,666,000 shallremain available until September 30, [2018] 2019: Provided further, That[$471,269,000] $358,530,000 shall be for information technology systems devel-opment, [modernization, and enhancement, ]and shall remain available untilSeptember 30, [2018] 2019: Provided further, That amounts made available forinformation technology systems development[, modernization, and enhancement]may not be obligated or expended until the Secretary of Veterans Affairs or theChief Information Officer of the Department of Veterans Affairs submits to theCommittees on Appropriations of both Houses of Congress a certification of theamounts, in parts or in full, to be obligated and expended for each developmentproject: Provided further, That amounts made available for salaries and expenses,operations and maintenance, and information technology systems development[,modernization, and enhancement] may be transferred among the three subaccountsafter the Secretary of Veterans Affairs [requests from ]submits notice thereof tothe Committees on Appropriations of both Houses of Congress[ the authority tomake the transfer and an approval is issued]: Provided further, That amounts madeavailable for the "Information Technology Systems" account for development[,modernization, and enhancement] may be transferred among projects or to newlydefined projects: Provided further, That no project may be increased or decreasedby more than [$1,000,000] $3,000,000 of cost prior to submitting [a request ]noticethereof to the Committees on Appropriations of both Houses of Congress[ to makethe transfer and an approval is issued, or absent a response, a period of 30 days haselapsed: Provided further, That funds under this heading may be used by the Inter-agency Program Office through the Department of Veterans Affairs to define datastandards, code sets, and value sets used to enable interoperability: Provided further,That of the funds made available for information technology systems development,modernization, and enhancement for VistA Evolution or any successor program,not more than 25 percent may be obligated or expended until the Secretary of Vet-erans Affairs:].

[(1) submits to the Committees on Appropriations of both Houses of Congressthe VistA Evolution Business Case and supporting documents regarding continu-ation of VistA Evolution or alternatives to VistA Evolution, including an analysisof necessary or desired capabilities, technical and security requirements, the planfor modernizing the platform framework, and all associated costs;][(2) submits to the Committees on Appropriations of both Houses of Congress,

and such Committees approve, the following: a report that describes a strategicplan for VistA Evolution, or any successor program, and the associated implement-ation plan including metrics and timelines; a master schedule and lifecycle costestimate for VistA Evolution or any successor; and an implementation plan forthe transition from the Project Management Accountability System to a new projectdelivery framework, the Veteran-focused Integration Process, that includes themethodology by which projects will be tracked, progress measured, and deliverablesevaluated;][(3) submits to the Committees on Appropriations of both Houses of Congress

a report outlining the strategic plan to reach interoperability with private sectorhealthcare providers, the timeline for reaching "meaningful use" as defined by theOffice of National Coordinator for Health Information Technology for each data



INFORMATION TECHNOLOGY SYSTEMS—Continued

domain covered under the VistA Evolution program, and the extent to which theDepartment of Veterans Affairs leverages the State Health Information Exchangesto share health data with private sector providers;][(4) submits to the Committees on Appropriations of both Houses of Congress,

and such Committees approve, the following: a report that describes the extent towhich VistA Evolution, or any successor program, maximizes the use of commer-cially available software used by DoD and the private sector, requires an openarchitecture that leverages best practices and rapidly adapts to technologies pro-duced by the private sector, enhances full interoperability between the VA andDoD and between VA and the private sector, and ensures the security of personallyidentifiable information of veterans and beneficiaries; and][(5) certifies in writing to the Committees on Appropriations of both Houses of

Congress that the Department of Veterans Affairs has met the requirements con-tained in the National Defense Authorization Act of Fiscal Year 2014 (Public Law113–66) which require that electronic health record systems of the Department ofDefense and the Department of Veterans Affairs have reached interoperability,comply with national standards and architectural requirements identified by theDoD/VA Interagency Program Office in collaboration with the Office of NationalCoordinator for Health Information Technology:][Provided further, That the funds made available under this heading for information

technology systems development, modernization, and enhancement, shall be for theprojects, and in the amounts, specified under this heading in the joint explanatorystatement accompanying this Act.] (Military Construction, Veterans Affairs, andRelated Agencies Appropriations Act, 2017.)



Obligations by program activity:359590464Development .............................................................................0001

2,4632,5522,531Operations and maintenance ....................................................00021,2261,2811,069Administrative and salaries ......................................................0003

.................13981P.L. 113–146, Sec. 801 - IT Support ..........................................0004

4,0484,5624,145Total direct obligations ..................................................................0799..................................4Development .............................................................................0801

404022Operations and maintenance ....................................................0802131312Administrative and salaries ......................................................0803




90389463Unobligated balance brought forward, Oct 1 .........................1000.................161.................Discretionary unobligated balance brought fwd, Oct 1 ......1001..................................35Recoveries of prior year unpaid obligations ...........................1021



–8–7–7Appropriations transferred to other accts [036–0169] .......1120..................................–76Appropriations transferred to other acct [036–0110] ........1120.................–8.................Appropriations permanently reduced ................................1130

4,0484,2634,050Appropriation, discretionary (total) .......................................1160Spending authority from offsetting collections, discretionary:

535337Collected ...........................................................................1700..................................1Change in uncollected payments, Federal sources ............1701

535338Spending auth from offsetting collections, disc (total) .........17504,1014,3164,088Budget authority (total) .............................................................19004,1914,7054,586Total budgetary resources available ..............................................1930




2,3362,1101,952Unpaid obligations, brought forward, Oct 1 ..........................30004,1014,6154,183New obligations, unexpired accounts ....................................3010

..................................75Obligations ("upward adjustments"), expired accounts ........3011–4,266–4,389–3,869Outlays (gross) ......................................................................3020




.................–1–4Uncollected pymts, Fed sources, brought forward, Oct 1 ........3060

..................................–1Change in uncollected pymts, Fed sources, unexpired ..........3070

.................14Change in uncollected pymts, Fed sources, expired ..............3071

..................................–1Uncollected pymts, Fed sources, end of year .............................3090Memorandum (non-add) entries:









..................................–1Change in uncollected pymts, Fed sources, unexpired .......4050





5410960Outlays from mandatory balances ....................................41014,0484,2634,050Budget authority, net (total) ..........................................................41804,2134,3363,827Outlays, net (total) ........................................................................4190

The Information Technology (IT) Systems appropriation funds IT servicessuch as systems development and performance, operations and maintenance,information security, and customer support. This appropriation enables theeffective and efficient delivery of services to the nation's largest healthcarenetwork, as well as the veterans benefits and corporate business lineswithin the Department of Veterans Affairs (VA).

Development.—The Office of Information & Technology invests inprojects designed to improve the delivery of VA services and benefits forveterans and their families. This account also supports improvements inthe Electronic Health Record and modernizations to veterans benefits andappeals processing.

Operations and Maintenance.—The Office of Information & Technologypurchases, maintains, manages, and supports all the computer, phone,telecommunication, and data systems equipment and infrastructure for allVA facilities.




747724668Full-time permanent .............................................................11.1.................1210Full-time permanent - Choice Act, P.L. 113–146, Sec. 801 ....11.1

747736678Total personnel compensation ...........................................11.9245242219Civilian personnel benefits ........................................................12.1

.................43Civilian personnel benefits -Choice Act, P.L. 113–146, Sec.

801 ........................................................................................12.1

10118Travel and transportation of persons .........................................21.0813830782Communications, utilities, and miscellaneous charges ............23.3

.................2220Communications/utilities - Choice Act, P.L. 113–146, Sec.

801 ........................................................................................23.3

1,5541,9171,653Other services from non-Federal sources ..................................25.2

.................514Other services from non-Federal -Choice Act, P.L. 113–146, Sec.

801 ........................................................................................25.2


.................4742Equipment - Choice Act, P.L. 113–146, Sec. 801 .......................31.0776Land and structures ..................................................................32.0

.................32Land and structures - Choice Act, P.L. 113–146, Sec. 801 ........32.012.................Insurance claims and indemnities ............................................42.0




Employment Summary



✦

NATIONAL CEMETERY ADMINISTRATION

For necessary expenses of the National Cemetery Administration for operationsand maintenance, not otherwise provided for, including uniforms or allowancestherefor; cemeterial expenses as authorized by law; purchase of one passenger motorvehicle for use in cemeterial operations; hire of passenger motor vehicles; and repair,alteration or improvement of facilities under the jurisdiction of the National CemeteryAdministration, [$286,193,000] $306,193,000, of which not to exceed 10 percentshall remain available until September 30, [2018] 2019. (Military Construction,Veterans Affairs, and Related Agencies Appropriations Act, 2017.)



11.................Balance, start of year ....................................................................0100Receipts:

Current law:..................................1Gifts and Donations, National Cemetery Gift Fund ................1130

111Total: Balances and receipts .....................................................2000

111Balance, end of year ..................................................................5099



Obligations by program activity:307292269Administrative expenses ...........................................................0201


234Unobligated balance brought forward, Oct 1 .........................1000

.................52Unobligated balance transfers between expired and unexpired

accounts ...........................................................................1012















The mission of the National Cemetery Administration is to honor veteranswith final resting places in national shrines and with lasting tributes thatcommemorate their service to our Nation. The National Cemetery Admin-istration's vision is to serve all veterans and their families with the utmost

dignity, respect, and compassion. Every national cemetery will be a placethat inspires visitors to understand and appreciate the service and sacrificeof our Nation's veterans. There are six related programs managed by theNational Cemetery Administration including: 1) burying eligible veteransand their family members in national cemeteries and maintaining the gravesand their environs as national shrines; 2) administering grants to States andTribal organizations in establishing, expanding, improving, or operatingveterans cemeteries; 3) providing headstones and markers for the gravesof eligible veterans; 4) providing presidential memorial certificates tofamily and friends of deceased veterans, recognizing the veterans' contri-bution and service to the Nation; 5) providing graveliners or partial reim-bursement for a privately purchased outer burial receptacle for each newgrave in open national cemeteries administered by the National CemeteryAdministration; and 6) recording First Notice of Veteran Deaths into VAelectronic files to ensure timely termination of benefits and next-of-kinnotification of possible entitlement to survivor benefits.

The National Cemetery Administration also reflects budget informationfor the National Cemetery Gift Fund and the National Cemetery Adminis-tration Facilities Operation Fund. Through the Gift Fund, the Secretary isauthorized to accept gifts and bequests which are made for the purpose ofbeautifying national cemeteries or are determined to be beneficial to suchcemeteries, or are made for the purpose of the operation, maintenance, orimprovement of the National Memorial Cemetery of Arizona. Through theFacilities Operation Fund, the Secretary is authorized to lease any un-developed land and unused or underutilized buildings of the NationalCemetery Administration, or parts or parcels thereof, for a term not to ex-ceed 10 years. Proceeds from such leases are deposited in the FacilitiesOperation Fund, and are available to cover costs incurred by the NationalCemetery Administration in the operation and maintenance of property ofthe Administration.




114112106Full-time permanent .............................................................11.1555Other than full-time permanent ............................................11.3

119117111Total personnel compensation ...........................................11.9434240Civilian personnel benefits ........................................................12.1343Travel and transportation of persons .........................................21.0222Transportation of things ............................................................22.0443Rent ..........................................................................................23.1779Communications, utilities, and miscellaneous charges ............23.3221Printing and reproduction .........................................................24.0

1018976Other services from non-Federal sources ..................................25.2121112Supplies and materials .............................................................26.011119Equipment .................................................................................31.0333Land and structures ..................................................................32.0


Employment Summary



✦

SUPPLY FUND



Obligations by program activity:320320453Reimbursable program-COGS-Merchandizing ...........................0801345345239Reimbursable program-Other-Operations .................................0802202010Reimbursable program-COGS-Printing and publications ..........0803

43743756Reimbursable program-Other ....................................................0804

978978540Reimbursable program-Equipment-Procurement services and

distribution ...........................................................................0805



SUPPLY FUND—Continued







Spending authority from offsetting collections, mandatory:2,1002,1001,403Collected ...........................................................................1800

..................................–128Change in uncollected payments, Federal sources ............1801

2,1002,1001,275Spending auth from offsetting collections, mand (total) .......18502,3272,3271,525Total budgetary resources available ..............................................1930



1,8731,2291,406Unpaid obligations, brought forward, Oct 1 ..........................30002,1002,1001,298New obligations, unexpired accounts ....................................3010



–1,288–1,288–1,416Uncollected pymts, Fed sources, brought forward, Oct 1 ........3060..................................128Change in uncollected pymts, Fed sources, unexpired ..........3070

–1,288–1,288–1,288Uncollected pymts, Fed sources, end of year .............................3090Memorandum (non-add) entries:

585–59–10Obligated balance, start of year ............................................3100585585–59Obligated balance, end of year ..............................................3200



2,1001,4561,386Outlays from mandatory balances ....................................4101Offsets against gross budget authority and outlays:

Offsetting collections (collected) from:–2,100–2,100–1,279Federal sources .................................................................4120


–2,100–2,100–1,403Offsets against gross budget authority and outlays (total) ....4130Additional offsets against gross budget authority only:

..................................128Change in uncollected pymts, Fed sources, unexpired .......4140

.................–644–17Outlays, net (mandatory) ...........................................................4170


.................–644–17Outlays, net (total) ........................................................................4190

Under the provisions of 38 U.S.C. 8121, the Supply Fund is responsiblefor the operation and maintenance of a supply system for VA. In this capa-city, it provides policy and oversight to VA's acquisition and logisticsprograms, and provides best value acquisition of goods and services throughits National Acquisition Center, Denver Acquisition and Logistics Center,Service and Distribution Center, Technology Acquisition Center andStrategic Acquisition Center. Operating as an intra-governmental revolvingfund without fiscal year limitations, the Supply Fund is financed by revenuefrom fees on acquisitions of supplies, equipment, and services for both VAand other Government agency (OGA) customers.



Reimbursable obligations:111111102Personnel compensation: Full-time permanent .........................11.1353532Civilian personnel benefits ........................................................12.1779Travel and transportation of persons .........................................21.0666Rental payments to GSA ............................................................23.1666Communications, utilities, and miscellaneous charges ............23.3

202010Printing and reproduction .........................................................24.0437437228Other services from non-Federal sources ..................................25.2500500417Supplies and materials .............................................................26.0978978488Equipment .................................................................................31.0


Employment Summary



✦

FRANCHISE FUND



Obligations by program activity:900892820Franchise Fund (Reimbursable) ................................................0801




Spending authority from offsetting collections, discretionary:900892738Collected ...........................................................................1700

..................................7Change in uncollected payments, Federal sources ............1701

900892745Spending auth from offsetting collections, disc (total) .........17501,0571,049977Total budgetary resources available ..............................................1930






–217–217–210Uncollected pymts, Fed sources, brought forward, Oct 1 ........3060..................................–7Change in uncollected pymts, Fed sources, unexpired ..........3070








Additional offsets against gross budget authority only:..................................–7Change in uncollected pymts, Fed sources, unexpired .......4050

–25212Outlays, net (discretionary) .......................................................4080...................................................Budget authority, net (total) ..........................................................4180

–25212Outlays, net (total) ........................................................................4190

The VA Franchise Fund was established under the authority of the Gov-ernment Management Reform Act of 1994 and the VA and Housing andUrban Development and Independent Agencies Act of 1997. VA was se-lected by the Office of Management and Budget (OMB) in 1996 as one ofthe six executive branch agencies to establish a franchise fund pilot pro-gram. Created as a revolving fund, the VA Franchise Fund began providingcommon administrative support services to the VA and other governmentagencies in 1997 on a fee-for-service basis. In 2006, under the MilitaryQuality of Life and Veterans Affairs Appropriations Act, Public Law109–114, permanent status was conferred upon the VA Franchise Fund.VA Enterprise Centers are the lines of business within the VA FranchiseFund and are expected to have billings of about $907 million and employ


1,754 in 2018. The Franchise Fund concept is intended to increase compet-ition for government administrative services, resulting in lower costs andhigher quality.



Reimbursable obligations:166166143Personnel compensation: Full-time permanent .........................11.1

111Civilian personnel benefits ........................................................12.1332Travel and transportation of persons .........................................21.0

11011099Communications, utilities, and miscellaneous charges ............23.3667Printing and reproduction .........................................................24.0

574566529Other services from non-Federal sources ..................................25.2445Supplies and materials .............................................................26.0

313130Equipment .................................................................................31.0554Land and structures ..................................................................32.0


Employment Summary



✦

ADMINISTRATIVE PROVISIONS

(INCLUDING TRANSFER OF FUNDS)SEC. 201. Any appropriation for fiscal year [2017]2018 for "Compensation and

Pensions", "Readjustment Benefits", and "Veterans Insurance and Indemnities" maybe transferred as necessary to any other of the mentioned appropriations: Provided,That, before a transfer may take place, the Secretary of Veterans Affairs shall [re-quest from]submit notice thereof to the Committees on Appropriations of bothHouses of Congress [the authority to make the transfer and such Committees issuean approval, or absent a response, a period of 30 days has elapsed].

(INCLUDING TRANSFER OF FUNDS)SEC. 202. Amounts made available for the Department of Veterans Affairs for

fiscal year [2017]2018, in this or any other Act, under the "Medical Services","Medical Community Care", "Medical Support and Compliance", and "MedicalFacilities" accounts may be transferred among the accounts: Provided, That anytransfers among the "Medical Services", "Medical Community Care", and "MedicalSupport and Compliance" accounts of 1 percent or less of the total amount appropri-ated to the account in this or any other Act may take place subject to notificationfrom the Secretary of Veterans Affairs to the Committees on Appropriations of bothHouses of Congress of the amount and purpose of the transfer: Provided further,That [any transfers among the "Medical Services", "Medical Community Care",and "Medical Support and Compliance" accounts in excess of 1 percent, or exceedingthe cumulative 1 percent for the fiscal year, may take place only after the Secretaryrequests from the Committees on Appropriations of both Houses of Congress theauthority to make the transfer and an approval is issued: Provided further, That anytransfers to or from the "Medical Facilities" account may take place only after theSecretary requests from the Committees on Appropriations of both Houses of Con-gress the authority to make the transfer and an approval is issued]before a transfermay take place, the Secretary of Veterans Affairs shall submit notice thereof to theCommittees on Appropriations of both Houses of Congress.

SEC. 203. Appropriations available in this title for salaries and expenses shall beavailable for services authorized by section 3109 of title 5, United States Code; hireof passenger motor vehicles; lease of a facility or land or both; and uniforms or al-lowances therefore, as authorized by sections 5901 through 5902 of title 5, UnitedStates Code.

SEC. 204. No appropriations in this title (except the appropriations for "Construc-tion, Major Projects", and "Construction, Minor Projects") shall be available for thepurchase of any site for or toward the construction of any new hospital or home.

SEC. 205. No appropriations in this title shall be available for hospitalization orexamination of any persons (except beneficiaries entitled to such hospitalization orexamination under the laws providing such benefits to veterans, and persons receivingsuch treatment under sections 7901 through 7904 of title 5, United States Code, orthe Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C.5121 et seq.)), unless reimbursement of the cost of such hospitalization or examina-tion is made to the "Medical Services" account at such rates as may be fixed by theSecretary of Veterans Affairs.

SEC. 206. Appropriations available in this title for "Compensation and Pensions","Readjustment Benefits", and "Veterans Insurance and Indemnities" shall be availablefor payment of prior year accrued obligations required to be recorded by law againstthe corresponding prior year accounts within the last quarter of fiscal year[2016]2017.

SEC. 207. Appropriations available in this title shall be available to pay prior yearobligations of corresponding prior year appropriations accounts resulting from sec-tions 3328(a), 3334, and 3712(a) of title 31, United States Code, except that if suchobligations are from trust fund accounts they shall be payable only from "Compens-ation and Pensions".

(INCLUDING TRANSFER OF FUNDS)SEC. 208. Notwithstanding any other provision of law, during fiscal year

[2017]2018, the Secretary of Veterans Affairs shall, from the National Service LifeInsurance Fund under section 1920 of title 38, United States Code, the Veterans'Special Life Insurance Fund under section 1923 of title 38, United States Code, andthe United States Government Life Insurance Fund under section 1955 of title 38,United States Code, reimburse the "General Operating Expenses, Veterans BenefitsAdministration" and "Information Technology Systems" accounts for the cost ofadministration of the insurance programs financed through those accounts: Provided,That reimbursement shall be made only from the surplus earnings accumulated insuch an insurance program during fiscal year [2017]2018 that are available for di-vidends in that program after claims have been paid and actuarially determined re-serves have been set aside: Provided further, That if the cost of administration ofsuch an insurance program exceeds the amount of surplus earnings accumulated inthat program, reimbursement shall be made only to the extent of such surplus earn-ings: Provided further, That the Secretary shall determine the cost of administrationfor fiscal year [2017]2018 which is properly allocable to the provision of each suchinsurance program and to the provision of any total disability income insurance in-cluded in that insurance program.

SEC. 209. Amounts deducted from enhanced-use lease proceeds to reimburse anaccount for expenses incurred by that account during a prior fiscal year for providingenhanced-use lease services, may be obligated during the fiscal year in which theproceeds are received.

(INCLUDING TRANSFER OF FUNDS)SEC. 210. Funds available in this title or funds for salaries and other administrative

expenses shall also be available to reimburse the Office of Resolution Management[of the Department of Veterans Affairs and], the Office of Employment Discrimin-ation Complaint Adjudication [under section 319 of title 38, United States Code],the Office of Accountability Review, the Central Whistleblower Office, the Office ofDiversity and Inclusion, and the Office of the Executive Director of Accountabilityand Whistleblower Protection for all services provided at rates which will recoveractual costs but not to exceed $47,668,000 for the Office of Resolution Management[and], $3,932,000 for the Office of Employment Discrimination Complaint Adju-dication, $10,057,000 for the Office of Accountability Review, $6,646,000 for theCentral Whistleblower Office, $2,973,000 for the Office of Diversity and Inclusion,and $917,000 for the Office of the Executive Director of Accountability and Whis-tleblower Protection: Provided, That payments may be made in advance for servicesto be furnished based on estimated costs: Provided further, That amounts receivedshall be credited to the "General Administration" and "Information TechnologySystems" accounts for use by the office that provided the service.

SEC. 211. No funds of the Department of Veterans Affairs shall be available forhospital care, nursing home care, or medical services provided to any person underchapter 17 of title 38, United States Code, for a non-service-connected disabilitydescribed in section 1729(a)(2) of such title, unless that person has disclosed to theSecretary of Veterans Affairs, in such form as the Secretary may require, current,accurate third-party reimbursement information for purposes of section 1729 of suchtitle: Provided, That the Secretary may recover, in the same manner as any otherdebt due the United States, the reasonable charges for such care or services fromany person who does not make such disclosure as required: Provided further, Thatany amounts so recovered for care or services provided in a prior fiscal year maybe obligated by the Secretary during the fiscal year in which amounts are received.

(INCLUDING TRANSFER OF FUNDS)SEC. 212. Notwithstanding any other provision of law, proceeds or revenues derived

from enhanced-use leasing activities (including disposal) may be deposited into the"Construction, Major Projects" and "Construction, Minor Projects" accounts and beused for construction (including site acquisition and disposition), alterations, andimprovements of any medical facility under the jurisdiction or for the use of theDepartment of Veterans Affairs. Such sums as realized are in addition to the amountprovided for in "Construction, Major Projects" and "Construction, Minor Projects".

SEC. 213. Amounts made available under "Medical Services" are available—(1) for furnishing recreational facilities, supplies, and equipment; and

997DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATIVE PROVISIONS

(2) for funeral expenses, burial expenses, and other expenses incidental to fu-nerals and burials for beneficiaries receiving care in the Department.

(INCLUDING TRANSFER OF FUNDS)SEC. 214. Such sums as may be deposited to the Medical Care Collections Fund

pursuant to section 1729A of title 38, United States Code, may be transferred to the"Medical Services" and "Medical Community Care" accounts to remain availableuntil expended for the purposes of these accounts.

SEC. 215. The Secretary of Veterans Affairs may enter into agreements with Fed-erally Qualified Health Centers in the State of Alaska and Indian tribes and tribalorganizations which are party to the Alaska Native Health Compact with the IndianHealth Service, to provide healthcare, including behavioral health and dental care,to veterans in rural Alaska. The Secretary shall require participating veterans andfacilities to comply with all appropriate rules and regulations, as established by theSecretary. The term "rural Alaska" shall mean those lands which are not within theboundaries of the municipality of Anchorage or the Fairbanks North Star Borough.

(INCLUDING TRANSFER OF FUNDS)SEC. 216. Such sums as may be deposited to the Department of Veterans Affairs

Capital Asset Fund pursuant to section 8118 of title 38, United States Code, maybe transferred to the "Construction, Major Projects" and "Construction, Minor Pro-jects" accounts, to remain available until expended for the purposes of these accounts.[SEC. 217. Of the amounts appropriated in title II of division J of Public Law

114–113 under the heading "Medical Services" which become available on October1, 2016, $7,246,181,000 are hereby rescinded.][SEC. 218. Not later than 30 days after the end of each fiscal quarter, the Secretary

of Veterans Affairs shall submit to the Committees on Appropriations of both Housesof Congress a report on the financial status of the Department of Veterans Affairsfor the preceding quarter: Provided, That, at a minimum, the report shall includethe direction contained in the paragraph entitled "Quarterly reporting", under theheading "General Administration" in the joint explanatory statement accompanyingthis Act.]

(INCLUDING TRANSFER OF FUNDS)SEC. [219]217. Amounts made available under the "Medical Services", "Medical

Community Care", "Medical Support and Compliance", "Medical Facilities","General Operating Expenses, Veterans Benefits Administration", "Board of VeteransAppeals", "General Administration", and "National Cemetery Administration" ac-counts for fiscal year [2017]2018 may be transferred to or from the "InformationTechnology Systems" account: Provided, [That such transfers may not result in amore than 10 percent aggregate increase in the total amount made available by thisAct for the "Information Technology Systems" account: Provided further,] That,before a transfer may take place, the Secretary of Veterans Affairs shall [requestfrom]submit notice thereof to the Committees on Appropriations of both Housesof Congress [the authority to make the transfer and an approval is issued].[SEC. 220. None of the funds appropriated or otherwise made available by this

Act or any other Act for the Department of Veterans Affairs may be used in a mannerthat is inconsistent with: (1) section 842 of the Transportation, Treasury, Housingand Urban Development, the Judiciary, the District of Columbia, and IndependentAgencies Appropriations Act, 2006 (Public Law 109–115; 119 Stat. 2506); or (2)section 8110(a)(5) of title 38, United States Code.]

(INCLUDING TRANSFER OF FUNDS)SEC. [221]218. Of the amounts appropriated to the Department of Veterans Affairs

for fiscal year [2017] 2018 for "Medical Services", "Medical Community Care","Medical Support and Compliance", "Medical Facilities", "Construction, MinorProjects", and "Information Technology Systems", up to [$274,731,000]$297,137,000, plus reimbursements, may be transferred to the Joint Department ofDefense-Department of Veterans Affairs Medical Facility Demonstration Fund, es-tablished by section 1704 of the National Defense Authorization Act for Fiscal Year2010 (Public Law 111–84; 123 Stat. 3571) and may be used for operation of thefacilities designated as combined Federal medical facilities as described by section706 of the Duncan Hunter National Defense Authorization Act for Fiscal Year 2009(Public Law 110–417; 122 Stat. 4500): Provided, That additional funds may betransferred from accounts designated in this section to the Joint Department of De-fense-Department of Veterans Affairs Medical Facility Demonstration Fund uponwritten notification by the Secretary of Veterans Affairs to the Committees on Ap-propriations of both Houses of Congress: Provided further, That section [223]222of title II of division [J]A of Public Law [114–113]114–223 is repealed.

(INCLUDING TRANSFER OF FUNDS)SEC. [222]219. Of the amounts appropriated to the Department of Veterans Affairs

which become available on October 1, [2017]2018, for "Medical Services","Medical Community Care", "Medical Support and Compliance", and "MedicalFacilities", up to [$280,802,000] $306,378,000, plus reimbursements, may betransferred to the Joint Department of Defense-Department of Veterans AffairsMedical Facility Demonstration Fund, established by section 1704 of the National

Defense Authorization Act for Fiscal Year 2010 (Public Law 111–84; 123 Stat.3571) and may be used for operation of the facilities designated as combined Federalmedical facilities as described by section 706 of the Duncan Hunter National DefenseAuthorization Act for Fiscal Year 2009 (Public Law 110–417; 122 Stat. 4500):Provided, That additional funds may be transferred from accounts designated in thissection to the Joint Department of Defense-Department of Veterans Affairs MedicalFacility Demonstration Fund upon written notification by the Secretary of VeteransAffairs to the Committees on Appropriations of both Houses of Congress.

(INCLUDING TRANSFER OF FUNDS)SEC. [223]220. Such sums as may be deposited to the Medical Care Collections

Fund pursuant to section 1729A of title 38, United States Code, for healthcareprovided at facilities designated as combined Federal medical facilities as describedby section 706 of the Duncan Hunter National Defense Authorization Act for FiscalYear 2009 (Public Law 110–417; 122 Stat. 4500) shall also be available: (1) fortransfer to the Joint Department of Defense-Department of Veterans Affairs MedicalFacility Demonstration Fund, established by section 1704 of the National DefenseAuthorization Act for Fiscal Year 2010 (Public Law 111–84; 123 Stat. 3571); and(2) for operations of the facilities designated as combined Federal medical facilitiesas described by section 706 of the Duncan Hunter National Defense AuthorizationAct for Fiscal Year 2009 (Public Law 110–417; 122 Stat. 4500): Provided, That,notwithstanding section 1704(b)(3) of the National Defense Authorization Act forFiscal Year 2010 (Public Law 111–84; 123 Stat. 2573), amounts transferred to theJoint Department of Defense-Department of Veterans Affairs Medical FacilityDemonstration Fund shall remain available until expended.

(INCLUDING TRANSFER OF FUNDS)SEC. [224]221. Of the amounts available in this title for "Medical Services",

"Medical Community Care", "Medical Support and Compliance", and "MedicalFacilities", a minimum of $15,000,000 shall be transferred to the DOD-VA HealthCare Sharing Incentive Fund, as authorized by section 8111(d) of title 38, UnitedStates Code, to remain available until expended, for any purpose authorized bysection 8111 of title 38, United States Code.[SEC. 225. None of the funds available to the Department of Veterans Affairs, in

this or any other Act, may be used to replace the current system by which the Veter-ans Integrated Service Networks select and contract for diabetes monitoring suppliesand equipment.][SEC. 226. The Secretary of Veterans Affairs shall notify the Committees on Ap-

propriations of both Houses of Congress of all bid savings in a major constructionproject that total at least $5,000,000, or 5 percent of the programmed amount of theproject, whichever is less: Provided, That such notification shall occur within 14days of a contract identifying the programmed amount: Provided further, That theSecretary shall notify the Committees on Appropriations of both Houses of Congress14 days prior to the obligation of such bid savings and shall describe the anticipateduse of such savings.][SEC. 227. None of the funds made available for "Construction, Major Projects"

may be used for a project in excess of the scope specified for that project in theoriginal justification data provided to the Congress as part of the request for appro-priations unless the Secretary of Veterans Affairs receives approval from the Com-mittees on Appropriations of both Houses of Congress.][SEC. 228. Not later than 30 days after the end of each fiscal quarter, the Secretary

of Veterans Affairs shall submit to the Committees on Appropriations of both Housesof Congress a quarterly report containing performance measures and data from eachVeterans Benefits Administration Regional Office: Provided, That, at a minimum,the report shall include the direction contained in the section entitled "Disabilityclaims backlog", under the heading "General Operating Expenses, Veterans BenefitsAdministration" in the joint explanatory statement accompanying this Act.][SEC. 229. Of the funds provided to the Department of Veterans Affairs for fiscal

year 2017 for "Medical Support and Compliance" a maximum of $40,000,000 maybe obligated from the "Medical Support and Compliance" account for the VistAEvolution and electronic health record interoperability projects: Provided, Thatfunds in addition to these amounts may be obligated for the VistA Evolution andelectronic health record interoperability projects upon written notification by theSecretary of Veterans Affairs to the Committees on Appropriations of both Housesof Congress.][SEC. 230. The Secretary of Veterans Affairs shall provide written notification to

the Committees on Appropriations of both Houses of Congress 15 days prior to or-ganizational changes which result in the transfer of 25 or more full-time equivalentsfrom one organizational unit of the Department of Veterans Affairs to another.][SEC. 231. The Secretary of Veterans Affairs shall provide on a quarterly basis

to the Committees on Appropriations of both Houses of Congress notification ofany single national outreach and awareness marketing campaign in which obligationsexceed $2,000,000.]

THE BUDGET FOR FISCAL YEAR 2018998 ADMINISTRATIVE PROVISIONS—Continued

(INCLUDING TRANSFER OF FUNDS)SEC. [232]222. The Secretary of Veterans Affairs, upon determination that such

action is necessary to address needs of the Veterans Health Administration, maytransfer to the "Medical Services" account any discretionary appropriations madeavailable for fiscal year [2017]2018 in this title [(except appropriations made tothe "General Operating Expenses, Veterans Benefits Administration" account)] orany discretionary unobligated balances within the Department of Veterans Affairs,including those appropriated for fiscal year [2017]2018, that were provided in ad-vance by appropriations Acts: Provided, That transfers shall be made only with theapproval of the Office of Management and Budget: Provided further, That thetransfer authority provided in this section is in addition to any other transfer authorityprovided by law: Provided further, That no amounts may be transferred from amountsthat were designated by Congress as an emergency requirement pursuant to a con-current resolution on the budget or the Balanced Budget and Emergency DeficitControl Act of 1985: Provided further, That such authority to transfer may not beused unless for higher priority items, based on emergent healthcare requirements,than those for which originally appropriated and in no case where the item for whichfunds are requested has been denied by Congress: Provided further, That, upon de-termination that all or part of the funds transferred from an appropriation are notnecessary, such amounts may be transferred back to that appropriation and shall beavailable for the same purposes as originally appropriated: Provided further, Thatbefore a transfer may take place, the Secretary of Veterans Affairs shall requestfrom the Committees on Appropriations of both Houses of Congress the authorityto make the transfer and receive approval of that request.

(INCLUDING TRANSFER OF FUNDS)SEC. [233]223. Amounts made available for the Department of Veterans Affairs

for fiscal year [2017]2018, under the "Board of Veterans Appeals" and the "Gen-eral Operating Expenses, Veterans Benefits Administration" accounts may betransferred between such accounts: Provided, That before a transfer may take place,the Secretary of Veterans Affairs shall [request from]submit notice thereof to theCommittees on Appropriations of both Houses of Congress [the authority to makethe transfer and receive approval of that request].[SEC. 234. The Secretary of Veterans Affairs may not reprogram funds among

major construction projects or programs if such instance of reprogramming willexceed $5,000,000, unless such reprogramming is approved by the Committees onAppropriations of both Houses of Congress.][SEC. 235. Of the unobligated balances available within the "DOD-VA Health

Care Sharing Incentive Fund", $40,000,000 are hereby rescinded.][SEC. 236. Of the discretionary funds made available in Public Law 114–113 for

the Department of Veterans Affairs for fiscal year 2017, $134,000,000 are rescindedfrom "Medical Services", $26,000,000 are rescinded from "Medical Support andCompliance", and $9,000,000 are rescinded from "Medical Facilities".][SEC. 237. The amounts otherwise made available by this Act for the following

accounts of the Department of Veterans Affairs are hereby reduced by the followingamounts:

(1) "Veterans Health Administration—Medical and Prosthetic Research",$2,000,000.

(2) "Departmental Administration—Board of Veterans Appeals", $500,000.(3) "Veterans Benefits Administration—General Operating Expenses, Veterans

Benefits Administration", $12,000,000.(4) "Departmental Administration—Information Technology Systems",

$8,000,000.(5) "Departmental Administration—Office of Inspector General", $500,000.]

[SEC. 238. The Secretary of Veterans Affairs shall ensure that the toll-free suicidehotline under section 1720F(h) of title 38, United States Code—

(1) provides to individuals who contact the hotline immediate assistance froma trained professional; and

(2) adheres to all requirements of the American Association of Suicidology.][SEC. 239. (a) The Secretary of Veterans Affairs shall treat a marriage and family

therapist described in subsection (b) as qualified to serve as a marriage and familytherapist in the Department of Veterans Affairs, regardless of any requirements es-tablished by the Commission on Accreditation for Marriage and Family TherapyEducation.

(b) A marriage and family therapist described in this subsection is a therapist whomeets each of the following criteria:

(1) Has a masters or higher degree in marriage and family therapy, or a relatedfield, from a regionally accredited institution.

(2) Is licensed as a marriage and family therapist in a State (as defined in section101(20) of title 38, United States Code) and possesses the highest level of licensureoffered from the State.

(3) Has passed the Association of Marital and Family Therapy Regulatory BoardExamination in Marital and Family Therapy or a related examination for licensureadministered by a State (as so defined).][SEC. 240. None of the funds in this or any other Act may be used to close Depart-

ment of Veterans Affairs (VA) hospitals, domiciliaries, or clinics, conduct an envir-onmental assessment, or to diminish healthcare services at existing Veterans HealthAdministration medical facilities located in Veterans Integrated Service Network23 as part of a planned realignment of VA services until the Secretary provides tothe Committees on Appropriations of both Houses of Congress a report includingthe following elements:

(1) a national realignment strategy that includes a detailed description of re-alignment plans within each Veterans Integrated Service Network (VISN), in-cluding an updated Long Range Capital Plan to implement realignment require-ments;

(2) an explanation of the process by which those plans were developed andcoordinated within each VISN;

(3) a cost vs. benefit analysis of each planned realignment, including the costof replacing Veterans Health Administration services with contract care or otheroutsourced services;

(4) an analysis of how any such planned realignment of services will impactaccess to care for veterans living in rural or highly rural areas, including traveldistances and transportation costs to access a VA medical facility and availabilityof local specialty and primary care;

(5) an inventory of VA buildings with historic designation and the methodologyused to determine the buildings' condition and utilization;

(6) a description of how any realignment will be consistent with requirementsunder the National Historic Preservation Act; and

(7) consideration given for reuse of historic buildings within newly identifiedrealignment requirements: Provided, That, this provision shall not apply tocapital projects in VISN 23, or any other VISN, which have been authorized orapproved by Congress.]

[SEC. 241. None of the funds appropriated in this or prior appropriations Acts orotherwise made available to the Department of Veterans Affairs may be used totransfer any amounts from the Filipino Veterans Equity Compensation Fund to anyother account within the Department of Veterans Affairs.][SEC. 242. Paragraph (3) of section 403(a) of the Veterans' Mental Health and

Other Care Improvements Act of 2008 (Public Law 110–387; 38 U.S.C. 1703 note)is amended to read as follows:

"(3) DURATION.—A veteran may receive health services under this section duringthe period beginning on the date specified in paragraph (2) and ending on September30, 2017.".][SEC. 243. (a) Section 1722A(a) of title 38, United States Code, is amended by

adding at the end the following new paragraph:"(4) Paragraph (1) does not apply to opioid antagonists furnished under this

chapter to a veteran who is at high risk for overdose of a specific medication orsubstance in order to reverse the effect of such an overdose.".(b) Section 1710(g)(3) of such title is amended—

(1) by striking "with respect to home health services" and inserting "with respectto the following:"

"(A) Home health services"; and(2) by adding at the end the following new subparagraph:

"(B) Education on the use of opioid antagonists to reverse the effects of over-doses of specific medications or substances.".]

[SEC. 244. Section 312 of title 38, United States Code, is amended in subsection(c)(1) by striking the phrase "that makes a recommendation or otherwise suggestscorrective action,".][SEC. 245. Of the funds provided to the Department of Veterans Affairs for each

of fiscal year 2017 and fiscal year 2018 for "Medical Services", funds may be usedin each year to carry out and expand the child care program authorized by section205 of Public Law 111–163, notwithstanding subsection (e) of such section.][SEC. 246. Section 5701(l) of title 38, United States Code, is amended by striking

"may" and inserting "shall".][SEC. 247. (a) PROCEDURE AND ADMINISTRATION.—

(1) IN GENERAL.—Chapter 7 of title 38, United States Code, is amended byadding at the end the following new subchapter:

"WHISTLEBLOWER COMPLAINTS.—SEC. 731. WHISTLEBLOWER COMPLAINT

DEFINED.—In this subchapter, the term "whistleblower complaint" means acomplaint by an employee of the Department disclosing, or assisting anotheremployee to disclose, a potential violation of any law, rule, or regulation, orgross mismanagement, gross waste of funds, abuse of authority, or substantialand specific danger to public health and safety.

999DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATIVE PROVISIONS—Continued

"(1) In addition to any other method established by law in which an employeemay file a whistleblower complaint, an employee of the Department may file awhistleblower complaint in accordance with subsection (g) with a supervisor ofthe employee.

"(2) Except as provided by subsection (d)(1), in making a whistleblowercomplaint under paragraph (1), an employee shall file the initial complaint withthe immediate supervisor of the employee.

"(1)(A) Not later than four business days after the date on which a supervisorreceives a whistleblower complaint by an employee under this section, the su-pervisor shall notify, in writing, the employee of whether the supervisor determ-ines that there is a reasonable likelihood that the complaint discloses a violationof any law, rule, or regulation, or gross mismanagement, gross waste of funds,abuse of authority, or substantial and specific danger to public health and safety.

"(B) The supervisor shall retain written documentation regarding the whis-tleblower complaint and shall submit to the next-level supervisor and the centralwhistleblower office described in subsection (h) a written report on the complaint.

"(2)(A) On a monthly basis, the supervisor shall submit to the appropriatedirector or other official who is superior to the supervisor a written report thatincludes the number of whistleblower complaints received by the supervisorunder this section during the month covered by the report, the disposition ofsuch complaints, and any actions taken because of such complaints pursuant tosubsection (c).

"(B) In the case in which such a director or official carries out this paragraph,the director or official shall submit such monthly report to the supervisor of thedirector or official and to the central whistleblower office described in subsection(h).

"(c) POSITIVE DETERMINATION.—If a supervisor makes a positive determin-ation under subsection (b)(1) regarding a whistleblower complaint of an employ-ee, the supervisor shall include in the notification to the employee under suchsubsection the specific actions that the supervisor will take to address the com-plaint.

"(1) If any circumstance described in paragraph (3) is met, an employee mayfile a whistleblower complaint in accordance with subsection (g) with the next-level supervisor who shall treat such complaint in accordance with this section.

"(2) An employee may file a whistleblower complaint with the Secretary ifthe employee has filed the whistleblower complaint to each level of supervisorsbetween the employee and the Secretary in accordance with paragraph (1).

"(3) A circumstance described in this paragraph is any of the following circum-stances:

"(A) A supervisor does not make a timely determination under subsection(b)(1) regarding a whistleblower complaint.

"(B) The employee who made a whistleblower complaint determines thatthe supervisor did not adequately address the complaint pursuant to subsection(c).

"(C) The immediate supervisor of the employee is the basis of the whis-tleblower complaint."(e) TRANSFER OF EMPLOYEE WHO FILES WHISTLEBLOWER COMPLAINT.—If

a supervisor makes a positive determination under subsection (b)(1) regardinga whistleblower complaint filed by an employee, the Secretary shall—

"(1) inform the employee of the ability to volunteer for a transfer in accord-ance with section 3352 of title 5; and

"(2) give preference to the employee for such a transfer in accordance withsuch section."(f) PROHIBITION ON EXEMPTION.—The Secretary may not exempt any em-

ployee of the Department from being covered by this section."(1) A whistleblower complaint filed by an employee under subsection (a) or

(d) shall consist of the form described in paragraph (2) and any supporting ma-terials or documentation the employee determines necessary.

"(2) The form described in this paragraph is a form developed by the Secretary,in consultation with the Special Counsel, that includes the following:

"(A) An explanation of the purpose of the whistleblower complaint form."(B) Instructions for filing a whistleblower complaint as described in this

section."(C) An explanation that filing a whistleblower complaint under this section

does not preclude the employee from any other method established by law inwhich an employee may file a whistleblower complaint.

"(D) A statement directing the employee to information accessible on theInternet website of the Department as described in section 735(d).

"(E) Fields for the employee to provide—"(i) the date that the form is submitted;"(ii) the name of the employee;"(iii) the contact information of the employee;

"(iv) a summary of the whistleblower complaint (including the option toappend supporting documents pursuant to paragraph (1)); and

"(v) proposed solutions to the complaint."(F) Any other information or fields that the Secretary determines appropriate.

"(3) The Secretary, in consultation with the Special Counsel, shall develop theform described in paragraph (2) by not later than 60 days after the date of theenactment of this section.

"(1) The Secretary shall ensure that the central whistleblower office—"(A) is not an element of the Office of the General Counsel;"(B) is not headed by an official who reports to the General Counsel;"(C) does not provide, or receive from, the General Counsel any information

regarding a whistleblower complaint except pursuant to an action regardingthe complaint before an administrative body or court; and

"(D) does not provide advice to the General Counsel."(2) The central whistleblower office shall be responsible for investigating all

whistleblower complaints of the Department, regardless of whether such com-plaints are made by or against an employee who is not a member of the SeniorExecutive Service.

"(3) The Secretary shall ensure that the central whistleblower office maintainsa toll-free hotline to anonymously receive whistleblower complaints.

"(4) The Secretary shall ensure that the central whistleblower office has suchstaff and resources as the Secretary considers necessary to carry out the functionsof the central whistleblower office.

"(5) In this subsection, the term "central whistleblower office" means the Officeof Accountability Review or a successor office that is established or designatedby the Secretary to investigate whistleblower complaints filed under this sectionor any other method established by law.

"(1) In accordance with paragraph (2), the Secretary shall carry out the follow-ing adverse actions against supervisory employees (as defined in section 7103(a)of title 5) whom the Secretary, an administrative judge, the Merit Systems Pro-tection Board, the Office of Special Counsel, an adjudicating body providedunder a union contract, a Federal judge, or the Inspector General of the Depart-ment determines committed a prohibited personnel action described in subsection(c):

"(A) With respect to the first offense, an adverse action that is not less thana 12-day suspension and not more than removal.

"(B) With respect to the second offense, removal."(2)(A) An employee against whom an adverse action under paragraph (1) is

proposed is entitled to written notice."(B)(i) An employee who is notified under subparagraph (A) of being the

subject of a proposed adverse action under paragraph (1) is entitled to 14 daysfollowing such notification to answer and furnish evidence in support of theanswer.

"(ii) If the employee does not furnish any such evidence as described in clause(i) or if the Secretary determines that such evidence is not sufficient to reversethe determination to propose the adverse action, the Secretary shall carry outthe adverse action following such 14-day period.

"(C) Paragraphs (1) and (2) of subsection (b) of section 7513 of title 5, subsec-tion (c) of such section, paragraphs (1) and (2) of subsection (b) of section 7543of such title, and subsection (c) of such section shall not apply with respect toan adverse action carried out under paragraph (1).

"(b) LIMITATION ON OTHER ADVERSE ACTIONS.—With respect to a prohibitedpersonnel action described in subsection (c), if the Secretary carries out an adverseaction against a supervisory employee, the Secretary may carry out an additionaladverse action under this section based on the same prohibited personnel actionif the total severity of the adverse actions do not exceed the level specified insubsection (a).

"(c) PROHIBITED PERSONNEL ACTION DESCRIBED.—A prohibited personnelaction described in this subsection is any of the following actions:

"(1) Taking or failing to take a personnel action in violation of section 2302of title 5 against an employee relating to the employee—

"(A) filing a whistleblower complaint in accordance with section 732 ofthis title;

"(B) filing a whistleblower complaint with the Inspector General of theDepartment, the Special Counsel, or Congress;

"(C) providing information or participating as a witness in an investigationof a whistleblower complaint in accordance with section 732 or with the In-spector General of the Department, the Special Counsel, or Congress;

"(D) participating in an audit or investigation by the Comptroller Generalof the United States;

"(E) refusing to perform an action that is unlawful or prohibited by theDepartment; or


"(F) engaging in communications that are related to the duties of the posi-tion or are otherwise protected."(2) Preventing or restricting an employee from making an action described

in any of subparagraphs (A) through (F) of paragraph (1)."(3) Conducting a negative peer review or opening a retaliatory investigation

because of an activity of an employee that is protected by section 2302 of title5.

"(4) Requesting a contractor to carry out an action that is prohibited by section4705(b) or section 4712(a)(1) of title 41, as the case may be."(1) In evaluating the performance of supervisors of the Department, the Sec-

retary shall include the criteria described in paragraph (2)."(2) The criteria described in this subsection are the following:

"(A) Whether the supervisor treats whistleblower complaints in accordancewith section 732 of this title.

"(B) Whether the appropriate deciding official, performance review board,or performance review committee determines that the supervisor was foundto have committed a prohibited personnel action described in section 733(b)of this title by an administrative judge, the Merit Systems Protection Board,the Office of Special Counsel, an adjudicating body provided under a unioncontract, a Federal judge, or, in the case of a settlement of a whistleblowercomplaint (regardless of whether any fault was assigned under such settlement),the Secretary."(1) The Secretary may not pay to a supervisor described in subsection (a)(2)(B)

an award or bonus under this title or title 5, including under chapter 45 or 53 ofsuch title, during the one-year period beginning on the date on which the determ-ination was made under such subsection.

"(2) Notwithstanding any other provision of law, the Secretary shall issue anorder directing a supervisor described in subsection (a)(2)(B) to repay the amountof any award or bonus paid under this title or title 5, including under chapter 45or 53 of such title, if—

"(A) such award or bonus was paid for performance during a period in whichthe supervisor committed a prohibited personnel action as determined pursuantto such subsection (a)(2)(B);

"(B) the Secretary determines such repayment appropriate pursuant to regu-lations prescribed by the Secretary to carry out this section; and

"(C) the supervisor is afforded notice and an opportunity for a hearing beforemaking such repayment."(a) TRAINING.—Not less frequently than once each year, the Secretary, in

coordination with the Whistleblower Protection Ombudsman designated undersection 3(d)(1)(C) of the Inspector General Act of 1978 (5 U.S.C. App.), shallprovide to each employee of the Department training regarding whistleblowercomplaints, including—

"(1) an explanation of each method established by law in which an employeemay file a whistleblower complaint;

"(2) an explanation of prohibited personnel actions described by section733(c) of this title;

"(3) with respect to supervisors, how to treat whistleblower complaints inaccordance with section 732 of this title;

"(4) the right of the employee to petition Congress regarding a whistleblowercomplaint in accordance with section 7211 of title 5;

"(5) an explanation that the employee may not be prosecuted or reprisedagainst for disclosing information to Congress, the Inspector General, or an-other investigatory agency in instances where such disclosure is permitted bylaw, including under sections 5701, 5705, and 7732 of this title, under section552a of title 5 (commonly referred to as the Privacy Act), under chapter 93 oftitle 18, and pursuant to regulations promulgated under section 264(c) of theHealth Insurance Portability and Accountability Act of 1996 (Public Law104–191);

"(6) an explanation of the language that is required to be included in allnondisclosure policies, forms, and agreements pursuant to section 115(a)(1)of the Whistleblower Protection Enhancement Act of 2012 (5 U.S.C. 2302note); and

"(7) the right of contractors to be protected from reprisal for the disclosureof certain information under section 4705 or 4712 of title 41."(b) MANNER TRAINING IS PROVIDED.—The Secretary shall ensure that

training provided under subsection (a) is provided in person."(c) CERTIFICATION.—Not less frequently than once each year, the Secretary

shall provide training on merit system protection in a manner that the SpecialCounsel certifies as being satisfactory.

"(1) The Secretary shall publish on the Internet website of the Department,and display prominently at each facility of the Department, the rights of an em-

ployee to file a whistleblower complaint, including the information describedin paragraphs (1) through (7) of subsection (a).

"(2) The Secretary shall publish on the Internet website of the Department,the whistleblower complaint form described in section 732(g)(2).

"(a) ANNUAL REPORTS.—Not less frequently than once each year, the Secretaryshall submit to the appropriate committees of Congress a report that includes—

"(1) with respect to whistleblower complaints filed under section 732 of thistitle during the year covered by the report—

"(A) the number of such complaints filed;"(B) the disposition of such complaints; and"(C) the ways in which the Secretary addressed such complaints in which

a positive determination was made by a supervisor under subsection (b)(1)of such section;"(2) the number of whistleblower complaints filed during the year covered

by the report that are not included under paragraph (1), including—"(A) the method in which such complaints were filed;"(B) the disposition of such complaints; and"(C) the ways in which the Secretary addressed such complaints; and

"(3) with respect to disclosures made by a contractor under section 4705 or4712 of title 41—

"(A) the number of complaints relating to such disclosures that were invest-igated by the Inspector General of the Department of Veterans Affairs duringthe year covered by the report;

"(B) the disposition of such complaints; and"(C) the ways in which the Secretary addressed such complaints.

"(b) NOTICE OF OFFICE OF SPECIAL COUNSEL DETERMINATIONS.—Notlater than 30 days after the date on which the Secretary receives from the SpecialCounsel information relating to a whistleblower complaint pursuant to section1213 of title 5, the Secretary shall notify the appropriate committees of Congressof such information, including the determination made by the Special Counsel.

"(c) APPROPRIATE COMMITTEES OF CONGRESS.—In this section, the term"appropriate committees of Congress" means—

"(1) the Committee on Veterans' Affairs and the Committee on HomelandSecurity and Governmental Affairs of the Senate; and

"(2) the Committee on Veterans' Affairs and the Committee on Oversightand Government Reform of the House of Representatives.".

(2) CONFORMING AND CLERICAL AMENDMENTS.—(A) CONFORMING AMENDMENT.—Such chapter is further amended by inserting

before section 701 the following:GENERAL EMPLOYEE MATTERS.—

(B) CLERICAL AMENDMENTS.—The table of sections at the beginning of suchchapter is amended—

(i) by inserting before the item relating to section 701 the following newitem:

"Subchapter I—General employee matters"and

(ii) by adding at the end the following new items:"Subchapter II—Whistleblower complaints"731.—Whistleblower complaint defined."732.—Treatment of whistleblower complaints."733.—Adverse actions against supervisory employees who commit prohibited

personnel actions relating to whistleblower complaints."734.—Evaluation criteria of supervisors and treatment of bonuses."735.—Training regarding whistleblower complaints."736.—Reports to Congress.".(b) TREATMENT OF CONGRESSIONAL TESTIMONY BY DEPARTMENT OF VETERANS

AFFAIRS EMPLOYEES AS OFFICIAL DUTY.—(1) IN GENERAL.—Subchapter I of chapter 7 of title 38, United States Code, as

designated by section 2(a)(2)(A), is amended by adding at the end the followingnew section:

"(a) CONGRESSIONAL TESTIMONY.—An employee of the Department is per-forming official duty during the period with respect to which the employee istestifying in an official capacity in front of either chamber of Congress, a com-mittee of either chamber of Congress, or a joint or select committee of Congress.

"(b) TRAVEL EXPENSES.—The Secretary shall provide travel expenses, includ-ing per diem in lieu of subsistence, in accordance with applicable provisionsunder subchapter I of chapter 57 of title 5, to any employee of the Departmentof Veterans Affairs performing official duty described under subsection (a).".(2) CLERICAL AMENDMENT.—The table of sections at the beginning of such

chapter, as amended by section 2(a)(2)(B), is further amended by inserting afterthe item relating to section 713 the following new item:715. Congressional testimony by employees: treatment as official duty.]


[SEC. 248. (a) IN GENERAL.—For the purposes of verifying that an individualperformed service under honorable conditions that satisfies the requirements of acoastwise merchant seaman who is recognized pursuant to section 401 of the GIBill Improvement Act of 1977 (Public Law 95–202; 38 U.S.C. 106 note) as havingperformed active duty service for the purposes described in subsection (c)(1), theSecretary of Defense shall accept the following:

(1) In the case of an individual who served on a coastwise merchant vesselseeking such recognition for whom no applicable Coast Guard shipping or dischargeform, ship logbook, merchant mariner's document or Z-card, or other official em-ployment record is available, the Secretary of Defense shall provide such recogni-tion on the basis of applicable Social Security Administration records submittedfor or by the individual, together with validated testimony given by the individualor the primary next of kin of the individual that the individual performed suchservice during the period beginning on December 7, 1941, and ending onDecember 31, 1946.

(2) In the case of an individual who served on a coastwise merchant vesselseeking such recognition for whom the applicable Coast Guard shipping or dis-charge form, ship logbook, merchant mariner's document or Z-card, or other officialemployment record has been destroyed or otherwise become unavailable by reasonof any action committed by a person responsible for the control and maintenanceof such form, logbook, or record, the Secretary of Defense shall accept other officialdocumentation demonstrating that the individual performed such service duringperiod beginning on December 7, 1941, and ending on December 31, 1946.

(3) For the purpose of determining whether to recognize service allegedly per-formed during the period beginning on December 7, 1941, and ending onDecember 31, 1946, the Secretary shall recognize masters of seagoing vessels orother officers in command of similarly organized groups as agents of the UnitedStates who were authorized to document any individual for purposes of hiring theindividual to perform service in the merchant marine or discharging an individualfrom such service.(b) TREATMENT OF OTHER DOCUMENTATION.—Other documentation accepted

by the Secretary of Defense pursuant to subsection (a)(2) shall satisfy all requirementsfor eligibility of service during the period beginning on December 7, 1941, andending on December 31, 1946.

(c) BENEFITS ALLOWED.—(1) MEDALS, RIBBONS, AND DECORATIONS.—An individual whose service is

recognized as active duty pursuant to subsection (a) may be awarded an appropriatemedal, ribbon, or other military decoration based on such service.

(2) STATUS OF VETERAN.—An individual whose service is recognized as activeduty pursuant to subsection (a) shall be honored as a veteran but shall not be entitledby reason of such recognized service to any benefit that is not described in thissubsection.][SEC. 249. Section 322(d)(1) of title 38, United States Code, is amended—

(1) by striking "allowance to a veteran" and inserting the following: "allowanceto—

"(A) a veteran";(2) in subparagraph (A), as designated by paragraph (1), by striking the period

at the end and inserting "; and"; and(3) by adding at the end the following new subparagraph:"(B) a veteran with a VA service-connected disability rated as 30 percent or

greater by the Department of Veterans Affairs who is selected by the UnitedStates Olympic Committee for the United States Olympic Team for any monthin which the veteran is competing in any event sanctioned by the NationalGoverning Bodies of the United States Olympic Sports.".]

[SEC. 250. (a) IN GENERAL.—Section 111(b)(1) of title 38, United States Code,is amended by adding at the end the following new subparagraph:

"(G) A veteran with vision impairment, a veteran with a spinal cord injury ordisorder, or a veteran with double or multiple amputations whose travel is inconnection with care provided through a special disabilities rehabilitation programof the Department (including programs provided by spinal cord injury centers,blind rehabilitation centers, and prosthetics rehabilitation centers) if such care isprovided—

"(i) on an in-patient basis; or"(ii) during a period in which the Secretary provides the veteran with temporary

lodging at a facility of the Department to make such care more accessible to theveteran.".

(b) REPORT.—Not later than 180 days after the date of the enactment of this Act,the Secretary of Veterans Affairs shall submit to the Committee on Veterans' Affairsof the Senate and the Committee on Veterans' Affairs of the House of Representativesa report on the beneficiary travel program under section 111 of title 38, United StatesCode, as amended by subsection (a), that includes the following:

(1) The cost of the program.

(2) The number of veterans served by the program.(3) Such other matters as the Secretary considers appropriate.

(c) EFFECTIVE DATE.—The amendment made by subsection (a) shall take effecton the first day of the first fiscal year that begins after the date of the enactment ofthis Act.][SEC. 251. (a) IN GENERAL.—Not later than 90 days after the date of the enactment

of this Act, the Secretary of Veterans Affairs shall establish a program to conductinspections of kitchens and food service areas at each medical facility of the Depart-ment of Veterans Affairs. Such inspections shall occur not less frequently than an-nually. The program's goal is to ensure that the same standards for kitchens and foodservice areas at hospitals in the private sector are being met at kitchens and foodservice areas at medical facilities of the Department.

(b) AGREEMENT.—(1) IN GENERAL.—The Secretary shall seek to enter into an agreement with the

Joint Commission on Accreditation of Hospital Organizations under which theJoint Commission on Accreditation of Hospital Organizations conducts the inspec-tions required under subsection (a).

(2) ALTERNATE ORGANIZATION.—If the Secretary is unable to enter into anagreement described in paragraph (1) with the Joint Commission on Accreditationof Hospital Organizations on terms acceptable to the Secretary, the Secretary shallseek to enter into such an agreement with another appropriate organization that—

(A) is not part of the Federal Government;(B) operates as a not-for-profit entity; and(C) has expertise and objectivity comparable to that of the Joint Commission

on Accreditation of Hospital Organizations.(c) REMEDIATION PLAN.—

(1) INITIAL FAILURE.—If a kitchen or food service area of a medical facility ofthe Department is determined pursuant to an inspection conducted under subsection(a) not to meet the standards for kitchens and food service areas in hospitals in theprivate sector, that medical facility fails the inspection and the Secretary shall—

(A) implement a remediation plan for that medical facility within 72 hours;and

(B) Conduct a second inspection under subsection (a) at that medical facilitywithin 14 days of the failed inspection.(2) SECOND FAILURE.—If a medical facility of the Department fails the second

inspection conducted under paragraph (1)(B), the Secretary shall close the kitchenor food service area at that medical facility that did not meet the standards forkitchens and food service areas in hospitals in the private sector until full remedi-ation is completed and all kitchens and food service areas at that medical facilitymeet such standards.

(3) PROVISION OF FOOD.—If a kitchen or food service area is closed at a med-ical facility of the Department pursuant to paragraph (2), the Director of the Vet-erans Integrated Service Network in which the medical facility is located shallenter into a contract with a vendor approved by the General Services Administrationto provide food at the medical facility.(d) QUARTERLY REPORTS.—Not less frequently than quarterly, the Under Secretary

of Health shall submit to Congress a report on inspections conducted under thissection, and their detailed findings and actions taken, during the preceding quarterat medical facilities of the Department.][SEC. 252. (a) IN GENERAL.—Not later than 90 days after the date of the enactment

of this Act, the Secretary of Veterans Affairs shall establish a program to conductrisk-based inspections for mold and mold issues at each medical facility of the De-partment of Veterans Affairs. Such facilities will be rated high, medium, or low riskfor mold. Such inspections at facilities rated high risk shall occur not less frequentlythan annually, and such inspections at facilities rated medium or low risk shall occurnot less frequently than biennially.

(b) AGREEMENT.—(1) IN GENERAL.—The Secretary shall seek to enter into an agreement with the

Joint Commission on Accreditation of Hospital Organizations under which theJoint Commission on Accreditation of Hospital Organizations conducts the inspec-tions required under subsection (a).

(2) ALTERNATE ORGANIZATION.—If the Secretary is unable to enter into anagreement described in paragraph (1) with the Joint Commission on Accreditationof Hospital Organizations on terms acceptable to the Secretary, the Secretary shallseek to enter into such an agreement with another appropriate organization that—

(A) is not part of the Federal Government;(B) operates as a not-for-profit entity; and(C) has expertise and objectivity comparable to that of the Joint Commission

on Accreditation of Hospital Organizations.(c) REMEDIATION PLAN.—If a medical facility of the Department is determined

pursuant to an inspection conducted under subsection (a) to have a mold issue, theSecretary shall—


(1) implement a remediation plan for that medical facility within 7 days; and(2) Conduct a second inspection under subsection (a) at that medical facility

within 90 days of the initial inspection.(d) QUARTERLY REPORTS.—Not less frequently than quarterly, the Under Secretary

for Health shall submit to Congress a report on inspections conducted under thissection, and their detailed findings and actions taken, during the preceding quarterat medical facilities of the Department.][SEC. 253. Section 1706(b)(5)(A) of title 38, United States Code, is amended, in

the first sentence, by striking "through 2008".][SEC. 254. (a) The Secretary of Veterans Affairs may use amounts appropriated

or otherwise made available in this title to ensure that the ratio of veterans to full-time employment equivalents within any program of rehabilitation conducted underchapter 31 of title 38, United States Code, does not exceed 125 veterans to one full-time employment equivalent.

(b) Not later than 180 days after the date of the enactment of this Act, the Secretaryshall submit to Congress a report on the programs of rehabilitation conducted underchapter 31 of title 38, United States Code, including—

(1) an assessment of the veteran-to-staff ratio for each such program; and(2) recommendations for such action as the Secretary considers necessary to

reduce the veteran-to-staff ratio for each such program.][SEC. 255. (a) None of the funds made available in this Act may be used to deny

an Inspector General funded under this Act timely access to any records, documents,or other materials available to the department or agency over which that InspectorGeneral has responsibilities under the Inspector General Act of 1978 (5 U.S.C.App.), or to prevent or impede that Inspector General's access to such records, doc-uments, or other materials, under any provision of law, except a provision of lawthat expressly refers to the Inspector General and expressly limits the InspectorGeneral's right of access.

(b) A department or agency covered by this section shall provide its InspectorGeneral with access to all such records, documents, and other materials in a timelymanner.

(c) Each Inspector General shall ensure compliance with statutory limitations ondisclosure relevant to the information provided by the establishment over which thatInspector General has responsibilities under the Inspector General Act of 1978 (5U.S.C. App.).

(d) Each Inspector General covered by this section shall report to the Committeeson Appropriations of the House of Representatives and the Senate within 5 calendardays any failures to comply with this requirement.][SEC. 256. None of the funds appropriated or otherwise made available in this

title may be used by the Secretary of Veterans Affairs to enter into an agreementrelated to resolving a dispute or claim with an individual that would restrict in anyway the individual from speaking to members of Congress or their staff on anytopic not otherwise prohibited from disclosure by Federal law or required by Exec-utive Order to be kept secret in the interest of national defense or the conduct offoreign affairs.][SEC. 257. Appropriations made available in this Act under the heading "Medical

Services" shall be available to carry out sections 322(d) and 521A of title 38, UnitedStates Code, to include the payment of the administrative expenses necessary tocarry out such sections. Of the amount appropriated for fiscal year 2017, up to$2,000,000 shall be available for the payment of monthly assistance allowances toveterans pursuant to 38 U.S.C. 322(d) and up to $8,000,000 shall be available forthe payment of grants pursuant to 38 U.S.C. 521A. Of the amounts appropriated inadvance for fiscal year 2018, up to $2,000,000 shall be available for the paymentof monthly assistance allowances to veterans pursuant to 38 U.S.C. 322(d) and upto $8,000,000 shall be available for the payment of grants pursuant to 38 U.S.C.521A.][SEC. 258. (a) In fiscal year 2017 and each fiscal year hereafter, beginning with

the fiscal year 2018 budget request submitted to Congress pursuant to section 1105(a)of title 31, United States Code, the budget justification documents submitted for the"Construction, Major Projects" account of the Department of Veterans Affairs shallinclude, at a minimum, the information required under subsection (b).

(b) The budget justification documents submitted pursuant to subsection (a) shallinclude, for each project—

(1) the estimated total cost of the project;(2) the funding provided for each fiscal year prior to the budget year;(3) the amount requested for the budget year;(4) the estimated funding required for the project for each of the 4 fiscal years

succeeding the budget year; and(5) such additional information as is enumerated under the heading relating to

the "Construction, Major Projects" account of the Department of Veterans Affairsin the joint explanatory statement accompanying this Act.

(c) Not later than 45 days after the date of enactment of this Act, the Secretary ofVeterans Affairs shall submit to the Committees on Appropriations of both Housesof Congress a proposed budget justification template that complies with the require-ments of this section.][SEC. 259. (a) The Secretary of Veterans Affairs may carry out the following

major medical facility projects, with each project to be carried out in an amount notto exceed the amount specified for that project:

(1) Seismic corrections to buildings, including retrofitting and replacement ofhigh-risk buildings, in San Francisco, California, in an amount not to exceed$180,480,000.

(2) Seismic corrections to facilities, including facilities to support homelessveterans, at the medical center in West Los Angeles, California, in an amount notto exceed $105,500,000.

(3) Seismic corrections to the mental health and community living center inLong Beach, California, in an amount not to exceed $287,100,000.

(4) Construction of an outpatient clinic, administrative space, cemetery, andcolumbarium in Alameda, California, in an amount not to exceed $87,332,000.

(5) Realignment of medical facilities in Livermore, California, in an amount notto exceed $194,430,000.

(6) Construction of a medical center in Louisville, Kentucky, in an amount notto exceed $150,000,000.

(7) Construction of a replacement community living center in Perry Point,Maryland, in an amount not to exceed $92,700,000.

(8) Seismic corrections and other renovations to several buildings and construc-tion of a specialty care building in American Lake, Washington, in an amount notto exceed $16,260,000.(b) There is authorized to be appropriated to the Secretary of Veterans Affairs for

fiscal year 2016 or the year in which funds are appropriated for the Construction,Major Projects, account, $1,113,802,000 for the projects authorized in subsection(a).

(c) The projects authorized in subsection (a) may only be carried out using—(1) funds appropriated for fiscal year 2016 pursuant to the authorization of ap-

propriations in subsection (b);(2) funds available for Construction, Major Projects, for a fiscal year before

fiscal year 2016 that remain available for obligation;(3) funds available for Construction, Major Projects, for a fiscal year after fiscal

year 2016 that remain available for obligation;(4) funds appropriated for Construction, Major Projects, for fiscal year 2016 for

a category of activity not specific to a project;(5) funds appropriated for Construction, Major Projects, for a fiscal year before

fiscal year 2016 for a category of activity not specific to a project; and(6) funds appropriated for Construction, Major Projects, for a fiscal year after

fiscal year 2016 for a category of activity not specific to a project.]SEC. [260]224. (a) Notwithstanding any other provision of law, the amounts ap-

propriated or otherwise made available to the Department of Veterans Affairs forthe "Medical Services" account may be used to provide—

(1) fertility counseling and treatment using assisted reproductive technology toa covered veteran or the spouse of a covered veteran; or

(2) adoption reimbursement to a covered veteran.(b) In this section:

(1) The term "service-connected" has the meaning given such term in section101 of title 38, United States Code.

(2) The term "covered veteran" means a veteran, as such term is defined in section101 of title 38, United States Code, who has a service-connected disability thatresults in the inability of the veteran to procreate without the use of fertility treat-ment.

(3) The term "assisted reproductive technology" means benefits relating to repro-ductive assistance provided to a member of the Armed Forces who incurs a seriousinjury or illness on active duty pursuant to section 1074(c)(4)(A) of title 10, UnitedStates Code, as described in the memorandum on the subject of "Policy for AssistedReproductive Services for the Benefit of Seriously or Severely Ill/Injured (CategoryII or III) Active Duty Service Members" issued by the Assistant Secretary of De-fense for Health Affairs on April 3, 2012, and the guidance issued to implementsuch policy, including any limitations on the amount of such benefits available tosuch a member.

(4) The term "adoption reimbursement" means reimbursement for the adoption-related expenses for an adoption that is finalized after the date of the enactmentof this Act under the same terms as apply under the adoption reimbursement pro-gram of the Department of Defense, as authorized in Department of Defense In-struction 1341.09, including the reimbursement limits and requirements set forthin such instruction.


(c) Amounts made available for the purposes specified in subsection (a) of thissection are subject to the requirements for funds contained in section 508 of divisionH of the Consolidated Appropriations Act, 2016 (Public Law 114–113).

SEC. 225. The 6th proviso under the heading "Department of Veterans Affairs—Vet-erans Health Administration—Medical Services" in title II of division J of the Con-solidated Appropriations Act, 2016 (Public Law 114–113) shall not apply to theunexpired balances of the funds made available under such heading by such Act.

(INCLUDING TRANSFER OF FUNDS)SEC. 226. Upon determination by the Secretary of Veterans Affairs that such action

is necessary for providing health care, benefits and other services, the Secretarymay transfer amounts made available to the Department of Veterans Affairs forfiscal year 2018 by this Act between any discretionary appropriations accounts forfiscal year 2018: Provided, That amounts so transferred shall be merged with theaccount to which transferred: Provided further, That the total amount the Secretarymay transfer under this section may not exceed two percent of the total discretionaryappropriations made available to the Department for fiscal year 2018 by this Act:Provided further, That a transfer of funds between the "Medical Services", "MedicalCommunity Care", "Medical Support and Compliance", and "Medical Facilities"accounts shall not be counted toward the two percent limitation in the previousproviso: Provided further, That the transfer authority provided by this section maybe exercised only to support activities in an appropriations account that havehigher priority than those undertaken in the appropriations account from which thebudget authority is transferred, as determined by the Secretary: Provided further,That such transfer authority may not be used to provide budget authority for anactivity that the Secretary lacks the authority to carry out: Provided further, Thatthe transfer authority provided in this section is in addition to any other transferauthority provided by law. (Military Construction, Veterans Affairs, and RelatedAgencies Appropriations Act, 2017.)

✦

GENERAL FUND RECEIPT ACCOUNTS(in millions of dollars)


Offsetting receipts from the public:

13114General Fund Proprietary Interest Receipts, not Otherwise

Classified ...................................................................036–143500

129147153Contributions from Military Personnel, Veteran's

Educational Assistance Act of 1984 ...........................036–247300

.................1,702312Housing Downward Reestimates ....................................036–273330

221Native American Veteran Housing Loans, Negative

Subsidies ...................................................................036–275110

11789.................Housing Negative Subsidies ...........................................036–275510

404039All Other General Fund Proprietary Receipts Including

Budget Clearing Accounts ..........................................036–322000

3011,991509General Fund Offsetting receipts from the public .....................................

Intragovernmental payments:

–5–5–4Undistributed Intragovernmental Payments and

Receivables from Cancelled Accounts ........................036–388500

–5–5–4General Fund Intragovernmental payments ..............................................

✦

TITLE IV—GENERAL PROVISIONS

GENERAL PROVISIONS

SEC. 501. No part of any appropriation contained in this Act shall remain availablefor obligation beyond the current fiscal year unless expressly so provided herein.

SEC. 502. None of the funds made available in this Act may be used for any pro-gram, project, or activity, when it is made known to the Federal entity or official towhich the funds are made available that the program, project, or activity is not incompliance with any Federal law relating to risk assessment, the protection of privateproperty rights, or unfunded mandates.[SEC. 503. All departments and agencies funded under this Act are encouraged,

within the limits of the existing statutory authorities and funding, to expand their

use of "E-Commerce" technologies and procedures in the conduct of their businesspractices and public service activities.]

SEC. [504]503. Unless stated otherwise, all reports and notifications required bythis Act shall be submitted to the Subcommittee on Military Construction and Vet-erans Affairs, and Related Agencies of the Committee on Appropriations of theHouse of Representatives and the Subcommittee on Military Construction and Vet-erans Affairs, and Related Agencies of the Committee on Appropriations of theSenate.

SEC. [505]504. None of the funds made available in this Act may be transferredto any department, agency, or instrumentality of the United States Government exceptpursuant to a transfer made by, or transfer authority provided in, this or any otherappropriations Act.

SEC. [506]505. None of the funds made available in this Act may be used for aproject or program named for an individual serving as a Member, Delegate, orResident Commissioner of the United States House of Representatives.[SEC. 507. (a) Any agency receiving funds made available in this Act, shall, subject

to subsections (b) and (c), post on the public Web site of that agency any report re-quired to be submitted by the Congress in this or any other Act, upon the determin-ation by the head of the agency that it shall serve the national interest.

(b) Subsection (a) shall not apply to a report if—(1) the public posting of the report compromises national security; or(2) the report contains confidential or proprietary information.

(c) The head of the agency posting such report shall do so only after such reporthas been made available to the requesting Committee or Committees of Congressfor no less than 45 days.]

SEC. [508]506. (a) None of the funds made available in this Act may be used tomaintain or establish a computer network unless such network blocks the viewing,downloading, and exchanging of pornography.

(b) Nothing in subsection (a) shall limit the use of funds necessary for any Federal,State, tribal, or local law enforcement agency or any other entity carrying out crim-inal investigations, prosecution, or adjudication activities.

SEC. [509]507. None of the funds made available in this Act may be used by anagency of the executive branch to pay for first-class travel by an employee of theagency in contravention of sections 301–10.122 through 301–10.124 of title 41,Code of Federal Regulations.

SEC. [510]508. None of the funds made available in this Act may be used to ex-ecute a contract for goods or services, including construction services, where thecontractor has not complied with Executive Order No. 12989.[SEC. 511. None of the funds made available by this Act may be used by the De-

partment of Defense or the Department of Veterans Affairs to lease or purchase newlight duty vehicles for any executive fleet, or for an agency's fleet inventory, exceptin accordance with Presidential Memorandum—Federal Fleet Performance, datedMay 24, 2011.]

SEC. [512]509. (a) IN GENERAL.—None of the funds appropriated or otherwisemade available to the Department of Defense in this Act may be used to construct,renovate, or expand any facility in the United States, its territories, or possessionsto house any individual detained at United States Naval Station, Guantnamo Bay,Cuba, for the purposes of detention or imprisonment in the custody or under thecontrol of the Department of Defense.

(b) The prohibition in subsection (a) shall not apply to any modification of facilitiesat United States Naval Station, Guantnamo Bay, Cuba.

(c) An individual described in this subsection is any individual who, as of June24, 2009, is located at United States Naval Station, Guantnamo Bay, Cuba, andwho—

(1) is not a citizen of the United States or a member of the Armed Forces of theUnited States; and

(2) is—(A) in the custody or under the effective control of the Department of Defense;

or(B) otherwise under detention at United States Naval Station, Guantnamo Bay,

Cuba.(Military Construction, Veterans Affairs, and Related Agencies Appropriations Act,2017.)


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