Military Construction, Veterans Affairs, and Related Agencies Appropriations Bill, 2022
Summary
House Report 117–81 is the report of the Committee on Appropriations, submitted by Ms. Wasserman Schultz of Florida and ordered to be printed July 2, 2021, with minority views, on H.R. 4355, the bill making appropriations for military construction, veterans affairs and related agencies for the fiscal year ending September 30, 2022. Its index to the bill and report lists the purpose of the bill, the summary of the Committee's recommendation and management and oversight initiatives, then Department of Defense military construction, the NATO Security Investment Program and family housing, and the Department of Veterans Affairs benefits, health, cemetery and administration accounts. The text read ends with that index.
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Cite this document
“Military Construction, Veterans Affairs, and Related Agencies Appropriations Bill, 2022.”
Original at www.govinfo.gov. Archived at Pandemic Darlings, https://pandemicdarlings.com/source-documents/crpt-crpt-117hrpt81-crpt-117hrpt81/
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117TH CONGRESS REPORT
" HOUSE OF REPRESENTATIVES !
1st Session 117–81
MILITARY CONSTRUCTION, VETERANS AFFAIRS, AND
RELATED AGENCIES APPROPRIATIONS BILL, 2022
JULY 2, 2021.—Committed to the Committee of the Whole House on the State of
the Union and ordered to be printed
Ms. WASSERMAN SCHULTZ of Florida, from the Committee on
Appropriations, submitted the following
R E P O R T
together with
MINORITY VIEWS
[To accompany H.R. 4355]
The Committee on Appropriations submits the following report in
explanation of the accompanying bill making appropriations for
military construction, veterans affairs and related agencies for the
fiscal year ending September 30, 2022.
INDEX TO BILL AND REPORT
Page Number
Bill Report
Purpose of the Bill ...................................................................................... 1 2
Summary of Committee Recommendation ............................................... 1 2
Management and Oversight Initiatives .................................................... 2 3
Department of Defense:
Military Construction ......................................................................... 2 6
NATO Security Investment Program ................................................ 9 21
Department of Defense Base Closure Account ................................. 10 21
Family Housing Construction and Operation and Maintenance .... 10 22
Department of Defense Family Housing Improvement Fund ......... 12 24
Department of Defense Military Unaccompanied Housing Im-
provement Fund .............................................................................. 12 24
Administrative Provisions .................................................................. 12 24
Department of Veterans Affairs:
Veterans Benefits Administration ..................................................... 27 29
Veterans Health Administration ....................................................... 31 38
National Cemetery Administration ................................................... 35 72
Departmental Administration ............................................................ 36 73
Administrative Provisions .................................................................. 44 84
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45–008
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Page Number
Bill Report
Related Agencies:
American Battle Monuments Commission ........................................ 71 89
U.S. Court of Appeals for Veterans Claims ...................................... 72 89
Cemeterial Expenses, Army ............................................................... 72 89
Armed Forces Retirement Home ....................................................... 73 90
Administrative Provision .................................................................... 74 91
General Provisions ..................................................................................... 74 91
PURPOSE OF THE BILL
The purpose of the bill is to support our military and their fami-
lies and provide the benefits and medical care that our Veterans
have earned because of their service to our Nation. This is accom-
plished through the programs funded in the bill, which provide the
facilities and infrastructure needed to house, treat, train, and equip
our military personnel to defend this Nation, both in the United
States and abroad; provide the housing and military community in-
frastructure that supports a good quality of life for them and their
families; and allow the military to maintain an efficient and effec-
tive base structure. The quality of life for our servicemembers and
their families is a key component of readiness. The bill also funds
a wide variety of assistance programs for Veterans, including dis-
ability and pension benefits, healthcare in many different settings,
educational assistance, and home loan and insurance programs. Fi-
nally, the bill funds four related agencies that provide support to
our Nation’s heroes: the American Battle Monuments Commission,
Cemeterial Expenses, Army (including Arlington National Ceme-
tery), the United States Court of Appeals for Veterans Claims, and
the Armed Forces Retirement Home.
SUMMARY OF COMMITTEE RECOMMENDATION
The Committee recommends $279,940,055,000 in total budget au-
thority, for the fiscal year 2022 programs and activities funded in
the bill. The fiscal year 2022 recommendation represents an in-
crease of $28,085,503,000 above the comparable fiscal year 2021
enacted level and $1,252,791,000 above the President’s request. Of
the increase over the fiscal year 2021 enacted level,
$16,709,491,000 is in mandatory programs. Included in the total
budget authority is $155,440,055,000 in mandatory budget author-
ity and $124,500,000,000 in discretionary budget authority.
The Committee recommendation highlights the continued com-
mitment to our servicemembers and their families and to our Vet-
erans. In overall discretionary budget authority, the bill is 10.1 per-
cent above the fiscal year 2021 enacted level. While the Committee
recommendation continues essential support for servicemembers
and Veterans, it does not provide funds for projects or activities
that lacked sufficient justification or urgency.
The programs funded in the bill for the Department of Defense
(DOD) address the priorities of the Department’s Agencies and the
Services for the numerous facility challenges that they face. The
funds provided support readiness improvements with new construc-
tion, family housing, and continued cleanup of military bases closed
during previous Base Realignment and Closure rounds, support
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Combatant Commanders’ requirements where appropriate, and en-
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sure that our military personnel and their families’ quality of life
is preserved.
The total recommended funding level for military construction
and family housing, is $10,918,400,000 which is $2,854,400,000
more than the fiscal year 2021 enacted level and $1,071,369,000
above the budget request. The recommendation provides critical in-
vestments in Family Housing and construction on our bases, in-
cluding additional resources above the budget request for child care
development centers, barracks, the Shipyard Infrastructure Opti-
mization Plan, installation resiliency, natural disaster recovery ex-
penses, and support for critical overseas investments. Finally, the
total provides $149,800,000 for the Services’ cost to complete
projects, which are previously appropriated projects that have expe-
rienced an increase in cost from the original contract award.
The total recommended funding level for fiscal year 2022 for the
Department of Veterans Affairs is $268,586,855,000, an increase of
$25,424,618,000 over the fiscal year 2021 enacted level. Of the
total, $155,440,055,000 is provided for mandatory benefit programs
and $113,146,800,000 is allocated to discretionary programs such
as medical care, claims processing, and construction. In this bill,
discretionary funding for the Department of Veterans Affairs is rec-
ommended at 8.3 percent over the fiscal year 2021 enacted level.
Of the total for fiscal year 2022, $94,183,260,000 for medical care
has been appropriated in advance.
In addition, the Committee recommendation includes
$111,287,000,000 in advance appropriations for fiscal year 2023 for
the four health care accounts of the Department and
$156,586,190,000 in advance appropriations for mandatory benefits
programs in fiscal year 2023.
The Committee recommendation provides a total of $434,800,000
for the four Related Agencies: The American Battle Monuments
Commission (ABMC), the U.S. Court of Appeals for Veterans
Claims, Arlington National Cemetery, and the Armed Forces Re-
tirement Home. The recommendation represents an increase of
$5,000,000 above the budget request. These funds are provided to
ensure that these agencies are able to continue their missions of
honoring the service and sacrifice of our servicemembers and Vet-
erans.
MANAGEMENT AND OVERSIGHT INITIATIVES
The Committee believes the effective stewardship of taxpayer
dollars is of the highest priority. In the interest of eliminating
waste, fraud, and abuse in Federal programs, the Committee has
and will continue to use public hearings, briefings, information re-
quests, and reviews by the Government Accountability Office
(GAO) and the Inspectors General to promote strong financial and
program management, oversight and leadership at the Department
of Defense (DOD), the Department of Veterans Affairs (VA), and
Related Agencies under the jurisdiction of this bill.
The fiscal year 2022 appropriations bill and the accompanying
report address management challenges of the Federal agencies it
funds, including directives to strengthen financial and program
management, eliminate redundancy, and improve implementation
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and oversight of initiatives that support the mission of this bill.
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The Committee will use every means at its disposal to reduce mis-
management that results in waste, fraud, and abuse.
The Committee notes that the Commerce, Justice, Science, and
Related Agencies Appropriations Act, 2022 directs the Attorney
General to continue efforts to implement training programs to
cover the use of force and de-escalation, racial profiling, implicit
bias, and procedural justice, to include training on the duty of Fed-
eral law enforcement officers to intervene in cases where another
law enforcement officer is using excessive force, and make such
training a requirement for Federal law enforcement officers. The
Committee further notes that several Departments and agencies
funded by this Act employ Federal law enforcement officers and are
Federal Law Enforcement Training Centers partner organizations.
The Committee directs such Departments and agencies to adopt
and follow the training programs implemented by the Attorney
General, and to make such training a requirement for its Federal
law enforcement officers. The Committee further directs such De-
partments and agencies to brief the House and Senate Committees
on Appropriations on their efforts relating to training no later than
90 days after the date of enactment of this Act.
In addition, the Committee directs such Departments and agen-
cies, to the extent that such Departments and agencies have not al-
ready done so, to submit their use of force data to the Federal Bu-
reau of Investigation (FBI)’s National Use of Force Data Collection
database. The Committee further directs such Departments and
agencies to brief the House and Senate Committees on Appropria-
tions no later than 90 days after the date of enactment of this Act
on their current efforts to tabulate and submit their use of force
data to the FBI.
Department of Defense Military Family Housing.—Privatized
housing has come under scrutiny in recent years. Complaints of in-
adequate housing across the DOD enterprise include lack of re-
pairs, rodents, mold, cracks in walls and peeling paint. The mili-
tary housing privatization initiative (MHPI) was established by
Congress in 1996 as a tool to help DOD improve the quality of life
for its servicemembers by improving the condition of their housing.
MHPI is a public/private venture (PPV) where private sector devel-
opers may own, operate, maintain, improve and assume responsi-
bility for military family housing. The private entity is responsible
for managing the construction, renovation, and day-to-day mainte-
nance and services for the community. The PPV housing may be
located on or off government property and may be former military
family housing. Congress has mandated that all military family
housing in the United States be eventually privatized. The Com-
mittee also includes report language directing DOD to submit var-
ious reports and maintain a maintenance database to track any
issues that may be prevalent in the future. The Committee notes
that the general welfare of a servicemember’s family contributes to
the overall state of readiness for DOD.
VA Electronic Health Record Modernization (EHRM).—After at
least a decade of Congressional encouragement to DOD and VA to
develop a single electronic health record (EHR), VA finalized a con-
tract in 2018 to acquire the same EHR system that DOD is adopt-
ing. The bill includes $2,637,000,000 for EHRM and continues
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strict quarterly reporting of timelines, performance milestones,
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costs, implementation, and change management. The bill also con-
tinues the requirement for GAO to review EHRM implementation
so that Congress can be informed of any problems at a point where
they can be promptly and economically addressed.
Disability Claims and Appeals.—Due to the significant invest-
ments Congress has provided in recent years, VA has been able to
hire the staff, acquire the technology, and change work processes
necessary to significantly reduce the disability claims backlog. But
as the number of claims continues to increase and the number of
appeals skyrockets once claims are decided, VA again runs the risk
of falling into serious claims and appeals backlogs. The Committee
recognizes this threat and provides resources within the Veterans
Benefits Administration to support staffing, scanning of records,
and other efforts to respond to claims. The Committee additionally
provides increases to the Board of Veterans Appeals and the Court
of Appeals for Veterans Claims to help ensure the prompt resolu-
tion of cases. The Committee hopes that with these additional in-
vestments and the recently passed legislation to reform the appeals
process, Congress will have taken the necessary management ac-
tion to prevent Veterans from enduring excessive wait times to re-
ceive the disability benefits they deserve.
Information Technology (IT).—The Committee continues to in-
clude bill language indicating that funds for information technology
systems development are available only for the projects and in the
amounts specified in the report. The bill limits the amount of funds
that can be transferred into the IT account to ten percent of the
total of either the source or destination account. The bill contains
language that permits the reprogramming of funds among develop-
ment projects upon prior notification to, and approval by, the Com-
mittees.
Stricter Control of Construction Funding.—The Committee con-
tinues to request that VA provide quarterly briefings on the
progress and cost of each facility managed by an outside entity.
Several additional bill language provisions are included to enhance
the Committee’s capacity to conduct oversight of VA’s facility con-
struction efforts including: (1) no funding greater than $7,000,000
may be reprogrammed between construction projects unless ap-
proved by the Committees on Appropriations of both Houses of
Congress; (2) any change to the scope of a construction project is
prohibited without the approval of the Committees; and (3) VA
must report any bid savings of $5,000,000 or more on projects as
soon as they are identified.
Armed Forces Retirement Home (AFRH).—The Committee con-
tinues to provide funding for AFRH to work on deferred mainte-
nance projects and directs AFRH to provide an expenditure plan
for these projects. Additionally, the bill continues to make oper-
ations and maintenance funds available for two years to allow
AFRH to make more effective use of its funds. These efforts will
ensure that AFRH is well-positioned to continue to improve its
standing and increase revenue for the long term. The Committee
notes that efforts are underway to stabilize the AFRH Trust Fund
and reduce reliance on transfers from the General Fund, and di-
rects AFRH to continue making progress toward improving AFRH’s
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sustainability.
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Army Corps of Engineers Updates on VA projects.—The Com-
mittee is concerned that VA projects under management of the
Army Corps of Engineers (USACE) might be delayed due to admin-
istrative delays during the initial transitional phase between
projects being authorized and appropriated by Congress, and an
interagency agreement being signed. Accordingly, the Committee
directs VA to continue to provide monthly updates on all current
and subsequent VA construction projects worth more than
$100,000,000 and jointly managed by VA and USACE. Regular re-
ports for certain projects may be submitted on a quarterly basis if
the Department and Committee come to an agreement that more
frequent reports are not necessary.
Advertising Contracts for Small Business.—The Committee un-
derstands that, as the largest advertiser in the United States, the
Federal government should work to ensure fair access to its adver-
tising contracts for small disadvantaged businesses and businesses
owned by minorities and women. The Committee directs each de-
partment and agency to include the following information in its fis-
cal year 2023 budget justification: Expenditures for fiscal year 2021
and expected expenditures for fiscal year 2023, respectively, for (1)
all contracts for advertising services; and (2) contracts for the ad-
vertising services of (I) socially and economically disadvantaged
small businesses concerns (as defined in section 8(a)(4) of the Small
Business Act (15 U.S.C. 637 (a)(4)); and (II) women- and minority-
owned businesses.
VA–DOD Joint Venture Facilities.—The Committee recognizes
the significant potential to improve access, quality and cost-effec-
tiveness of healthcare delivery to veterans, servicemembers and
their families across the Indo-Pacific through greater integration of
the Spark M. Matsunaga VA Medical Center and Tripler Army
Medical Center VA–DOD Joint Venture. The Committee encour-
ages the DOD and VA to seek further opportunities to cooperate
and integrate medical personnel and services. Therefore the Com-
mittee directs the DOD and VA to each submit a report no later
than 180 days after the enactment of this Act on (1) lessons
learned from existing VA–DOD joint ventures facilities; (2) per-
formance measures used for each joint venture to assess and man-
age shared healthcare resource-sharing goals; and (3) the benefits
of further integration of staff and services between VA–DOD joint
venture facilities to include communication channels, facility plan-
ning, primary healthcare, specialty healthcare, mental healthcare,
and training.
TITLE I
DEPARTMENT OF DEFENSE
MILITARY CONSTRUCTION OVERVIEW
Appropriation, fiscal year 2021 ......................................................... $8,064,000,000
Budget request, fiscal year 2022 ....................................................... 9,847,031,000
Committee Recommendation, fiscal year 2022 ................................ 10,918,400,000
Change from enacted level ......................................................... +2,854,400,000
Change from budget request ...................................................... +1,071,369,000
Military construction accounts provide funds for new construc-
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tion, construction improvements, planning and design, and host na-
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tion support. Projects funded by these accounts include facilities for
operations, training, readiness, maintenance, research and develop-
ment, supply, medical care, and force protection, as well as unac-
companied housing, military-owned family housing, utilities infra-
structure, and land acquisition.
In addition to the notification and reporting requirements for
military construction programs contained in Title 10, United States
Code, the Committee’s recommendations include several provisions
requiring DOD to report on various aspects of military construction
programs, or to provide notification to the Committee when certain
actions are taken. The Committee also retains prior approval au-
thority for any reprogramming of funds exceeding a specific thresh-
old.
Reprogramming Guidelines.—The following reprogramming
guidelines apply for all military construction and family housing
projects. A project or account (including the sub-elements of an ac-
count) that has been specifically reduced by Congress in acting on
the budget request is considered to be a Congressional interest
item and as such, prior approval is required. Accordingly, no re-
programming to an item specifically reduced below the threshold
by Congress is permitted, except that DOD may seek reprogram-
ming for appropriated increments.
The reprogramming criteria that applies to military construction
projects is 25 percent of the funded amount or $2,000,000 and in-
cludes new housing construction projects and improvements. To
provide the Services the flexibility to proceed with construction con-
tracts without disruption or delay, the costs associated with envi-
ronmental hazard remediation such as asbestos removal, radon
abatement, lead-based paint removal or abatement, and any other
legislated environmental hazard remediation may be excluded, if
such remediation requirements could not be reasonably anticipated
at the time of the budget submission. Reprogramming is a courtesy
provided to DOD and can be taken away if the authority is abused.
This exclusion applies to projects authorized in this budget year, as
well as projects authorized in prior years for which construction
has not been completed. Planning and design costs associated with
military construction and family housing projects may also be ex-
cluded from these guidelines. In instances where prior approval for
a reprogramming request for a project or account has been received
from the Committees on Appropriations of both Houses of Con-
gress, the adjusted amount approved becomes the new base for any
future increase or decrease via below-threshold reprogramming
(provided that the project or account is not a Congressional interest
item as defined above).
In addition to these guidelines, the Services are directed to ad-
here to the guidance for military construction reprogramming ac-
tions and notifications, including the pertinent statutory authori-
ties contained in DOD Financial Management Regulation 7000.14–
R and relevant updates and policy memoranda. The Committee fur-
ther encourages the Office of the Director of National Intelligence
to use a format similar to that used by the Office of the Secretary
of Defense to submit reprogramming requests.
Facilities Sustainment, Restoration and Modernization
(FSRM).—DOD is directed to continue describing on form 1390 the
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backlog of FSRM requirements at installations with future con-
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struction projects. For troop housing requests, form 1391 should de-
scribe any FSRM conducted in the past two years. Likewise, future
requirements for unaccompanied housing at the corresponding in-
stallation should be included. Additionally, the forms should in-
clude English equivalent measurements for projects presented in
metric measurement. Rules for funding repairs of facilities under
the operation and maintenance accounts are described below:
(1) components of the facility may be repaired by replace-
ment. Such replacement can be up to current standards or
codes;
(2) interior arrangements and restorations may be included
as repair;
(3) additions and new facilities, may be done concurrently
with repair projects as long as the final conjunctively funded
project is a complete and usable facility; and
(4) the appropriate Service Secretary shall notify the appro-
priate committees 21 days prior to carrying out any repair
project with an estimated cost in excess of $7,500,000.
Quarterly Summary of Notifications.—The Committee directs the
Services and the Office of the Secretary of Defense (on behalf of
itself and defense agencies) to continue to submit a quarterly re-
port listing all notifications that have been submitted to the Com-
mittees during the preceding three-month period.
Work in Progress or Planned (WIP) Curve.—The Committee di-
rects the Services and the Office of the Secretary of Defense (on be-
half of itself and defense agencies) to submit a WIP curve for each
project requested in a budget submission above $90,000,000 with
the form 1391 justification to the congressional defense committees.
The Committee acknowledges that there is an alarming amount of
unawarded prior-year military construction projects, and therefore
the Committee directs the Secretary of Defense to report to the
congressional defense committees quarterly, beginning in the sec-
ond quarter of fiscal year 2022 and each quarter thereafter of
projects that remain unawarded from the current and prior fiscal
years and the reasons for delay.
Transfer of Funds To and From the Foreign Currency Fluctua-
tions, Construction, Defense Account.—The Committee directs DOD
to submit a quarterly report to the Committees on Appropriations
of both Houses of Congress on the transfer of funds from military
construction and family housing accounts to the Foreign Currency
Fluctuations, Construction, Defense account. The report shall speci-
fy the amount transferred to the Foreign Currency account from
each military construction and/or family housing account, and all
other accounts for which an appropriation is provided in this Act,
during the preceding fiscal quarter, and the amounts transferred
from the Foreign Currency account to the above accounts during
the same period. This report shall be submitted no later than 30
days after the close of each fiscal quarter. In addition, DOD shall
notify the Committees on Appropriations of both Houses of Con-
gress within seven days of transferring any amount in excess of
$10,000,000 to or from the Foreign Currency account.
Bid Savings.—The Committee directs the Secretary of Defense to
continue to submit 1002 reports on military construction bid sav-
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ings at the end of each fiscal quarter to the subcommittees on Mili-
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tary Construction, Veterans Affairs, and Related Agencies of both
Houses of Congress.
Investing in Multi-hazard Resilient Defense Infrastructure Plan-
ning, Development, and Testing.—The Committee supports the
military’s continued focus on building lasting and resilient military
installations, including methods that update hurricane-resistant
building codes for bases, barracks, hospitals, and airfields. It fur-
ther considers the impact of severe drought and desertification as
high potential instability areas and how these two hazards impact
bases and missions. In addition to Department-wide initiatives
such as revised structure planning, conservation programs and
modeling new installations with the threat of sea-level rise in
mind, the Committee encourages the Department of Defense to
prioritize investing in climate-sustainable infrastructure projects
that have yielded positive results like increased resiliency and cost-
savings. As such, the bill includes section 411 prohibiting the use
of funds to construct facilities that do not meet resiliency stand-
ards.
Incremental Funding of Projects.—In general, the Committee
supports full funding for military construction projects if they are
executable. However, it continues to be the practice of the Com-
mittee to provide incremental funding for certain large projects to
enable the Services to more efficiently allocate military construc-
tion dollars among projects that can be executed in the year of ap-
propriation. Therefore, the Committee recommendation includes
twelve projects that have been incrementally funded; however, the
full authorization of the projects will be provided in the fiscal year
2022 National Defense Authorization Act.
Federally Recognized Tribes.—The Committee reminds the Serv-
ices that consultations with the Tribes are required by current law
and as such expects the Services to begin tribal consultations on
proposed military construction projects that are likely to affect trib-
al lands, cultural properties or treaty rights as early as possible
and preferably prior to submission of DD Form 1391 Project Data
Sheet.
Child Development Centers (CDCs).—The bill includes
$213,000,000 for 7 child development center projects. This invest-
ment of resources is necessary to address both insufficient accessi-
bility to child care facilities, as well as the poor conditions of exist-
ing facilities. Such shortfalls in capacity are an unacceptable bur-
den to military families, leading to thousands of children of
servicemembers forced onto waitlists for child care. The Committee
is disappointed by the lack of attention paid to this priority in the
budget requests and directs the Department to assign greater pri-
ority to CDC construction projects in future budget requests.
Unaccompanied Housing.—The Committee provides $237,200,000
for 7 additional barracks projects to ensure that servicemembers
who live in unaccompanied personnel housing have safe, modern,
and secure living facilities, for a total of $550,000,000 in fiscal year
2022.
ROTC Facilities.—The Committee is concerned that certain new
ROTC sites may not have adequate infrastructure for the success
of the program, particularly in non-contiguous states. The Com-
mittee directs the DOD to report back no later than 180 days after
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enactment of this legislation on (1) unmet requirements for ROTC
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10
facilities in non-contiguous states, particularly in states and terri-
tories with relatively new ROTC programs; and (2) options for ad-
dressing these requirements.
U.S. Indo-Pacific Command Planning and Design.—The rec-
ommendation includes $15,000,000 for U.S. Indo-Pacific Command
Planning and Design, World-Wide Unspecified (Pacific Deterrence
Initiative).
DOD Strategy for Joint-Use Facilities.—When planning for facili-
ties and infrastructure that might be used by multiple services
with the DOD or by another Federal Agency, the DOD has no writ-
ten long-term strategy. Instead, joint use facilities are authorized
on a case-by-case basis. In the Indo-Pacific area of operations,
where facility locations are limited by geography and host country
agreements, this results in the potential inefficient use of facilities
and infrastructure and missed opportunities to address military
construction needs in a cost-effective manner. Therefore, the Com-
mittee directs the Assistant Secretary of Defense for Sustainment
to report no later than 180 days after the enactment of this legisla-
tion on: (1) the overall strategy for joint use facilities in the Indo-
Pacific; (2) the challenges and benefits of adding ports to the DODs
joint-use planning; and (3) limitations imposed by current authori-
ties that may hinder cost-sharing efforts.
Unfunded Priority Lists (UPL) and Future Years Defense Pro-
gram (FYDP).—The Committee directs the Department of Defense
to submit updated UPL and FYDP lists to the congressional de-
fense committees for military construction projects no later than
the transmission of the yearly President’s Budget.
Cross Laminated Timber.—The Committee is aware that the use
of cross laminated timber and other mass timber products as a
building material has the potential for reducing costs and increas-
ing functionality of various military structures. The Committee en-
courages the Secretary of Defense to expand the application of
these innovative technologies in future military construction
projects.
Efficiency within the Military Construction Accounts.—The Com-
mittee supports military construction projects that incorporate re-
quirements from both Active Duty and Reserve and Guard compo-
nents in order to maximize efficiency within military construction
accounts and eliminate the need for multiple construction projects
and reduces costs.
Joint Base Pearl Harbor-Hickam.—The Committee recognizes the
challenges the Navy and Air Force face to preserve key aspects of
historical structures related to the December 7, 1941, attacks on
Joint Base Pearl Harbor-Hickam (JBPHH), including aircraft hang-
ars. While the JBPHH continues to maintain its hangars and
works to meet its legal obligations under the National Historic
Preservation Act, many of its hangar facilities have become unsafe,
costly-to-maintain, or no longer used for their intended purpose.
This exposes many aviation assets to the elements, shortening
their useful lives and increasing operating costs. To better assess
this assistance and determine what additional support may be
needed to help JBPHH meet its operational needs and ensure com-
pliance with existing laws, the Committee directs the Assistant
Secretary of the Navy for Energy, Installations, and the Environ-
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ment, to submit a report no later than 180 days after the enact-
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11
ment of this legislation describing the status of all historic aircraft
hangars at JBPHH including: (1) how many hangars are no longer
capable of housing aircraft; (2) current use limitations for each
hanger that can support aircraft; (3) how JBPHH uses hangers
that cannot support aircraft; (4) a description of the outstanding re-
pairs needed to ensure the efficient and effective use of the hang-
ers; and (5) how many aircraft remain unprotected on the flight
line due to lack of sufficient hangar space.
MILITARY CONSTRUCTION, ARMY
Appropriation, fiscal year 2021 ......................................................... $628,900,000
Budget request, fiscal year 2022 ....................................................... 834,692,000
Committee Recommendation, fiscal year 2022 ................................ 898,692,000
Change from enacted level ......................................................... +269,792,000
Change from budget request ...................................................... +64,000,000
The Committee recommends $898,692,000 for the Army in fiscal
year 2022, of which $62,010,000 is for the following projects in the
following amounts:
Project Amount
Camp Bullis at Joint Base San Antonio—Vehicle Maintenance Shop ......................................................... $10,000,000
Anniston Army Depot—Welding Facility ........................................................................................................ 25,010,000
Fort Drum—Wellfield Expansion Resilience Project ...................................................................................... 27,000,000
Within the total for Military Construction, Army, the rec-
ommendation also includes $181,649,000 for planning and design,
which is $30,000,000 above the budget request; and $60,543,000 for
unspecified minor construction, which is $25,000,000 above the
budget request.
Further detail of the Committee’s recommendation is provided in
the State table at the end of this report.
Redstone Arsenal.—The Committee is concerned that the pro-
jected project timeline for the Gate 7 Access Control Point at the
Redstone Arsenal is insufficient to meet current and future de-
mands at the base. The Committee encourages the Army to expe-
dite the planning and construction of Gate 7.
Mobilization Force Generation Installations.—The Committee is
concerned that installations with rapid deployment requirements,
including Mobilization Force Generation installations, have insuffi-
cient rail and transport logistics infrastructure to efficiently move
equipment in support of deployments, training operations, and
evolving Army requirements. Therefore, the Secretary of the Army
is directed to conduct a review of rail and transport logistics infra-
structure and equipment deployment methods at installations with
rapid deployment requirements. This review and a plan to address
the issues identified in the review, delineated by fiscal year, must
be submitted to the congressional defense committees no later than
90 days after the enactment of this Act.
Army Barracks.—The Committee understands the importance of
maintaining our servicemembers at the highest level of readiness
as our nation continues to face new threats. A key component of
that readiness is providing high-quality barracks. The Committee
recommends the refurbishment of housing on installations whose
condition has fallen below the Army’s high standards.
Immediate Response Force (IRF).—The Committee is concerned
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that without significant investment, the Army is not prepared to
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maintain the requirements of the Immediate Response Force (IRF)
to be able to deploy anywhere in the world within 18 hours. In
order to deter aggression against U.S. interests and maintain an ef-
fective global deterrent, there are significant military construction
needs across installations that cannot be sufficiently mitigated with
other funding sources. The Committee urges the Army to prioritize
facilities that will support the global mission of the IRF and main-
tain this critical capability.
Kawaihāpai (Dillingham) Airfield.—The Committee is aware
that the Hawai’i Department of Transportation (HDOT) is seeking
to cancel its lease with the U.S. Army for civilian use of
Kawaihāpai (Dillingham) Airfield. The Committee encourages the
U.S. Army Garrison Hawai’i to work with HDOT, the Federal Avia-
tion Administration, and other stakeholders to assess various long-
term options to maximize the use of Kawaihāpai Airfield. The Com-
mittee recognizes that a confounding lease term for HDOT is main-
tenance of the airfield’s private water system. Potable water for the
airfield comes from an on-site well. Water is distributed free of
charge to the City and County of Honolulu for use at Mokuleia
Beach Park, Camp Erdman YMCA, several private residences, and
the Kaena Point Satellite Tracking Station, five miles to the west.
The Committee directs the U.S. Army to develop a plan for estab-
lishing a water utility cooperative or other structure to manage the
water system on the airfield.
MILITARY CONSTRUCTION, NAVY AND MARINE CORPS
Appropriation, fiscal year 2021 ......................................................... $1,716,144,000
Budget request, fiscal year 2022 ....................................................... 2,368,352,000
Committee Recommendation, fiscal year 2022 ................................ 1,937,428,000
Change from enacted level ......................................................... +221,284,000
Change from budget request ...................................................... ¥430,924,000
The Committee recommends $1,937,428,000 for the Navy and
Marine Corps in fiscal year 2022, of which $7,000,000 is for the fol-
lowing planning and design project in the following amount:
Project Amount
Marine Corps Support Facility Blount Island—P–021 Lighterage and Small Craft Facility Center ............ $7,000,000
Within the total for Military Construction, Navy and Marine
Corps, the recommendation also includes $413,252,000 for planning
and design, which is $50,000,000 above the budget request; and
$81,435,000 for unspecified minor construction, which is
$25,000,000 above the budget request.
Further detail of the Committee’s recommendation is provided in
the State table at the end of this report.
Shipyard Infrastructure Optimization Plan.—The Committee rec-
ognizes the critical strategic and logistics role our public shipyards
play in the security of our nation. To address chronically unmet in-
frastructure needs at the shipyards, the Fiscal Year 2018 National
Defense Authorization Act included language directing the Depart-
ment of Defense to create and implement a Shipyard Infrastructure
Optimization Plan. The Committee is very concerned that the
Navy’s Shipyard Infrastructure Optimization Plan is falling behind
schedule because details on multiple projects that are needed to
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properly assess and evaluate this critical recapitalization effort
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have not been timely and fully provided to the Committee. There
are also concerns whether the Navy can maintain its current oper-
ational depot level maintenance schedule as dry docks are tempo-
rarily unavailable when they are upgraded and replaced, if current
construction plans accounts for unforeseen ship and submarine
maintenance, whether adequate resourcing has been provided to
the managing program office to mitigate the risk of construction
cost increases, and how the Navy will meet its commitment to its
budget for these projects. Additionally, despite a previously enacted
reporting requirement outlined in Section 346 of the National De-
fense Authorization Act for Fiscal Year 2021 (P.L. 116–57), no in-
formation from the Navy has been forthcoming. Therefore, the
Committee directs the Navy to suspend further expenditure of the
supplemental planning and design funding provided to the Ship-
yard Infrastructure Optimization Plan under Public Law 116–260
unless and until a detailed status report on plan implementation
is transmitted to all committees of jurisdiction.
The Committee recognizes that Project Labor Agreements (PLAs)
promote economy and efficiency in contracting, as well as foster
labor-management stability and ensure compliance with worker
protection laws. The Committee is also aware that the first mili-
tary construction project which used a PLA, the Explosive Han-
dling Wharf at Naval Base Kitsap, came under budget by over
$250,000,000 when it was completed in 2016. For these reasons,
the Committee encourages the Department of the Navy to utilize
PLAs for military construction projects that will take place at the
Navy’s four public shipyards as part of the Shipyard Infrastructure
Optimization Plan.
The Committee is also concerned that the Navy’s Shipyard Infra-
structure Optimization Plan may not sufficiently account for the
differences between the nation’s four historical public shipyards.
Each shipyard has a unique history, design, and local workforce
with valuable knowledge of its respective facilities that can help
ensure the proper modernization and optimization of these facili-
ties. Rather than relying solely on a one-size-fits-all approach that
is centralized without fully considering local conditions, the Com-
mittee urges the Navy’s Shipyard Infrastructure Optimization Plan
program office to seek more input and engagement from these local
workforces and their installation leadership to efficiently and effec-
tively build and maintain shipyards that can sustain the fleet for
generations to come.
NAWS China Lake Earthquake Recovery Efforts.—NAWS China
Lake is a critical installation that provides important capabilities
to support our national defense. The Committee appreciates the
Navy’s efforts to rebuild NAWS China Lake in response to the 2019
earthquakes that caused significant damage to the installation. The
Committee also applauds the close coordination with supporting
communities to maximize these rebuilding efforts. The Committee
directs the Navy to continue to prioritize the rebuilding efforts and
maintain open communication with the supporting communities to
ensure the projects stay on track for timely completion.
JB Pearl-Harbor Dry Dock 3.—The older Dry Dock 3 will be
filled in during the construction of the newer and larger Dry Dock
5. The Committee is concerned that with the last scheduled avail-
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ability for Dry Dock 3 in 2023 and with Dry Dock 5 not scheduled
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for completion until 2028, there will be a significant lack of facili-
ties to maintain fleet readiness. Additionally, during this time the
local shipyard workforce will be underutilized, adversely affecting
the local defense industrial base. Therefore, the Committee directs
Naval Sea Systems Command to submit a report, no later than 180
days after enactment of this legislation, detailing (1) the impact of
the current military construction timelines shipyard availabilities
from FY 2024 through FY 2029, and (2) the planned utilization of
the PHYNSY & IMF workforce during this same period if Dry Dock
5 is not completed before the closure of Dry Dock 3.
Hawaii Infrastructure Readiness Initiative (HIRI).—HIRI was
created by Congress to address critical military construction and
readiness shortfalls. Failing and failed infrastructure has put oper-
ational needs at risk. To fix this crisis, HIRI allocates between
$50,000,000 and $150,000,000 per year through FY 2030 to address
major infrastructure needs, with a ten-year cost of $1,100,000,000
billion. However, it has come to the Committee’s attention that
competing demands with the Army military construction plan may
have caused the deferral of several HIRI projects until later years.
Additionally, the Committee is concerned that the Army has arbi-
trarily limited annual HIRI spending to $100,000,000, which has
caused several inefficiencies such as the segmented construction of
aviation facilities over several years in order to keep annual con-
struction within $100,000,000. Therefore, the Committee directs
the Secretary of the Army to submit a report no later than 180
days after the enactment of this legislation consisting of: (1) a cer-
tified list of HIRI projects for the next 8 fiscal years; (2) a list of
infrastructure requirements that cannot be met under current
HIRI funding; (3) detailed criteria as to how the Army selects and
prioritized HIRI projects; and (4) confirmation that the Army has
not self-imposed yearly spending caps that are resulting in cost in-
efficiencies.
MILITARY CONSTRUCTION, AIR FORCE
Appropriation, fiscal year 2021 ......................................................... $616,156,000
Budget request, fiscal year 2022 ....................................................... 2,102,690,000
Committee Recommendation, fiscal year 2022 ................................ 1,893,690,000
Change from enacted level ......................................................... +1,277,534,000
Change from budget request ...................................................... ¥209,000,000
The Committee recommends $1,893,690,000 for the Air Force in
fiscal year 2022, of which $82,000,000 is for the following projects
in the following amounts:
Project Amount
Lackland AFB at Joint Base San Antonio—Child Development Center ........................................................ $22,000,000
Barksdale AFB—New Entrance Road and Gate Complex ............................................................................. 36,000,000
Wright Patterson Air Force Base—Child Development Center ...................................................................... 24,000,000
Within the total for Military Construction, Air Force, the rec-
ommendation also includes $279,301,000 for planning and design,
which is $50,000,000 above the budget request; and $83,884,000 for
unspecified minor construction, which is $25,000,000 above the
budget request.
Further detail of the Committee’s recommendation is provided in
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the State table at the end of this report.
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Air Education and Training Command (AETC).—The Committee
recognizes the importance of adequate facilities for basic military
training, flight training, and the other training missions for AETC.
Outdated and inadequate AETC facilities, including dormitories,
harm the Air Force’s ability to recruit, train, and retain Airmen
and increases operations and maintenance costs. The Committee
urges the Air Force to prioritize funding for AETC facility design,
construction, and construction improvements because of the critical
role training plays in the force readiness for future threats to na-
tional security. The Committee looks forward to receiving the re-
port on the Secretary of the Air Forces efforts in these areas within
60 days of enactment of the Act.
Access Control Points.—The Committee encourages the Air Force
to accelerate funding for current access control point construction
projects at installations that face high-security risks to critical mis-
sions and to prioritize funding for access control points in heavily
congested areas in large urban settings that place major transpor-
tation links at risk of incident closures or that are required for
heavy traffic hazard mitigation, airport security and installation
force protection.
Air Force Laboratory Infrastructure.—The Committee is con-
cerned that aging laboratory infrastructure threatens the ability of
the Air Force and Space Force to maintain the advanced technology
necessary to keep ahead of U.S. adversaries in air, space, and
cyberspace. No later than January 31, 2022, the Committee directs
the Air Force to advance the top science and technology labora-
tories Major MILCON project or projects to a level of 35 percent
complete design, based on the priorities established pursuant to
section 2806 of the Duncan Hunter National Defense Authorization
Act for Fiscal Year 2018 (P.L. 115–91).
MILITARY CONSTRUCTION, DEFENSE-WIDE
Appropriation, fiscal year 2021 ......................................................... $2,041,909,000
Budget request, fiscal year 2022 ....................................................... 1,957,289,000
Committee Recommendation, fiscal year 2022 ................................ 2,023,416,000
Change from enacted level ......................................................... ¥18,493,000
Change from budget request ...................................................... +66,127,000
The Committee recommends $2,023,416,000 for Military Con-
struction, Defense-Wide in fiscal year 2022. Within the total, the
recommendation provides $61,464,000 for unspecified minor con-
struction, and $261,313,000 for planning and design, including
$15,000,000 above the budget request for INDOPACOM.
Further detail of the Committee’s recommendation is provided in
the State table at the end of this report.
Energy Resilience and Conservation Investment Program
(ERCIP).—The Committee supports DOD’s investments in energy
efficiency, resilience, renewable energy systems, and energy secu-
rity, and as such provides $382,980,000 for the Energy Resilience
and Conservation Program, an increase of $136,380,000 above the
request.
Tripler Army Medical Center and Veterans Affairs.—As the larg-
est military and veterans medical facility in the Pacific Basin, Tri-
pler Army Medical Center and VA is responsible for nearly 450,000
beneficiaries who are eligible to receive care at the facility. Due to
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the constraining geography and parking shortfall, veterans and
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servicemembers have difficulty finding parking, which is particu-
larly challenging for elderly veterans, wounded soldiers and those
who have difficulty walking unassisted. According to Army’s own
assessment using formulas included in the Department of Defense
Unified Facilities Criteria (UFC) 4–510–01, Design: Medical Mili-
tary Facilities, the facility should have 5,936 parking stalls to ac-
commodate its workforce and patients, but the facility only has
3,713 stalls. The facility is also not readily accessible to public
transit, making ground transportation with parking the only reli-
able option for care. Currently there are no plans to construct a
parking structure at Tripler Army Medical Center until tentative
recapitalization plans for the entire facility are completed, which
would further delay solutions to a problem that is already affecting
elderly veterans, servicemembers and their families who depend
upon this facility. Therefore, the Committee directs the Secretary
of the Army and the Director of the Defense Health Agency, in con-
sultation with the Department of Veterans Affairs, to submit a
joint report to the congressional defense committees no later than
90 days after enactment of this Act detailing (1) the current park-
ing situation and requirements of the facility over the next four
years; (2) the estimated cost of constructing a parking facility sepa-
rately from the recapitalization efforts of the primary Tripler Army
Medical Center facility, to include likely cost items and possible
category codes; and (3) estimated timeline for designing and con-
structing a typical parking structure in Hawaii.
Defense Access Roads (DAR) Program.—The Committee supports
Defense Access Roads as a vital mechanism to improve transpor-
tation infrastructure at domestic installations and their sur-
rounding communities. The Fiscal Year 2020 National Defense Au-
thorization Act clarified that appropriated funds for the DAR Pro-
gram may be used to cover the cost of repairing damage or miti-
gating infrastructure risk to access roads caused by recurrent flood-
ing or sea level fluctuation. The Committee urges the Department
to identify military installations with transportation infrastructure
affected by sea level fluctuation and recurrent flooding and,
through the appropriate contacts at affected installations and sites,
work with surrounding local communities to identify affected trans-
portation infrastructure and conduct transportation needs assess-
ments to understand the magnitude of the improvement required.
Military Facility Resilience Funding.—The Committee recognizes
that the Armed Services must continue to improve efforts to ensure
its military installations are resilient to flooding, sea level rise, and
hurricanes, which are increasing in frequency and scale. The Com-
mittee continues to support efforts to improve the resilience of mili-
tary installations and to encourage installations to develop plans
that take into account current and future risks from extreme
weather, including by utilizing modeling technologies that measure
sea-level rise. Furthermore, the Committee directs the Services to
prioritize and commit funding to projects that improve the resil-
ience of military installations and their missions and notes the
need to ensure that infrastructure and facilities remain operational
against natural and manmade threats. Recognizing that such in-
vestments are critical to installation readiness, the agreement pro-
vides $25,000,000 in planning and design and construction funding
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for each of the Services, and Defense-Wide to continue to develop
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projects, conduct studies and analyses, and update Unified Facili-
ties Criteria, that will directly enhance military installation resil-
ience. No later than 90 days after enactment of this Act the Serv-
ices are directed to provide a spend plan on the funds appropriated
in fiscal year 2022.
Missile Defense Capabilities on Guam.—The Committee is con-
cerned about the lack of progress in addressing the military con-
struction requirements to provide 360 degrees of persistent air and
missile defense capability for Guam. Addressing this requirement
is critical to protecting Guam, which is home to over 170,000 U.S.
citizens, over 21,700 military members and their families, and vital
defense assets. While the DOD has yet to settle on a qualified pro-
gram of record to meet this requirement, progress can still be made
to assess possible future locations and preliminary military con-
struction planning for systems that could help protect Guam from
precision, long-range strikes. Therefore, the Committee directs the
Director of the Missile Defense Agency to submit a report no later
than 180 days after enactment of this act detailing: (1) potential lo-
cations on Guam that could host either a large fixed or mobile plat-
form capable of fulfilling requirements for an air and missile de-
fense system; (2) approximate military construction costs associated
with preparing each location to host a system; and (3) the time it
will take before each location could be viable to the military con-
struction need to host an acquired system.
Energy Conservation.—The Committee commends the DOD’s for-
ward posture on the need to increase energy conservation efforts,
limit carbon emissions, and reduce energy costs. As the DOD works
to construct new facilities and upgrade facilities, the Committee
urges the Secretary to evaluate and integrate the use of new and
innovative technologies, such as batteryless sensors, to monitor and
manage DOD energy resources more effectively.
Alternative Fuel Infrastructure.—The Committee encourages
DOD to prioritize funding for the installation of alternative fuel in-
frastructure at military installations to ensure continuity of oper-
ations as DOD transitions to utilizing alternative fuel vehicles.
Resilient Military Installations.—The Committee supports the
Department’s efforts, including updating hurricane-related building
codes for bases, barracks, hospitals, and airfields and investing in
energy efficiency, renewable energy and water conservation
projects, to ensure U.S. military installations are resilient and en-
courages the Services to seek out projects that mitigate risk to mis-
sion-critical assets while also providing resiliency.
Comprehensive Energy Audits.—The Department of Defense is
urged to increase the use of third-party comprehensive energy au-
dits through the ERCIP.
Batteryless Sensor Technology.—The Committee encourages the
Energy Resilience and Conservation Investment Program to sup-
port technologies, including batteryless sensor technology, to mon-
itor and reduce energy consumption and deliver a more resilient
and sustainable infrastructure for the Department of Defense.
Stormwater Best Management Practices.—The Committee com-
mends the Department’s work to address energy resiliency on mili-
tary installations and encourages the Department to take similar
steps to address water and flood resiliency. Of the amounts avail-
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able for the Energy Resilience and Conservation Investment Pro-
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gram, the Committee supports investment in implementing and
maintaining stormwater Best Management Practices that enhance
resiliency and water quality on military installations. In addition
to meeting force protection requirements, implementing and main-
taining these Best Management Practices will help military instal-
lations reduce pollution runoff consistent with state-based water-
shed implementation plans required by the Environmental Protec-
tion Agency.
Joint Spectrum Center.—The Committee directs the Secretary of
Defense to provide the Committee with an update on the facility
chosen for the Joint Spectrum Center’s relocation and the timeline
for execution, no later than 120 days after the enactment of this
Act.
GUARD AND RESERVE INITIATIVE
Regional Training Institutes.—The Committee recognizes the im-
portance of Regional Training Institutes (RTI) across the country
for the readiness of Army National Guard (ARNG) and is concerned
about the lack of infrastructure to support the mission of the RTIs.
For example, the RTI at Fort Hood is lacking sufficient facilities to
provide the proper training to achieve optimum readiness. The
Committee urges the Department of Defense to prioritize facilities
for this important and vital mission of ARNG and Army Reserve.
National Guard Training Center.—The Committee recognizes the
importance of the National Guard Texas Training Center, which
has been in development since 2010 and has had execution delays.
The Committee recognizes that the Texas Training Center remains
a high priority and the Texas Army National Guard shall continue
its efforts to establish the Center.
MILITARY CONSTRUCTION, ARMY NATIONAL GUARD
Appropriation, fiscal year 2021 ......................................................... $349,437,000
Budget request, fiscal year 2022 ....................................................... 257,103,000
Committee Recommendation, fiscal year 2022 ................................ 335,603,000
Change from enacted level ......................................................... ¥13,834,000
Change from Budget Request .................................................... +78,500,000
The Committee recommends $335,603,000 for the Army National
Guard in fiscal year 2022, of which $15,500,000 is for the following
projects in the following amounts:
Project Amount
Camp Shelby Joint Forces Training Center—Mobilization and Annual Training Equipment Site (MATES)
Project ........................................................................................................................................................ $15,500,000
Within the total for Military Construction, Army National Guard,
the recommendation also includes $72,000,000 for planning and de-
sign, which is $50,000,000 above the budget request; and
$52,471,000 for unspecified minor construction, which is
$13,000,000 above the budget request.
Further detail of the Committee’s recommendation is provided in
the State table at the end of this report.
Readiness Center Transformation Master Plan.—The Army Na-
tional Guard (ARNG) completed its Readiness Center Trans-
formation Master Plan (RCTMP) in 2015; however, since that time,
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the investment in executing the military construction required
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under the RCTMP has not kept up with the demand. The Com-
mittee is concerned that the mission readiness of these critical fa-
cilities is further deteriorating, and it encourages increased invest-
ments in ARNG Readiness Centers over the FYDP. Further, given
the changing conditions of readiness centers across the country
since the last RCTMP was completed, the Committee encourages
the ARNG to update the RCTMP to ensure current its military con-
struction priorities align with the Transformation Master Plan. Ac-
cordingly, the Committee provides an additional $50,000,000 in
Army National Guard planning & design and $100,000,000 for con-
struction.
ARNG Aviation Support Facilities.—The Committee is concerned
that ARNG Aviation Support Facilities (AASF) are not prepared to
protect and properly maintain next generation airframe priorities
simultaneously as the Army. The operation and maintenance of
new aircraft platforms requires significant investment in AASFs
across the country so that they can provide the required shelter
and support for new airframes, as well as regular maintenance for
the existing airframes. The Committee urges both the Army and
the ARNG to prioritize facilities that support readiness of ARNG
aviation units as they prepare to gain new aircraft platforms.
MILITARY CONSTRUCTION, AIR NATIONAL GUARD
Appropriation, fiscal year 2021 ......................................................... $64,214,000
Budget request, fiscal year 2022 ....................................................... 197,770,000
Committee Recommendation, fiscal year 2022 ................................ 246,770,000
Change from enacted level ......................................................... +182,556,000
Change from budget request ...................................................... +49,000,000
The Committee recommends $246,770,000 for the Air National
Guard in fiscal year 2022, of which $24,000,000 is for the following
projects in the following amounts:
Project Amount
New Castle County Airport—Delaware National Guard—Fuel Cell and Corrosion Control Hangar ............ $17,500,000
Boise Air Terminal (Gowen Field)—Medical Training Facility ....................................................................... 6,500,000
Within the total for Military Construction, Air National Guard,
the recommendation also includes $28,402,000 for planning and de-
sign, which is $10,000,000 above the budget request; and
$44,088,000 for unspecified minor construction, which is
$15,000,000 above the budget request.
Further detail of the Committee’s recommendation is provided in
the State table at the end of this report.
C130–J Requirements.—The Committee is concerned with the
state of ANG infrastructure across the country. Specifically, many
of the ANG Aviation Support Facilities are not configured to pro-
tect and properly maintain the most modernized airframes. As the
Air Force continues to select ANG units to receive the most current
and modernized airframes, investments must be made in current
facilities. The Committee encourages the ANG to utilize unspecified
minor military construction, as authorized, to speed up projects
across the country and increase the readiness of the ANG.
Aviation Support Facility Relocation (AASF) and Aircraft Mainte-
nance Hangar.—The Committee is concerned that there are exist-
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ing inadequate facilities for Army National Guard aviation support.
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There are no other DoD aviation facilities available to support the
requirement of certain aircraft. If replacement facilities are not
constructed to meet maintenance and sustainment requirements it
will directly result in the loss and relocation of aircraft and units.
These types of facilities directly enable training, administrative,
operational, and logistical requirements Army National Guard
Army Aviation mission. Therefore, the Committee urges the Direc-
tor of the National Guard to provide planning and design funds to
these critical projects, that would facilitate the most efficient and
least costly solution.
MILITARY CONSTRUCTION, ARMY RESERVE
Appropriation, fiscal year 2021 ......................................................... $88,337,000
Budget request, fiscal year 2022 ....................................................... 64,911,000
Committee Recommendation, fiscal year 2022 ................................ 77,411,000
Change from enacted level ......................................................... ¥10,926,000
Change from budget request ...................................................... +12,500,000
The Committee recommends $77,411,000 for the Army Reserve
in fiscal year 2022, including $12,167,000 for planning and design,
which is $5,000,000 above the budget request; and $22,044,000 for
unspecified minor construction, which is $7,500,000 above the
budget request.
Further detail of the Committee’s recommendation is provided in
the State table at the end of this report.
MILITARY CONSTRUCTION, NAVY RESERVE
Appropriation, fiscal year 2021 ......................................................... $70,955,000
Budget request, fiscal year 2022 ....................................................... 71,804,000
Committee Recommendation, fiscal year 2022 ................................ 84,804,000
Change from enacted level ......................................................... +13,809,000
Change from budget request ...................................................... +13,000,000
The Committee recommends $84,804,000 for the Navy Reserve in
fiscal year 2022, including $13,005,000 for planning and design,
which is $7,000,000 above the budget request; and $8,359,000 for
unspecified minor construction, which is $6,000,000 above the
budget request.
Further detail of the Committee’s recommendation is provided in
the State table at the end of this report.
MILITARY CONSTRUCTION, AIR FORCE RESERVE
Appropriation, fiscal year 2021 ......................................................... $23,117,000
Budget request, fiscal year 2022 ....................................................... 78,374,000
Committee Recommendation, fiscal year 2022 ................................ 104,574,000
Change from enacted level ......................................................... +81,457,000
Change from budget request ...................................................... +26,200,000
The Committee recommends $104,574,000 for the Air Force Re-
serve in fiscal year 2022, of which $8,700,000 is for the following
projects in the following amounts:
Project Amount
Youngstown Air Reserve Station—Assault Strip Widening ........................................................................... $8,700,000
Within the total for Military Construction, Air Force Reserve, the
recommendation also includes $12,330,000 for planning and design,
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which is $6,500,000 above the budget request; and $26,444,000 for
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21
unspecified minor construction, which is $11,000,000 above the
budget request.
Further detail of the Committee’s recommendation is provided in
the State table at the end of this report.
NORTH ATLANTIC TREATY ORGANIZATION SECURITY INVESTMENT
PROGRAM
Appropriation, fiscal year 2021 ......................................................... $173,030,000
Budget request, fiscal year 2022 ....................................................... 205,835,000
Committee Recommendation, fiscal year 2022 ................................ 205,835,000
Change from enacted level ......................................................... +32,823,000
Change from budget request ...................................................... –––
The North Atlantic Treaty Organization Security Investment
Program (NSIP) consists of annual contributions by North Atlantic
Treaty Organization (NATO) member countries. The program fi-
nances the costs of construction needed to support the roles of the
major NATO commands. The investments cover facilities such as
airfields, fuel pipelines and storage, harbors, communications and
information systems, radar and navigational aids, and military
headquarters, both within NATO Nations and for ‘‘out of area’’ op-
erations such as Afghanistan.
The United States occasionally has been forced to temporarily
delay the authorization of projects due to shortfalls in United
States obligation authority. The Committee directs the Secretary of
Defense to notify the Committee within 14 days of the United
States taking action to delay the authorization of projects tempo-
rarily, or to temporarily withhold funds from previously authorized
projects, due to shortfalls in U.S. obligation authority.
DEPARTMENT OF DEFENSE BASE CLOSURE ACCOUNT
Appropriation, fiscal year 2021 ......................................................... $480,447,000
Budget request, fiscal year 2022 ....................................................... 284,639,000
Committee Recommendation, fiscal year 2022 ................................ 564,639,000
Change from enacted level ......................................................... +84,192,000
Change from budget request ...................................................... +280,000,000
The Committee recommends $564,639,000 for the Base Closure
account, which is $84,192,000 more than fiscal year 2021 and
$280,000,000 above the budget request.
The recommendation includes an additional $80,000,000 above
the budget request for the Navy to accelerate environmental reme-
diation at installations closed under previous Base Closure and Re-
alignment (BRAC) rounds. Furthermore, the Navy shall provide to
the Committee a spend plan for these additional funds no later
than 60 days after enactment of this Act.
The recommendation also provides an additional $50,000,000
above the budget request for the Army to accelerate ordnance re-
mediation at installations closed under previous Base Closure and
Realignment rounds where the Army has a legal requirement to
complete the clean-up by a specified date. Furthermore, the Army
shall provide to the congressional defense committees a spend plan
for these additional funds no later than 60 days after enactment
of this Act.
Hensley Field.—The Committee is concerned that 23 years after
the closure of Naval Air Station Dallas (Hensley Field) in BRAC
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1998, the Department of the Navy has not yet completed environ-
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mental remediation at the former Naval Air Station Dallas. The
Committee therefore instructs the Navy to work with the City of
Dallas and the Texas Commission on Environmental Quality to
complete the environmental remediation of former Naval Air Sta-
tion Dallas.
Remediation Technologies at BRAC Sites.—The Committee is
aware of promising technologies, including the supercritical water
oxidation process, for destroying PFAS and encourages the Services
to utilize these technologies, as appropriate, at BRAC cleanup sites.
Perfluorooctane Sulfonate (PFOS) and Perfluorooctanoic Acid
(PFOA).—The Committee continues to be very concerned about the
extent of PFOS/PFOA contamination at U.S. military installations
and how that contamination is measured. Therefore, the Com-
mittee includes an additional $150,000,000 above the budget re-
quest within the Base Closure Account to increase the pace of
cleanup at the military installations affected by PFOS/PFOA.
PFOS/PFOA Regulation and Research.—The Committee expects
the Department to continue working with the U.S. Environmental
Protection Agency on its regulatory initiatives and engaging Fed-
eral health agencies, including the Agency for Toxic Substances
and Disease Registry, to ensure that it is using the best and most
up-to-date science to guide DOD remediation plans and processes.
PFOS/PFOA Reporting Requirement.—Over the past two fiscal
years, the Committee has directed the Department to keep it ap-
prised of new findings of PFOS/PFOA at BRAC sites. The Com-
mittee recognizes that the Services have provided some informa-
tion. However, the process for identifying PFOS/PFOA contamina-
tion at BRAC sites and determining the appropriate remediation
plan remains unclear. Therefore, the Deputy Assistant Secretary of
Defense for Environment is directed to prepare a comprehensive re-
port for the congressional defense committees no later than 60 days
after enactment of this Act that establishes a baseline of informa-
tion regarding PFOS/PFOA at closed military installations. At a
minimum, the report should 1) provide a list of all closed military
installations; 2) indicate whether PFOS/PFOA has been detected in
drinking water and groundwater; 3) indicate the level of contami-
nation that has been detected; 4) provide information on the likely
sources of contamination; 5) explain current mitigation efforts and
proposed remediation plans; 6) discuss the status of remediation; 7)
provide a timeline for cleanup; and 8) estimate the total cost of de-
tection, mitigation and remediation.
FAMILY HOUSING OVERVIEW
Appropriation, fiscal year 2021 ......................................................... $1,336,592,000
Budget request, fiscal year 2022 ....................................................... 1,423,554,000
Committee Recommendation, fiscal year 2022 ................................ 1,423,554,000
Change from enacted level ......................................................... +86,962,000
Change from budget request ...................................................... –––
Family housing construction accounts provide funds for new con-
struction, construction improvements, the federal government’s
costs for family housing privatization projects, and planning and
design. The operation and maintenance accounts provide funds to
pay for maintenance and repair, furnishings, management, serv-
ices, utilities, leasing, interest, mortgage insurance, and miscella-
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Housing Support Costs and Management Accounts.—The rec-
ommendation includes sufficient funds within Housing Support
Costs under Family Housing Operation and Maintenance accounts
in order to support the Services’ ability to provide oversight and
management, and personnel to track current and future issues that
may occur in military family housing.
Military Housing Privatization Initiative (MHPI).—A priority for
the Committee continues to be the state of homes within the
MHPI, the timeliness and thoroughness of repair and remediation
of reported problems, and the Department of Defense and Services’
oversight communications with tenants and the base housing prop-
erty management companies. The Department is directed to report
to the Committee all progress in these areas within 30 days of en-
actment of this Act.
At this time, the Tenant Bill of Rights, as proscribed by the Na-
tional Defense Authorization Act for Fiscal Year 2020, has been im-
plemented except for Rights #16, #17, and #18. The Committee di-
rects the Services to report on the status of implementation of
these three Rights within 60 days of enactment of this Act.
Homeownership Education.—The Committee encourages the
Services to work with privatized housing partners to develop and
provide basic homeownership education programs for
Servicemembers and their families.
FAMILY HOUSING CONSTRUCTION, ARMY
Appropriation, fiscal year 2021 ......................................................... $119,400,000
Budget request, fiscal year 2022 ....................................................... 99,849,000
Committee Recommendation, fiscal year 2022 ................................ 99,849,000
Change from enacted level ......................................................... ¥19,551,000
Change from budget request ...................................................... –––
FAMILY HOUSING OPERATION AND MAINTENANCE, ARMY
Appropriation, fiscal year 2021 ......................................................... $352,342,000
Budget request, fiscal year 2022 ....................................................... 391,227,000
Committee Recommendation, fiscal year 2022 ................................ 391,227,000
Change from enacted level ......................................................... +38,885,000
Change from budget request ...................................................... –––
FAMILY HOUSING CONSTRUCTION, NAVY AND MARINE CORPS
Appropriation, fiscal year 2021 ......................................................... $42,897,000
Budget request, fiscal year 2022 ....................................................... 77,616,000
Committee Recommendation, fiscal year 2022 ................................ 77,616,000
Change from enacted level ......................................................... +34,719,000
Change from budget request ...................................................... –––
FAMILY HOUSING OPERATION AND MAINTENANCE, NAVY AND
MARINE CORPS
Appropriation, fiscal year 2021 ......................................................... $346,493,000
Budget request, fiscal year 2022 ....................................................... 357,341,000
Committee Recommendation, fiscal year 2022 ................................ 357,341,000
Change from enacted level ......................................................... +10,848,000
Change from budget request ...................................................... –––
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FAMILY HOUSING CONSTRUCTION, AIR FORCE
Appropriation, fiscal year 2021 ......................................................... $97,214,000
Budget request, fiscal year 2022 ....................................................... 115,716,000
Committee Recommendation, fiscal year 2022 ................................ 115,716,000
Change from enacted level ......................................................... +18,502,000
Change from budget request ...................................................... –––
FAMILY HOUSING OPERATION AND MAINTENANCE, AIR FORCE
Appropriation, fiscal year 2021 ......................................................... $317,021,000
Budget request, fiscal year 2022 ....................................................... 325,445,000
Committee Recommendation, fiscal year 2022 ................................ 325,445,000
Change from enacted level ......................................................... +8,424,000
Change from budget request ...................................................... –––
FAMILY HOUSING OPERATION AND MAINTENANCE, DEFENSE-WIDE
Appropriation, fiscal year 2021 ......................................................... $54,728,000
Budget request, fiscal year 2022 ....................................................... 49,785,000
Committee Recommendation, fiscal year 2022 ................................ 49,785,000
Change from enacted level ......................................................... ¥4,943,000
Change from budget request ...................................................... –––
DEPARTMENT OF DEFENSE FAMILY HOUSING IMPROVEMENT FUND
Appropriation, fiscal year 2021 ......................................................... $5,897,000
Budget request, fiscal year 2022 ....................................................... 6,081,000
Committee Recommendation, fiscal year 2022 ................................ 6,081,000
Change from enacted level ......................................................... +184,000
Change from budget request ...................................................... –––
DEPARTMENT OF DEFENSE MILITARY UNACCOMPANIED HOUSING
IMPROVEMENT FUND
Appropriation, fiscal year 2021 ......................................................... $600,000
Budget request, fiscal year 2022 ....................................................... 494,000
Committee Recommendation, fiscal year 2022 ................................ 494,000
Change from enacted level ......................................................... ¥106,000
Change from budget request ...................................................... –––
ADMINISTRATIVE PROVISIONS
The bill includes a total of 32 Administrative provisions, 27 of
which are in effect in fiscal year 2021.
The bill includes section 101 prohibiting the use of funds for pay-
ments under a cost-plus-a-fixed-fee contract for construction where
cost estimates exceed $25,000. An exception for Alaska is provided.
The bill includes section 102 permitting the use of construction
funds for the hire of passenger motor vehicles.
The bill includes section 103 permitting funds to be expended on
the construction of defense access roads under certain cir-
cumstances.
The bill includes section 104 prohibiting construction of new
bases in the United States without a specific appropriation.
The bill includes section 105 limiting the use of funds for the
purchase of land or land easements that exceed 100 percent of
value except under certain conditions.
The bill includes section 106 prohibiting the use of funds to ac-
quire land, prepare sites, or install utilities for family housing ex-
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cept housing for which funds have been appropriated.
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The bill includes section 107 limiting the use of minor construc-
tion funds to relocate any activity from one installation to another
without prior notification.
The bill includes section 108 prohibiting the procurement of steel
unless American producers, fabricators, and manufacturers have
been allowed to compete.
The bill includes section 109 prohibiting the use of funds to pay
real property taxes in foreign nations.
The bill includes section 110 prohibiting the use of funds to ini-
tiate a new installation overseas without prior notification.
The bill includes section 111 establishing a preference for United
States architectural and engineering services where the services
are in Japan, NATO member countries, or countries bordering the
Arabian Sea.
The bill includes section 112 establishing a preference for United
States contractors for military construction in the United States
territories and possessions in the Pacific and on Kwajalein Atoll, or
countries within the Central Command area of responsibility, ex-
cept bids by Marshallese contractors for military construction on
Kwajalein Atoll.
The bill includes section 113 requiring the Secretary of Defense
to give prior notice to Congress of military exercises where con-
struction costs exceed $100,000.
The bill includes section 114 allowing funds appropriated in prior
years to be used for new projects authorized during the current ses-
sion of Congress.
The bill includes section 115 allowing the use of expired or
lapsed funds to pay the cost of supervision for any project being
completed with lapsed funds.
The bill includes section 116 providing that funds for military
construction projects are available until the end of the fourth fiscal
year following the fiscal year in which funds are appropriated, sub-
ject to certain conditions.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 117 allowing for the transfer of funds
from Family Housing Construction accounts to the Department of
Defense Family Housing Improvement Fund and funds from Mili-
tary Construction accounts to the Department of Defense Military
Unaccompanied Housing Improvement Fund.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 118 providing transfer authority to the
Homeowners Assistance Program.
The bill includes section 119 requiring that funds in this title be
the sole source of all operation and maintenance for flag and gen-
eral officer quarter houses and limits the repair on these quarters
to $15,000 per year without notification.
The bill includes section 120 making funds in the Ford Island
Improvement Fund available until expended.
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(INCLUDING TRANSFER OF FUNDS)
The bill includes section 121 allowing the transfer of expired
funds to the ‘‘Foreign Currency Fluctuations, Construction, De-
fense’’ ’ account.
The bill includes section 122 prohibiting the use of funds for
projects at Arlington National Cemetery.
The bill includes section 123 directing all amounts appropriated
to Military Construction (all accounts) be immediately available
and allotted for the full scope of the authorized project.
The bill includes section 124 defining the congressional defense
committees.
The bill includes section 125 providing additional funds for var-
ious military construction accounts and requires a spend plan for
each.
The bill includes section 126 prohibiting funds from being used
to consolidate or relocate any element of RED HORSE outside of
the United States until the Secretary of the Air Force provides cer-
tain requirements.
The bill includes section 127 providing additional funds for im-
proving resilience and the effects of climate change on military in-
stallations.
The bill includes section 128 providing additional funds for child
development centers.
The bill includes section 129 providing additional funds for bar-
racks.
The bill includes section 130 providing additional funds for the
Shipyard Infrastructure Optimization Program.
The bill includes section 131 providing additional funds for the
Army National Guard Transformation Plan.
The bill includes section 132 providing additional funds for the
Air Force and Navy and Marine Corps for expenses incurred as a
result of natural disasters.
The bill includes section 133 prohibiting funds from being used
for construction or planning and design of Space Force projects
until a site selection audit is complete.
TITLE II
DEPARTMENT OF VETERANS AFFAIRS
Appropriation, fiscal year 20211 ............................................ $243,162,237,000
Budget request, fiscal year 20221 ......................................... $268,410,433,000
Committee recommendation, fiscal year 20221 .................... $268,586,855,000
Change from enacted level ............................................. +$25,424,618,000
Change from budget request .......................................... +$176,422,000
Fiscal year 2023 advance budget request ............................. $267,873,190,000
Fiscal year 2023 Committee recommendation in the bill ... $267,873,190,000
1All funding cited excludes amounts in the Medical Care Collections Fund.
The Department of Veterans Affairs (VA) provides health care for
9,200,000 Veteran enrollees, disability compensation benefits to
nearly 6,000,000 Veterans and survivors, pension benefits for over
357,000 Veterans and survivors, life insurance for more than
5,500,000 Veterans, servicemembers and their families, educational
assistance for nearly 900,000 trainees, and interment of more than
130,000 Veterans and eligible family members in national ceme-
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teries. To serve adequately the Nation’s Veterans, VA employs
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more than 425,000 people, making it one of the largest Federal
agencies in terms of employment.
The Committee strongly supports the implementation of the
Deborah Sampson Act, enacted into law as part of the Johnny Isak-
son and David P. Roe, M.D. Veterans Health Care and Benefits Im-
provement Act of 2020 (P.L. 116–315), and notes that the funding
level provided for the Department for fiscal year 2022 will fully
fund the implementation of the Deborah Sampson Act, as indicated
in the Department’s budget justification materials. The Committee
believes firmly that the Department should dedicate sufficient re-
sources to support the needs of women veterans in a variety of pro-
gram areas, including hiring and training staff, strategic planning,
health research, eliminating sexual harassment and sexual assault,
and retrofitting existing medical facilities to make it safer and easi-
er for women veterans to get care. The Committee directs VA to
provide a plan and timeline for implementation of this law, includ-
ing an expenditure plan in each of these areas, to the Committees
on Appropriations of both Houses of Congress, no later than 90
days after enactment of this Act.
Sexual Harassment and Sexual Assault Protections for VA Bene-
ficiaries and Employees.—Eliminating sexual harassment and as-
sault at VA is critical to creating a safe and welcoming environ-
ment for veterans, their families, caregivers, and survivors, as well
as VA employees. The Committee is concerned by the lack of cen-
tralized reporting mechanisms and resources for VA beneficiaries
who are harassed or assaulted by VA employees or on VA property,
as well as the potential for retaliation from within the Department.
The Committee is further concerned that the Department has not
yet issued a comprehensive sexual assault and harassment policy,
as required by Section 5303 of P.L. 116–315, despite continued re-
ports of incidences of sexual assault and harassment at the Depart-
ment, and directs the Department to report to the Committee no
later than 30 days after the date of enactment of this Act on the
status of its efforts to comply with this statutory requirement. It
is critical for VA to move swiftly with the implementation of Sec-
tion 5303, create a centralized reporting mechanism with a com-
prehensive information technology database, and designate sexual
harassment and assault prevention coordinators, so that veterans
know where to turn when subjected to degrading treatment while
accessing care and benefits.
Native Hawaiian, Pacific Islander and United States-Affiliated
Pacific Islander Veteran Health Care.—Native Hawaiian, Pacific Is-
lander, and United States-Affiliated Pacific Islanders disproportion-
ately serve in the U.S. military and therefore represent significant
numbers of Veterans across the United States and Pacific, particu-
larly in rural and remote locations. The Committee continues to
support additional research, service, and education to improve the
lives of Native Hawaiian, Pacific Islander and U.S.-Affiliated Pa-
cific Islander Veterans, and looks forward to the results of VA’s fea-
sibility study on the establishment of a dedicated VA Center for
this population, as directed in Division J of the Joint Explanatory
Statement accompanying the Consolidated Appropriations Act,
2021 (P.L. 116–260). In performing this effort, VA should consider
partnering with non-government institutions and universities to ex-
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amine telehealth and telepharmacy; models of interprofessional pri-
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mary care, including the integration of pharmacists and behavioral
health; electronic health records and data analytics; health work-
force; and indigenous people innovation.
Women Veteran Transitional Housing Support.—The Committee
recognizes the need for transitional and supportive housing serv-
ices for women Veterans, and minority women veterans, who are
experiencing homelessness or housing insecurity. The Committee
also recognizes that in the past, Veteran services were primarily
designed for men and do not always meet the needs of women and
minority women Veterans. Women and minority women Veterans
struggling with the acclimation to civilian and community life often
find themselves in at-risk circumstances that may differ from those
of men, such as women with children escaping domestic violence,
and therefore women and minority women Veterans require spe-
cialized interventions and programming. The Committee encour-
ages the Department to work with the Department of Defense and
the Department of Labor to provide robust gender-specific case
management services for women and minority women Veterans
transitioning from military service. Additionally, the Committee
supports VA’s continued investment in the Women’s Health Transi-
tion Training Program, as this highly successful and innovative
program helps servicewomen across every branch of our armed
forces transition out of active duty service.
Eliminating Barriers to Accessing Earned Benefits for Veterans in
the Outlying Areas.—The Committee directs the Department of
Veterans Affairs to conduct a comprehensive review of its programs
and services to identify those that are unavailable to veterans re-
siding in outlying areas such as the Northern Mariana Islands and
the Freely Associated States, the reasons for the lack of avail-
ability, and the actions needed to eliminate the barriers to access.
The VA shall report its findings and recommendations to the Com-
mittee within 180 days of enactment of this paragraph.
Combatting Online Misinformation and Extremism.—The Com-
mittee is concerned by foreign and domestic actions to exploit vet-
erans through the use of online misinformation and manipulation.
These efforts to spread extremist views and conspiracy theories
among the veteran community have severely damaging effects,
such as spreading conspiracies that may have motivated participa-
tion in the Capitol insurrection on January 6, 2021. The Committee
feels strongly that the VA should engage with the veteran commu-
nity to better understand the unique vulnerabilities that Veterans
face online, and that the Department should establish a com-
prehensive, evidence-based program to educate veterans about ma-
lign influences, transition assistance to include specialized coun-
seling services, as well as research into operations and methods to
discern against disinformation. This should include developing evi-
dence-based social media and internet propaganda literacy pro-
grams that are appropriately targeted to different veteran popu-
lations and an understanding of appropriate counseling options.
The Committee encourages the Department to engage with the De-
partments of Justice and Homeland Security, as well as civil soci-
ety partners, in developing this program, and directs VA to report
to the Committee within 60 days of the enactment of this Act on
its plans to implement this program, including a cost estimate of
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additional resources that would assist in implementation.
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Protecting Immigrant Veterans.—The Committee recognizes the
value and service of immigrant veterans and is concerned about the
deportation of veterans, as well as family members, workers, and
other visitors interacting with VA who may also be at risk for de-
portation. The Committee asserts that VA should take action to
prevent deportations and ensure veterans and their families feel
welcome at VA, and directs the Department to undertake a review
of its policies and practices within 180 days to ensure that VA is
not engaging in any policies that put veterans or others at risk for
deportations. VA is additionally directed to submit to the Com-
mittee a plan to implement corrections to any policies identified.
This review and plan must include a clarification that mutual sup-
port agreements with federal, state and local law enforcement
agencies cannot include the sharing of information that puts vet-
erans at risk for deportation. Further, VA is directed to take steps
to ensure that non-citizen Veterans are made aware of their op-
tions to naturalize as U.S. citizens. Finally, the Committee strongly
urges VA to take every step possible to assist detained and pre-
viously deported veterans, including by providing administrative
guidance and assistance with relevant applications and paperwork.
The Department is encouraged to work with the Department of
Homeland Security to develop methods that allow the Department
to maintain contact with detained and previously deported vet-
erans and ensure that they are able to access this and other VA
assistance and benefits to which they are entitled.
Performance Measures.—The Committee directs the Department
of Veterans Affairs to comply with title 31 of the United States
Code, including the development of organizational priority goals
and outcomes such as performance outcome measures, output
measures, efficiency measures, and customer service measures. The
Secretary shall submit a report to the Committee within 60 days
of enactment of the Act on the progress it has made on Perform-
ance Measures.
Customer Service Standards.—The Committee continues to sup-
port efforts to improve customer service in accordance with Execu-
tive Order 13571—Streamlining Service Delivery and Improving
Customer Service. The Committee directs the Secretary of Veterans
Affairs to develop standards to improve customer service and incor-
porate the standards into the performance plans required under 31
U.S.C. 1115. The Committee requests a report on the progress the
Secretary has made on this issue within 60 days of enactment of
the Act.
VETERANS BENEFITS ADMINISTRATION (VBA)
COMPENSATION AND PENSIONS
(INCLUDING TRANSFER OF FUNDS)
Appropriation, fiscal year 2021 ................................................. $124,357,226,552
Budget request, fiscal year 2022 ............................................... 137,575,487,000
Committee recommendation, fiscal year 2022 ......................... 137,575,487,000
Change from enacted level ................................................. +13,218,260,000
Change from budget request .............................................. –––
This appropriation provides funds for service-connected com-
pensation payments to an estimated 5,503,550 Veterans, 475,146
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survivors, and 1,281 dependents in fiscal year 2022. In addition,
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pension payments will be funded for an estimated 209,355 Vet-
erans and 147,472 survivors. The average payment per compensa-
tion case for Veterans in fiscal year 2022 is estimated at $20,403
and pension payments are projected at $13,760.
For fiscal year 2023, the bill provides an advance appropriation
of $147,569,474,000.
The appropriation includes authority to transfer funding not to
exceed $20,115,000 in fiscal year 2023 to General Operating Ex-
penses, Veterans Benefits Administration and Information Tech-
nology Systems. These funds are for the administrative expenses of
implementing cost-saving provisions required by the Omnibus
Budget Reconciliation Act of 1990 (P.L. 101–508), the Veterans’
Benefits Act of 1992 (P.L. 102–568), and the Veterans’ Benefits Im-
provements Act of 1994 (P.L. 103–446). These cost-saving provi-
sions include verifying pension income against Internal Revenue
Service and Social Security Administration (SSA) data; establishing
a match with SSA to obtain verification of Social Security numbers;
and applying the VA pension cap for Medicaid-eligible single Vet-
erans and surviving spouses alone in Medicaid-covered nursing
homes. The bill also continues to include language permitting this
appropriation to reimburse such sums as may be earned to the
Medical Care Collections Fund to help defray the operating ex-
penses of individual medical facilities for nursing home care pro-
vided to pensioners.
Financial Hardship and Bankruptcy.—The Committee continues
to support VA programs, such as disability-related benefits, that
seek to address the root causes of Veteran and dependent financial
hardship, which is a known contributory factor to negative out-
comes such as mental health issues, substance use disorder, and
suicide. For example, disability-related benefits not only honor the
service and sacrifice of the veterans who receive them, but also
help to replace lost wages and provide a critical source of economic
well-being.
Performance Measures and Communication Efforts.—The Com-
mittee remains interested in VA’s implementation of performance
measures in response to the findings of the Government Account-
ability Office (GAO) report entitled, ‘‘Better Measures Needed to
Assess Regional Office Performance in Processing Claims’’ (GAO
19–15). The Committee encourages VA to continue to improve re-
gional office communication with Veterans Service Organizations
(VSOs) and congressional caseworkers, including discussions sur-
rounding the feasibility of locating satellite congressional member
offices within VA Medical Centers (VAMCs).
Dependency and Indemnity Compensation.—To address concerns
with the processing of Dependency and Indemnity Compensation
claims where the cause of death is listed as COVID–19, the Com-
mittee directs the Department to provide additional guidance for
survivors on how to request a medical opinion to determine if a
service-connected cause of death exists.
Pro-bono Legal Services.—The Committee recognizes an unmet
need for holistic programs that offer pro-bono legal services to Vet-
erans and their dependents. The Committee acknowledges existing
VA initiatives that guide Veterans during benefit-related inter-
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actions with administrative agencies and believes that public land-
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31
grant university law schools are suited to complement existing
agency efforts in underserved areas.
Disability Claims Backlogs during COVID–19.—The Committee
remains concerned about delays that Veterans experience in the
resolution of pending compensation and pension claims, which have
reportedly worsened during the COVID–19 pandemic. The Com-
mittee urges VA to dedicate sufficient resources and attention to
reducing the claims backlog to ensure that Veterans have timely
access to the benefits they have earned. The Committee continues
to require quarterly reporting on the status of disability claims
backlog and requests that VA provide a report within 90 days of
the enactment of this Act.
READJUSTMENT BENEFITS
Appropriation, fiscal year 2021 ....................................................... $12,578,965,000
Budget request, fiscal year 2022 ..................................................... 14,946,618,000
Committee recommendation, fiscal year 2022 ............................... 14,946,618,000
Change from enacted level ....................................................... +2,367,653,000
Change from budget request .................................................... –––
This appropriation finances the education and training of Vet-
erans and servicemembers through the Post-9/11 GI Bill and the
All-Volunteer Force Educational Assistance Program. Supplemental
education benefits are also provided to certain Veteran members of
the Selected Reserve and are funded through transfers from DOD.
In addition, certain disabled Veterans are provided with vocational
rehabilitation, specially adapted housing grants, and grants for
automobiles with approved adaptive equipment. This account also
finances educational assistance allowances for eligible dependents
of Veterans who died from service-connected causes or have a total
and permanent service-connected disability, as well as dependents
of servicemembers who were captured or are missing in action. Al-
most 80 percent of the funds in the account support the Post-9/11
GI Bill.
For fiscal year 2023, the bill provides $8,906,851,000.
Transition Coordination.—The Committee believes that VA, in
consultation with the Departments of Labor and Defense, should
further coordinate efforts and resources to ensure Veterans have a
successful transition to civilian life. This includes sharing informa-
tion on community resources, including nonprofits and VSOs, that
are available to the Veteran and their family as they depart the
service. The Committee also urges VA to explore options for Vet-
erans to access hands-on job placement services that connect Vet-
erans directly with employers, and encourages VA to look at suc-
cessful state and local programs in this area.
Veteran Awareness of Student Loan Forgiveness.—The Com-
mittee understands that Veterans may have student loans they ac-
quired either prior to enlistment or outside of their GI Bill benefits.
The Committee encourages VA to coordinate with other agencies,
including the Departments of Education and Defense, and increase
efforts to ensure that Veterans are aware of all their student loan
forgiveness options or repayment programs for which they may be
eligible.
GI Bill Comparison Tool.—The Committee emphasizes the im-
portance of providing Veterans with the necessary information to
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make informed decisions when selecting institutions of higher edu-
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cation (IHE). The Committee understands that VA is working to
make available through the GI Bill Comparison Tool, in a search-
able format, the following information: whether an IHE is a minor-
ity serving institution (MSI), a gender-specific institution, or a reli-
giously-affiliated school. The Committee looks forward to the
launch of the updated GI Bill Comparison Tool.
GI Benefits During COVID–19.—Public Law 116–128 and Public
Law 116–140 provided the VA temporary authority until December
21, 2021 to pay education benefits and Monthly Housing Allowance
(MHA) payments to GI Bill students at the resident rate when the
training modalities of programs are converted from in-person to on-
line learning solely due to COVID–19. These laws cover situations
where schools are offering hybrid training (combining online with
resident training) or schools are offering students the option to
choose online training in lieu of physically, in-person training.
While these changes were necessitated due to the recent COVID–
19 pandemic, the Committee is aware that there have been many
benefits to students and institutions in having flexibility in train-
ing modalities (i.e., in person or online training) such as giving
adult students more flexibility to schedule coursework around other
commitments in their lives. The Committee is also aware that in-
dustry and even the VA itself are increasingly using both online
and in-person training modalities to train their employees and
partners. Therefore, the Committee encourages the VA to explore
options to support education benefits and MHA at the resident rate
for approved resident training programs that continue to offer hy-
brid training in a combination of online and in-person modalities
after December 21, 2021.
Technology for Student Veterans.—During the pandemic, remote
learning technology such as computers and routers for internet
were more important than ever for so many veteran students. The
Committee directs the VA to explore options for ensuring all vet-
eran students have access to the technology and connectivity they
need to be successful in school.
Vocational Rehabilitation and Employment.—The Committee
continues to support the work of vocational rehabilitation and em-
ployment programs that provide no-cost, wrap-around support serv-
ices for the Veteran community, including career track and job
readiness programs. These services help participants develop both
job-specific knowledge and abilities, as well as the attitudes, habits,
and behaviors needed to successfully secure and retain employment
and earn family-sustaining wages in occupations that offer opportu-
nities for career progression. Given the impacts of COVID–19 on
employment for Veterans, the services provided by VA’s vocational
rehabilitation and employment programs are especially important.
Student Veterans and Access to Child Care.—The Committee re-
quests a report no later than 120 days after the enactment of this
Act on student veterans who lack access to reliable, affordable, and
quality child care. The report should identify barriers that student
veterans encounter in accessing child care, the number of veterans
who have struggled to find reliable child care, and establish wheth-
er lack of child care has impacted veterans’ ability to complete edu-
cation or training programs. The report should include veterans
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who are in college, university, or a job training program full or part
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time. It also should capture veterans that use family, friend, or
neighbor forms of child care and/or child care centers.
Veterans Benefits Administration, Workforce Development.—The
Committee recognizes that there is an acute need to improve the
coordination of federal efforts around the preparation of our na-
tional security and defense workforce. The Committee recognizes
the success in the small-scale implementation of the Veterans
Technology Education Course and Edith Nourse Rogers STEM
Scholarship and encourages further review to inform potential ex-
pansion of the programs. The Committee directs the VA to partici-
pate and coordinate as essential federal stakeholders with the De-
partment of Defense as it leads efforts to establish a Defense Edu-
cation and Workforce Pipeline Strategy.
Student Housing Assistance.—In light of the VAOIG report in
April of this year documenting how post-9/11 GI Bill Non-college
degree entitlement calculations lead to differences in Housing Al-
lowance Payments, the Committee directs the VA to submit to Con-
gress a report on how VA is working to ensure efficient Housing
Allowance Payments to all students. This report should include any
recommendations for legislative proposals to change the statutory
formula for charging entitlement for the pursuit of programs at
educational institutions other than institutions of higher learning.
Transition assistance grant program.—The transition from mili-
tary to civilian life brings significant challenges, which can be exac-
erbated by difficulties navigating a patchwork of different pro-
grams. The Committee believes that centralized community re-
sources are needed to ensure veterans have a successful transition.
Therefore, the Committee directs VA to work towards timely imple-
mentation of the transition assistance grant program established
by Section 4304 of the Johnny Isakson and David P. Roe, M.D. Vet-
erans Health Care and Benefits Improvement Act of 2020 (P.L.
116–315).
VETERANS INSURANCE AND INDEMNITIES
Appropriation, fiscal year 2021 ......................................................... $131,372,000
Budget request, fiscal year 2022 ....................................................... 136,950,000
Committee Recommendation, fiscal year 2022 ................................ 136,950,000
Change from enacted level ......................................................... +5,578,000
Change from budget request ...................................................... –––
The Veterans Insurance and Indemnities appropriation is made
up of the former appropriations for military and naval insurance,
applicable to World War I Veterans; national service life insurance
(NSLI), applicable to certain World War II Veterans;
servicemember’s indemnities, applicable to Korean Conflict Vet-
erans; and Veterans mortgage life insurance, applicable to individ-
uals who have received a grant for specially adapted housing.
For fiscal year 2023, the bill provides $109,865,000.
The amount provided will enable the Department to transfer
funding to the service-disabled Veterans insurance fund and trans-
fer additional amounts for payments for policies under the Vet-
erans mortgage life insurance program. These policies are identi-
fied under the Veterans Insurance and Indemnities appropriation
since they provide insurance to service-disabled Veterans unable to
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qualify under basic NSLI.
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VETERANS HOUSING BENEFIT PROGRAM FUND PROGRAM ACCOUNT
Limitation on direct
loans for specially Administrative
Program Account adapted housing Expenses
loans
Appropriation, fiscal year 2021 .................................................... ––– ($500,000) $204,400,000
Budget request est., fiscal year 2022 ......................................... ––– (500,000) 229,500,000
Committee recommendation, fiscal year 2022 ............................ ––– (500,000) 229,500,000
Change from enacted level ................................................. ––– ––– +25,100,000
Change from budget request .............................................. ––– ––– –––
The purpose of the home loan guaranty program is to facilitate
the extension of mortgage credit on favorable terms by private
lenders to eligible Veterans. This appropriation provides for all
costs, with the exception of the Native American Veterans housing
loan program, of the Department’s direct and guaranteed loans pro-
grams. The Federal Credit Reform Act of 1990 (P.L. 101–508) re-
quires budgetary resources to be available prior to incurring a di-
rect loan obligation or a loan guaranty commitment. In addition,
the bill requires all administrative expenses of a direct or guaran-
teed loan program to be funded through a program account. Loan
guaranties are made to servicemembers, Veterans, reservists, and
single surviving spouses for the purchase of homes, condominiums,
and manufactured homes and for refinancing loans. The Depart-
ment guarantees part of the total loan, permitting the purchaser
to obtain a mortgage with a competitive interest rate, even without
a down payment if the lender agrees. The Department requires
that a down payment be made for a manufactured home. With a
Department guaranty, the lender is protected against loss, up to
the amount of the guaranty, if the borrower fails to repay the loan.
Home Loan Income Verification.—The Committee understands
that as directed by House Report 116–63, VA has clarified that
nothing in VA statutes or regulations specifically prohibits a Vet-
eran whose income is derived from state-legalized cannabis activi-
ties from obtaining a certificate of eligibility for VA home loan ben-
efits. The Committee is disappointed with VA’s inaction on the di-
rective included in House Report 116–445 and again directs the VA
to improve communication with eligible lending institutions to re-
duce confusion among lenders and borrowers on this matter and to
report to the Committee on progress made no later than 180 days
after the enactment of this Act.
VOCATIONAL REHABILITATION LOANS PROGRAM ACCOUNT
Limitation on direct Administrative
Program Account loans Expenses
Appropriation, fiscal year 2021 .................................................... $33,826 ($2,469,522) $424,272
Budget request, fiscal year 2022 ................................................. 2,838 (1,662,758) 429,467
Committee recommendation, fiscal year 2022 ............................ 2,838 (1,662,758) 429,467
Change from enacted level ................................................. ¥30,988 (¥806,764) +5,195
Change from budget request .............................................. ––– ––– –––
This appropriation covers the subsidy cost of direct loans for vo-
cational rehabilitation of eligible Veterans and includes administra-
tive expenses necessary to carry out the direct loan program. Loans
of up to $1,300 (based on indexed chapter 31 subsistence allowance
rate) are available to service-connected disabled Veterans enrolled
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in vocational rehabilitation programs when the Veteran is tempo-
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rarily in need of additional assistance. Repayment is made in
monthly installments, without interest, through deductions from
future payments of compensation, pension, subsistence allowance,
educational assistance allowance, or retirement pay. Most loans are
repaid in full in less than one year. The Federal Credit Reform Act
of 1990 (P.L. 101–508) requires budgetary resources to be available
prior to incurring a direct loan obligation.
It is estimated that the Department will make 1,570 loans in fis-
cal year 2022, with an average amount of $1,059.
NATIVE AMERICAN VETERAN HOUSING LOAN PROGRAM
Administrative expenses:
Appropriation, fiscal year 2021 ......................................................... $1,186,000
Budget request, fiscal year 2022 ....................................................... 1,186,000
Committee recommendation, fiscal year 2022 ................................. 1,400,000
Change from enacted level ......................................................... +214,000
Change from budget request ...................................................... +214,000
The Native American Veteran Housing Loan Program, as author-
ized by title 38 United States Code, chapter 37, subchapter V, pro-
vides the Secretary with authority to make direct housing loans to
Native American Veterans for the purpose of purchasing, con-
structing, or improving dwellings on trust lands, including Hawai-
ian Home Lands. Native Hawaiians, Alaska Natives, and Native
Americans enroll in the military at higher rates than non-Natives.
These loans are available to purchase, construct, or improve homes
to be occupied as Veterans’ residences.
The Committee includes increased resources in FY 2022 to boost
awareness of the program through improved communication and
outreach to Veterans eligible for a loan under this program.
GENERAL OPERATING EXPENSES, VETERANS BENEFITS
ADMINISTRATION
Appropriation, fiscal year 2021 ......................................................... $3,180,000,000
Budget request, fiscal year 2022 ....................................................... 3,423,000,000
Committee recommendation, fiscal year 2022 ................................. 3,419,400,000
Change from enacted level ......................................................... +239,400,000
Change from budget request ...................................................... ¥3,600,000
The General Operating Expenses, Veterans Benefits Administra-
tion account provides funding for VBA to administer entitlement
programs such as service-connected disability compensation, edu-
cation benefits, and vocational rehabilitation services.
The bill makes available through September 30, 2023, up to ten
percent of these funds.
The Committee provides $3,419,400,000 for the General Oper-
ating Expenses, VBA account, to enable VBA to deliver the benefits
that our Veterans rely on. VBA should prioritize use of these funds
to process claims, including claims related to new Agent Orange
presumptive conditions, and reduce the claims backlog.
Toxic Exposures.—The Committee has long been concerned about
service-connected exposures to toxic substances, such as burn pits,
Agent Orange, PFAS, radiation, and asbestos, among veterans and
the VA’s presumption process. The Committee is very interested in
VA’s research and efforts to confirm new conditions that are associ-
ated with service-related toxic exposures and encourages the De-
partment to establish a consistent, transparent and evidence-based
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framework to be used to expeditiously establish new presumptions
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of service-connection between health conditions and toxic expo-
sures.
Blue Water Navy Vietnam Veterans Health Care Eligibility.—
Since the passage of the Blue Water Navy Vietnam Veterans Act
of 2019, some veterans who were made eligible for VA Health Care
benefits by the law have applied and been denied access to care.
Instead, these veterans have received instructions to submit a
claim for VA disability compensation to become eligible for health
care because of a VA disability rating. The Committee understands
that Blue Water Navy Vietnam veterans, who are not otherwise el-
igible for health care due to disability or income, must undergo a
VBA eligibility confirmation process before gaining access to VA
Health Care. These non-rating requests from VHA to VBA for eligi-
bility confirmation are not prioritized, so veterans may wait indefi-
nitely to confirm their eligibility and be denied access to critical
health care resources during that time. The Committee encourages
the Secretary to consider ways to give these requests pertaining to
VA health care benefits the same priority as VBA rating claims for
disability compensation and pension. Further, the Committee re-
quests a report on how VBA is supporting VHA efforts to enroll
veterans who, like these Blue Water Navy Vietnam veterans, are
eligible for VA health care only through special authority and not
otherwise eligible due to disability rating or income level.
Disability Claims.—The Committee continues to be concerned
about reports of delays that Veterans experience in the resolution
of pending compensation and pension claims. While the Committee
appreciates the focus in attention and resources the Department
has given to this concern, reducing the claims backlog and making
sustainable improvement in the waiting period for claims adjudica-
tion is essential. The Committee urges the Department to prioritize
resources toward providing Veterans with the timely relief and
support they deserve. The funding level is sufficient to continue
programs that support effective management of claims, including
the Veterans Claims Intake Program.
Burn Pits Data Tracking and Reporting.—The Committee is con-
cerned with the lack of data concerning veteran exposure to open
burn pits (burn pits), which may result in chronic health effects.
The Committee believes it is vital for the VA to place a stronger
emphasis on this issue by beginning to properly track cases of ex-
posure. Such an approach will enable VA to learn more about the
hazards veterans are exposed to and to better understand how to
care for and coordinate veterans’ resulting health issues. To date,
there has been no large-scale systematic data collection or mainte-
nance effort focused on the effects of exposure to burn pit emissions
other than the Burn Pits Registry.
The Committee directs the VA to partner with the Department
of Defense, TRICARE, private sector health providers, and the Cen-
ters for Medicare & Medicaid Services (CMS) system to compile a
report to the Committee on Appropriations within 180 days. The
report should address the following: the total number of veterans
who have filed claims for disability compensation related to burn
pits; the demographics of these veterans, including age, sex, and
race; the medical diagnoses of the veterans and the treatment pro-
vided, approved and denied by the Secretary of Veterans Affairs
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and the rationale of the denials; and the locations of the open burn
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pits at which the covered veterans were exposed to toxic airborne
chemicals and fumes. When compiling this Report, the VA is di-
rected to make every attempt possible to track data as far back as
January 1, 1990.
Equitable Relief.—The Committee reiterates that it understands
VA is working to implement new systems and protocols to elimi-
nate instances of administrative error. However, as VA enacts sys-
tem-wide reforms, ending equitable relief for Veterans who were
deemed eligible for benefits in error would place an unfair burden
on Veterans and their families. The Secretary is directed to con-
tinue to grant or extend equitable relief to eligible Veterans ini-
tially deemed eligible in instances of administrative error. Not later
than April 1, 2022, the Secretary shall submit to the Committee a
report containing a statement as to the disposition of each case rec-
ommended to the Secretary for equitable relief under 38 U.S.C 503
during the preceding calendar year.
Military Sexual Trauma (MST) claims.—The Committee wel-
comes the VA’s commitment to specialized MST training for claims
processors and encourages the continued inclusion of MST sur-
vivors in training programs. Because veterans filing claims for dis-
abilities incurred or aggravated by MST may be referred to a third-
party contract provider for the required Compensation and Pension
(C&P) exam, the Committee directs the VA to provide information
to Congress, in the form of a report, related to required, specialized
MST training for both contract and VHA examiners. Further, the
Committee seeks claim outcome data for veterans referred to a
third-party provider as compared to those evaluated by a VHA
medical provider, and requests that this data be provided at the
smallest geographic-level as possible, such as zip code. The Com-
mittee remains concerned that Veterans suffering from a mental
health disorder as a result of sexual trauma during service have
different standards of evidence based on their diagnosis. The Com-
mittee recognizes that evidence in personnel files is rare, no matter
the resulting condition following MST, therefore, the Committee
urges VA to support the extension of the relaxed evidentiary stand-
ard to all those suffering from mental health disorders as a result
of MST. Further, the Committee urges VA to continue to report to
Congress on information relating to claims for disabilities incurred
or aggravated by MST, as provided by section 113 of the Jeff Miller
and Richard Blumenthal Veterans Health Care and Benefits Im-
provement Act of 2016 (P.L. 114–315).
WWII Filipino Veterans Equity Compensation Fund.—The Com-
mittee understands the unique challenges for WWII Filipino vet-
erans and their families to verify eligibility for the WWII Filipino
Veterans Equity Compensation Fund. Although the VA has con-
ducted outreach efforts, many WWII veterans and their families
may live without adequate records or the means to communicate
their eligibility for this program. The Committee directs the De-
partment to provide a report no later than 180 days after the en-
actment of this Act on (1) the estimated number of remaining
WWII Filipino veterans; (2) outreach barriers and documentation
challenges facing WWII Filipino veterans and how the VA at-
tempted to overcome these challenges; and (3) the feasibility and
costs of options for extending the time limit for accepting initial
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and revised claims for the program.
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VETERANS HEALTH ADMINISTRATION (VHA)
The Department operates the largest Federal medical care deliv-
ery system in the country, with 146 hospitals, 120 residential reha-
bilitation treatment programs, 134 nursing homes, 300 Vet Cen-
ters, 83 Mobile Vet Centers, and 783 Community-Based outpatient
Clinics (CBOCs). Approximately 7,100,000 patients will be treated
in fiscal year 2022.
The Veterans Health Administration budget comprises five ac-
counts: Medical Services, Medical Community Care, Medical Sup-
port and Compliance, Medical Facilities, and Medical and Pros-
thetic Research. For the first four accounts, which are funded in
advance, the Committee provides an additional $3,369,000,000 for
fiscal year 2022, which is $100,000,000 above the budget request.
In addition, VA will receive an estimated $3,386,000,000 in the
Medical Care Collections Fund in fiscal year 2022. The Administra-
tion has requested total resources for fiscal year 2023 of
$111,287,000,000 in direct appropriations to fund the four advance
appropriations of VHA. The Committee also provides $902,000,000
for Medical and Prosthetic Research.
Veterans Transportation.—The Committee continues to support
the Department’s programs to provide Veterans across the country
with transportation to VA medical facilities, making it easier for
rural and disabled and impaired Veterans to receive medical care.
The Committee directs the Department to allocate robust funding
for these programs, including the Veterans Transportation Pro-
gram and the Volunteer Transportation Network, so that they can
continue to expand access to VA services for Veterans across the
country.
Dispute Resolution.—The Committee urges VA to ensure that
veterans are clearly advised of their rights to contest VA billing
charges and determinations and of the step-by-step process for dis-
puting billing charges. VA is further urged to ensure this informa-
tion is available in publicly accessible areas at each VA medical
center.
MEDICAL SERVICES
Appropriation, fiscal year 2021 ......................................................... $56,655,483,000
Budget request, fiscal year 2022 ....................................................... 58,897,219,000
Committee recommendation, fiscal year 2022 ................................. 58,997,219,000
Change from enacted level ......................................................... +2,341,736,000
Change from budget request ...................................................... +100,000,000
The bill includes an additional $100 million for Medical Services
in fiscal year 2022 as well as $70,323,116,000 for advance fiscal
year 2023 funding. The Committee has included bill language to
make $1,500,000,000 of the Medical Services advance appropriation
for fiscal year 2023 available through September 30, 2024.
Of the funds provided for fiscal year 2022, a total of
$13,179,171,000 is for mental health; a total of $2,154,450,000 in
base funding is provided for homelessness initiatives, in addition to
the $486,000,000 made available by the American Rescue Plan; a
total of $307,455,000 is for rural health; a total of $778,500,000 is
for gender-specific care for women; a total of $83,600,000 is for
Whole Health initiatives, which is $10,000,000 above the budget re-
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quest; a total of $598,997,000 is provided for suicide prevention ef-
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forts; and a total of $621,334,000 is provided for opioid prevention
and treatment.
Changes in Funding Requirements Due to Modeling.—The Com-
mittee expects VA to continue to include in the sufficiency letter re-
quired by section 117(d) of title 38, United States Code, which is
due to the Congress on July 31 of each year, a description of any
changes exceeding $250,000,000 in funding requirements for the
Medical Services account resulting from the spring recalculation of
the Enrollee Healthcare Projection Model.
Caregivers Program.—The caregivers program provides an un-
precedented level of benefits to families with Veterans seriously in-
jured in the line of duty. These benefits include stipends paid di-
rectly to the family caregiver, enrollment for the family member in
the VA Civilian Health and Medical Program (CHAMPVA), an ex-
panded respite benefit, and mental health treatment. The Com-
mittee provides the request level of $1,353,133,000 for the care-
givers program. The Committee also continues the requirement
from the fiscal year 2018 on quarterly reporting on obligations for
the caregivers program.
Allocation of Health Funding.—The Committee continues to be
concerned that the process VA uses to allocate the health services
appropriation through the Veterans Integrated Service Networks
(VISNs) and from them to the medical centers may shortchange the
ultimate users because of excessive funding retained at head-
quarters or at the VISNs. The Committee continues to request a
report each year, no later than 30 days after VA allocates the med-
ical services appropriation to the VISNs, that identifies: (1) the
amount of general purpose funding that is allocated to each VISN;
(2) the amount of funding that is retained by central headquarters
for specific purposes, with amounts identified for each purpose; and
(3) the amount of funding that is retained by each VISN before al-
locating it to the medical centers, identifying separately the
amounts retained for purposes such as network operations, net-
work initiatives, and emergencies.
MENTAL HEALTH
The Committee provides $13,179,171,000 in base funding for
mental health programs. Of the amounts provided for mental
health programs in fiscal year 2022, $2,340,341,000 shall be used
for suicide prevention and treatment programs. Specifically,
$598,997,000 shall be used for suicide prevention outreach, which
is $286,362,000 above fiscal year 2021. The Committee continues to
direct the Department to focus on efforts to address parking lot sui-
cides and connect Veterans to care. The Department is directed to
provide a report to the Committee, no later than 90 days after en-
actment of this Act, identifying a detailed expenditure plan for all
suicide outreach and treatment programs and how VA is meeting
the Committee’s directives.
The Department should continue to work to improve community
outreach and increase access to care regardless of discharge status
or service history. The Department should also continue to engage
with Veterans Service Organizations (VSOs) to help remove the
stigma that is associated with seeking mental healthcare. Further-
more, VA is directed to remove barriers that affect a Veteran when
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trying to receive mental healthcare and to implement a twenty-first
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century outreach program that incorporates social media and other
electronic means to reach Veterans before they are at a crisis point.
In addition, the Committee directs VA to engage with DOD to
help servicemembers transition from active duty to civilian life to
ensure that mental health needs are addressed throughout the
transition process.
Improving the Veterans Crisis Line (VCL).—The Committee pro-
vides funding to support the VCL at a level of $255,968,000 to meet
the growing demand, and continues to monitor the VCL to ensure
Veterans are receiving appropriate clinical care. To support this
critical care, the Committee instructs the Secretary to ensure that
Federal funding for the VCL is utilized to make any necessary im-
provements to VCL’s operations in order to best meet the needs of
Veterans seeking assistance. This includes, but is not limited to,
ensuring appropriate staffing for call centers and back-up centers,
providing necessary training for VCL staff, and ensuring that staff
are able to appropriately and effectively respond to the needs of
Veterans needing assistance through the VCL.
The Committee maintains bill language requiring the VCL to: (1)
provide to individuals who contact the hotline immediate assist-
ance from a trained professional; and (2) to adhere to all require-
ments of the American Association of Suicidology.
Peer Specialist Program.—The Committee is encouraged by the
success of VA’s Peer Specialist program. By providing connections
to their peers, this program is ensuring Veterans can access mental
health benefits and resources in a supportive context. The Com-
mittee encourages VHA to explore opportunities to add new peers
to support the Substance Use Disorder programs administered by
OMHSP. The Committee also encourages the Peer Specialist pro-
gram to ensure community-based peer mentoring organizations are
activated to direct candidate Veterans to the VHA’s program, and
encourages eliminating barriers to participation for Veterans in law
enforcement and other fields by expanding patient/participant con-
fidentiality where appropriate.
Improving Depression Treatment with Precision Medicine.—The
Committee recognizes that depression is one of the most common
conditions associated with military service and combat exposure.
Further, the risk of suicide increases with this diagnosis and each
time a Veteran tries and fails a medication. The Committee is en-
couraged by ongoing genetic testing research to aid in depression
treatment selection. VHA is encouraged to use pharmacogenomic
tests in the treatment of depression if they have been shown to im-
prove health outcomes of Veterans in clinical trials.
Public-Private Partnerships.—The Committee continues to be
concerned by the alarming number of suicides committed by Vet-
erans each day. While the Committee appreciates the important
work being done by the Department to combat suicide and improve
mental health among Veterans, more can and must be done. The
Committee recommends that the Department continue to seek out
public-private partnerships, in particular with research univer-
sities, teaching hospitals, and other partners, to expand upon its
existing efforts related to suicide prevention, PTSD, traumatic
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brain injury (TBI), and substance use disorders. Of the funds pro-
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vided for mental health programs in fiscal year 2022, up to
$5,000,000 is included for expansion of public-private partnerships.
Law Enforcement Liaison.—The Committee appreciates VHA’s
past efforts in working to educate the law enforcement community
regarding the unique issues facing Veterans, especially those re-
turning from combat operations. Such education is invaluable in
cases where Veterans are determined to be an immediate threat to
themselves or others. In such instances, it is imperative that the
Veteran’s needs be addressed in an expeditious, humane, and re-
spectful manner.
Non-Citizen Veteran Outreach.—The Committee is concerned
about the level of awareness regarding mental health services by
at-risk, non-citizen Veterans. The Committee therefore urges VA to
conduct more aggressive outreach targeting this group of Veterans
to offer mental health and other early intervention services, drug
and alcohol services, and mental health counseling.
Adverse Childhood Experiences (ACEs).—ACEs exist within the
Veteran population at a substantially higher rate than the general
public. These experiences correlate with significant negative health
outcomes, including on behavioral, mental, and physical health.
The Committee encourages VA to track ACEs among Veterans and
target individualized treatment. To ensure appropriate treatment
from the moment a Veteran enters VA, it is critical that VA coordi-
nate with DOD to obtain information on ACEs from
servicemembers and provide a seamless transition in care.
Agritherapy.—An increasing number of states now have pro-
grams that assist Veterans in starting farms, and many Veterans
turning to farming suffer from PTSD. The benefits of agritherapy
have been reported in the news media; however, limited research
and insufficient opportunities exist to offer the benefits of
agritherapy to those suffering from PTSD. VA is encouraged to
work with the Department of Agriculture on providing agritherapy
programs to Veterans. Additionally, the Committee supports a pilot
program to train Veterans in agricultural vocations, including
urban and vertical farming, while also tending to behavioral and
mental health needs with behavioral healthcare services and treat-
ments from licensed providers at no fewer than three locations.
Military Sexual Assault.—The Committee continues to be aware
of the high prevalence of sexual assault, among both men and
women, during their service. Effects from this assault persist once
servicemembers return home and can manifest in mental health
disorders such as depression, PTSD, SUDs, eating disorders, and
anxiety. Because sexual trauma is so prevalent, the Committee rec-
ommends that all Veterans seeking treatment services are screened
for sexual assault using an evidence-based screening tool in order
to successfully treat those who have experienced assault.
Post-Deployment Rehabilitation and Evaluation Program
(PREP).—The Committee believes that the physical rehabilitation
and mental health needs of our active duty servicemembers and
Veterans is a top priority. The Post-Deployment Rehabilitation and
Evaluation Program (PREP) run by VA is an inpatient initiative
that focuses on an individualized evaluation for servicemembers
and Veterans to treat combat-related physical, cognitive and men-
tal health systems. The Committee believes it is important to ex-
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pand the number of servicemembers and Veterans able to receive
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care through this initiative. The Committee directs VA to include
programmatic information and funding levels for PREP in future
budget requests.
Post-Traumatic Growth Programs.—As the Department con-
tinues to highlight Veterans’ mental healthcare and suicide preven-
tion as a key priority, there is an opportunity to explore effective
alternative treatments focused on the area of post-traumatic
growth. The Committee encourages the Department to continue to
collaborate, partner with and support non-profit post-traumatic
growth organizations and programs.
Post-Traumatic Stress Disorder (PTSD) Service Dogs.—The Com-
mittee recognizes the positive role that service, guide, and hearing
dogs have played in mitigating Veterans’ disabilities and providing
assistance and rehabilitation. The Committee also notes that VA is
currently completing a study to assess the potential therapeutic ef-
fectiveness of service dogs in the treatment of PTSD. The Com-
mittee remains concerned that the report detailing the results and
economic impact of the study has been so long delayed and con-
tinues to require monthly reports on the status of the study until
it is fully completed, beginning 30 days after this report is filed.
The Committee is interested in the possibility of providing service
dogs to Veterans with a mental health mobility disorder related to
post-traumatic stress or traumatic brain injury. VA is urged to use
the results of the study to identify barriers that limit access to
service dogs for Veterans with a mental health mobility disorder
related to post-traumatic stress or traumatic brain injury.
National Center for Post-traumatic Stress Disorder.—Recognizing
the importance of VA’s National Center for PTSD in promoting bet-
ter prevention, diagnoses and treatment of PTSD, the Committee
provides $45,000,000 for the Center.
The Committee supports the Center’s continuing efforts to ensure
that groups of Veterans who are more likely to develop PTSD, such
as African-Americans and Latinos, receive appropriate care and
support, and looks forward to receiving the report requested in
House Report 116–445 on this matter.
The Committee continues to expect VA to provide cultural com-
petency training to healthcare professionals serving Veterans of
color; analyze whether minority Veterans receive quality and cul-
turally appropriate care; ensure the unique mental health needs of
minority Veterans are addressed; and correct any disparities,
whether perceived or real, in care.
The Committee also encourages the Center to explore academic
and interagency collaborations that investigate novel approaches,
such as dietary interventions and non-invasive brain stimulations,
and test new integrative treatments to treat PTSD. The Committee
supports efforts by the Center to expand its partnerships, as appro-
priate, and participate in cooperative efforts that support medium
to large scale trials on promising integrative treatments.
Alternative PTSD Treatments.—The Committee recognizes the
challenges in treating and healing posttraumatic stress disorder
(PTSD), and notes the Comprehensive Addiction and Recovery Act
of 2016 (P.L. 114–198) authorized the Creating Options for Vet-
erans Expedited Recovery (COVER) Commission, a federal commis-
sion tasked with providing recommendations to the President of the
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United States, the United States Congress, and the Secretary of
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Veterans Affairs to guarantee our nation’s Veterans receive the
mental health care they need. The Committee directs VA to report
to the Committees on Appropriations of both Houses of Congress
within 90 days of enactment of this Act on its progress on imple-
menting the COVER Commission’s ten recommendations.
Modeling and Simulation Treatment of PTSD.—As a mechanism
to explore treatments for PTSD, the Committee is aware that the
use of modeling and simulation technology has enabled the devel-
opment of innovative and immersive therapies, which can extend
trauma management therapy protocol. The Committee encourages
VA to continue its Trauma Management Therapy study that ex-
plores exposure therapy involving virtual reality in combination
with group therapy for the treatment of individuals with symptoms
relating to PTSD, and requests a report at the conclusion of the
study.
SUICIDE PREVENTION OUTREACH
VetsCorps.—The Committee continues to strongly support the
VetsCorps pilot program and urges that it be fully implemented
without further delay. Although VA has other outreach programs,
a key and unique aspect of VetsCorps is that Veterans themselves,
working with VA, proactively seek out and connect with Veterans
in their communities who have not been served by the Department,
in order to help connect them with available programs and serv-
ices. VA should track Veterans brought into the system through
this outreach. The Committee continues to direct the Department
to provide quarterly reports on the status of the implementation of
the VetsCorps pilot program. Furthermore, at the conclusion of the
pilot, the Committee directs the Department to report to the Com-
mittees on Appropriations of both Houses of Congress on the effec-
tiveness of the pilot program at reaching Veterans, particularly
those in need, and increasing utilization of VA services and evalu-
ate the cost-effectiveness of the program compared to existing out-
reach efforts.
Governor’s and Mayor’s Challenges to Prevent Suicide Among
Service Members, Veterans, and their Families.—The Committee
applauds the work of the Governor’s and Mayor’s Challenges to
Prevent Suicide Among Service Members, Veterans, and their Fam-
ilies. The bill includes sufficient funding to extend this program to
additional States. The Committee additionally urges VA to use up
to $1,000,000 to improve data collection with states to better in-
form suicide prevention activities.
Social Media.—The Committee continues to encourage the De-
partment to investigate using social media platforms to identify
and engage Veterans at risk of suicide and work with academic
partners to develop and test tools for identifying and engaging
these Veterans.
Collaboration on Gun Safety and Storage.—The Committee sup-
ports continued collaboration across public and private sectors to
end the national tragedy of suicide, and encourages VA medical
centers to collaborate with state and local law enforcement and
health officials in states that have adopted extreme risk protection
orders, also known as ‘‘red flag’’ laws, and similar gun safety laws,
to adopt programs and protocols on firearm safety and storage to
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assist Veterans who may be struggling with suicidal thoughts.
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Lethal Means Safety Training.—Data show that individuals who
reduce their access to lethal means during times of heightened risk
are reducing their risk of dying by suicide. The Committee is
pleased that VA has implemented mandatory lethal means safety
trainings for clinical health care providers in VHA facilities. To en-
sure that every employee who regularly interacts with Veterans is
prepared to have a conversation that could save a Veteran’s life,
the Committee urges VA to implement mandatory lethal means
safety trainings for all VHA and VBA employees who regularly
interact with Veterans in their work, compensation and pension ex-
aminers, employees of Veterans Centers and vocational rehabilita-
tion facilities, community care providers, and family caregivers.
Suicide Prevention Coordinators.—The Committee recognizes the
importance of consistent and timely follow-up engagement with
Veterans identified as at-high-risk for suicide. The Committee en-
courages VA to explore the use of real-time, interactive technology
to help Suicide Prevention Coordinators manage and identify op-
portunities to improve performance.
HOMELESS ASSISTANCE
The Committee provides $2,154,450,000 in base funding for VA
homeless assistance programs, an increase of $167,568,000 above
the comparable fiscal year 2021 enacted level and fully funding the
President’s budget request. An estimated $8,247,124,000 is pro-
vided for homeless Veterans treatment costs, an increase of
$247,012,000 above the comparable fiscal year 2021 enacted level.
In addition, $486,000,000 in funds made available by the American
Rescue Plan (P.L. 117–2) will support VA’s homelessness programs
in fiscal year 2022.
Programs to assist homeless Veterans include the Homeless Pro-
viders Grant and Per Diem (GPD), Health Care for Homeless Vet-
erans (HCHV), the Domiciliary Care for Homeless Veterans, the
Supportive Services for Low Income Veterans and Families (SSVF),
Veterans Justice Outreach Homeless Prevention (VJO), and the
Department of Housing and Urban Development-Department of
Veterans Affairs Supported Housing (HUD–VASH) programs,
among others.
Healthcare for Homeless Veterans.—The Committee directs the
Secretary to submit an updated report to the Committees on Ap-
propriations of both Houses of Congress within 90 days of enact-
ment of this Act on the benefits of expanding the Healthcare for
Homeless Veterans Program H–PACT program, to include the ben-
efits of expanding the program, location of additional locations, to
include rural areas, and additional services to improve the pro-
gram.
Ending Veteran Homelessness.—The Committee recognizes the
value and impact of the HUD–VASH program, which serves Vet-
erans experiencing homelessness and pairs each HUD affordable
housing voucher earmarked for Veterans with intensive case man-
agement from VA to assist with benefits and income, mental health
care, recovery services, and permanent housing stability. Case
management services are critically important to the function of the
program, and public housing authorities rely on VA Medical Cen-
ters referrals to house Veterans. Due to the joint nature of HUD–
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VASH funding, the Committee recommends that VA’s budget for
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case managers be increased commensurate with any increases in
HUD’s budget for new vouchers and to account for increased costs
in staffing and recent expansions in eligibility.
HUD–VASH Case Manager Contracting.—The Committee re-
mains concerned that the Department is not properly staffing its
HUD–VASH program to meet the needs of the homeless Veterans
population, which may be contributing to increasing homelessness
nationwide. The Committee directs the Secretary to provide quar-
terly reports on the implementation of Section 4207 of P.L. 116–
315, as related to the contracting of HUD–VASH case manager po-
sitions to local community providers, as well as on the Depart-
ment’s efforts to notify rural areas of the implementation of these
provisions.
Legal Assistance for the SSVF Program.—The Committee notes
that university law schools are willing to work with Veterans on
a pro-bono basis to provide legal assistance. This can result in ad-
ditional benefits such as training law students in Veteran disability
law and legal skills critical to providing advocacy within the VA
system and inspiring next-generation lawyers to serve Veterans in
practice. The Committee encourages the SSVF program to work
with grantees to expand their legal service offerings, particularly in
rural areas where access to private legal assistance can be limited.
Within the funds provided, the Department is encouraged to estab-
lish one or more pilot projects to partner SSVF grantees with uni-
versity law schools in rural areas or within underserved popu-
lations to enhance legal assistance to Veterans.
Shallow Subsidy Initiative.—The Committee encourages VA to
prioritize funding within the SSVF program for the Shallow Sub-
sidy Initiative to expand the number of Veterans served by the pro-
gram, targeting areas with high rental costs and large homeless
Veteran populations.
Homeless Veterans Near the United States-Mexico Border.—The
Committee notes that there may be homeless Veterans living near
the United States-Mexico border who, historically, may not have
been counted in point-in-time homeless surveys. The Committee di-
rects VA to work with HUD to develop strategies and recommenda-
tions for addressing Veteran homelessness near the United States-
Mexico border and to take into account these undercounted Vet-
erans when awarding HUD–VASH vouchers. The Committee ap-
preciates VA’s efforts to implement strategies and make rec-
ommendations to decrease Veteran homelessness on the border,
such as the development of a Homelessness Screening Clinical Re-
minder, data sharing, improving the accuracy of data, and con-
tracting case management in rural areas.
Chronic Homelessness.—The Committee notes that the HUD–
VASH program aims to help Veterans who are homeless and their
families find and sustain permanent housing, and that the HUD–
VASH program prioritizes the ‘‘chronically homeless.’’ However, the
Committee is concerned about the program’s ability to reach Vet-
erans who may not meet the statutory definition under the McKin-
ney-Vento Homeless Assistance Act, but still experience unstable
housing. The Committee directs the Department of Veterans Af-
fairs to provide a report to the Committee no later than 180 days
after enactment of this Act that identifies the number of Veterans
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who meet the program’s definition of ‘‘homelessness,’’ but who do
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not meet the definition of ‘‘chronically homeless’’ due to being
homeless for a duration less than one year or less than four sepa-
rate occasions in the last three years. Further, the Department
should address in its report whether unused HUD–VASH vouchers
are available for use by homeless Veterans who fail to meet the
definition of ‘‘chronically homeless.’’
Supportive Housing for Veterans with Serious Mental Illness.—
The Committee applauds the HUD–VASH program for providing
housing opportunities for Veterans experiencing homelessness and
commends their success in decreasing the rate of homeless Vet-
erans by nearly 50 percent since 2010. The Committee understands
not all Veterans in need fit the traditional definition of homeless
and that Veterans experiencing serious mental illness also experi-
ence difficulties acquiring housing, whether due to a co-occurring
substance use disorder or conditions related to their service, includ-
ing PTSD and TBI. Thus, the Committee encourages VA to build
upon the tangible achievements of the HUD–VASH program and
explore whether a new model of vouchers could provide housing op-
portunities for low-income Veterans experiencing serious mental ill-
ness who seek healthcare services from VA.
STAFFING ISSUES
Staffing Shortages.—The Committee has long recognized the
growing shortage of VHA physicians and medical professionals has
negatively affected the delivery of care for Veterans at VHA med-
ical centers and clinics across the country. VHA facilities have been
forced to provide care with fewer staff than are medically necessary
to properly care for our nation’s Veterans. The Committee looks
forward to the comprehensive report required in the Joint Explana-
tory Statement accompanying the Consolidated Appropriations Act,
2021 (P.L. 116–260) on the Department’s plan to address critical
workforce issues.
Addressing Mental and Behavioral Health Workforce Short-
ages.—The Committee remains concerned about the negative ef-
fects of VHA workforce shortages on the delivery of care for Vet-
erans at VHA medical centers and clinics across the country, par-
ticularly in the areas of mental and behavioral health care. A VA
Office of the Inspector General Report published on September 23,
2020 found severe occupational staffing shortages across 277 occu-
pations in VHA medical centers. Some of the most common facility-
designated severe occupational staffing shortages were in psychi-
atry, psychology, and nurse practitioners focusing on mental health
and substance use disorders. The Committee continues to direct the
Department to prioritize hiring mental health professionals, and
encourages VA to prioritize initiatives to recruit and retain mental
and behavioral health professionals at VHA medical centers and
clinics to ensure Veterans with mental health conditions and sub-
stance use disorders have access to high-quality care.
VA/HHS Taskforce on Health Workforce Shortages.—The Com-
mittee encourages VA to create a taskforce with HHS to explore
ways the agencies can work together to increase the availability of
providers, including in the behavioral health workforce and among
physicians specializing in cancer, spinal cord, and neuropsychiatric
conditions. The taskforce is urged to examine VA’s recruitment
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challenges, review programs that could enhance recruitment and
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retainment, and to think creatively on how other federal agencies
like HHS can identify and address provider shortages. The
taskforce is also encouraged to consult with DOD to explore recruit-
ing those who have left the military.
Medical and Nursing Understaffing.—The Committee recognizes
that understaffing, especially in medical and nursing positions, is
a principal obstacle to timely access to care for Veterans and en-
courages the Department to investigate the use of commercially
available hospital management information technologies to reduce
nursing administrative workloads while simultaneously improving
patient flow and access to care.
ACCESS FOR RURAL VETERANS
Office of Rural Health (ORH).—The bill includes $307,455,000 for
rural health, which is $7,455,000 above the enacted level, to im-
prove access and quality of care for the more than 3,000,000 en-
rolled Veterans residing in rural and highly rural areas. ORH im-
proves access and quality of care for enrolled Veterans residing in
geographically rural areas. In addition to providing healthcare
services, ORH’s important work includes identifying barriers to
healthcare delivery in rural areas and implementing new ways to
deliver healthcare and services to Veterans in these locations.
Office of Rural Health Operating Plan.—The Committee directs
the Office of Rural Health to submit to the Committee no later
than 30 days after enactment of this Act an operating plan for fis-
cal year 2022 funding, as well as for the fiscal year 2023 funding
provided in advance by this Act.
Transportation Challenges.—The Committee recognizes the
transportation challenges and barriers to care that rural and re-
mote Veterans face, and that the Veteran population is dispropor-
tionately both rural and mobility challenged when compared to the
public at large. The Committee directs the Office of Rural Health
to increase efforts to improve transportation mobility for our na-
tion’s Veterans and includes funding to enhance rural access and
transportation services. Additionally, the Committee continues to
encourage VA to look into the feasibility of utilizing accessible au-
tonomous electric vehicles in the future to overcome these chal-
lenges, and requests VA report to the Committee on the bench-
marks and metrics that VA will use to determine feasibility of this
technology.
Rural Transportation Study.—The Committee continues to sup-
port the Office of Rural Health’s rural transportation study by the
Veterans Rural Health Resource Center, Iowa City, Iowa, and re-
quests an interim report to the Committees on Appropriations of
both Houses of Congress regarding initial findings by December 31,
2021.
Rural Veteran Transportation.—The Committee acknowledges
continued progress in addressing transportation barriers for Vet-
erans, especially those in rural or highly rural areas. While the
Committee recognizes the important work of Veteran Service Orga-
nizations (VSOs) and the existence of the Veterans Transportation
Program, a transportation gap still exists for many VA service
areas, especially predominantly exurban and rural ones. The Com-
mittee notes that as new forms of mobility are being developed and
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becoming increasingly available, options like demand-responsive
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microtransit may help improve accessibility for Veterans, and en-
courages the Veterans Transportation Program to explore increased
adoption of this technology.
Lack of Rural Health Providers.—The Committee is aware of a
shortage of medical healthcare providers nationwide, which cor-
responds to persistent issues for VA health facilities in rural areas
in recruiting and retaining health providers in this highly competi-
tive environment. To address the rural health provider gap, the
Committee encourages VA to continue to consider expanded use of
physician assistants, through both physical facilities and expanded
access to telehealth services. The Committee directs VA to submit
a report to the Committees on Appropriations of both Houses of
Congress, no later than 90 days after enactment of this Act pro-
viding an update on VA hiring needs in rural areas and VA plans
to address the provider gap in rural areas. The Committee also di-
rects VA to submit an updated report to the Committees on Appro-
priations of both Houses of Congress providing an analysis of the
hardest-to-reach rural Veterans, the barriers to accessing these
Veterans, and next steps to address the needs of these Veterans,
no later than 120 days after enactment of this Act.
Clinical Resource Hub.—The Committee supports the success of
the Clinical Resource Hub at the Office of Rural Health. This pro-
gram is an innovative model that delivers high-quality health care
services to Veterans in underserved locations. The Committee rec-
ognizes the unique challenges faced by Veterans living in rural
communities who often require access to a suite of health services
across a spectrum of specialty medical professionals. The Com-
mittee also recognizes the impact that expanded access to tele-
health services has had on rural Veterans that live beyond the
reach of critical care services. The Clinical Resource Hub combines
telehealth services with in-person care to bring access within reach
for Veterans across rural America. The Committee will continue
monitoring the progress of this program through the fiscal year.
TELEHEALTH AND CONNECTED CARE
The bill includes $2,585,182,000 for telehealth and connected
care, which includes home telehealth, home telehealth prosthetics,
and clinic-based telehealth.
Telehealth Benefits.—Telehealth services increase Veteran access
to care. The Committee directs VA to continue to expand telehealth
availability to include additional mental health, primary care, and
rehabilitation services as a means to deliver care in rural and un-
derserved communities. Additionally, VA is encouraged to leverage
newly gained telehealth capacity to address backlogs for disability
exams and health care appointments when appropriate.
Telehealth Services.—The Committee directs VA to continue to
implement plans to improve Veteran and provider satisfaction, in-
crease awareness of the telehealth program, and enhance adoption
of telehealth by Veterans and providers. The Department’s plans
should include efforts to make telehealth more accessible to pa-
tients in highly rural areas.
Telehealth Access.—The Committee recognizes and appreciates
the significant improvements made in Telehealth Service by VA in
the past year. These timely improvements were critical in meeting
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the health care needs of our Veterans during the COVID–19 pan-
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demic. As the pandemic travel restrictions are relaxed, the Com-
mittee urges the Department to continue to develop and implement
Telehealth Services with a focus on easing the burdens of rural
Veterans with limited travel options. The Committee encourages
the continued growth of the Accessing Telehealth through Local
Area Stations (ATLAS) program and investment in supportive pe-
ripheral technologies. The Committee also encourages the Depart-
ment to continue to seek partnerships, such as ATLAS sites, to
bridge gaps in access to broadband services that prevent Veterans
in rural and underserved communities from accessing telehealth
resources.
ATLAS Program Implementation.—The Committee commends
VA for being a leader in the adoption of connected care solutions
through its Anywhere-to-Anywhere telehealth initiative, such as
the ATLAS Program. Where deployed, ATLAS offers Veterans the
ability to securely access VA care in purpose-built settings from
easily accessed locations in their home communities. The Com-
mittee urges VA to continue the Department’s Anywhere-to-Any-
where initiative, and directs the Secretary to submit a report to the
Committees on Appropriations of both Houses of Congress, no later
than 180 days after enactment of this Act, that (1) details VA’s
progress on, and timetable for, the expansion of the program, par-
ticularly in rural and tribal areas where in-person healthcare op-
tions are even more limited; and (2) assesses the feasibility, cost,
possible partner locations and advisability of expanding the project
to remote Veteran communities in the Pacific Islands Region by
opening new ATLAS stations in Hawaii, Guam, American Samoa,
the Commonwealth of the Northern Mariana Islands, and the Free-
ly Associated States.
Telehealth Technology and Capabilities.—While the Department
has made considerable advancements in telehealth solutions for pa-
tient Veterans since the onset of the coronavirus pandemic, the
Committee recognizes the further potential in the use of software
as a service (SaaS) and cloud data storage systems. The Committee
encourages the Department to adopt telehealth and remote moni-
toring device systems which utilize such software as a service
model and cloud data delivery with commercial off the shelf solu-
tions which are device agnostic and capable of integrating as many
commercially available patient monitoring devices as possible.
GENDER-SPECIFIC CARE FOR WOMEN
Women are now the fastest growing cohort within the Veteran
community. The number of women Veterans using VHA services
has increased 32 percent in six years from 423,642 women Vet-
erans in 2014 to 560,737 in 2020. The increased number of women
using VHA services necessitates a greater investment of resources
in order to provide and expand VA’s gender-specific services to
women Veterans and ensure women Veterans’ health needs, which
often differ from men, are met. The bill provides $778,500,000 for
gender-specific care for women, which is $117,809,000 above the
fiscal year 2021 enacted level. The bill also includes $104,946,000
for the purpose of expanding programmatic support for women’s
healthcare. The Committee supports continued efforts to identify
and address the unique issues experienced by women veterans. VA
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system and facilities to ensure women receive equitable, timely,
and high-quality healthcare.
VA is directed to provide an expenditure plan no later than 90
days after enactment of this Act, detailing how the funding for gen-
der-specific care and for programmatic support will be spent. Fur-
thermore, the Committee requires quarterly briefings on the ex-
penditure of these funds. The Committee continues to direct the de-
livery of care to women Veterans be through an organized program
within normal business operations of VA. The women’s health pro-
gram is required to have appropriate staffing levels and executive
support that is operationalized to ensure all aspects of care for
women Veterans are available.
Program managers within each VA facility should be equipped,
at a minimum, with at least one designated women’s health pro-
vider, the appropriate number of nurses, administrative support,
care coordinators, and peer navigators. The Committee directs VA
to continue to build on its training initiatives for women’s health
providers and nurses in order to meet the increased demand in
care. VA is further directed to provide greater resources at the field
level to build visible women-specific health programs, including sui-
cide prevention programs, reproductive mental health programs,
and combined pain and opioid use programs. As such, the Com-
mittee requests a report within 90 days of enactment of this Act
on VA’s plans to provide and expand these programs for women.
The Department is further directed to prioritize hiring women
primary care providers and psychologists for women’s clinics using
the Medical Services appropriation. To supplement VA’s recruit-
ment efforts to hire and retain women clinicians at the field and
VISN levels, the Committee directs the Department to deploy a
large national women-specific advertising campaign to appeal to
women Veterans to receive their care at VA facilities and to
women-specific healthcare providers to work at VA.
Additionally, the Committee continues to direct that Women’s
Health Program Managers be full-time jobs and not be tasked with
supplemental responsibilities outside of their specified job descrip-
tions.
The Committee also supports the work of the Office of Women’s
Health at the Veterans Health Administration and directs the De-
partment to invest resources in strategic planning regarding
women Veterans, as required in the Deborah Sampson Act enacted
as part of P.L. 116–315.
Women Providers.—The Committee is encouraged by the Depart-
ment’s recognition of the need to hire additional women’s health
personnel nationally. The desire for women Veterans to seek care
from women providers extends beyond specialties traditionally
dominated by women, such as gynecology and mental health.
Therefore, the Committee encourages the Department to hire
women providers in specialties within the Department with lower
rates of such providers, in order to more accurately represent the
growing number of women Veterans seeking services. In addition,
the Committee is also strongly supportive of efforts by the Depart-
ment to train and hire Women’s Health Primary Care Providers
(WH–PCP). The Department is directed to report to the Commit-
tees on Appropriations of both Houses of Congress within 180 days
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providing care in the Department, the total number of women pro-
viders in each care specialty, and the number of women providers
in each specialty as a percentage of total providers within that re-
spective specialty. In addition, the Department is urged to note
separately for each reporting requirement the number of women
providers hired since September 30, 2020.
Breast Cancer Screening Guidelines.—The Committee commends
VA’s decision to offer breast cancer screening and mammography
to eligible women Veterans beginning at age 40. However, the De-
partment should be prepared to offer screening to eligible younger
women Veterans should a physician determine, or risk factors war-
rant, screening before age 40. The Committee supports this effort
to ensure that the care women Veterans receive is consistent with
the private sector and will continue to monitor the Department’s
implementation of this policy. The Department should closely fol-
low ongoing debate within the scientific community on breast can-
cer screening and mammography coverage to provide Veterans the
best care possible. The recommendation includes bill language to
ensure VA maintains this policy through fiscal year 2024.
Peer Support for Women Veterans.—Peer support programs of-
fered at VA have proven effective in improving health outcomes,
and they continue providing vital support to Veterans across the
nation. The Committee includes funding for VA to hire new quali-
fied peer support specialists to broaden its programs and provide
targeted support for the gender-specific health needs of women Vet-
erans. Additionally, the Committee welcomes the role of the
Women Veterans Network (WoVeN), a national peer support net-
work for women Veterans run by researchers from the National
Center for PTSD—Women’s Health Sciences Division. The research
component of this peer support program will drive innovation in
addressing PTSD in women Veterans. The bill includes $1,000,000
for peer support programs for women Veterans.
Maternity Health Care and Coordination Programs.—The Com-
mittee notes that the United States has the highest maternal mor-
tality rate among high-income countries and significant racial and
ethnic disparities in maternal health outcomes. Some of the causes
of adverse maternal health outcomes can be even more prevalent
in Veterans, such as military sexual trauma, which is linked with
risk factors for pregnancy-related complications. The Committee is
pleased that to coordinate prenatal and postpartum care provided
in the community, VA has established maternity health care and
coordination programs, which have been successful in ensuring
that Veterans can receive high-quality, culturally appropriate care
and robust support during and after pregnancy. The Committee
supports these maternity health care and coordination programs
and encourages VA to continue to ensure Veterans have access to
high-quality, well-coordinated care and robust services to address
social determinants of maternal health, including access to hous-
ing, nutrition, and transportation. The Committee further encour-
ages VA to provide trainings for community maternity care pro-
viders so that nurses, midwives, and physicians caring for pregnant
and postpartum Veterans understand the unique needs of their
Veteran patients, particularly related to mental and behavioral
health conditions that might have been caused or exacerbated by
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Doula Access.—According to studies published by the National
Institutes of Health, expectant mothers who are matched with a
doula have better birth outcomes than those who are not. Doula-
assisted mothers were four times less likely to have a low birth
weight, two times less likely to experience a birth complication in-
volving themselves or their baby, and significantly more likely to
initiate breastfeeding. Additionally, pregnant Veterans have been
found to be disproportionately impacted by mental health dis-
orders, further highlighting the need for maternal support. Recog-
nizing the positive impact that doulas can have on maternal health
outcomes, the Committee strongly urges VA to support the use of
doulas for expectant mothers and explore ways to improve access
to doula support services.
PHARMACY ISSUES
Drug Pricing Report.—Rising drug prices are a significant cost
driver in healthcare. However, VA receives substantial discounts
when purchasing prescription drugs. Common-sense approaches
such as using lower-cost generic drugs, providing care from expert
pharmacists, and making drug companies compete for business can
help drive down the cost of healthcare. The Committee remains in-
terested in information regarding VA drug pricing and appreciates
VA providing a report as requested in Fiscal Years 2020 and 2021
on VA’s spending on prescription drugs. The Committee encourages
VA to conduct this analysis annually and requests robust and rou-
tine updates to Congress. In addition to cost information, the re-
port is suggested to include country of origin information on drugs
and active pharmaceutical ingredients.
At-home Drug Disposal for Veterans.—The Committee is aware
that many unused and unwanted prescription opioids and other
powerful medications remain in homes and are subject to diversion.
This is too often the beginning of a pathway to dependence, addic-
tion, and overdose. Furthermore, medication take-back programs
are proving to be difficult to access for many Americans and inad-
equate to broadly impact disposal behavior. The Committee notes
that newer technologies to deactivate and safely dispose of pre-
scription drugs in the home have been shown through independent
research to lead to improved outcomes. The Committee is pleased
that in response to the direction in House Report 116–445, VA con-
cluded that a pilot program to evaluate the benefits of co-dis-
pensing at-home drug disposal products for post-surgical patients is
both appropriate and feasible. VA is directed to move forward with
this demonstration and evaluation initiative.
Safe Medicine.—The Committee recognizes that the Nation’s in-
creased reliance on foreign-based sources of medicine and active
pharmaceutical ingredients may present a health security risk to
VA as they provide medicine for our Veterans. The Committee con-
tinues to encourage VA to examine potential vulnerabilities and
safety risks VA faces purchasing medicine from off-shore sources,
including supply chain and dependency issues, and encourages VA
to address strategies to buy American and produce medicine do-
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OPIOID SAFETY INITIATIVES AND SUBSTANCE USE DISORDER CARE
The Committee is pleased that VA has taken an aggressive pos-
ture in reducing the volume of opioid prescriptions it dispenses and
is turning to alternative approaches to pain relief, including the
use of complementary medicine tools. The Committee encourages
VA to continue the challenging effort to reduce opioid use among
Veterans, half of whom suffer from chronic pain. The bill includes
$621,334,000 for opioid treatment and prevention efforts, which is
$148,639,000 above fiscal year 2021, and of which $245,666,000 is
provided for activities authorized by the Comprehensive Addiction
and Recovery Act of 2016 (P.L. 114–198). With Veteran opioid ad-
diction numbers outpacing those for the rest of the U.S. population,
and the full effects on the coronavirus global pandemic on Veteran
opioid addition still unknown, this funding will allow VA to reach
more Veterans in need of assistance with their opioid addiction and
lessen the numbers who fall victim to COVID–19. The bill also in-
cludes $155,970,000 for Substance Use Disorder (SUD) efforts to
ensure greater number of Veterans can receive SUD specialty serv-
ices.
Jason Simcakoski Memorial and PROMISE Act Implementa-
tion.—The Committee supports robust funding to facilitate the con-
tinued implementation of the Jason Simcakoski Memorial and
Promise Act, which passed as Title IX of the Comprehensive Addic-
tion and Recovery Act of 2016 (P.L. 114–198), including updating
therapy and pain management guidelines, strengthening provider
education and training, and improving patient advocacy.
Behavioral Health and Substance Use Screening.—The Com-
mittee continues to be aware of the high prevalence of mental ill-
ness and substance abuse among Veterans, particularly PTSD, de-
pression, anxiety, and alcohol and opioid abuse. The Committee
strongly recommends that all Veterans seeking treatment services
in a VA facility be screened for the listed illnesses, at a minimum
annually, using evidence-based assessment tools.
Substance Use Disorders.—The Committee recognizes the ongo-
ing work of VA to reduce substance use disorder among Veterans.
The Committee is aware of the Substance Abuse and Mental
Health Services Administration studies concluding that 90 percent
of people who die by suicide suffer from depression, substance use
disorders, or both. Veterans face unique health challenges and the
suicide rate among Veterans continues to be unacceptable. The
Committee is aware that male Veterans have greater rates of prob-
lematic substance use but that the rates of problematic substance
use among women Veterans is increasing. The Committee supports
new and innovative solutions to intervene early with at-risk Vet-
erans and supports programs that provide Veterans and their fami-
lies with the tools they need to meet these challenges. The Com-
mittee encourages VA to increase education among its primary care
practitioners on the diagnosis and treatment of alcohol use dis-
orders with Federal Drug Administration (FDA)-approved medica-
tion-assisted treatments. Additionally, the Committee recognizes
the importance of programs that utilize harm reduction techniques
and offer confidential education information that can reduce sub-
stance use, relapse, hospital visits and suicide, and therefore in-
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dence-based and confidential internet-based substance abuse edu-
cation, case management, and peer coaching pilot program. The
Committee directs the Department to report to the Committees on
Appropriations of both Houses of Congress within 60 days of enact-
ment of this Act on the efforts made in establishing this program.
WHOLE HEALTH INITIATIVE
Traditionally, Veteran medical providers have focused on the
physical symptoms of Veterans, zeroing in on their diseases and
ailments. However, VA is continuing to work to expand this focus
by incorporating a whole health model of care, which is a holistic
look at the many areas of life that can affect a Veteran’s health,
including their work environment, relationships, diet, sleep pat-
terns, and more. Whole Health is an approach to healthcare that
empowers and enables the Veteran to take charge of their health
and well-being and live their life to the fullest. The Committee is
extremely pleased with the Whole Health model of care and in-
cludes $83,600,000 in the bill, which is $10,000,000 above the re-
quest, to continue to implement and expand Whole Health to all
VA facilities.
Continued Support and Expansion for Whole Health.—Recent
data about the Whole Health System reveals participation in-
creased more than 140 percent between 2017 and 2019, resulting
in a 24 percent drop in total healthcare costs among the partici-
pating Veterans. Additionally, a recent survey found that 97 per-
cent of Veterans are interested in using Whole Health. The Com-
mittee is pleased by this evidence that points to the ability of the
Whole Health System to deliver care efficiently and effectively to
our nation’s Veterans, and urges VA to continue supporting the
program and to expand it further in fiscal year 2022.
Creative Arts Therapies.—The Committee continues to acknowl-
edge the effective use of creative arts therapies and arts and hu-
manities partnerships in treating Veterans with traumatic brain
injuries and psychological health conditions. The Committee sup-
ports the ongoing integration of the arts and creative arts therapies
provided by VA’s Office of Patient Centered Care and Cultural
Transformation through the Whole Health initiative and encour-
ages VA’s continued partnerships with healing arts providers. The
Committee strongly supports the Secretary in continuing to expand
these innovative programs throughout the Veterans Healthcare
Networks, particularly in areas that are serving rural, isolated or
underserved Veteran populations, and includes $5,000,000 to do so.
OTHER HEALTH ISSUES
Veterans Exposed to Open Burn Pits and Airborne Hazards.—In
order to provide full and effective medical care, it is essential for
the Department to better understand the impacts that exposure
during military service has had on the health of Veterans. There-
fore, the Committee continues to support VA’s work through the
Airborne Hazards and Burn Pits Center of Excellence on diagnoses,
mitigation, and treatment of conditions related to airborne hazards
and burn pits, and includes $7,500,000 to carry out responsibilities
and activities of the Airborne Hazards and Burn Pits Center of Ex-
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Burn Pits Center of Excellence Expansion.—The Committee notes
that the VA Research Advisory Committee has recommended the
establishment of Centers of Excellence to facilitate the development
and availability of new treatments in clinical settings. Cost effec-
tive models for rapid development of new treatments for Gulf War
Illness using computational models, research funding through the
Department of Defense’s Congressionally Directed Medical Re-
search Programs, and clinical experts in environmental medicine
have been proven effective in partnership with VA medical centers.
The Committee directs the Secretary to continue activities as de-
scribed in House Report 116–445 to establish and expand a Center
of Excellence focused on toxic environmental exposures, including
investigations of gender-based differences in disease and treatment
to leverage research funding through partnerships.
Neurology Centers of Excellence.—The Committee recognizes the
increasing number of Veterans affected by neurologic conditions,
including but not limited to epilepsy, headache, multiple sclerosis,
and Parkinson’s disease. The Department is directed to signifi-
cantly increase its investment to maintain and expand existing cen-
ters of excellence within VA dedicated to these conditions to en-
hance their value in coordinating innovative clinical care, edu-
cation, and research efforts. No later than 120 days after enact-
ment of this Act, the Committee directs the Secretary to submit a
report to the Committees on Appropriations of both Houses of Con-
gress providing details on opportunities to enhance care for Vet-
erans with neurologic conditions, including potential collaboration
between the neurology centers of excellence.
Epilepsy Centers of Excellence.—The bill includes $10,000,000 to-
ward maintaining and expanding the Epilepsy Centers of Excel-
lence within VA. The Committee directs the Department to provide
an update on the status of these Centers to the Committee no later
than 60 days after enactment of this Act.
Headache Disorders Centers of Excellence.—The Committee rec-
ognizes that chronic headache disorders commonly affect Veterans,
particularly as a result of traumatic brain injuries and other inju-
ries sustained during the Global War on Terror. In fiscal year 2018,
Congress provided VHA with $10,000,000 for the establishment of
at least five Headache Disorders Centers of Excellence (HCoEs),
and VHA currently maintains 14 active HCoE sites. To ensure eq-
uitable access to specialized Headache Medicine services for all
Veterans that seek them, the bill includes $20,000,000 for contin-
ued support of the active sites, as well as expansion of the HCoE
system to include a total of at least 28 sites nationally. These sites
will provide equitable access to specialty consultation, direct health
care delivery, education of VHA health care providers, and research
to improve the care and clinical outcomes of Veterans. Further, the
Committee expects VHA to provide sustained support for the HCoE
system to ensure the successful recruitment and retention of health
care providers with specialty training in Headache Medicine.
Central Alabama Veterans Health Care System (CAVHCS).—The
Committee calls the Department’s attention to the urgent need to
improve the care provided at and the management of CAVHCS.
The Department is directed to immediately and fully correct defi-
ciencies and problems at CAVHCS and ensure VA Southeast Net-
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to the system. The Committee directs the Department to develop
a plan to resolve these problems and to fill vacancies of permanent
leadership and senior member staff and to submit quarterly reports
describing implementation of the plan, including current status of
hiring permanent leadership and senior member staff. The Com-
mittee strongly urges the Department to fully utilize every incen-
tive, bonus, or other measures to hire and retain permanent med-
ical staff to provide quality care for Veterans in Central Alabama.
The Committee directs the Department to issue a report, no later
than 60 days after enactment of this Act, on all levels of permanent
staffing at CAVHCS along with vacancies and efforts that are
being made to fill those vacancies.
Nuclear Medicine Quality Improvements.—The Committee under-
stands that the Nuclear Regulatory Commission and Centers for
Medicare and Medicaid Services are considering regulatory actions
to improve nuclear medicine injection quality. The Committee con-
tinues to encourage VA to monitor injection quality, as well as
image extravasations and perform dosimetry and notify patients
when they occur, and urges the Department to adopt any new reg-
ulatory requirements.
Hospital-Acquired Pressure Ulcers and Pressure Injuries.—The
Committee understands that Veterans treated at VA hospitals are
more vulnerable to pressure injuries and commends VA for the
March 2019 guidance (VHA Directive 1352) on Prevention and
Management of Pressure Injuries. The Committee urges VA to up-
date VHA Directive 1352 to follow the 2019 International Guide-
lines for the Prevention and Treatment of Pressure Injuries as VA’s
standard of care that was led and co-published by the US National
Pressure Injury Advisory Panel. Furthermore, the Committee di-
rects VHA to report to the Committees on Appropriations of both
Houses of Congress within 120 days of enactment of this Act with
a timeline to implement the Standardized Pressure Injury Preven-
tion Protocol (SPIPP) Checklist to improve pressure injury preven-
tion and support the development of best practices through the
VHA medical system.
Nutrition and Food Services.—The Committee recognizes the
value of proper nutrition and food’s impact on one’s health and re-
mains concerned regarding the nutritional health and well-being of
Veterans. Patients with three or more chronic conditions represent
35 percent of Veterans receiving VA care and account for 65 per-
cent of VHA costs. Acknowledging the correlation between obesity
and co-occurring chronic conditions, such as diabetes, the Com-
mittee directed in House Report 116–445 that VA provide a report
on Veterans’ nutritional habits. The Committee expects this report
to be completed in a timely manner, and urges that it reflect the
experiences of a range of individuals from various demographics of
age, gender, and with varying health conditions. Furthermore, the
Committee continues to urge VA to be proactive in promoting
wellness and disease prevention by providing evidence-based nutri-
tional guidelines for Veterans and their caretakers.
Produce Prescription Pilot Program.—The Committee is con-
cerned with food insecurity among the Veteran population and rec-
ognizes the role of access to healthy produce in managing chronic
disease and reducing health care utilization. The Committee is fur-
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that allow medical providers to prescribe fresh fruits and vegeta-
bles to individuals or households who are at-risk due to health sta-
tus or income, often pairing these prescriptions with financial in-
centives or nutrition education resources. The Committee under-
stands that VA has demonstrated interest in supporting efforts to
provide produce prescriptions to Veterans in partnership with com-
munity-based organizations and/or government entities with dem-
onstrated experience and expertise, and provides up to $2,000,000
for VA to provide guidance and resources for VA facilities to de-
velop local programs and pursue strategies for patient education
and outreach.
Long-Term Care.—The Committee notes the aging of the Veteran
population and supports long-term care that focuses on facilitating
Veteran independence, enhancing quality of life, and supporting
the family members of Veterans.
Long-Term Care Facilities for Spinal Cord Injuries and Dis-
orders.—The Committee is concerned with the lack of long-term
care options for Veterans with spinal cord injuries and disorders
(SCI/D), as well as with the uneven geographic distribution of these
facilities. Currently, the Department operates six facilities, with
only one located west of the Mississippi River. While the Com-
mittee understands that the development, design, and funding
processes for SCI/D long-term care facilities has extensive time-
frames, projects that would address the geographic distribution
have not been properly included in long-term planning documents.
The Committee directs the Department to provide a report to the
Committees on Appropriations of both Houses of Congress within
120 days of enactment of this Act on the strategy to address long-
term care needs for Veterans with SCI/D that address the geo-
graphic imbalance of current facilities.
Expanded Access to Noninstitutional Long Term and Extended
Care.—The Committee is aware that Veterans prefer to receive
long-term and extended care services in their local communities.
The Committee encourages VA to increase the number of local VA
Medical Center partnerships with Programs of All-Inclusive Care
(PACE). For Veterans at high risk of nursing home placement,
such collaborations will enable them to continue living safely in
their homes and enjoy improved quality of life, heightened inde-
pendence, and increased support for their family caregivers. Addi-
tional PACE–VAMC partnerships will provide better outcomes and
higher quality of care for Veterans, while reducing costs by pre-
venting or delaying nursing home placement. For these reasons,
the Committee urges the Department to ascertain if its eligibility
criteria for PACE should be expanded to facilitate serving more
Veterans with this proven model of care.
Medical School Affiliations.—The Committee continues to be
pleased with VA’s improvements to its academic affiliation activi-
ties with minority medical schools. As such, VA is urged to expand
collaboration with minority medical schools in order to enhance
medical training initiatives, improve patient care, and provide edu-
cational opportunities for our nation’s Veterans. The Committee
also urges the Veterans Health Administration and Office of Aca-
demic Affiliations to maintain this ongoing commitment to minority
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Committees on Appropriations of both Houses of Congress within
90 days of enactment of this Act on the progress of these efforts.
Minority Veteran Care.—The Committee notes that the Veteran
population is becoming increasingly diverse and that according to
VA’s Center for Minority Veterans, more than one third of Vet-
erans will come from minority groups by the year 2040. The Com-
mittee supports the Office of Health Equity’s efforts to address
health disparities among Veterans and directs VA to provide ade-
quate resources to make sure that VA can provide high quality
medical care to all groups of Veterans. The Committee remains
concerned with not only ongoing healthcare disparities between
Veterans of varying ethnicities, but also VA’s difficulties in report-
ing on these disparities. The Committee acknowledges that the De-
partment currently has a working group which has the goal of de-
veloping streamlined data collection processes. The Committee
looks forward to the report directed in House Report 116–445 on
how VA can restructure its data collection practices to more accu-
rately and consistently capture data on the race and ethnicity of
Veterans across its various systems. Additionally, the Committee
directs VA to submit a report to the Committees on Appropriations
of both Houses of Congress within 180 days of enactment of this
Act on the costs, feasibility and advisability of regularly collecting
racial data for all major benefits programs and disaggregating the
data by ethnic categories as defined by the Office of Management
and Budget Race and Ethnic Standards for Federal Statistics and
Administrative Reporting.
Dialysis Services.—The Committee understands that VA has a
long history of providing dialysis services through community di-
alysis providers under the Nationwide Dialysis Services contracts
when VA is unable to directly provide such care. The Committee
expects that VA will ensure that care is not disrupted or dimin-
ished for the Veterans who receive treatment through experienced
providers under the Nationwide Dialysis Services contracts.
Reducing Airborne Infections.—The Committee recognizes that
airborne bacteria and viruses remain a significant source of
healthcare-associated infections at health care facilities. Although
High Efficiency Particulate Air (HEPA) filters are widely used to
filter the air, airborne transmission still accounts for a significant
portion of health care-associated infections. The Committee appre-
ciates that VA is undertaking a review of its air filtration stand-
ards as a result of the coronavirus pandemic, which has increased
the urgency of addressing airborne contaminants, and directs VA
to provide a report to the Committee with the results of the review
no later than 60 days after this review is completed. In House Re-
port 116–445, the Committee directed VA to initiate a pilot pro-
gram of new commercial, off-the-shelf technology that has the po-
tential to capture and destroy airborne contaminants, and reiter-
ates that this pilot should be carried out expeditiously to ensure
that facilities are not using outdated technology and putting Vet-
erans at risk.
Negative Air Room Containment Systems for Pandemic and
Surge Capabilities.—The Committee expresses concern about the
scalability and surge capacity of negative room containment sys-
tems. The Department is directed to explore options for portable
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spond to surge capacity during pandemics and other medical events
at Veterans installations.
Creutzfeldt-Jakob Disease Monitoring.—Veterans and their de-
pendents who resided at United States military installations in
Germany, Belgium, and the Netherlands for six months or more
from 1980 through 1990, and Veterans and their dependents who
resided at United States military installations in Greece, Turkey,
Spain, Portugal, and Italy for six months or more from 1980
through 1996 are barred from donating blood due to their potential
exposure during their military service to beef that was infected
with bovine spongiform encephalopathy, resulting in possible infec-
tion of Creutzfeldt-Jakob Disease (CJD), a human prion disease.
The Committee is committed to understanding the residual impacts
of CJD within the Veteran community. The Committee continues
to urge the Department to reference data from existing medical
records of Veterans to determine the percentage of Veterans from
the above referenced subgroup that have more frequent or unex-
plained symptoms associated with CJD compared to the civilian
population. This body of data could be helpful in clarifying the ex-
tent and specifics of the medical issues suffered by Veterans from
exposure to CJD.
Molecular Diagnostics for All Cancers.—The Committee believes
that every Veteran with cancer deserves the highest quality and
most medically advanced diagnosis and treatment available, given
their heightened exposure to hazards during their service that may
be associated with an increased risk of cancer. Molecular
diagnostics and precision oncology, performed at the first occur-
rence of cancer, can provide vital information regarding the specific
tumor type and its drivers, which can lead to the most accurate
precision medicine for patients. The Committee commends the De-
partment’s Precision Oncology Program and includes up to
$15,000,000 to accelerate the adoption of molecular diagnostics for
numerous cancers, which includes rare cancers. VA is encouraged
to provide information to clinicians on the value of using molecular
diagnostics to cancer patients and on how to contribute tissue
specimens to a repository started among the Department, Depart-
ment of Defense and NIH. The Committee further directs the De-
partment to issue a report no later than 60 days after the enact-
ment of this Act describing how these funds will be used to en-
hance the use of molecular diagnostics, including information on
the use of specific types of molecular diagnostics, such as
microarray, whole exome, whole genome, and RNA Seq.
Innovative Technological Solutions for Injured Veterans.—The
Department is encouraged to ensure injured Veterans are inte-
grated into product development teams so that adaptive tech-
nologies are effectively tailored to meet the needs of these Vet-
erans.
Oral Contraceptives.—Given the potential advantages for pa-
tients in receiving a full year’s supply of hormonal contraceptive
products at once, and the findings of the 2019 study, ‘‘Financial Im-
plications of 12–Month Dispensing of Oral Contraceptive Pills in
the Veterans Affairs Health Care System’’, published in JAMA In-
ternal Medicine, the Committee urges the Department to encourage
prescribers to proactively offer patients the option to receive a full
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year’s supply, when medically appropriate. The Committee re-
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quests a report within 90 days of enactment of this Act on how VA
is implementing this option for all Veterans with hormonal contra-
ceptive prescriptions and efforts to ensure patients are notified of
that option.
Intimate Partner Violence Program.—The Committee continues
to support VA’s efforts to expand its Intimate Partner Violence Pro-
gram, which provides a holistic approach that involves under-
standing, recognizing and responding to the effects of all types of
trauma, with the ultimate goals to end violence, prevent further vi-
olence, and promote healthy relationships.
Adaptive Sports.—The bill provides $27,048,000 for National Vet-
erans Sports Programs, including $16,000,000 for adaptive sports
programs, and recommends that the Department use no less than
$1,500,000 of funding provided for the adaptive sports program for
equine therapy. Additionally, the Committee understands that VA
is currently conducting a study that will inform opportunities to
further expand and integrate recreation therapy and creative arts
therapy across inpatient rehabilitation settings, outpatient clinics,
and in Veterans’ home communities, and looks forward to the re-
sults of this study. The Committee recognizes the significant im-
provements that adaptive sports and recreational therapy have on
Veterans’ mental and physical health, as well as the efforts of com-
munity providers, especially in rural areas, who have been able to
use this key program to successfully reintegrate Veterans back into
their communities. The Committee acknowledges that community
providers of adaptive sports grants spend considerable time and ef-
fort in planning and implementing their Veteran service programs.
Vet Centers.—The Committee recognizes the importance of Vet
Centers and the role they play in helping Veterans readjust to ci-
vilian life. The Committee encourages VA to work with local stake-
holders to increase access to the readjustment counseling services
provided by Vet Centers, Mobile Vet Centers, Outstations, and
Community Access Points, and directs the Department to increase
outreach to Veterans so they are aware of these counseling centers
and services.
Assisted Reproductive Services.—The Committee considers the
limitations of VA’s current policy for providing assisted reproduc-
tive services to be completely unacceptable. Such services include
in vitro fertilization (IVF) treatment for Veterans who have sus-
tained serious or severe illness and/or injury while on active duty
that led to the loss of their natural procreative ability. It is out-
rageous that VA infertility services are denied to a growing number
of Veterans due to marital status, and it is similarly unacceptable
that Veterans who cannot use their own genetic material or carry
their own child to term are being discriminated against with the
current barriers to coverage for donated gametes and gestational
surrogacy. The Committee finds the current reproductive services
policy to be discriminatory, unjust, and antiquated. The Committee
directs VA to submit a report within 180 days of enactment of this
Act with a recommendation for a new policy that is non-discrimina-
tory and equitable. The Committee notes that Veterans have dif-
ferent needs than active duty servicemembers, and it is imperative
that VA be able to create a unique policy that benefits the popu-
lation it serves. Additionally, the Committee is concerned by the in-
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equities presented when VA must maintain different sets of eligi-
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bility standards for different types of reproductive services, such as
intrauterine insemination or in vitro fertilization. VA should de-
velop a policy recommendation for providing assisted reproductive
services that does not discriminate against women who cannot
carry their own child to term, couples who need the use of donated
gametes to conceive, and couples who would otherwise be ineligible
under the existing policy, including same-sex couples.
Fertility Treatment Data.—The Committee remains concerned by
the Department’s challenges in tracking how many Veterans have
been able to access fertility treatment or have been denied these
benefits. The Committee looks forward to the report required in the
Joint Explanatory Statement accompanying the Consolidated Ap-
propriations Act, 2021 (P.L. 116–260) detailing the number of Vet-
erans and spouses who have received fertility treatment, and those
who are ineligible, and directs VA to provide this report annually.
Additionally, future reports should include information on partners
of Veterans who have received fertility treatment or counseling, as
well as information on Veterans who are denied these benefits as
a result of their infertility not having been determined to be serv-
ice-connected. The Department is further urged to develop a system
for better understanding the population of Veterans who are denied
or determined to be ineligible for these benefits, as the Committee
understands they currently may not be properly captured in data
systems.
Adoption Reimbursement and Assisted Reproductive Services.—
The Committee directs VA to provide a report to the Committees
on Appropriations of both Houses of Congress within 90 days of en-
actment of this Act on the Department’s outreach and education ac-
tivities to make Veterans aware of the adoption reimbursement
and assisted reproductive services benefits available to them under
Sec. 234 of P.L. 116–260 and in previous Acts. The Committee is
concerned that many Veterans who could benefit from these op-
tions may not be aware of the full range of services available to
them, and urges the Department to increase its efforts to ensure
Veterans are informed about these services, including during ear-
lier medical visits.
Medication Optimization for Veterans.—The Committee recog-
nizes that many Veterans have at least one gene variant that im-
pacts medication efficacy or safety and that over half of Veterans
are prescribed at least one drug where pharmacogenomic informa-
tion would be critical to drug or dose selection to prevent patient
harm. Those taking several medications are at the highest risk of
negative drug-gene and drug-drug interactions leading to adverse
drug events (ADEs), including death. Training health care profes-
sionals on the use of pharmacogenomic testing, analysis, alerting,
and entry into electronic health records are essential parts of preci-
sion medicine and can save Veterans’ lives, improve outcomes and
lower expenditures. Therefore, the bill includes $5,000,000 for the
Department to continue to expand the use of clinically validated,
evidence-based pharmacogenomic analysis, testing and clinical de-
cision support tools to assess Veterans, especially polypharmacy pa-
tients, and those at higher risk for ADEs.
Acute Post-Surgical Pain Management.—The Committee recog-
nizes the notable reduction in prescription opioids for Veterans who
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utilize the VA health care system. The Committee credits this to
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VA’s focus on transforming chronic pain management with alter-
native therapies and an aggressive educational effort on safe and
responsible use of prescription opioids. One further area of oppor-
tunity is the need to balance acute pain management and opioid
use post-surgery. The Committee is aware that some non-opioid op-
tions may not be a good option for Veterans with liver problems
and others may be more effective for post-surgical acute pain man-
agement. The Committee recognizes that Enhanced Recovery After
Surgery (ERAS) refers to evidence-based protocols that standardize
care to minimize pain, reduce opioid administration, expedite pa-
tient recovery, decrease perioperative complications and shorten
hospital length of stay. The Committee encourages VA to broadly
adopt ERAS protocols and ensure that frontline clinicians have full
access to a range of post-surgical pain management tools.
Commercially Available Pain Management Review.—While chiro-
practic care is authorized for use for Veterans Health Administra-
tion enrollees with a referral, the Committee notes that Veterans
with chronic pain and severe disabilities, including Veterans with
spinal cord injuries and traumatic brain injuries, may seek other
pain management care outside of the services offered by the De-
partment. The Committee encourages the Department to conduct
reviews of commercially available options for pain management not
currently authorized for use by enrollees.
Continuous Glucose Monitors.—The Committee understands that
Veterans are three times more likely than non-Veterans to have di-
abetes, which, if untreated, may lead to higher risk of heart dis-
ease, kidney failure, limb amputations, and blindness. The Com-
mittee is encouraged by innovations in diabetes treatment options,
including recent technological advancements to continuous glucose
monitoring systems (CGMs) and appreciates the Department’s deci-
sion to facilitate access to CGMs during the public health emer-
gency by suspending certain coverage criteria. The Committee re-
quests that the Secretary provide a report to the Committees on
Appropriations of both Houses of Congress detailing VA’s coverage
criteria as it relates to frequency of blood glucose testing, including
the clinical rationale for these criteria, no later than 90 days after
enactment of this Act.
Diabetes Care Management.—The Committee directs the Vet-
erans Health Administration and the Center for Care and Payment
Innovation to explore the utilization of episode-based alternative
payment models for chronic care management, to include diabetes
and digital diabetes care management.
Focused Ultrasound Technology.—The Committee supports the
development and adoption of innovative technologies that provide
less invasive treatment alternatives, reduce complications and
other adverse side effects, and lower healthcare costs. The Com-
mittee encourages VA to explore the use of focused ultrasound
technologies for use in cancer, neurological, and women’s health in-
dications, which may give Veterans access to non-invasive treat-
ments for conditions that often have higher incidence rates in the
Veterans’ population like prostate cancer and Parkinson’s disease.
Infertility and Sexual Assault.—The Committee expresses con-
cern with the high incidence of infertility among Veterans, particu-
larly in those who experienced sexual assault or harassment during
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their service. The Committee urges the Veterans Health Adminis-
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tration to conduct trainings among their infertility specialists on
the specific needs of this population and requests a report to the
Committees on Appropriations of both Houses of Congress within
180 days of the enactment of this Act on how VA is implementing
medically-informed best practices for these health care providers.
Reducing Blood Contamination.—The Committee is aware that
blood culture contamination leads to enormous clinical implica-
tions, laboratory ramifications, and economic costs. The Committee
directs VA to prioritize the development and implementation of a
specific quality measure for blood contamination based on a rec-
ommendation of less than 1% blood culture contamination rate
within 6 months of enactment. VA is directed to report to the Com-
mittees on Appropriations of both Houses of Congress within 180
days of the enactment of this Act detailing the implementation of
this standard of care across the VA medical system.
Diabetic Foot Ulcers.—The Committee recognizes that expanding
access to remote patient diabetes monitoring provides more oppor-
tunities for continual Veteran monitoring, improving care outcomes
at a lower cost than traditional methods and without the need for
in-person encounters. The Committee supports the Department’s
Initiative to End Diabetic Limb Loss, which uses remote tempera-
ture monitoring in early detection of diabetic foot ulcers, preventing
the need for amputations and other costly and life altering proce-
dures. The Committee supports the Department’s current expan-
sion and evaluation of its remote patient remote monitoring pilot
program, and urges that it be expanded to additional VISNs and
greater numbers of Veterans at high risk of amputation as soon as
is feasible. The Committee further directs the Department to pro-
vide a report to the Committee on Appropriations of both Houses
of Congress within 60 days after the conclusion of the pilot detail-
ing the amputation rate of Veterans participating in the pilot pro-
gram as compared to non-participating Veterans.
Bladder Cancer Testing.—The Committee recognizes that cancer
is the second most common cause of death in Veterans, and bladder
cancer is the fourth most common cancer among the Department’s
patient population. VA performs roughly 40,000 cystoscopies annu-
ally and diagnoses approximately 3,100 new cases of bladder cancer
each year. In the wake of the COVID–19 pandemic, new cancer di-
agnoses and testing has decreased significantly. The Committee is
pleased the Department has taken an aggressive posture in reduc-
ing bladder cancer through the Cooperative Studies Program 2022,
Screening Asymptomatic Veterans for Bladder Cancer Early Detec-
tion (SAVE). The Committee acknowledges that an increase in non-
invasive testing may decrease the burden of surveillance and long-
term management, and is encouraged by technological develop-
ments, such as non-invasive diaper inserts that monitor moisture
and test urine content. The Committee directs VA to increase ac-
cess to at-home, non-invasive diagnostic, and surveillance testing
for bladder cancer to reduce burdens on Veterans, improve early
detection and maximize healthcare outcomes for Veterans.
Safe Syringes for VA Health Workers.—The Committee recog-
nizes the importance of safety for VA health workers providing vac-
cines to Veterans, particularly in light of the COVID–19 vaccina-
tion effort. The Committee is concerned about the risks that incon-
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sistencies in standards of procured syringes present to VA
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healthcare staff who deliver intravenous medicines and vaccines
and requests a report to the Committees on Appropriations of both
Houses of Congress within 90 days of enactment of this Act detail-
ing the Department’s syringe procurement standards and strate-
gies to purchase syringes from domestic producers.
Hyperbaric Oxygen Therapy.—The Committee encourages the De-
partment to provide hyperbaric oxygen treatment to Veterans suf-
fering from chronic post-traumatic stress disorder, as appropriate.
MEDICAL COMMUNITY CARE
Appropriation, fiscal year 2021 ......................................................... $18,511,979,000
Budget request, fiscal year 2022 ....................................................... 23,417,244,000
Committee recommendation, fiscal year 2022 ................................. 23,417,244,000
Change from enacted level ......................................................... + 4,905,265
Change from budget request ...................................................... –––
The Medical Community Care account was created in the Surface
Transportation and Veterans Health Care Choice Improvement Act
of 2015 (P.L. 114–41). Per the MISSION Act of 2018, all commu-
nity care programs are consolidated into one community care pro-
gram. For fiscal year 2023, the bill provides an advance appropria-
tion of $24,156,659,000, of which $2,000,000,000 is available until
September 30, 2024.
The Committee provides an additional $3,269,000,000 to be avail-
able for fiscal year 2022 as proposed in the budget request in re-
sponse to readjusted actuarial estimates for medical community
care.
Third-Party Payments and Reimbursements.—The Committee
continues to be concerned about the timeliness of reimbursements
by VA to private healthcare/third-party providers. The Committee
believes VA must prioritize efficient and prompt payment to com-
munity providers to ensure timely access to quality care. Delays in
processing of such payments undermine the ability to recruit and
retain private healthcare providers to service our Nation’s Vet-
erans. The Committee continues to direct VA to provide com-
prehensive reports on a quarterly basis detailing the amount owed
to outside providers for every state, outstanding payments over six
months old and the corrective actions being implemented to ad-
dress these outstanding balances, and average time for repayment.
Long-Term Care for Veterans with Severe Traumatic Brain Injury
(TBI).—The Committee continues to note the increasing prevalence
of deployment-related traumatic brain injuries. This increase con-
tinues to demonstrate the longstanding need for providing ade-
quate long-term specialty care for Veterans suffering from severe
TBIs. The Committee appreciates the VA’s progress on this issue
and directs VA to (1) ensure an adequate number of long-term resi-
dential care facilities tailored to care for Veterans with severe TBIs
are available and (2) consider entering into agreements to provide
long-term specialty care for Veterans suffering from severe TBIs
where VA-provided direct care is not available.
Shortage of VA Community Care Providers in Rural Areas.—The
Committee is aware that certain rural regions of the country are
experiencing a shortage in private health care providers electing to
participate in VA’s Community Care Program, as authorized by the
VA MISSION Act (P.L. 115–182). The Committee encourages the
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Secretary to continue working with its partners to recruit private
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health care providers in rural communities to participate in the
Community Care Network System to serve veterans in their local
communities. The Committee requests a report within 60 days of
enactment of this Act regarding the Department’s and its partners’
outreach strategies to private health care providers located in rural
areas regarding this program.
Reliance on Community Care Versus VA Medical Center and
Clinic Expansion and Development.—The Committee recommends
the Department develop a system to accurately compare the costs
of providing care in the community, as envisioned by the MISSION
Act, to the costs of providing care within the VA healthcare system.
The data captured by the system should be gathered and made
available in a manner that allows the accurate comparison of the
cost of various services to help inform future decisions regarding
the most cost-effective delivery of healthcare services to Veterans.
The Committee also recommends that VHA solicit ‘‘360-degree’’
feedback from VA medical center directors on their service and
funding needs. The Committee continues to look forward to work-
ing with the Department to develop and refine a medical care cost
data collection system.
MEDICAL SUPPORT AND COMPLIANCE
Appropriation, fiscal year 2021 ......................................................... $8,214,191,000
Budget request, fiscal year 2022 ....................................................... 8,403,117,000
Committee recommendation, fiscal year 2022 ................................. 8,403,117,000
Change from enacted level ......................................................... + 188,926,000
Change from budget request ...................................................... –––
The Medical Support and Compliance appropriation funds the ex-
penses of management and administration of the Department’s
healthcare system, including financial management, public health
and environmental hazard, quality and performance management,
medical inspection, human research oversight, training programs
and continuing education, security, volunteer operations, and
human resources.
The bill provides $9,673,409,000 in advance fiscal year 2023
funding. The Committee has included bill language to make
$200,000,000 of the Medical Support and Compliance appropriation
for fiscal year 2023 available through September 30, 2024.
MEDICAL FACILITIES
Appropriation, fiscal year 2021 ............................................. $6,583,265,000
Budget request, fiscal year 2022 ........................................... 6,734,680,000
Committee recommendation, fiscal year 2022 ..................... 6,734,680,000
Change from enacted level ............................................. +151,415
Change from budget request .......................................... –––
The Medical Facilities appropriation provides funds for the oper-
ation and maintenance of the Department’s healthcare system’s
capital infrastructure. Included under this heading are provisions
for costs associated with utilities, engineering, capital planning,
leases, laundry, groundskeeping, garbage, housekeeping, facility re-
pair, and property disposition and acquisition.
The bill provides $7,133,816,000 in advance fiscal year 2023
funding. The Committee has included bill language to make avail-
able through September 30, 2024, $350,000,000 of the advance
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Medical Facilities appropriation for fiscal year 2023.
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Of the funds provided for non-recurring maintenance (NRM), the
Committee directs VA to prioritize projects that expand women’s
access to gender-specific care and that repurpose vacant and under-
utilized space for mental health needs, particularly projects that in-
crease the number of beds available for overnight mental health
treatment for Veterans. VA is directed to provide an expenditure
plan detailing how the additional funding will meet both of these
initiatives no later than 90 days after enactment of this Act.
Spend Plan.—The Committee expects VA to provide, no later
than 30 days after enactment of this Act, an expenditure plan de-
tailing the planned use of the funds provided. The Committee un-
derstands that some of the projects planned for fiscal year 2022
may not be ready within that timeframe, requiring an adjustment
to the spending plan. The Committee requests a quarterly update
of the plan if the funding for any single project changes by more
than $3,000,000 during that time period.
Facility Transformations.—The Committee remains concerned
that VA has failed to keep up with a growing population of women
Veterans who deserve equitable access to medical care. When one
in four women Veterans report having experienced unwanted sex-
ual attention while serving, it is concerning that the very system
intended to address their trauma is failing to foster a safe environ-
ment for them. The Committee directs the Department to prioritize
funding for medical facilities to accommodate women Veterans and
to make it safer and easier for women veterans to get care. This
includes correcting environment of care deficiencies, such as adding
doors, curtains, and soundproofing in treatment and check-in areas.
Community-Based Outpatient Clinic in Bakersfield, California.—
The Committee remains concerned that a new Bakersfield CBOC
remains unbuilt over a decade after Congress authorized this facil-
ity in P.L. 111–82. The Committee directs the Secretary to expedi-
tiously execute Lease No. 36C10F20L0008 and activate the CBOC
by the third quarter of Fiscal Year 2023, as provided in the lease.
The Committee directs the Secretary to provide monthly reports on
the CBOC’s progress until completion and activation.
VA Facility Security.—The Committee continues to encourage the
Department to improve the security of its campuses and facilities
to ensure the safety of Veterans, visitors, and employees and sup-
ports the Department’s investments in this area. The Committee
recommends that VA take a holistic approach to security and tech-
nology upgrades by exploring the deployment of proven tech-
nologies that allow for greater interoperability within the VA and
with outside first responders, protect VA employees and patients,
enhance accountability and transparency, and provide actionable,
real-time data.
VA Facility Leases.—The Committee supports the 21 leases pro-
posed in the FY22 budget request but acknowledges the challenges
related to their authorization. Recognizing that the primary obsta-
cle is not related to appropriations, the Committee continues to di-
rect the Department to work with the Office of Management and
Budget and Congress, including the Budget and Veterans Affairs
Committees of the House and Senate, to resolve the issues that in-
hibit VA’s ability to execute leases for medical, research and ad-
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ministrative offices and facilities.
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Energy Monitoring.—The Committee commends the Department
for its efforts to improve energy resilience, reduce energy waste,
and limit energy costs. As the VA explores additional ways to con-
serve energy, the Committee encourages the VA to increase its use
of advanced technologies, such as batteryless sensor networks, that
can reduce energy consumption, enhance operational readiness,
and equip operations and maintenance personnel with tools to
monitor and manage energy resources more effectively.
Medical Waste Report.—The Committee reminds the Department
of its interest in the costs and benefits of on-site medical waste
treatment systems, and that House Report 116–445 requested a re-
port on the issue. The Committee directs VA to provide the report
within 30 days of enactment of this Act.
West Los Angeles VA Homeless Housing Development.—The Com-
mittee is aware of the ongoing effort to redevelop the West Los An-
geles VA, one of the largest VA facilities in the country that serves
one of the largest homeless veteran populations in the United
States. The Greater Los Angeles Healthcare System’s Master Plan
calls for the delivery of more than 1,200 units of housing for vet-
erans experiencing homelessness. This plan would include the com-
pletion of seismic retrofits and construction on seismically deficient
buildings, including those that were previously funded as Major
Construction projects. The Committee urges the Department to
work with its Principal Developer to expeditiously finalize this por-
tion of the project, which is crucial to ensuring the rest of the Mas-
ter Plan may proceed toward its goal of delivering housing for vet-
erans in need.
MEDICAL AND PROSTHETIC RESEARCH
Appropriation, fiscal year 2021 ......................................................... $815,000,000
Budget request, fiscal year 2022 ....................................................... 882,000,000
Committee recommendation, fiscal year 2022 ................................. 902,000,000
Change from enacted level ......................................................... +87,000
Change from budget request ...................................................... +20,000
This appropriation provides for medical, rehabilitative, and
health services research. The bill provides $902,000,000 available
through September 30, 2023. The Committee recognizes the impor-
tance of the research conducted by VA for Veterans’ quality of life
and health and provides $20,000,000 above the request and
$87,000,000 above fiscal year 2021 for these activities.
Medical research, which helps ensure the best medical and hos-
pital services for Veterans, is an important aspect of the Depart-
ment’s programs. The prosthetic research program is also essential
in the development and testing of prosthetic, orthopedic, and sen-
sory aids for the purpose of improving the care and rehabilitation
of eligible disabled Veterans, including amputees, paraplegics, and
the blind. The health services research program provides unique
opportunities to improve the effectiveness and efficiency of the
healthcare delivery system. Budgetary resources from a number of
areas, including appropriations from the medical care accounts, re-
imbursements from DOD, grants from the National Institutes of
Health, private proprietary sources, and voluntary organizations,
provide support for the Department’s researchers. Estimated fiscal
year 2022 research resources in addition to those provided in the
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research account are $1,350,700,000.
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The Committee is pleased that toxic exposures will be an area of
focus for VA’s research programs in fiscal year 2022 and supports
VA’s plan to launch the Military Exposure Research Program. The
Committee encourages the Department to continue and expand its
research on the effects of and treatments for Veterans exposed to
toxins, such as Agent Orange, open burn pits, per- and
polyfluoroalkyl substances (PFAS), radiation, and asbestos, during
the course of their active duty service.
Per- and Polyfluoroalkyl Substances (PFAS) Research.—The
Committee is deeply concerned about the impact of PFAS at mili-
tary bases on servicemembers, their families, and surrounding com-
munities, and recognizes that the effects of PFAS exposure may
continue for servicemembers once they are under the care of the
VA. While the Committee directs VA to continue collaborating with
the Defense Department’s Per- and Polyfluoroalkyl Substances
(PFAS) Task Force, academia, and other health institutions and
agencies to monitor research activities, results, and publications on
the health effects from PFAS, the Committee also believes that VA
can and should play an active role in research on the effects of
PFAS exposure and health monitoring as it relates to our Veterans.
Gender-Specific Impacts of Toxic Exposure.—The Committee rec-
ognizes the gender-specific impacts of toxic exposure and remains
concerned that the VA is not adequately addressing the healthcare
needs of women Veterans. In order to provide full and effective
medical care, it is essential for the Department to understand the
health effects of women Veterans exposed to toxins during their
service. The Committee encourages the Department to continue
and expand its research on the effects of toxic exposure and ensure
gender-specific research on women Veterans is included in these ef-
forts.
Exposure to Herbicide-Related Toxins.—Veterans have frequently
expressed long-held concerns that toxic exposure during their mili-
tary service is related to adverse health conditions. The Committee
is committed to understanding the residual impacts of Agent Or-
ange/Dioxin and other herbicide-related toxic exposures among Vet-
erans who served in Vietnam, Thailand, Guam, the Northern Mar-
iana Islands, American Samoa, and all other geographic areas
where these toxic substances were dispersed. The Committee urges
the Department to reference data from existing medical records of
Veterans to determine the percentage of Veterans from the above
referenced subgroup that have more frequent or unexplained dis-
eases compared to the civilian population. This body of data could
be helpful in clarifying the extent and specifics of the medical
issues suffered by Veterans from exposure to herbicides.
Women Veterans Research.—Women Veterans have unique
health needs that are substantially different than both civilian
women and men Veterans. The Committee directs the Department
to ensure its research program adequately addresses the unique
needs and concerns of women Veterans. Additionally, the Com-
mittee continues to direct VA to prioritize medical and prosthetic
research to adequately address prosthetics meant for women, given
that women have different physical requirements for prosthetics
compared to men.
Neural-Enabled Prosthetics.—The Committee understands the
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uniqueness of limb trauma injuries sustained by servicemembers in
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combat. Traumatic injury or neurological diseases can also signifi-
cantly alter or impair the lifestyle of the individual and their care-
givers. The Committee encourages VA to fund research that will
design and develop technology to offset the effects of limb amputa-
tion, orthopedic injury and disease, neuropathic pain, and other
neurodegenerative diseases. Thus, the Committee includes
$25,000,000 for VA to prioritize this line of research, including
through collaborative research with a coalition of universities
aimed at accelerating functional recovery and rehabilitation of
sensorimotor function through engineering of wirelessly activated
implantable biomedical technologies capable of focal stimulation in-
side nerves and that is personalized to the needs of the patient.
Access to Clinical Oncology Trials.—The Committee continues to
applaud the ongoing collaborative efforts between VA medical cen-
ters and NCI-designated comprehensive cancer centers that allow
Veterans to have access to the highest quality cancer care avail-
able, including cutting-edge clinical trials for cancers that occur at
high rates in the Veteran population, such as prostate, lung and
melanoma. In each of Fiscal Years 2020 and 2021, the Committee
provided $5,000,000 to expand these efforts to ensure that States
with large Veteran populations are able to access these treatments.
The Committee appreciates that the Department has begun to im-
plement this initiative and looks forward to being kept apprised of
further progress. To continue this forward progress, the Committee
directs VA to allocate not less than $10,000,000 to support these
new partnerships between VA hospitals and NCI-designated facili-
ties that allow for Veterans to access cancer clinical trials at VA
health centers consistent with the guidance provided in the FY2020
and FY2021 Committee reports.
Gulf War Illness Studies.—The Committee recommends the De-
partment continue to conduct epidemiological studies regarding the
prevalence of Gulf War Illness, morbidity, and mortality in Persian
Gulf War Veterans and the development of effective treatments,
preventions, and cures. The Committee continues to encourage the
findings of all research conducted by or for the Executive Branch
relating to the health consequences of military service in the Per-
sian Gulf theater of operations during the Persian Gulf War be
made publicly available as soon as possible. The Committee also
urges the Department to publish disease-specific mortality data re-
lated specifically to Persian Gulf War Veterans. The Committee
continues to encourage the Department to utilize the term ‘‘Gulf
War Illness’’’ for the signature adverse health outcome of the Per-
sian Gulf War, as recommended by the Institute of Medicine (IOM).
Furthermore, the Committee once again encourages VA to
strengthen the training of primary, specialty, and mental
healthcare providers on the current and soon to be revised Gulf
War Illness case definitions recommended by IOM, as well as edu-
cation and training of VA clinicians on effective assessment, diag-
nosis, and clinical management of Gulf War Illness. The Committee
notes that this education and training should be aligned with the
recently completed revision of the Clinical Practice Guidelines for
Chronic Multisymptom Illness.
Dystonia.—The Committee continues to urge the VA to pursue
collaborative efforts with the dystonia stakeholder community and
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related federal agencies. The Committee also requests an update on
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relevant research projects that examine the connection between
traumatic brain injury (TBI) and dystonia.
Cannabis Research.—The Committee notes that VA has made
progress on cannabis research and continues to request updates on
the status of this research, as described in House Report 116–63.
Public Access to Scientific Data.—The Committee commends the
Department on issuing its Policy and Implementation Plan for Pub-
lic Access to Scientific Publications and Digital Data from Research
Funded by the Department of Veterans Affairs on July 23, 2015.
The Committee urges VA to continue its efforts towards full imple-
mentation of the plan.
NICoE Collaboration.—The Committee recognizes the high-qual-
ity mental health care and neurological research being conducted
at Walter Reed National Intrepid Center of Excellence (NICoE). As
Veterans and servicemembers continue to face higher rates of brain
trauma than civilians, impacting brain function, agencies should
continue to collaborate to study neurological conditions such as
PTSD, bipolar, schizophrenia, depression, suicide and substance
use disorders. The Committee directs VA to expand its work with
NICoE to strengthen VA’s research capacity, streamline
servicemembers’ access to preventive care, and share best practices
so health professionals can learn from NICoE’s important work and
contribution to the health community. The Committee encourages
the VA to pursue new collaborative initiatives with NICoE and con-
sider public academic medical centers as partners in such efforts.
Furthermore, the Committee encourages VA to assist DOD with
their efforts to optimize research to implement solutions and de-
liver better health outcomes for Veterans.
Advanced Platform Technology (APT) Center.—The Committee
applauds VA for the progress being made to provide our nation’s
Veterans with new assistive and restorative technologies that ad-
dress sensory, motor, or cognitive deficits, as well as limb loss. The
APT Center has effectively utilized a partnership model to leverage
local and national research expertise to drive dramatic progress in
diverse areas including artificial lung development, wound healing,
and neurally-connected sensory prosthesis. The Committee sup-
ports the APT Center’s efforts.
Spinal Cord Research.—The Committee recognizes the severity of
spinal cord injuries sustained by servicemembers in combat and
supports additional research in this area. Thus, the Committee en-
courages the Department to work with outside organizations on
spinal cord injury research to cure paralysis and improve the qual-
ity of life of impaired and disabled Veterans, and includes
$10,000,000 to do so.
Severe Depression and Suicide Prevention.—The Committee is
concerned with the continuing problem of suicide among Veterans,
and notes the need for ongoing efforts to improve methods of sui-
cide risk mitigation. The Committee supports VA’s commitment to
understanding Veteran suicide and applying epidemiological find-
ings to inform Veteran suicide prevention while also proactively im-
plementing outreach, programs, and interventions to end suicide.
Studies conducted by the National Institutes of Mental Health
(NIMH) investigating the use of Scopolamine in treating depression
and suicide prevention have shown promising initial results in rap-
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idly decreasing patients’ Montgomery-Asberg Depression Rating
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Scale (MADRS) scores, with over 50% of patients achieving remis-
sion. The Committee directs the Department to collaborate with
the Departments of Defense and Health and Human Services to
further validate the findings of the NIMH study, including poten-
tially conducting a joint study. The Department is requested to pro-
vide a report to the Committee not later than 180 days after the
enactment of this Act describing its plan to validate these findings.
Nanoscale Next-Generation Nonsurgical Neurotechnology.—The
Committee acknowledges the potential for benefit in collaboration
between the VA and DARPA in developing and testing
neurotechnology for Veteran movement rehabilitation. The Com-
mittee is aware of the success of DARPA’s Next-Generation Non-
surgical Neurotechnology (N3) program, which presents the oppor-
tunity to help wounded warriors control their own limbs via muscle
stimulation/rehabilitation and regain independence without
invasive surgery. The Committee directs VA to continue to work to-
gether with DARPA, particularly to include disabled Veteran can-
didates in DARPA’s human clinical trials of the nanoscale mini-
mally invasive brain computer interface and demonstrate the po-
tential benefits of this emerging neurotechnology in restoring
movement and offering independence without invasive surgical pro-
cedures.
Tinnitus Research.—The Committee encourages the Department
to work with academic partners, as appropriate, to address and im-
prove the outcomes for Veterans experiencing problematic tinnitus,
including research to identify contributing factors associated with
tinnitus onset and progression to chronic tinnitus and develop
novel interventional therapies and self-management models.
Research Facilities and Academic Affiliates.—The close partner-
ship between the VA and its academic affiliates has led to develop-
ment of new health care specialties, modern models of delivery and
has grown into the most comprehensive academic health system
partnership in history. The Department’s academic affiliation net-
work has also provided an effective pathway for VA to recruit high-
ly qualified health care professionals into its health care system.
While this partnership has led to a number of clinical innovations
and better quality of care for Veterans, there are areas where the
affiliation could be better leveraged, including through shared re-
search space. VA is encouraged to consider greater utilization of
available research space available at its academic affiliates to sup-
port its work, especially given growing capital needs at its own fa-
cilities. Leveraging these partnerships to include greater use of re-
search space on a shared basis could prove to be useful, especially
for principal investigators who are both VA clinicians and on fac-
ulty at the respective affiliate. Therefore, the Committee directs
the Secretary to report back no later than 90 days after enactment
of this Act, on locations where the Department has, can, or plans
to employ arrangements that would allow for sharing agreements
between local VA Medical Centers to utilize existing research space
at an academic affiliate.
Metastatic Cancer Research.—While recent research has revealed
that there is a genetic basis for susceptibility to metastatic cancer
or resistance to metastasis, more research is required to develop a
comprehensive understanding of this complex process. Clinical
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trials are an important aspect of that progress, and diverse rep-
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resentation of patients in clinical trials is integral to the develop-
ment of medications and therapies that effectively treat disease.
Ethnicity, gender, age and genetics all play a role in the safety and
efficacy of a treatment for an individual. Therefore, in order to
achieve representation of the demographics of the United States
population in these trials, the Committee directs the VA to partner
with DOD to fully implement the outstanding recommendations in
this area made to the Department by DOD’s April 2018 Task Force
Report to Congress on Metastatic Cancer.
MEDICAL CARE COLLECTIONS FUND
The Department of Veterans Affairs Medical Care Collections
Fund (MCCF) was established by the Balanced Budget Act of 1997
(P.L. 105–33). The Department deposits first-party and pharmacy
co-payments, third-party insurance payments and enhanced-use
collections, long-term care co-payments, Compensated Work Ther-
apy Program collections, Compensation and Pension Living Ex-
penses Program collections, and Parking Program fees into the
MCCF. The Department uses these funds for medical care and
services to Veterans. The estimate of fees that will be collected in
fiscal year 2022 is $3,386,000,000.
MCCF Third-Party Billing.—The Committee remains concerned
over potential discrepancies in VA’s billing and collection processes.
Procedures to provide for correct billing and prompt collection must
be improved at VA. Therefore, the Committee continues to require
the Department to submit to the Committees on Appropriations of
both Houses of Congress a quarterly report identifying the amount
of third-party health billings that were owed to VA in the previous
quarter and the amount collected. The reports should include bil-
lings and collections data for both large claims (greater than
$1,000) and small claims (equal to or less than $1,000). In addition,
the reports should also include updates on current efforts under-
way to increase VA’s efficiency, accuracy, and collection process, as
well as what management practices are in place to provide proper
oversight of the billing process, including appeals, so as to elimi-
nate unnecessary and duplicative functions.
NATIONAL CEMETERY ADMINISTRATION
Appropriation, fiscal year 2021 ......................................................... $352,000,000
Budget request, fiscal year 2022 ....................................................... 394,000,000
Committee recommendation, fiscal year 2022 ................................. 392,000,000
Change from enacted level ......................................................... +40,000,000
Change from budget request ...................................................... ¥2,000,000
The National Cemetery Administration (NCA) was established in
accordance with the National Cemeteries Act of 1973 (P.L. 93–43).
It has a fourfold mission: to provide for the interment of, in any
national cemetery with available grave space, the remains of eligi-
ble deceased servicemembers and discharged Veterans, together
with their spouses and certain dependents, and to permanently
maintain their graves; to provide headstones for, and to mark
graves of eligible persons in National, State and Tribal, and private
cemeteries; to administer the grant program for aid to States and
tribal governments in establishing, expanding, or improving State
and tribal government Veterans’ cemeteries; and to administer the
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Presidential Memorial Certificate Program. This appropriation will
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provide for the operation and maintenance of 158 national ceme-
teries and 34 other cemeterial installations.
The Committee provides these funds to meet increasing workload
and burial expansions. NCA should prioritize maintaining the cur-
rent level of services at existing cemeteries and activating new
cemeteries to increase burial access.
The bill includes language making ten percent of the total avail-
able until September 30, 2023.
Prisoners of War Headstones.—The Committee appreciates the
Department’s actions to replace headstones of prisoners of war that
feature swastikas and inscriptions glorifying the Nazi regime. The
Committee understands that this replacement work has been par-
tially completed, and strongly urges the Department to expedi-
tiously complete the project. The Committee continues to direct VA
to provide monthly reports on the status of this process to the Com-
mittees on Appropriations of both Houses of Congress. Further-
more, the Committee continues to direct VA to include in these
monthly reports details on its proposal to provide interpretive signs
and historical context at cemeteries with headstones of prisoners of
war, and reminds the Department to carefully craft the design and
wording of planned interpretive signage to provide the appropriate
historical context but be sensitive to those most affected by it.
Rural Cemetery Access.—The Committee remains concerned that
NCA is not adequately serving the Nation’s Veterans in rural areas
and that there are geographic pockets in the country which con-
tinue to go unserved. The Committee therefore directs VA to con-
tinue to pursue efforts to ensure that a burial option, including
those utilizing public-private partnerships, within 75 miles of all
Veteran homes is available and accessible. The Committee directs
the Department to report to the Committees on progress made in
this regard, and on strategies to address the remaining need in the
future, within 60 days of enactment of this Act.
DEPARTMENTAL ADMINISTRATION
GENERAL ADMINISTRATION
(INCLUDING TRANSFER OF FUNDS)
Appropriation, fiscal year 2021 ......................................................... $365,911,000
Budget request, fiscal year 2022 ....................................................... 401,200,000
Committee recommendation, fiscal year 2022 ................................. 396,911,000
Change from enacted level ......................................................... +31,000,000
Change from budget request ...................................................... ¥4,289,000
The General Administration account provides funds for the Office
of the Secretary, the General Counsel, six Assistant Secretaries,
and two Department-level staff offices. The Committee has in-
cluded bill language to make available through September 30,
2023, up to ten percent of these funds and to permit the transfer
of funds in this account to the General Operating Expenses, Vet-
erans Benefits Administration account.
VA Five Year Development Plan (VFYDP).—The Committee is
very pleased that the Department has provided a VFYDP in its fis-
cal year 2022 budget and looks forward to reviewing the VFYDP
in future VA budget submissions.
Quarterly Financial Information Reports.—The bill includes an
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administrative provision that extends the requirement for submis-
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sion of the quarterly financial information required in the fiscal
year 2017 bill and conference report.
Additional Budgetary Information.—The Committee continues its
request that items described in previous House reports continue to
be included in the budget justifications submitted each year. Fur-
ther, the Committee directs VA to include in its budget justification
materials a table for each account that shows a five-year funding
history for requested and enacted levels.
Staff Relocations Within VA.—The bill continues the administra-
tive provision requiring written notification 15 days prior to organi-
zational changes that result in the transfer of 25 or more full-time
equivalent staff from one organizational unit of the Department to
another.
Performance Bonuses.—The Committee believes it is important to
know how VA is allocating its resources with regard to performance
bonuses. Therefore, the Committee directs VA to submit a report,
no later than 90 days after enactment of this Act, which provides
the aggregate total of VA performance bonuses covering the five
most recent fiscal years for which the data is available. The data
should be divided between bonuses for Senior Executive Service
(SES) staff and non-SES staff. The report should also include the
percentage of SES and non-SES employees who received a bonus
and the average dollar amount of the bonuses by grade covering
the same time period. The report, however, should not include any
personally identifiable information.
Financial Management Business Transformation (FMBT).—The
Committee provides $19,590,000 for FMBT. The current legacy fi-
nancial management system is over 30 years old, and its imminent
failure presents significant risks to VA. In the fiscal year 2018 con-
ference report, VA was directed to provide the Committee, on a
quarterly basis, a report that compares actual progress on the fi-
nancial management system to the performance benchmarks and
timeline provided in the first report. The Committee continues to
expect the Department to continue this quarterly report throughout
fiscal year 2022.
Supporting Minority and Disadvantaged Contractors.—The Com-
mittee recognizes the need to continue to meet its goals for con-
tracting with minority, disadvantaged, and women-owned busi-
nesses. Therefore, the Committee directs the Department to
prioritize awarding contracts to contractors that consistently exe-
cute approved small business subcontracting plans. The Committee
further urges the Department to prioritize minority-owned and dis-
advantaged contractors and subcontractors. The Committee re-
quests a report, within 180 days of enactment of this Act and annu-
ally thereafter, detailing the number of contractors that submitted
a small business subcontracting plan during the fiscal year,
disaggregated by race and ethnicity. This report should include an
analysis detailing which contractors successfully implemented sub-
contracting plans and recommendations on how the Department
could better achieve its prime and subcontracting goals for small
businesses.
Data on Women and Minority Veterans.—The Committee recog-
nizes the lack of data specific to women and minority Veterans
made available to Congress by the Department. The Committee
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recommends, when applicable, the Secretary display information in
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the annual report(s) submitted to Congress separately for women
Veterans and minority Veterans.
Veterans First Contracting Program.—The Committee recognizes
the tremendous value of the Veterans First Contracting Program in
assisting in the expansion and growth of service-disabled Veteran
and Veteran-owned small businesses. Therefore, the Committee en-
courages VA to continue to expand and make mandatory the train-
ing of contracting officers in the requirements of the Veterans First
Contracting Program, with particular attention being paid to con-
ducting the market research necessary to ensure that service-dis-
abled Veteran and Veteran-owned small businesses are awarded
VA contracts when appropriate.
21st Century IDEA Act Compliance for the Center for Women Vet-
erans.—The Committee supports the mission of VA’s Center for
Women Veterans to monitor and coordinate VA’s administration of
health care and benefits services, and programs for women Vet-
erans. The Committee also supports the full implementation of the
21st Century IDEA (Public Law 115–336) and the need for a cus-
tomized, self-service website that serves as a centralized source for
the provision to women veterans of information about the benefits
and services available to them under laws administered by the Sec-
retary. Therefore, the bill includes $1 million for the Center for
Women Veterans to stand up a user-friendly, mobile responsive
website that fully implements the requirements of PL 115–336.
The Committee believes this improved digital service delivery for
women veterans will increase participation in VA benefits and
services and reduce service costs. The Committee directs the Sec-
retary of the VA to brief the appropriate committees of Congress
not later than 180 days following enactment of this Act on plans
to modernize its Center for Women Veterans Health website and
digital service delivery programs.
Center for Women Veterans.—The Committee recognizes that the
Center for Women Veterans (CWV) serves to monitor and coordi-
nate the Department of Veterans Affairs administration of health
care and benefits services, and programs for women veterans and
to serve as an advocate for cultural transformation, both within VA
and in the general public, in recognizing the service and contribu-
tions of women Veterans and women in the military. The CWV is
tasked with 12 specific functions under title 38 of U.S. Code. The
Committee directs VA to submit a report to the Committees on Ap-
propriations of both Houses of Congress within 120 days of enact-
ment of this act detailing: (1) how the work of the Center fulfills
these 12 Congressionally-mandated functions, including data on
the Center’s previous success and outcomes on delivering these
functions; (2) how the Center is coordinating with other VA entities
to meet those functions; (3) any challenges in fulfilling those statu-
torily mandated functions, including any specific budgetary con-
straints; and (4) a strategic plan for meeting these functions in the
next two years.
Grant and Federal Assistance Oversight.—The Committee is
aware that the VA lacks a departmental office to support and over-
see its growing number of grants and federal assistance programs,
which could impact program implementation and public reporting
of data, such as through USAspending reports. The Committee en-
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courages the VA to ensure grant programs are stood up effectively
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and in a timely manner, and that improvements are made to inter-
nal systems responsible for informational updates to grant assist-
ance listings, CFDA numbers, and USAspending reports.
Federated Learning.—The Office of Enterprise Integration’s Inno-
vation Center is encouraged to utilize commercially available fed-
erated learning solutions to expand diagnostic and medical care
services that can be provided at rural VA clinics with limited or no
broadband capabilities.
ASSET AND INFRASTRUCTURE REVIEW
Appropriation, fiscal year 2021 ......................................................... –––
Budget request, fiscal year 2022 ....................................................... $5,000,000
Committee recommendation, fiscal year 2022 ................................. 5,000,000
Change from enacted level ......................................................... +5,000,000
Change from budget request ...................................................... –––
This appropriation funds the work of the ‘‘Asset and infrastruc-
ture Review Commission’’ (the Commission), an independent com-
mission established in the VA MISSION Act of 2018 (P.L. 115–
182), Title II, section 202. The Commission will review VA’s rec-
ommendations to modernize or realign VHA facilities, including
leased facilities. The Commission will conduct public hearings and
provide a report to the President on the VA’s plan along with any
additional recommendations from the Commission. Support staff
will conduct in-depth field hearings to receive input from Veterans,
Veterans Service Organizations, local VA providers, and local gov-
ernment. The staff of the Commission are anticipated to begin pre-
paratory work in the first months of FY 2022.
BOARD OF VETERANS APPEALS
Appropriation, fiscal year 2021 ......................................................... $196,000,000
Budget request, fiscal year 2022 ....................................................... 228,000,000
Committee recommendation, fiscal year 2022 ................................. 228,000,000
Change from enacted level ......................................................... +32,000,000
Change from budget level ........................................................... –––
The bill makes ten percent of this funding available through Sep-
tember 30, 2023.
The Board of Veterans’ Appeals (BVA) is the component of VA
responsible for making final decisions on behalf of the Secretary for
the thousands of claims for Veterans’ benefits that are presented
to BVA for appellate review. The majority of BVA’s workload de-
rives from the benefit claims initiated at VBA regional offices. The
appellate process has multiple steps, most of which occur at the
local regional office level. If a Veteran is not satisfied with a re-
gional office determination, he or she may appeal to BVA for a final
agency decision. BVA adjudicates appeals covering all areas of Vet-
erans’ benefits, but most of the workload concerns appeals for Vet-
erans’ disability compensation or pension benefits. On February 19,
2019, VA implemented the new legislative framework that modern-
ized the claims and appeals process and provided greater choice to
Veterans by providing them three options for claims and appeals:
(1) a supplemental claim; (2) a higher-level review; or (3) a direct
appeal to the Board of Veterans’ Appeals.
Prior to COVID–19, the Board was on target to reach its goal of
conducting a record 24,300 hearings in 2020 and the number of
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pending hearing requests was 77,621. Due to the effects of the pan-
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demic, the Board completed 15,669 hearings in 2020, resulting in
86,849 pending hearing requests.
In March 2020, BVA fully implemented a virtual tele-hearing so-
lution, allowing Veterans to participate in hearings before the
Board via voice and video transmission over the Internet using
non-VA cell phones and laptops. This technology, designed to in-
crease hearing show rates, also provides greater access and flexi-
bility, especially for rural Veterans and representatives. Approxi-
mately 97% of hearings are now virtual.
INFORMATION TECHNOLOGY SYSTEMS
(INCLUDING TRANSFER OF FUNDS)
Appropriation, fiscal year 2021 ......................................................... $4,912,000,000
Budget request, fiscal year 2022 ....................................................... 4,842,800,000
Committee recommendation, fiscal year 2022 ................................. 4,842,800,000
Change from enacted level ......................................................... ¥69,200,000
Change from budget request ...................................................... –––
The Information Technology (IT) Systems account supports IT
services such as systems development and performance, operations
and maintenance, information protection, and customer support.
The program permits the effective and efficient delivery of Vet-
erans’ healthcare services and benefits programs.
Within the account total, the Committee allocates $1,414,215,000
for pay and associated costs, $3,131,585,000 for operations and
maintenance, and $297,000,000 for development. The bill makes
available three percent of pay and associated costs and five percent
of operations and maintenance funds until September 30, 2023. All
development funds are available until September 30, 2023.
The Committee encourages VA to allocate sufficient resources for
IT improvements that support research and research facilities.
The Committee continues bill language permitting the transfer of
funding among the three subaccounts upon approval of the Com-
mittees on Appropriations of both Houses of Congress.
The bill also continues language allowing for the reprogramming
of funds among development projects upon approval by the Com-
mittees on Appropriations of both Houses of Congress.
The chart below reflects the Committee’s allocation for develop-
ment projects. This chart will serve as the Department’s approved
list of development projects, and all requested changes are subject
to the reprogramming guidelines as outlined in the accompanying
Act.
INFORMATION TECHNOLOGY DEVELOPMENT PROJECTS
(In thousands of dollars)
Committee
Project Recommendation
Clinical Applications ...................................................................................................................................... $103,624
Health Management Platforms ...................................................................................................................... 69,096
Health Research and Development ................................................................................................................ 8,660
Benefits Systems ............................................................................................................................................ 87,390
Memorial Affairs ............................................................................................................................................. 9,030
Cybersecurity .................................................................................................................................................. 11,200
Information/Infrastructure Management ........................................................................................................ 8,000
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Total All Development ........................................................................................................................... 297,000
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The Committee expects the Office of Information and Technology
to continue to provide an IT expenditure report to the Committees
on Appropriations of both Houses of Congress on a monthly basis.
This report should include a comparison to the project costs in-
cluded in the development funding chart above and provide an ex-
planation for any differences in excess of $3,000,000.
Cybersecurity Strategy.—The Committee is pleased that the De-
partment is updating its cybersecurity strategy and plans to pub-
lish it by the end of 2021 and encourages it to remain vigilant
against current and future cybersecurity challenges.
Technology Investments.—As the Department of Veterans Affairs
rolls out its enterprise applications and moves toward more agile
development, the Committee encourages the Department to review
and consider the Department of Defense’s success implementing
the Software Factory concept of operations.
21st Century IDEA VA Forms Modernization.—The Committee
supports the Department’s efforts to modernize its internal and ex-
ternal digital services, consistent with the requirements of the 21st
Century IDEA (Public Law No. 115–336). The Committee believes
that the 21st Century IDEA will enable the VA’s Office of Informa-
tion Technology and Veterans Customer Experience to improve dig-
ital service delivery for both Veterans and internal workflows.
Encrypted Communications for Telehealth.—In coordination with
the Veterans Health Administration and Office of Electronic Health
Records Modernization, the Office of Information Technology is di-
rected to utilize the best technologies, such as end-to-end encrypted
communications with zero-trust architecture, that can reliably
serve Veterans and healthcare providers.
Veterans Affairs Sexual Harassment Tracking.—The Committee
directs the Department to develop a centralized data supporting
system cataloguing sexual harassment and assault complaint data
pursuant to Section 5303 of the Deborah Sampson Act.
Digital Protection Pilot Program.—The Committee continues to
believe that it is our country’s duty to protect our Veterans, the De-
partment of Veterans Affairs (VA), and Congressionally Charted
VSOs from both foreign and domestic threats across the digital
landscape attempting to steal money, pilfer personal information or
peddle foreign influence via social media or other online campaigns.
In Fiscal Year 2021, the Committee provided $5,000,000 million for
a ‘‘Digital Protection Pilot Program’’ within the Office of Informa-
tion Technology Systems at VA to use commercially available, prov-
en, automated technology to continuously detect, disrupt and dis-
able these threats. The Committee directs the Department to pro-
vide a report on the status of implementation of the ‘‘Digital Pro-
tection Pilot Program’’ within 90 days of the enactment of this Act.
VETERANS ELECTRONIC HEALTH RECORD (EHR)
Appropriation, fiscal year 2021 ......................................................... $2,627,000,000
Budget request, fiscal year 2022. ...................................................... 2,663,000,000
Committee recommendation, fiscal year 2022 ................................. 2,637,000,000
Change from enacted level ......................................................... +10,000,000
Change from budget request ...................................................... ¥26,000,000
The Veterans Electronic Health Record is a unified account de-
signed to manage the effort to develop an interoperable electronic
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health record system that will access seamlessly the records of Vet-
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79
erans in the VA system and those of the Department of Defense
and of community providers. The VA system is the same as the one
chosen by DOD and is planned to be rolled out with the same
timeline and geographic areas as DOD in order to realize cost effi-
ciency savings.
The bill provides an increase of $10,000,000 above the fiscal year
2021 level to support VA’s on-going efforts to deploy the new elec-
tronic health record system. Within the total funding, the bill in-
cludes $1,416,498,000 for the electronic health record contract,
$276,705,000 for program management, and $943,797,000 for infra-
structure support. Funding is made available for three years due
to the uncertainty of the timing of obligations for this substantial
effort.
This account is intended to be the single source of funding within
VA for the electronic health record effort. No authority is provided
for funds from other VA accounts to be transferred into this ac-
count nor for funds from this account to be transferred out to other
accounts. Consistent with the effort to centralize financial manage-
ment of the development of the electronic health record, the Com-
mittee continues to direct the Department to manage this effort at
the headquarters level in the Office of the Deputy Secretary.
The bill continues language requiring the Secretary to submit a
quarterly report to the Committees on Appropriations of both
Houses of Congress detailing obligations, expenditures, and deploy-
ment strategy by facility. VA is directed to continue quarterly brief-
ings on performance milestones, costs, and changes to implementa-
tion and management plans, and to provide an accurate up-to-date
deployment schedule each quarterly briefing. Additionally, the
Committee directs the Department to provide updates on plans and
efforts to integrate community care providers into the new EHR
system. Such updates should be submitted concurrently with the
quarterly reports.
In addition, bill language is included requiring notice to and ap-
proval from the Committees on Appropriations of both Houses of
Congress on any changes to the deployment schedule. Should there
be any deviation from the deployment schedule, the Committee di-
rects the Department to formally submit in writing a proposed up-
dated deployment schedule within 7 days of notification to the
Committees of any potential Change, and prior to implementation
of the updated deployment schedule. The Committee repeats the
fiscal year 2020 directive for GAO to perform quarterly perform-
ance reviews of the VA electronic health record deployment. It is
expected that this quarterly reporting will provide the Committees
and VA with timely information to properly oversee this effort and
address important issues.
Cybersecurity for Electronic Health Records and Blockchain Tech-
nology.—Recognizing the ongoing challenges of sharing data be-
tween MHS GENESIS and the Department’s EHRM initiative, the
Committee encourages the Department to continue prioritizing ef-
forts to protect Veterans’ sensitive information when implementing
EHRM, and recommends the Department consider emerging tech-
nologies, such as blockchain technology, if future requirements
drive a need to modify VA’s security architecture and technical so-
lutions. The Committee understands that the Department is under-
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taking a pilot to study the use of blockchain technology to share
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data and looks forward to the results of the pilot being shared with
the Committee.
Transparency on EHRM Third-Party Application Review.—The
Committee continues to encourage VA to ensure that the new
EHRM initiative provides an open architecture that allows a gov-
ernance and oversight process for administering access and support
to deploy third-party applications, components, and application pro-
gramming interfaces. The Committee encourages the Department
and the Federal Electronic Health Record Modernization Program
Office to ensure the standards and evaluation criteria for commer-
cially available software, tools and products that advance inter-
operability and seamless care are readily available for review, such
as on the EHRM webpage.
Informatics.—Based on the lessons learned at the Mann-
Grandstaff VA Medical Center, the Committee notes the need for
integrating informatics infrastructure and capabilities as the De-
partment transitions additional facilities to a new electronic health
record. Workflow process modelling, healthcare standards imple-
mentation, and terminology standardization are critical to multiple
areas of veteran care, including staff productivity and community
care. The Committee requests a report within 120 days of enact-
ment of this Act on what the Department is doing to integrate
informatics infrastructure and capabilities as the Department tran-
sitions from VistA to the new electronic health record system, in-
cluding detailing the minimum informatics requirements that all
facilities must meet as part of this transition.
Electronic Health Record Infrastructure.—The Committee appre-
ciates the Department’s March 2, 2021, response to its request for
a report on the total cost of the installations of all remaining infor-
mation technology and related infrastructure required to complete
the deployment of the electronic health record. However, in light of
the Office of Inspector General’s Report #20–03178–116, Defi-
ciencies in Reporting Reliable Physical Infrastructure Cost Esti-
mates for the Electronic Health Record Modernization Program, the
Committee is concerned with the accuracy and reliability of the
data provided. As such, the Committee directs the Department to
swiftly implement the recommended actions and to provide a new
estimate that includes the information requested in Division J of
the FY21 the conference agreement (P.L. 116–260).
OFFICE OF INSPECTOR GENERAL
Appropriation, fiscal year 2021 ......................................................... $228,000,000
Budget request, fiscal year 2022 ....................................................... 239,000,000
Committee recommendation, fiscal year 2022 ................................. 239,000,000
Change from enacted level ......................................................... +11,000,000
Change from budget request ...................................................... –––
The Office of Inspector General (OIG) was established by the In-
spector General Act of 1978 and is responsible for the audit, inves-
tigation, and inspection of all VA programs and operations. The
overall operational objective is to focus available resources on areas
that would help improve services to Veterans and their bene-
ficiaries, assist managers of Department programs to operate eco-
nomically in accomplishing program goals, and to prevent and
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deter recurring and potential fraud, waste, and inefficiencies.
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The bill makes up to ten percent of this funding available until
September 30, 2023.
The Committee continues to request robust oversight of MIS-
SION Act and EHRM implementation.
Federal Electronic Health Record Management Program Office
(FEHRM).—The Committee looks forward to receiving the VA Of-
fice of Inspector General audit report regarding the governance
policies and practices of the FEHRM.
VA Backlog.—The OIG is encouraged to review the causes of
VA’s current claims backlog and provide all appropriate feedback
on the work VA is doing to address backlog issues. The OIG shall
report to the Committee on the status of the backlog, how VA is
addressing the backlog, and any changes in the amount of time vet-
erans are waiting to hear back on their claims.
CONSTRUCTION, MAJOR PROJECTS
Appropriation, fiscal year 2021 ......................................................... $1,316,000,000
Budget request, fiscal year 2022 ....................................................... 1,611,000,000
Committee recommendation, fiscal year 2022 ................................. 1,611,000,000
Change from enacted level ......................................................... +295,000,000
Change from budget request ...................................................... –––
The Construction, Major Projects appropriation provides for con-
structing, altering, extending, and improving any of the facilities
under the jurisdiction or for the use of VA, including planning, ar-
chitectural and engineering services, assessments, and site acquisi-
tion where the estimated cost of a project is more than $20,000,000.
The Committee recommendation makes $657,326,000 of these
funds available for a five-year period.
As required by language that is in permanent law, all major con-
struction projects costing more than $100,000,000 must be man-
aged by a non-VA government entity such as the Army Corps of
Engineers. While the Committee no longer duplicates this lan-
guage, the Committee intends to continue its oversight of the qual-
ity of the outside entity management and will continue to receive
quarterly briefings on each of the large construction projects.
The chart below reflects the Committee’s recommendation for
Major Construction projects.
CONSTRUCTION, MAJOR PROJECTS
[In thousands of dollars]
Project Amount
Veterans Health Administration
Biloxi, MS Restoration of Hospital/Consolidation of Gulfport ........................................................................ $22,500
Portland, OR Upgrade Portland Bldg 100/101 for Seismic Retrofit and Renovation ................................... 20,000
Louisville, KY New Medical Center ................................................................................................................. 93,000
San Francisco, CA New Research Facility ..................................................................................................... 74,400
West Los Angeles, CA Build New Critical Care Center ................................................................................. 40,000
Long Beach, CA Mental Health & Community Living Center ........................................................................ 20,000
Canandaigua, NY Construction & Renovation ............................................................................................... 60,159
San Diego, CA SCI & Seismic Building 11 .................................................................................................... 10,000
Dallas, TX Spinal Cord Injury ......................................................................................................................... 43,239
Oklahoma City, OK Construct Surgical Intensive Care Unit and Renovate Operating Room ....................... 18,103
St. Louis (JC), MO Replace Bed Tower, Clinical Bldg Expansion & Parking Garage ................................... 92,000
El Paso, TX Construct New Health Care Center ............................................................................................ 150,000
Advance Planning and Design Fund .............................................................................................................. 417,699
Asbestos ......................................................................................................................................................... 12,000
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Construction and Facilities
Staff ................................................................................................................................................................ 124,600
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CONSTRUCTION, MAJOR PROJECTS—Continued
[In thousands of dollars]
Project Amount
Hazardous Waste ............................................................................................................................................ 4,000
Judgment Fund ............................................................................................................................................... 35,000
Non-Dept. Fed. Entity Project Management Support ..................................................................................... 132,000
Seismic Corrections ........................................................................................................................................ 100,000
Total, VHA .............................................................................................................................................. 1,468,700
National Cemetery Administration
Fort Logan, CO Phase 1 Gravesite Expansion ............................................................................................... 50,000
Indiantown Gap, PA Phase 5 Gravesite Expansion ....................................................................................... 44,500
Advance Planning and Design Fund .............................................................................................................. 35,000
NCA Land Acquisition ..................................................................................................................................... 1,000
Total, NCA .............................................................................................................................................. 130,500
General Administration
Staff Offices Advanced Planning Fund .......................................................................................................... 11,800
Total, Major Construction ...................................................................................................................... 1,611,000
To enhance the Committee’s capacity to conduct oversight on
VA’s facility construction efforts, several administrative provisions
are continued in the bill: (1) No funding amount greater than
$7,000,000 may be reprogrammed between construction projects
unless approved by the Committees on Appropriations of both
Houses of Congress; (2) any change to the scope of a construction
project is not permitted without the approval of the Committees;
and (3) VA must report any bid savings of $5,000,000 or more on
projects as soon as they are identified.
CONSTRUCTION, MINOR PROJECTS
Appropriation, fiscal year 2021 ......................................................... $390,000,000
Budget request, fiscal year 2022 ....................................................... 553,000,000
Committee recommendation, fiscal year 2022 ................................. 553,000,000
Change from enacted level ......................................................... +163,000,000
Change from budget request ...................................................... –––
The Construction, Minor Projects appropriation provides for con-
structing, altering, extending, and improving any of the facilities
under the jurisdiction of, or for the use of, the Department, includ-
ing planning, assessment of needs, architectural and engineering
services, and site acquisition, where the estimated cost of a project
is equal to or less than $20,000,000.
The Committee recommendation makes $55,300,000 of the funds
provided available until expended.
The Committee encourages the Department to prioritize con-
struction for expanding gender-specific care for women and mental
health programs, in particular mental health Residential Rehabili-
tation Treatment Program facilities and new inpatient Substance
Use Disorder treatment facilities within the VA system. The Com-
mittee also notes that inpatient Substance Use Disorder facilities
are of particular importance for Veterans in rural communities.
The Committee also encourages VA to allocate sufficient resources
for improvements to research facilities, particularly to address any
priority deficiencies.
Construction of Housing for Rural Homeless Veterans.—The De-
partment has made great efforts to find suitable housing for home-
less Veterans and their families. The Committee encourages more
non-traditional efforts to eliminate Veteran homelessness. For ex-
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ample, some cities and towns have started pilot programs using
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‘‘Micro’’ or ‘‘Tiny Homes’’, or renovated shipping containers, to help
deal with homelessness. The Committee encourages VA to continue
its efforts to house homeless Veterans and their families and ex-
plore the feasibility of providing ‘‘Tiny Homes’’ or renovated ship-
ping containers as housing.
National VA History Center.—The Committee supports the De-
partment’s decision to establish the VA History Office and the Na-
tional VA History Center (NVAHC) to collect and preserve the de-
partment’s history. Because the VA was one of the few cabinet-
level agencies without an official history office, this fills a long-
standing need to develop an overarching program to collect, pre-
serve and provide access to VA’s relevant historical records and ar-
tifacts to tell a comprehensive story of VA and its predecessor orga-
nizations. The Committee encourages VA to continue restoration
necessary to develop the NVAHC to serve as the principal VA-wide
location for centralized VA historical collections.
GRANTS FOR CONSTRUCTION OF STATE EXTENDED CARE FACILITIES
Appropriation, fiscal year 2021 ......................................................... $90,000,000
Budget request, fiscal year 2022 ....................................................... –––
Committee recommendation, fiscal year 2022 ................................. 90,000,000
Change from enacted level ......................................................... –––
Change from budget request ...................................................... +90,000,000
This appropriation provides grants to assist States in con-
structing State home facilities, for furnishing domiciliary or nurs-
ing home care to Veterans, and to expand, remodel, or alter exist-
ing buildings for furnishing domiciliary, nursing home, or hospital
care to Veterans in State homes. A grant may not exceed 65 per-
cent of the total cost of the project. The bill makes this funding
available until expended.
The American Rescue Plan Act of 2021 (P.L. 117–2) included
$500 million that allowed VA to fund all projects on the priority
list, thereby eliminating the backlog of priority projects in fiscal
year 2021.
Supporting grants for construction of state extended care facili-
ties has been and will continue to be a priority of the Committee.
As such, in order to ensure that VA has the resources required to
address priority project applications submitted in April 2021, the
bill maintains level funding of $90 million for fiscal year 2022.
GRANTS FOR CONSTRUCTION OF VETERANS CEMETERIES
Appropriation, fiscal year 2021 ......................................................... $45,000,000
Budget request, fiscal year 2022 ....................................................... 45,000,000
Committee recommendation, fiscal year 2022 ................................. 47,097,000
Change from enacted level ......................................................... +2,097,000
Change from budget request ...................................................... +2,097,000
This program provides grants to assist States and tribal govern-
ments with the establishment, expansion, and improvement of Vet-
erans’ cemeteries that are operated and permanently maintained
by the States and tribal governments. Grants under this program
fund up to 100 percent of construction costs and the initial equip-
ment expenses when the cemetery is established. State and tribal
governments remain responsible for providing the land and for pay-
ing all costs related to the operation and maintenance of the State
cemeteries, including the costs for subsequent equipment pur-
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chases. The bill makes this funding available until expended.
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ADMINISTRATIVE PROVISIONS
The bill includes 49 administrative provisions, of which 48 were
in effect in fiscal year 2021 in some form and one is a new provi-
sion. The administrative provisions included in the bill are as fol-
lows:
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 201 allowing for the transfer of funds
among three mandatory appropriations. The Administration pro-
posal to modify this provision is not adopted.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 202 allowing the Department to transfer
funding among the four medical appropriations accounts in fiscal
year 2022. The Administration proposal to modify this provision is
not adopted.
The bill includes section 203 allowing for salaries and expenses
funds to be used for hire of passenger vehicles, lease of facilities
or land, and purchase of uniforms.
The bill includes section 204 providing that only funding in ‘‘Con-
struction, Major Projects’’ and ‘‘Construction, Minor Projects’’ can
be used for the purchase of any site for any new hospital or home
or to construct any new hospital or home.
The bill includes section 205 requiring the Department to be re-
imbursed for medical services it provides to any person not defined
as a beneficiary to ensure the Department is receiving payment for
all medical services provided.
The bill includes section 206 allowing for the use of funds appro-
priated in fiscal year 2022 for ‘‘Compensation and Pensions’’, ‘‘Re-
adjustment Benefits’’, and ‘‘Veterans Insurance and Indemnities’’
for payment of accrued obligations recorded in the last quarter of
fiscal year 2021.
The bill includes section 207 allowing for the use of fiscal year
2022 funds to pay prior year obligations resulting from implemen-
tation of sections 3328(a), 3334, and 3712(a) of title 31, United
States Code.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 208 allowing the Department to use sur-
plus earnings from the national service life insurance, U.S. Govern-
ment life insurance, and Veterans’ special life insurance program
to administer these programs.
The bill includes section 209 allowing enhanced-use lease pro-
ceeds deducted for administrative expenses that were incurred in
a prior fiscal year to be available until expended.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 210 limiting the amount of reimburse-
ment the Office of Resolution Management, Diversity and Inclu-
sion, the Office of Employment Discrimination Complaint Adjudica-
tion, and the Alternative Dispute Resolution function within the
Office of Human Resources and Administration can charge other of-
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fices and accounts of the Department for services provided.
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The bill includes section 211 requiring the Department to collect
current and accurate third-party reimbursement information for
the purposes of third-party insurance collections. If persons receiv-
ing care or medical services do not disclose this information, the
Department is allowed to bill them reasonable charges for services
provided.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 212 allowing the Department to use en-
hanced-use lease funds for construction and alteration of medical
facilities.
The bill includes section 213 allowing the Department to use the
Medical Services appropriation for expenses related to the broader
mission of medical care to Veterans.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 214 allowing the Department to transfer
Medical Care Collections to the ‘‘Medical Services’’ and ‘‘Medical
Community Care’’ accounts to be used for Veterans medical care
and makes those funds available until expended.
The bill includes section 215 allowing Veterans who reside in
Alaska to obtain medical services from medical facilities supported
by the Indian Health Service or tribal organizations, and provides
for reimbursement for those services from VA.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 216 allowing the Department to transfer
the proceeds received from the transfer of real property deposited
into the VA Capital Asset Fund to the Major and Minor Construc-
tion appropriations accounts and makes those funds available until
expended.
The bill includes section 217 requiring the Secretary to submit
quarterly reports to the Committees on Appropriations of both
Houses of Congress on the financial status of the Department of
Veterans Affairs.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 218 prohibiting the Department from in-
creasing total resources of the Information Technology appropria-
tion by more than ten percent by transferring funding from the
other VA accounts and requires the Department to receive approval
from the Committees on Appropriations of both Houses of Congress
before such transfer. The Administration proposal to modify this
provision is not adopted.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 219 providing up to $379,009,000 of fis-
cal year 2022 funds for transfer to the Joint DOD–VA Medical Fa-
cility Demonstration Fund. Additional funding may be transferred
from these accounts upon written notification to the Committees on
Appropriations of both Houses of Congress.
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(INCLUDING TRANSFER OF FUNDS)
The bill includes section 220 permitting the transfer of
$323,242,000 of fiscal year 2023 funding appropriated for medical
accounts to the Joint DOD–VA Medical Facility Demonstration
Fund for the operation of facilities designated as combined Federal
medical facilities.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 221 permitting the transfer of funds de-
posited in the Medical Care Collections Fund to the Joint DOD–VA
Medical Facility Demonstration Fund for facilities designated as
combined Federal medical facilities.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 222 directing that a minimum of
$15,000,000 shall be transferred from the four medical care appro-
priations to the Department of Defense/Department of Veterans Af-
fairs Health Care Sharing Incentive Fund, to be available until ex-
pended.
The bill includes section 223 requiring the Secretary to notify the
Committees on Appropriations of both Houses of Congress of all bid
savings when identified in Major Construction projects that total at
least $5,000,000 or five percent of the programmed amount of the
project. The Administration proposal to delete this provision is not
adopted.
The bill includes section 224 prohibiting the original scope of
work for a Major Construction project from being increased above
the scope specified for that project in the original justification data
provided to Congress unless approved by the Committees on Appro-
priations of both Houses of Congress. The Administration proposal
to delete this provision is not adopted.
The bill includes section 225 requiring a quarterly report from
each VBA regional office on pending disability claims, both initial
and supplemental; error rates; the number of claims processing
personnel; corrective actions taken; training programs; and review
team audit results. In addition, the bill requires quarterly report-
ing on pending appeals at VBA, as well as BVA. The Administra-
tion proposal to delete this provision is not adopted.
The bill includes section 226 requiring advance written notifica-
tion to the Committees on Appropriations of both Houses of Con-
gress 15 days prior to organizational changes which result in the
transfer of 25 or more full-time equivalent staff from one organiza-
tional unit to another. The Administration proposal to delete this
provision is not adopted.
The bill includes section 227 requiring the Secretary to provide,
on a quarterly basis to the Committees on Appropriations of both
Houses of Congress, notification of any single national outreach
and awareness marketing campaign in which obligations exceed
$1,000,000. The Administration proposal to delete this provision is
not adopted.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 228 permitting the transfer to ‘‘Medical
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Services’’ from any discretionary program except ‘‘General Oper-
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ating Expenses, Veterans Benefits Administration’’ upon approval
of the Committees on Appropriations of both Houses of Congress.
This provision is intended to give VA flexibility as it administers
the changes to its traditional healthcare program and the MIS-
SION Act. The Administration proposal to modify this provision is
not adopted.
(INCLUDING TRANSFER OF FUNDS)
The bill includes section 229 permitting the transfer of funds be-
tween the ‘‘Board of Veterans Appeals’’ and ‘‘General Operating Ex-
penses, Veterans Benefits Administration’’ upon approval of the
Appropriations Committees on Appropriations of both Houses of
Congress. The Administration proposal to modify this provision is
not adopted.
The bill includes section 230 prohibiting the reprogramming of
funds exceeding $7,000,000 among the Major Construction projects
unless the Committees on Appropriations of both Houses of Con-
gress approve the request. The Administration proposal to modify
this provision is not adopted.
The bill includes section 231 requiring the Secretary to ensure
that the toll-free suicide hotline provides immediate assistance
from a trained professional and adheres to all requirements of the
American Association of Suicidology. The Administration request to
delete this provision is not adopted.
The bill includes section 232 requiring VA to use the mammog-
raphy screening guidelines announced by the Secretary on May 10,
2017 through January 1, 2024. The Administration request to de-
lete this provision is not adopted.
The bill includes section 233 permanently allowing the use of
Medical Services funding for assisted reproductive technology treat-
ment and adoption reimbursement for Veterans and their spouses
if the Veteran has a service-connected disability that results in
being unable to procreate without such fertility treatment.
The bill includes section 234 prohibiting any funds from being
used in a manner that is inconsistent with statutory limitations on
outsourcing.
The bill includes section 235 pertaining to exceptions for Indian-
or Native Hawaiian-owned businesses contracting with VA.
The bill includes section 236 directing the elimination over a se-
ries of years of the use of Social Security numbers in VA programs.
The bill includes section 237 referencing the provision in the
Continuing Appropriations and Military Construction, Veterans Af-
fairs, and Related Agencies Appropriations Act, 2017, and Zika Re-
sponse and Preparedness Act (P.L. 114–223) pertaining to certifi-
cation of marriage and family therapists. The Administration re-
quest to delete this provision is not adopted.
The bill includes section 238 which prohibits funds from being
used to transfer funding from the Filipino Veterans Equity Com-
pensation Fund to any other VA account. The Administration re-
quest to delete this provision is not adopted.
The bill includes section 239 permitting funding to be used in fis-
cal years 2022 and 2023 to carry out and expand the child care
pilot program authorized by section 205 of the Caregivers and Vet-
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erans Omnibus Health Services Act of 2010 (P.L. 111–163).
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The bill includes section 240 prohibiting VA from using funds to
enter into an agreement to resolve a dispute or claim with an indi-
vidual that would restrict the individual from speaking to Members
of Congress or their staff on any topic, except those required to be
kept secret in the interest of national defense or the conduct of for-
eign affairs. The Administration request to delete this provision is
not adopted.
The bill includes section 241 referencing language in the Con-
tinuing Appropriations and Military Construction, Veterans Af-
fairs, and Related Agencies Appropriations Act, 2017, and Zika Re-
sponse and Preparedness Act (P.L. 114–223) requiring certain data
to be included in budget justifications for major construction
projects. The Administration request to delete this provision is not
adopted.
The bill includes section 242 prohibiting the use of funds to deny
the Inspector General timely access to information, unless a provi-
sion of law expressly refers to the Inspector General and expressly
limits such access. The Administration request to modify this provi-
sion is not adopted.
The bill includes section 243 prohibiting funding from being used
in a manner that would increase wait times for Veterans at med-
ical facilities. The Administration request to delete this provision
is not adopted.
The bill includes section 244 prohibiting the use of funds in fiscal
year 2022 to convert any program that received specific purpose
funds in fiscal year 2021 to a general purpose-funded program
without the approval of the Committees on Appropriations of both
Houses of Congress at least 30 days prior to any such action. The
Administration request to delete this provision is not adopted.
The bill includes section 245 eliminating category D or E pain
testing on dogs or cats.
The bill includes section 246 to allow fiscal year 2022 and 2023
‘‘Medical Community Care’’ funds to be used to cover obligations
that would have otherwise been paid by the Veterans Choice Fund.
The bill includes section 247 allowing obligations and expendi-
tures applicable to the ‘‘Medical Services’’ account in fiscal years
2017 through 2019 for aid to state homes to remain in the ‘‘Medical
Community Care’’ account for such fiscal years.
This bill includes section 248 specifying an amount from the four
medical care accounts for gender-specific care for women.
The bill includes section 249 establishing a timeline for site prep-
aration in accordance with a lease.
TITLE III
RELATED AGENCIES
Funds under Title III support the agencies that honor and re-
spect the service of our Nation’s heroes. Though it may be a small-
er title of the bill, the agencies funded under Title III are the pub-
lic face of America’s commitment to our servicemembers and Vet-
erans. The American Battle Monuments Commission and Arlington
Cemetery commemorate those who made the ultimate sacrifice,
while the Armed Forces Retirement Home and the United States
Court of Appeals for Veterans Claims are critical parts of keeping
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our promise to serve those who served our Nation.
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AMERICAN BATTLE MONUMENTS COMMISSION
SALARIES AND EXPENSES
Appropriation, fiscal year 2021 ......................................................... $84,100,000
Budget request, fiscal year 2022 ....................................................... 84,800,000
Committee recommendation, fiscal year 2022 ................................. 88,100,000
Change from enacted level ......................................................... +4,000,000
Change from budget request ...................................................... + 3,300,000
The recommendation includes $88,100,000 for Salaries and Ex-
penses of the American Battle Monuments Commission (ABMC).
The Committee notes the significant maintenance needs of the
American Battle Monuments around the world, which are specifi-
cally designed to honor our fallen servicemembers. The Committee
continues to direct ABMC to emphasize maintaining and repairing
existing monuments and memorials in a proactive and timely man-
ner that honors the service, achievements, and sacrifices of the
United States Armed Forces.
FOREIGN CURRENCY FLUCTUATIONS ACCOUNT
The recommendation includes such sums as necessary for the
Foreign Currency Fluctuations Account.
UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS
SALARIES AND EXPENSES
Appropriation, fiscal year 2021 ......................................................... $37,100,000
Budget request, fiscal year 2022 ....................................................... 41,700,000
Committee recommendation, fiscal year 2022 ................................. 41,700,000
Change from enacted level ......................................................... +4,600,000
Change from budget request ...................................................... –––
The recommendation includes $41,700,000 for Salaries and Ex-
penses for the United States Court of Appeals for Veterans Claims
(the Court).
Caseload.—The Committee recognizes that caseloads at the
Court continue to increase and directs the Court to continue using
available resources to respond effectively to the growing demand.
DEPARTMENT OF DEFENSE—CIVIL
CEMETERIAL EXPENSES, ARMY
SALARIES AND EXPENSES
Appropriation, fiscal year 2021 ......................................................... $81,815,000
Budget request, fiscal year 2022 ....................................................... 87,000,000
Committee recommendation, fiscal year 2022 ................................. 87,000,000
Change from enacted level ......................................................... +5,185,000
Change from budget request ...................................................... –––
The recommendation includes $87,000,000 for Salaries and Ex-
penses for Arlington National Cemetery (the Cemetery), which is
equal to the fiscal year 2022 budget request. The Committee is
pleased to see an acknowledgment of its repeated direction that the
Cemetery’s budget requests reflect the funding needed to respond
to increased costs and to maintain the current level of services.
Updated Interment Policy.—The Committee is aware that the
Secretary of the Army is in the process of finalizing revised criteria
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for interment at the Cemetery to preserve it as an active burial
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ground well into the future, and the Committee notes that it will
continue to follow closely to ensure that the Cemetery can continue
to live up to its mission to honor those who have served.
Protestant Chaplain Memorial.—The Committee strongly be-
lieves that our nation’s deceased military chaplains of all faiths
should be properly honored in Arlington National Cemetery, and
that the monuments located on Chaplains Hill represent a key part
of this commitment. The Committee urges the Cemetery to con-
tinue to work productively with stakeholders on proposals to re-
store and update the Protestant Chaplain Memorial and ensure
that it can continue to honor those who have served.
CONSTRUCTION
Appropriation, fiscal year 2021 ......................................................... $– – –
Budget request, fiscal year 2022 ....................................................... 141,000,000
Committee recommendation, fiscal year 2022 ................................. 141,000,000
Change from enacted level ......................................................... + 141,000,000
Change from budget request ...................................................... –––
The recommendation includes $141,000,000 for planning and de-
sign and construction of Southern Expansion to remain available
until expended. This will complete the anticipated $360,000,000
cost of the Southern Expansion and road realignments to extend
the life of the cemetery. The Committee provides this funding to
ensure that the life of our Nation’s most prestigious cemetery is ex-
tended into the 2050 timeframe.
ARMED FORCES RETIREMENT HOME
TRUST FUND
The recommendation includes $77,000,000 for the Armed Forces
Retirement Home (AFRH), including $9,000,000 for capital
projects, although $25,000,000 of the total is provided from the gen-
eral fund of the Treasury, and not the Trust Fund.
General Fund.—The Committee continues to express concern
about the use of the General Fund to support the work of AFRH.
The Committee directs AFRH to continue to make progress on ef-
forts to increase revenues and stabilize the AFRH Trust Fund for
the long term, and to continue to report to the Committee on its
further initiatives to improve sustainability and maintain the high-
quality services provided to AFRH residents.
Land Redevelopment.—The Committee continues to be interested
in the redevelopment of the 80-acre master planned parcel on the
Washington campus and continues to direct AFRH to report to the
Committee on the progress of the redevelopment project.
OPERATION AND MAINTENANCE
Appropriation, fiscal year 2021 ......................................................... $66,300,000
Budget request, fiscal year 2022 ....................................................... 68,000,000
Committee recommendation, fiscal year 2022 ................................. 68,000,000
Change from enacted level ......................................................... +1,700,000
Change from budget request ...................................................... –––
The Committee makes these operation and maintenance funds
available until September 30, 2023, as requested, to provide AFRH
greater ability to respond to emergency situations and ensure sta-
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CAPITAL PROGRAM
Appropriation, fiscal year 2021 ......................................................... $9,000,000
Budget request, fiscal year 2022 ....................................................... 7,300,000
Committee recommendation, fiscal year 2022 ................................. 9,000,000
Change from enacted level ......................................................... –––
Change from budget request ...................................................... +1,700,000
Capital Maintenance Spending Plan.—The Committee directs
AFRH to provide, no later than 30 days after enactment of this Act,
an expenditure plan detailing the planned use of the funds pro-
vided for construction and renovation. The Committee further di-
rects AFRH to prioritize completing projects that are currently un-
derway.
ADMINISTRATIVE PROVISION
The bill includes section 301 permitting funds from concessions
at Army National Military Cemeteries to be used to support activi-
ties at the Cemeteries.
TITLE IV
GENERAL PROVISIONS
The bill includes a total of 11 provisions that were in effect in
fiscal year 2021:
The bill includes section 401 prohibiting the obligation of funds
beyond the current fiscal year unless expressly so provided.
The bill includes section 402 prohibiting the use of funds for pro-
grams, projects, or activities not in compliance with Federal law re-
lating to risk assessment, the protection of private property rights,
or unfunded mandates.
The bill includes section 403 encouraging all departments and
agencies funded in this Act to expand the use of ‘‘E-Commerce’’
technologies and procedures.
The bill includes section 404 specifying the Congressional com-
mittees that are to receive all reports and notifications.
The bill includes section 405 prohibiting the transfer of funds to
any instrumentality of the United States Government without au-
thority from an appropriations Act.
The bill includes section 406 prohibiting any funds in this Act to
be used for a project or program named for an individual serving
as a Member, Delegate, or Resident Commissioner of the United
States House of Representatives.
The bill includes section 407 requiring all reports submitted to
the Congress to be posted on official websites of the submitting
agency.
The bill includes section 408 prohibiting the use of funds to es-
tablish or maintain a computer network unless such network
blocks the viewing, downloading, and exchanging of pornography,
except for law enforcement investigation, prosecution, or adjudica-
tion activities.
The bill includes section 409 prohibiting the use of funds for pay-
ment of first-class travel by an employee of the executive branch.
The bill includes section 410 prohibiting the use of funds in this
Act for any contract where the contractor has not complied with E-
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The bill includes section 411 prohibiting the use of funds in this
Act to construct facilities on military installations that do not meet
resiliency standards.
HOUSE OF REPRESENTATIVES REPORT REQUIREMENTS
The following items are included in accordance with various re-
quirements of the Rules of the House of Representatives:
STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES
Pursuant to clause 3(c)(4) of rule XIII of the Rules of the House
of Representatives, the following is a statement of general perform-
ance goals and objectives for which this measure authorizes fund-
ing:
The Committee on Appropriations considers program perform-
ance, including a program’s success in developing and attaining
outcome-related goals and objectives, in developing funding rec-
ommendations.
RESCISSIONS
The bill does not contain any rescissions, as defined in clause
3(f)(2) of rule XIII of the Rules of the House of Representatives.
TRANSFER OF FUNDS
Pursuant to clause 3(f)(2) of rule XIII of the Rules of the House
of Representatives, the following statements are submitted describ-
ing the transfer of funds provided in the accompanying bill.
Language is included to allow for the transfer of funds from
Family Housing, Construction accounts to the Department of De-
fense Family Housing Improvement Fund and funds from Military
Construction accounts to the Department of Defense Military Unac-
companied Housing Improvement Fund.
Language is included to provide transfer authority from the
BRAC account to the Homeowners Assistance Program.
Language is included to allow the transfer of expired funds to the
‘‘Foreign Currency Fluctuations, Construction, Defense’’ account.
Language is included to transfer not to exceed $20,115,000 in fis-
cal year 2022 from Compensation and Pensions to General Oper-
ating Expenses, Veterans Benefits Administration and Information
Technology Systems. These funds are for the administrative costs
of implementing cost-savings proposals required by the Omnibus
Budget Reconciliation Act of 1990 and the Veterans’ Benefits Act
of 1992. Language is also included transferring funds to the med-
ical care collections fund to augment funding of medical facilities
for nursing home care provided to pensioners.
Language is included to permit the transfer of funds from Gen-
eral Administration to General Operating Expenses, Veterans Ben-
efits Administration.
Language is included to permit the transfer of funds between In-
formation Technology Systems development projects and among the
three sub-accounts identified in bill language subject to the ap-
proval of the Committee.
Language is included to provide authority for the Department of
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Veterans Affairs for any funds appropriated in 2022 for Compensa-
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tion and Pensions, Readjustment Benefits, and Veterans Insurance
and Indemnities to be transferred among those three accounts.
Language is included to transfer funds among the Medical Serv-
ices, Medical Community Care, Medical Support and Compliance,
and Medical Facilities accounts.
Language is included to permit the funds from three life insur-
ance funds to be transferred to General Operating Expenses, Vet-
erans Benefits Administration and Information Technology Sys-
tems for the costs of administering such programs.
Language is included to permit funding up to $78,417,225 to be
transferred to General Administration and Information Technology
Systems from any funds appropriated in fiscal year 2022 to reim-
burse three headquarters offices for services provided.
Language is included to transfer certain funds derived from en-
hanced-use leasing activities to the Construction, Major Projects
and Construction, Minor Projects accounts.
Language is included to transfer funds from the Medical Care
Collections Fund to the Medical Services and Medical Community
Care accounts.
Language is included to allow the transfer of funds from the Cap-
ital Asset Fund to the Construction, Major Projects and Construc-
tion, Minor Projects accounts.
Language is included to allow the transfer of funds from various
accounts to the Information Technology Systems account in an ag-
gregate amount not to exceed ten percent of the account appropria-
tion, subject to approval by the Committee.
Language is included to allow the transfer of funds in fiscal year
2022 provided for the Department of Veterans Affairs to the Joint
Department of Defense-Department of Veterans Affairs Medical
Facility Demonstration Fund.
Language is included allowing fiscal year 2023 medical care
funding to be transferred to the Joint Department of Defense-De-
partment of Veterans Affairs Medical Facility Demonstration fund.
Language is included permitting funds deposited to the Medical
Care Collections Fund for healthcare provided at a combined Fed-
eral medical facility to be transferred to the Joint Department of
Defense-Department of Veterans Affairs Medical Facility Dem-
onstration Fund.
Language is included under the Department of Veterans Affairs
that would transfer no less than $15,000,000 for the DOD–VA
Health Care Sharing Incentive Fund as authorized by section
8111(d) of title 38, United States Code.
Language is included that permits the transfer from all discre-
tionary accounts except General Operating Expenses, Veterans
Benefits Administration, to Medical Services, subject to approval by
the Committee.
Language is included that permits transfer of funds between
General Operating Expenses, Veterans Benefits Administration
and the Board of Veterans Appeals, subject to approval by the
Committee.
DISCLOSURE OF EARMARKS AND CONGRESSIONALLY DIRECTED
SPENDING ITEMS
The following table is submitted in compliance with clause 9 of
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rule XXI, and lists the congressional earmarks (as defined in para-
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94
graph (e) of clause 9) contained in the bill or in this report. Neither
the bill nor the report contain any limited tax benefits or limited
tariff benefits as defined in paragraphs (f) or (g) of clause 9 of rule
XXI.
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MILITARY CONSTRUCTION, VETERANS AFFAIRS, AND RELATED AGENCIES
[Community Project Funding Items]
Jkt 045008 Account Location Project Amount Requestor(s)
Air National Guard Delaware: New Castle County Airport Fuel Cell and Corrosion Control Hangar $17,500,000 Blunt Rochester
Army Texas: Joint Base San Antonio Camp Bullis Vehicle Maintenance Shop $10,000,000 Gonzales, Tony
PO 00000
Air Force Texas: Joint Base San Antonio Lackland Air Force Base Child Development Center $22,000,000 Gonzales, Tony
Air Force Louisiana: Barksdale Air Force Base New Entrance Road and Gate Complex $36,000,000 Johnson (LA)
Frm 00095
Army National Guard Mississippi: Camp Shelby Joint Forces Training Center Mobilization and Annual Training Equipment Site (MATES) $15,500,000 Palazzo
Project
Army Alabama: Anniston Army Depot Welding Facility $25,010,000 Rogers (AL)
Fmt 6659
Navy and Marine Corps Florida: Marine Corps Support Facility Blount Island Lighterage and Small Craft Facility $7,000,000 Rutherford
95
Air Force Reserve Ohio: Youngstown Air Reserve Station Assault Strip Widening $8,700,000 Ryan
Sfmt 6602
Air National Guard Idaho: Boise Air Terminal (Gowen Field) Medical Training Facility $6,500,000 Simpson
Army New York: Fort Drum Wellfield Expansion Resilience Project $27,000,000 Stefanik
Air Force Ohio: Wright Patterson Air Force Base Child Development Center $24,000,000 Turner
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96
COMPLIANCE WITH RULE XIII, CL. 3(e) (RAMSEYER RULE)
In compliance with clause 3(e) of rule XIII of the Rules of the
House of Representatives, changes in existing law made by the bill,
as reported, are shown as follows (existing law proposed to be omit-
ted is enclosed in black brackets, new matter is printed in italics,
existing law in which no change is proposed is shown in roman):
SECTION 220 OF DIVISION J OF THE CONSOLIDATED
APPROPRIATIONS ACT, 2021
(Public Law 116–260)
AN ACT Making consolidated appropriations for the fiscal year ending September
30, 2021, providing coronavirus emergency response and relief, and for other pur-
poses.
ø(INCLUDING TRANSFER OF FUNDS)
øSEC. 220. Of the amounts appropriated to the Department of
Veterans Affairs which become available on October 1, 2021, for
‘‘Medical Services’’, ‘‘Medical Community Care’’, ‘‘Medical Support
and Compliance’’, and ‘‘Medical Facilities’’, up to $327,126,000, plus
reimbursements, may be transferred to the Joint Department of
Defense—Department of Veterans Affairs Medical Facility Dem-
onstration Fund, established by section 1704 of the National De-
fense Authorization Act for Fiscal Year 2010 (Public Law 111–84;
123 Stat. 3571) and may be used for operation of the facilities des-
ignated as combined Federal medical facilities as described by sec-
tion 706 of the Duncan Hunter National Defense Authorization Act
for Fiscal Year 2009 (Public Law 110–417; 122 Stat. 4500): Pro-
vided, That additional funds may be transferred from accounts des-
ignated in this section to the Joint Department of Defense—De-
partment of Veterans Affairs Medical Facility Demonstration Fund
upon written notification by the Secretary of Veterans Affairs to
the Committees on Appropriations of both Houses of Congress.¿
TITLE 38, UNITED STATES CODE
* * * * * * *
PART II—GENERAL BENEFITS
* * * * * * *
CHAPTER 17—HOSPITAL, NURSING HOME,
DOMICILIARY, AND MEDICAL CARE
SUBCHAPTER I—GENERAL
Sec.
1701. Definitions.
* * * * * * *
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SUBCHAPTER II—HOSPITAL, NURSING HOME, OR
DOMICILIARY CARE AND MEDICAL TREATMENT
1710. Eligibility for hospital, nursing home, and domiciliary care.
* * * * * * *
1720K. Provision of assisted reproductive technology or adoption reimbursements for
certain disabled veterans.
* * * * * * *
SUBCHAPTER II—HOSPITAL, NURSING HOME, OR
DOMICILIARY CARE AND MEDICAL TREATMENT
* * * * * * *
§ 1720K. Provision of assisted reproductive technology or
adoption reimbursements for certain disabled vet-
erans
(a) PROVISION OF SERVICES.—Subject to the availability of appro-
priations, the Secretary may provide—
(1) fertility counseling and treatment using assisted reproduc-
tive technology to a covered veteran or the spouse of a covered
veteran; or
(2) adoption reimbursement to a covered veteran.
(b) LIMITATIONS.—Amounts made available for the purposes spec-
ified in subsection (a) are subject to the requirements for funds con-
tained in section 508 of division H of the Consolidated Appropria-
tions Act, 2017 (Public Law 115–31).
(c) DEFINITIONS.—In this section:
(1) The term ‘‘adoption reimbursement’’ means reimbursement
for the adoption-related expenses for an adoption that is final-
ized after the date of the enactment of this section under the
same terms as apply under the adoption reimbursement pro-
gram of the Department of Defense, as authorized in Depart-
ment of Defense Instruction 1341.09, including the reimburse-
ment limits and requirements set forth in such instruction, as
in effect on the date of the enactment of this section.
(2) The term ‘‘assisted reproductive technology’’ means bene-
fits relating to reproductive assistance provided to a member of
the Armed Forces who incurs a serious injury or illness on ac-
tive duty pursuant to section 1074(c)(4)(A) of title 10, as de-
scribed in the memorandum on the subject of ‘‘Policy for As-
sisted Reproductive Services for the Benefit of Seriously or Se-
verely Ill/Injured (Category II or III) Active Duty Service Mem-
bers’’ issued by the Assistant Secretary of Defense for Health Af-
fairs on April 3, 2012, and the guidance issued to implement
such policy, as in effect on the date of the enactment of this sec-
tion, including any limitations on the amount of such benefits
available to such a member, except that—
(A) the periods regarding embryo cryopreservation and
storage set forth in part III(G) and in part IV(H) of the first
part IV of such memorandum shall not apply; and
(B) such term includes embryo cryopreservation and stor-
age without limitation on the duration of such
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(3) The term ‘‘covered veteran’’ means a veteran who has a
service-connected disability that results in the inability of the
veteran to procreate without the use of fertility treatment.
* * * * * * *
CHANGES IN APPLICATION OF EXISTING LAW
Pursuant to clause 3(f)(1)(A) of rule XIII of the Rules of the
House of Representatives, the following statements are submitted
describing the effect of provisions in the accompanying bill that di-
rectly or indirectly change the application of existing law.
Language is included in various parts of the bill to continue on-
going activities that require annual authorization or additional leg-
islation, which to date have not been enacted.
Language is included in various parts of the bill to place limita-
tions on the use of funds in the bill or change existing limitations
and which might, under some circumstances, be construed as
changing the application of existing law.
Language is included in various parts of the bill to allow the Sec-
retary of Defense to exceed certain limitations upon notification to
the Committee.
Language is included in various parts of the bill to allow funding
to be used for official reception and representation expenses.
Language is included in various parts of the bill to enable var-
ious appropriations to remain available for more than one year for
some programs for which the basic authority legislation does not
presently authorize such extended availability.
Language is included in various parts of the bill to permit the
transfer of funds to other accounts.
Language is included under Title I to prohibit payments for cost-
plus-a-fixed-fee contracts under certain circumstances.
Language is included in various parts of the bill to allow funds
to be used for the hire of passenger motor vehicles.
Language is included under Title I to allow advances to the Fed-
eral Highway Administration, Department of Transportation under
certain circumstances.
Language is included under Title I to prohibit the use of funds
to begin construction of new bases without specific appropriations.
Language is included under Title I to prohibit the use of funds
for purchase of land or land easements under certain cir-
cumstances.
Language is included under Title I to prohibit the use of funds
for land acquisition, site preparation, and utility installation for
family housing unless funds have been made available in annual
appropriations Acts.
Language is included under Title I to prohibit the use of minor
construction funds to transfer an activity between installations
without prior notification.
Language is included under Title I to prohibit the use of funds
for the procurement of steel for any activity if American steel pro-
ducers have been denied the opportunity to compete for such steel
procurements.
Language is included under Title I to prohibit the use of funds
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Language is included under Title I to prohibit the use of funds
to initiate a new installation overseas without prior notification.
Language is included under Title I to limit the use of funds for
architect and engineer contracts under certain circumstances.
Language is included under Title I to limit the use of funds for
awarding contracts to foreign contractors under certain cir-
cumstances.
Language is included under Title I to require the Department of
Defense to notify the appropriate committees of Congress of any
proposed military exercises under certain circumstances.
Language is included under Title I to allow prior year construc-
tion funding to be available for currently authorized projects.
Language is included under Title I to allow payment for the cost
associated with supervision, inspection, overhead, engineering and
design on family housing or military construction projects that are
being completed with expired or lapsed funds.
Language is included under Title I to allow funds to be expended
on military construction projects for four fiscal years after enact-
ment under certain circumstances.
Language is included under Title I to allow construction funds to
be transferred to Housing Improvement Funds.
Language is included under Title I to allow for the transfer of
BRAC funds to the Homeowners Assistance Program.
Language is included under Title I to limit funds for the oper-
ation and maintenance of family housing to those provided in this
appropriation and to limit amounts expended on repairs of general
and flag officer quarters under certain circumstances.
Language is included under Title I to allow funds in the Ford Is-
land Improvement Account to be available until expended for cer-
tain purposes.
Language is included under Title I to allow for the transfer of ex-
pired funding to the Foreign Currency Fluctuation Account under
certain circumstances.
Language is included under Title I to prohibit funds to be used
for projects at Arlington Cemetery.
Language is included under Title I providing additional funds for
Military Construction, Army.
Language is included under Title I providing additional funds for
Military Construction, Navy and Marine Corps.
Language is included under Title I providing additional funds for
Military Construction, Air Force.
Language is included under Title I providing additional funds for
Military Construction, Army National Guard.
Language is included under Title I providing additional funds for
Military Construction, Air National Guard.
Language is included under Title I providing additional funds for
Military Construction, Army Reserve.
Language is included under Title I defining the congressional de-
fense committees.
Language is included under Title I directing all amounts appro-
priated to Military Construction (all accounts) be immediately
available and allotted for the full scope of the authorized project.
Language is included under Title I providing additional funds for
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Military Construction, Army for cost to complete projects.
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Language is included under Title I providing additional funds for
Military Construction, Navy and Marine Corps for cost to complete
projects.
Language is included under Title I providing additional funds for
Military Construction, Air Force for cost to complete projects.
Language is included under Title I providing additional funds for
Military Construction, Army Reserve for cost to complete projects.
Language is included under Title I providing additional funds for
Military Construction, Navy Reserve for cost to complete projects.
Language is included under Title I providing additional funds for
Family Housing Construction, Army for cost to complete projects.
Language is included under Title I providing additional funds for
Family Housing Operations and Maintenance, Army.
Language is included under title I for child development centers.
Language is included under title I for barracks.
Language is included under title I for Natural Disasters.
Language is included prohibiting funds for construction and
planning and design associated with Space Force until completion
of site selection reviews.
Language is included under Title II providing for the reimburse-
ment to the Department of Defense for the costs of overseas em-
ployee mail.
Language is included under Title II to require that the Secretary
of Veterans Affairs establish a priority for treatment of Veterans
who are service-connected disabled, lower income, or have special
needs.
Language is included under Title II to require that the Secretary
of Veterans Affairs give priority funding of basic medical benefits
to priority groups 1 through 6.
Language is included under Title II to allow the Secretary of Vet-
erans Affairs to dispense prescription drugs from VHA facilities to
enrolled Veterans with privately written prescriptions at no addi-
tional cost to the Department.
Language is included under Title II requiring the Secretary to
ensure sufficient funding is available for the acquisition of pros-
thetics designed for women Veterans.
Language is included under Title II requiring sufficient funding
is available for prosthetic research specifically for female Veterans
and for toxic exposure research.
Language is included under Title II to require approval of a
transfer between development projects in the Information Tech-
nology Systems account.
Language is included under Title II prohibiting funding in the
Veterans Electronic Health Record account from being obligated in
a manner inconsistent with deployment schedules.
Language is included under Title II establishing time limitations
and reporting requirements concerning the obligation of Major Con-
struction funds, limiting the use of funds, allowing the use of funds
for program costs, and allowing for the reimbursement to the ‘‘Gen-
eral Administration’’ account for the salaries and expenses of the
Office of Construction and Facilities Management employees.
Language is included under Title II to allow Minor Construction
funds to be used to repair non-medical facilities damaged by nat-
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ural disaster or catastrophe.
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Language is included under Title II permitting transfers between
mandatory and discretionary accounts, limiting and providing for
the use of certain funds, funding administrative expenses associ-
ated with life insurance programs from excess program revenues,
allowing reimbursement from enhanced-use leases and for certain
services, requiring notification of construction bid savings, limiting
reprogramming amount of major construction projects, restricting
changes in the scope of major construction projects, requiring dis-
closure of insurance and income information, allowing a recovery
audit collection program, allowing Veterans in the State of Alaska
to use Indian Health Service facilities under certain conditions, re-
quiring quarterly reports on the Department’s financial status, per-
formance measures, and data, allowing medical services funds for
recreational and funeral expenses, and requiring notification of or-
ganizational changes that transfer 25 or more employees from one
VA organizational unit to another.
Language is included under Title II requiring notification of any
single national outreach and awareness marketing campaign in
which obligations exceed $1,000,000.
Language is included under Title II requiring the Secretary to
maintain certain requirements in operating the toll-free suicide
hotline.
Language is included under Title II prohibiting funds from being
used in contravention of certain breast cancer screening guidance.
Language is included under Title II to allow covered Veterans
and their spouses, under certain conditions, to receive assisted re-
productive technology services and adoption reimbursement.
Language is included under Title II pertaining to exceptions for
Indian- or Native Hawaiian-owned businesses contracting with the
Department.
Language is included under Title II directing the elimination of
using Social Security account numbers to identify individuals in all
information systems of the Department.
Language is included under Title II pertaining to certification of
marriage and family therapists.
Language is included under Title II prohibiting funds from being
used to transfer funding from the Filipino Veterans Equity Com-
pensation Fund to any other VA account.
Language is included under Title II permitting funds to carry out
and expand the child care program.
Language is included under Title II prohibiting funds to enter
into an agreement to resolve a dispute or claim with an individual
that would restrict the individual from speaking to Members of
Congress or their staff.
Language is included under Title II requiring certain data to be
included in budget justifications for major construction projects.
Language is included under Title II prohibiting the Inspector
General timely access to information.
Language is included under Title II prohibiting funding to be
used that would increase wait times for Veterans who seek medical
care.
Language is included under Title II prohibiting the use of funds
in fiscal year 2022 to convert any program that received specific
purpose funding in fiscal year 2021 to a general purpose-funded
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Language is included under Title II prohibiting the use of dogs
or cats as part of the conduct of any study.
Language is included under Title II allowing for funds within the
Medical Community Care account to be used for expenses that
would have otherwise been payable from the Veterans Choice
Fund.
Language is included under Title II allowing for obligations and
expenditures applicable to the Medical Services account in fiscal
years 2017 through 2019 for aid to state homes to remain in the
Medical Community Care account for such fiscal years.
Language is included under Title II providing for a certain
amount within the medical care accounts to be made available for
gender-specific care for women.
Language is included under Title II establishing a timeline for
site preparation in accordance with a lease.
Language is included under Title III United States Court of Ap-
peals for Veterans Claims, Salaries and Expenses, to permit the
use of funds for a pro bono program.
Language is included under Title III Cemeterial Expenses, Army,
Salaries and Expenses, to permit the use of funds for parking
maintenance and repairs.
Language is included under Title III Armed Forces Retirement
Home to permit payment from the general fund of the Treasury to
the Trust Fund.
Language is included under Title III to allow for the use of con-
cession fees.
Language is included under Title IV prohibiting funding beyond
the current fiscal year unless expressly so provided.
Language is included under Title IV to limit the use of funds for
Federal entities when they are not in compliance with Federal law
relating to risk assessment, the protection of private property
rights, or unfunded mandates.
Language is included under Title IV providing funding to expand
the use of ‘‘E Commerce’’ technologies and procedures.
Language is included under Title IV specifying the Congressional
committees that are to receive all reports and notifications.
Language is included under Title IV prohibiting the transfer of
funds to any instrumentality of the United States Government
without authority from an appropriations Act.
Language is included under Title IV prohibiting the use of funds
for a project or program named for an individual serving as a Mem-
ber, Delegate, or Resident Commissioner of the United States
House of Representatives.
Language is included under Title IV requiring all reports sub-
mitted to the Congress to be posted on the official public Website
of that agency.
Language is included under Title IV prohibiting funds from being
used to maintain or establish a computer network unless such net-
work blocks the viewing, downloading, and exchanging of pornog-
raphy.
Language is included under Title IV prohibiting funds from being
used to pay for first-class travel in violation of Federal regulations.
Language is included under Title IV prohibiting funds from being
used to execute a contract for goods or services where a contractor
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Language is included under Title IV prohibiting the use of funds
in this Act to construct facilities on military installations that do
not meet resiliency standards.
APPROPRIATIONS NOT AUTHORIZED BY LAW
Pursuant to clause 3(f)(1)(B) of rule XIII of the Rules of the
House of Representatives, the following table lists the appropria-
tions in the accompanying bill which are not authorized by law for
the period concerned:
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[dollars in thousands]
Agency/program Last year of Authorization Appropriations Appropriations
authorization level in last year of in this bill
authorization
Military Construction, Army................................................... 2021 880,076 628,900 898,692
Military Construction, Navy and Manne Corps. 2021 2,007,085 1,716,144 1,937,428
Military Construction, Air Force ............................................. 2021 717,432 616,156 1,893,690
Military Construction, Defense-Wide.................................... 2021 1,886,366 2,041,909 2,023,416
Military Construction, Army National Guard ......................... 2021 371,272 349,437 335,603
Military Construction, Air National Guard ...... , ..... , ... ,. .... 2021 90,837 64,214 246,770
Military Construction, Army Reserve .................................... 2021 83,795 88,337 77,411
Military Construction, Navy Reserve .. ................................. 2021 93,714 70,995 84,804
Military Construction, Air Force Reserve. ................ ,., ......... 2021 48,117 23,117 104,574
North Atlantic Treaty Organization Security Investment
Program ............................................................................. 2021 173,030 173,030 205,853
Family Housing Construction, Army................... 2021 119,400 119,400 99,849
Family Housing Operation and Maintenance, Army............ 2021 393,142 352,342 391,227
Family Housing Construction, Navy and Marine Corps....... 2021 42,897 42,897 77,616
Family Housing Operation and Maintenance, Navy and
Marine Corps ........................... ·················'"·····"········· 2021 371,493 346,493 357,341
Family Housing Construction, Air Force ............................... 2021 97,214 97,214 115,716
Family Housing Operation and Maintenance, Air Force...... 2021 326,021 317,021 325,445
Family Housing Operation and Maintenance,
Defense-Wide ................................. .............. ,. .. , .............. 2021 54,728 54,728 49,785
Department of Defense Family Housing Improvement
Fund .................................................................................. 2021 5,897 5,897 6,081
Department of Defense Military Unaccompanied
Housing Improvement Fund 2021 600 600 494
Base Realignment and Closure Account... .... ...................... 2021 322,868 480,447 564,639
Dept. of Veterans Affairs, Major Construction ................. done each yr. 1,316,000 1,611,000
Dept. of Veteran Affairs, Major Leases ................................ done each yr. 92,830 283,381
Armed Forces Retirement Home................ ......................... 2021 70,300 75,300 77,000
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105
PROGRAM DUPLICATION
No provision of this bill establishes or reauthorizes a program of
the Federal Government known to be duplicative of another Fed-
eral program, a program that was included in any report from the
Government Accountability Office to Congress pursuant to section
21 of Public Law 111–139, or a program related to a program iden-
tified in the most recent Catalog of Federal Domestic Assistance.
COMMITTEE HEARINGS
For the purposes of section 103(i) of H. Res. 6 Pursuant to cl.
3(c)(6) of rule XIII of the Rules of the House of Representatives—
The following hearings were used to develop or consider the Mili-
tary Construction, Department of Veterans Affairs, and Related
Agencies Appropriations Act, 2022:
The Subcommittee on Military Construction, Department of Vet-
erans Affairs, and Related Agencies held a hearing on February 16,
2021, entitled ‘‘Oversight of Military Privatized Housing’’. The Sub-
committee received testimony from:
Mr. Paul Cramer, Principal Deputy Assistant Secretary of De-
fense for Sustainment (Installations)
Ms. Elizabeth A. Field, Director, Defense Capabilities Manage-
ment, Government Accountability Office (GAO)
The Subcommittee on Military Construction, Department of Vet-
erans Affairs, and Related Agencies held a hearing on February 19,
2021, entitled ‘‘Department of Veterans Affairs COVID 19 Re-
sponse’’. The Subcommittee received testimony from:
Dr. Richard Stone, Acting Under Secretary for Health, Veterans
Health Administration accompanied by:
Dr. Kameron L. Matthews, Assistant Under Secretary for Health
for Clinical Services, Veterans Health Administration
The Subcommittee on Military Construction, Department of Vet-
erans Affairs, and Related Agencies held a hearing on March 5,
2021, entitled ‘‘Status of Department of Veterans Affairs Infra-
structure’’. The Subcommittee received testimony from:
Mr. Tony Costa, Deputy Executive Director, Construction & Fa-
cilities Management, Department of Veterans Affairs
Mr. Edward Litvin, Deputy to the Assistant Under Secretary for
Health for Administrative Operations, Veterans Health Adminis-
tration
Mr. Brett Simms, Executive Director, Office of Asset and Enter-
prise Management, Department of Veterans Affairs
The Subcommittee on Military Construction, Department of Vet-
erans Affairs, and Related Agencies held a hearing on March 9,
2021, entitled ‘‘Challenges Facing Veterans in Accessing Fertility
Services’’. The Subcommittee received testimony from:
Ms. Barbara Collura, President CEO, RESOLVE: The National
Infertility Association
Ms. Maureen Elias, Associate Legislative Director of Government
Relations, Paralyzed Veterans of America
The Subcommittee on Military Construction, Department of Vet-
erans Affairs, and Related Agencies held a hearing on March 12,
2021, entitled ‘‘VA Specialty Healthcare: Oversight of Women’s
Health, Mental Health, and Suicide Prevention, Whole Health and
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Homelessness’’. The Subcommittee received testimony from:
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Dr. David Carroll, Executive Director, Mental Health Operations,
Veterans Health Administration
Ms. Laura Duke, Chief Financial Officer, Veterans Health Ad-
ministration
Dr. Patricia M. Hayes, Chief Consultant, Women’s Health Serv-
ices, Veterans Health Administration
Dr. Kameron L. Matthews, Assistant Under Secretary for Health
for Clinical Services, Veterans Health Administration
The Subcommittee on Military Construction, Department of Vet-
erans Affairs, and Related Agencies held a hearing on March 24,
2021, entitled ‘‘Remediation and Impact of PFAS’’. The Sub-
committee received testimony from:
Mr. Mark Correll, Deputy Assistant Secretary of the Department
of the Air Force (Environment, Safety and Infrastructure)
Mr. Paul Cramer, Principal Deputy Assistant Secretary of De-
fense for Sustainment (Installations), Department of Defense
Dr. Patricia R. Hastings, Chief Consultant, Post Deployment
Health Services, Veterans Health Administration
Dr. Terry Rauch, Director of Medical Research and Development,
Department of Defense
Ms. Erin Brockovich, Environmental Activist, Consumer Advo-
cate, and President of Brockovich Research and Consulting
Dr. Jamie DeWitt, Associate Professor, East Carolina University,
Department of Pharmacology & Toxicology, Brody School of Medi-
cine
The Subcommittee on Military Construction, Department of Vet-
erans Affairs, and Related Agencies held a hearing on April 15,
2021, entitled ‘‘FY 2022 Budget Hearing: Department of Veterans
Affairs’’. The Subcommittee received testimony from:
The Honorable Denis R. McDonough, Secretary, Department of
Veterans Affairs, accompanied by:
Mr. Jon Rychalski, Assistant Secretary for Management and
Chief Financial Officer, Department of Veterans Affairs
Master Chief Petty Officer Russell Smith, Master Chief Petty Of-
ficer of the Navy
Vice Admiral Ricky Williamson, Deputy Chief of Naval Oper-
ations for Fleet Readiness and Logistics
The Subcommittee on Military Construction, Department of Vet-
erans Affairs, and Related Agencies held a hearing on May 18,
2021, entitled ‘‘Air Force Quality of Life and Installations Update’’.
The Subcommittee received testimony from:
Chief Master Sergeant Joanne Bass, Chief Master Sergeant of
the Air Force
Brigadier General William Kale, Air Force Director of Civil Engi-
neers
Ms. Jennifer Miller, Acting Secretary of the Air Force for Instal-
lations, Environment and Energy
Chief Master Sergeant Roger Towberman, Chief Master Sergeant
of the Space Force
The Subcommittee on Military Construction, Department of Vet-
erans Affairs, and Related Agencies held a hearing on May 20,
2021, entitled ‘‘Member Day’’. The Subcommittee received testi-
mony from:
The Honorable Veronica Escobar, Member of Congress
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The Honorable Richard Hudson, Member of Congress
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The Subcommittee on Military Construction, Department of Vet-
erans Affairs, and Related Agencies held a hearing on May 24,
2021, entitled ‘‘Army Quality of Life and Installations Update’’. The
Subcommittee received testimony from:
Lieutenant General Jason T. Evans, Deputy Chief of Staff of the
Army, G9
Sergeant Major Michael A. Grinston, Sergeant Major of the Army
Mr. J.E. ‘‘Jack’’ Surash, Acting Assistant Secretary of the Army
for Installations, Energy and Environment
BUDGETARY IMPACT OF THE FY 2022 MILITARY CONSTRUCTION, VET-
ERANS AFFAIRS, AND RELATED AGENCIES APPROPRIATIONS BILL
PREPARED IN CONSULTATION WITH THE CONGRESSIONAL BUDGET
OFFICE PURSUANT TO SEC. 308(a), PUBLIC LAW 93–344, AS AMENDED
[In millions of dollars]
COMPARISON WITH BUDGET RESOLUTION
Section 308(a)(1)(A) of the Congressional Budget Act of 1974 re-
quires the report accompanying a bill providing new budget author-
ity to contain a statement comparing the levels in the bill to the
suballocations submitted under section 302(b) of the Act for the
most recently agreed to concurrent resolution on the budget for the
applicable fiscal year.
[In millions of dollars]
302(b) Alocation This Bill
Budget Budget
Outlays Outlays
Authority Authority
Comparison of amounts in the bill with Committee al-
locations to its subcommittees: Subcommittees on
Military Construction, Veterans Affairs, and Related
Agencies
Discretionary .......................................................... 124,500 129,500 124,500 1 128,938
Mandatory .............................................................. 138,638 149,930 138,638 1149,930
1 Includes outlays from prior-year budget authority.
FIVE-YEAR OUTLAY PROJECTIONS
In compliance with section 308(a)(1)(B) of the Congressional
Budget Act of 1974, the following table contains five-year projec-
tions associated with the budget authority provided in the accom-
panying bill.
[In millions of dollars]
Outlays
Projection of outlays associated with the recommendation:
2022 ................................................................................................................................................................ 1 164,059
2023 ................................................................................................................................................................ 106,202
2024 ................................................................................................................................................................ 15,259
2025 ................................................................................................................................................................ 4,070
2026 and future years .................................................................................................................................... 3,189
1 Excludes outlays from prior-year budget authority.
FINANCIAL ASSISTANCE TO STATE AND LOCAL GOVERNMENTS
In accordance with section 308(a)(1)(C) of the Congressional
Budget Act of 1974, the Congressional Budget Office has provided
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108
vided by the accompanying bill for financial assistance to State and
local governments.
[In millions of dollars]
Budget Outlays
Authority
Financial assistance to State and local governments for 2022 ................................ 191 1 28
1Excludes outlays from prior-year budget authority.
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MILITARY CONSTRUCTION
(AMOUNTS IN THOUSANDS)
BUDGET
REQUEST HOUSE
ALABAMA
ARMY
REDSTONE ARSENAL
PROPULSION SYSTEMS LAB ........................... . 55,000 55,000
ANNISTON ARMY DEPOT
WELDING FACILITY ................................ . 25,000
TOTAL ALABAMA .................................. . 55,000 80,000
ALASKA
AIR FORCE
JB ELMENDORF-RICHARDSON
EXTEND RUNWAY 16/34, (INC. 1) ................... .. 79,000 79,000
TOTAL, ALASKA .................... , .. , .......... . 79,000 79,000
ARIZONA
AIR FORCE
DAVIS-MONTHAN AFB
SOUTH WILMOT GATE ........................ , .... , . , . 13,400 13,400
LUKE AFB
F-35A ADAL AMU FACILITY SQUADRON #6 ..•.•. , ....... . 28,000 28,000
F-35A SQUADRON OPERATIONS FACILITY #6 ... , , , , .•.... 21,000 21,000
TOTAL, ARIZONA ..... , ........................... . 62,400 62,400
CALIFORNIA
ARMY
FORT IRWIN
SIMULATIONS CENTER ............................... . 52,000 52,000
NAVY
CAMP PENDLETON
I MEF CONSOLIOATED INFORMATION CENTER (INC. 3), ... 19,869 19,869
LEMOORE
F-35C HANGAR 6 PHASE 2 (MOD 3/4) (INC. 2) ........ . 75,070 50,000
SAN DIEGO ANGS
PIER 6 REPLACEMENT (INC. 2) ...................... . 50,000 50,000
SEAL BEACH
t!ISSILE MAGAZINES (INC. 2) ...................... .. 10,840 10,840
SAN NICHOLAS ISLAND
DIRECTED ENERGY WEAPONS TEST FACILITIES ...•....... 19,907 19,907
AIR FORCE
EDWARDS AFB
FLIGHT TEST ENGINEERING LAB COMPLEX .............. . 4,000 4,000
VANDENBERG AFB
GBSD RE-ENTRY VEHICLE FACILITY.,, ................ . 48,000 48,0DO
GBSD STAGE PROCESSING FACILITY ................... . 19,000 19,000
DEFENSE-WIOE
CAMP PENDLETON
VETERINARY TREATMENT FACILITY REPLACEMENT .•....... 13,600 13,600
CORONADO
SOF ATC OPERATIONS SUPPORT FACILITY, ............. . 21,700 21,700
SOF NSWG11 OPERATIONS SUPPORT FACILITY ........... . 12,000 12,000
- ...... .., .... _____
TOTAL, CALIFORNIA .............................. .
------~----N
345,986 320,916
COLORADO
DEFENSE-WIDE
BUCKLEY AFB
JCC EXPANSION ................................... . . 20,000 20,000
TOTAL, COLORADO ................................ . 20,000 20,000
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MILITARY CONSTRUCTION
(AMOUNTS IN THOUSANDS)
BUDGET
REQUEST HOUSE
CONNECT! CUT
ARMY NATIONAL GUARD
PUTNAM
NATIONAL GUARD READINESS CENTER .... , • , •........ , , , 17,500 17,500
TOTAL, CONNECTICUT,.,,,,,, .. ,,,,,,,,. 17,500 17,500
DELAWARE
AIR NATIONAL GUARD
NEW CASTLE COUNTY AIRPORT
FUEL CELL AND CORRIS!ON AND CONTROL HANGER .• ,,,,.. 17,500
TOTAL, OELAWARE .... , .. , .. , ..... .,, .. , .. ,, ..... ,, 17,500
DISTRICT OF COLUMBIA
AIR FORCE
JB ANACDSTIA BOLLING
JOINT AIR DEFENSE OPERATIONS CENTER PHASE I!,,,,., 24,000 24,000
TOTAL, DISTRICT OF COLUMBIA ..... ,., .. ,., .... , 24,000 24,000
FLORIDA
AIR FORCE RESERVE
HOMESTEAD AFS
CORROSION CONTROL FACILITY ........ ,,, ••...•. ,,,,,, 14,000 14,000
PATRICK AFB
SIMULATOR C-130J., ... , . .,,,,, .. , .. , .... ,,,,,,,,,,, 18,500 18,500
TOTAL, FLORIDA.,,, .. , .............. , ........... . 32,500 32,500
GEORGIA
ARMY
FORT GORDON
CYBER INSTRUCTIONAL FAC (ADMIN/CDM), (INC. 2).,.,. 69,000 69,000
DEFENSE-WIDE
FORT BENNING
SOF BATTALION HEADQUARTERS FACILITY, ...•..•••. , . , , 62,000 62,000
ARMY NATIONAL GUARD
FORT BENNING
POST-INITIAL MIL. TRAINING UNACCDMP. HOUSING ...... 13,200 13,200
TOTAL, GEORGIA .... ,,,,,,,,, .. 144,200 144,200
HAWAII
ARMY
WEST LOCH NAV MAG ANNEX
AMMUNITION STORAGE ... , ... , .. , .. , ..... ,,., .. ,, .... , 51,000 51,000
DEFENSE-WIDE
JOINT BASE PEARL HARBOR-HICKAM
VETERUNARY TREATMENT FACILITY REPLACEMENT, , •.. , , , , 29,800 29,800
TOTAL, HAWAII ............... . 80,800 80 1 BOO
IDAHO
ARMY NATIONAL GUARD
JEROME
NATIONAL GUARD READINESS CENTER.,,,, ....•• ,,, ..... 15,000 15,000
AIR NATIONAL GUARD
GOWEN FIELD
MEDICAL TRAINING FACILITY, . , , .• , , , , , .... , , . , , , , , • , 6,500
TOTAL, IDAHO .....•..•..........•....•. , ...... , .. 15,000 21,500
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MILITARY CONSTRUCTION
(AMOUNTS IN THOUSANDS)
BUDGET
REQUEST HOUSE
ILLINOIS
ARMY NATIONAL GUARD
BLOOMINGTON
NATIONAL GUARD VEHICLE MAINTENANCE SHOP .......... . 15,000 15,000
TOTAL, ILLINOIS. , ............. , , , .............. . 15,000 15,000
KANSAS
ARMY NATIONAL GUARD
TOPEKA
NATIONAL GUARD/RESERVE CENTER BUILDING ......•..... 16,732 16,732
TOTAL, KANSAS ... ,., ............................ , 16,732 16,732
LOUISIANA
ARMY
FORT POLK
JOINT OPERATIONS CENTER .......................... . 55,000 55,000
AIR FORCE
BARKSDALE AFB
WEAPONS GENERATION FACILITY, (INC.1) ............. . 40,000 40,000
ENTRANCE ROAD ANO GATE COMPLEX ..........•......... 36,000
ARMY NATIONAL GUARD
LAKE CHARLES
NATIONAL GUARD READINESS CENTER .................. . 1B,500 1B,500
TOTAL, LOUISIANA ............................... . 113,500 149,500
MAINE
NAVY
KITTERY
MULTI-MISSION DRYDOCK #1 EXTENSION {INC. 2) ....... . 250,000 250,000
ARMY NATIONAL GUARD
SACO
NATIONAL GUARD VEHICLE MAINTENANCE SHOP ......... . 21,200 21,200
TOTAL, MAINE .........•.....................•.. .. 271,200 271,200
MARYLAND
ARMY
FORT MEADE
BARRACKS .................................. ....... . 81,000 81,000
AIR FORCE
JOINT BASE ANDREWS
FIRE CRASH RESCUE STATION ........................ . 26,000 26,000
DEFENSE-WIDE
BETHESDA NAVAL HOSPITAL
MEDCEN ADDITION/ALTERATION, (INC. 5) .......•.•.... 153,233 153,233
FORT MEADE
NSAW RECAP BUILDNG 4, (INC. 1) .................. .. 104,100 104,100
NSAW MISSION OPS AND RECORDS CENTER (INC. 1) ..... . 94,000 94,000
100,000.... . ___________
SOF OPERATIONS FACILITY .......................... . __________ 100,000
TOTAL, MARYLAND ................................ . 558,333 558,333
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MILITARY CONSTRUCTION
(AMOUNTS IN THOUSANDS)
BUDGET
REQUEST HOUSE
MASSACHUSETTS
AIR FORCE
HANSCOM AFB
NC3 ACQUISITIONS MANAGEMENT FACILITY ............. . 66,000 66,000
AIR NATIONAL GUARD
BARNES MAP
COMBINED ENGINE/ ASE/ND! SHOP ..................... . 12,200 12,200
TOTAL, MASSACHUSETTS ........................... . 78,200 78,200
MICHIGAN
ARMY RESERVE
SOUTHFIELD
AREA MAINTENANCE SUPPORT ACTIVITY ................ . 12,000 12,000
NAVY RESERVE
BATTLE CREEK
RESERVE CENTER & VEHICLE MAINTENANCE FACILITY .. ,,, 49,090 49,090
AIR NATIONAL GUARD
ALPENA COUNTY REGIONAL AIRPORT
AIRCRAFT MAINTENANCE HANGAR/SHOPS ................ . 23,000 23,000
W.K. KELLOG REGIONAL AIRPORT
CONSTRUCT MAIN BASE ENTRANCE ............... ,,,,, .. 10,000 10,000
........ .... ----- _________
.,,
,...,_
TOTAL, MICHIGAN ................................ . 94,090 94,090
MINNESOTA
NAVY RESERVE
MINNEAPOLIS
JOINT RESERVE INTELLIGENCE CENTER ................ . 14,350 14,350
AIR FORCE RESERVE
MINNEAPOLIS-ST PAUL IAP
MISSION SUPPORT GROUP FACILITY ..... ,, ............ . 14,000 14,000
TOTAL, MINNESOTA ...............•................ 28,350 28,350
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MILITARY CONSTRUCTION
(AMOUNTS IN THOUSANDS)
BUDGET
REQUEST HOUSE
MISSISSIPPI
ARMY NATIONAL GUARD
CAMP SHELBY
MOBILIZATION AND ANNUAL TRAINING EQUIPMENT SITE
(MATES) , ..... , .. , ..... , . , . , ... , , . , ............. . 15,500
AIR NATIONAL GUARD
JACKSON IAP
FIRE CRASH AND RESCUE STATION .................... . 9,300 9,300
TOTAL, MISSISSIPPI .....................•........ 9,300 24,8DO
MISSOURI
DEFENSE-WIDE
FORT LEONARD WOOD
HOSPITAL REPLACEMENT (INC. 4) ..............•.•.... 160,000 160,000
TOTAL, MISSOURI. ............................... . 160,000 160,000
MONTANA
ARMY NATIONAL GUARD
BUTTE
NATIONAL GUARD READINESS CENTER .................. . 16,000 16,000
TOTAL, MONTANA ................................. . 16,000 16,000
NEVADA
NAVY
FALLON
TRAINING RANGE LAND ACQUISITION· PHASE 2 ........ . 48,250 48,250
TOTAL, NEVADA ......................•.•......... . 48,250 4B,250
NEW MEXICO
DEFENSE-WIDE
KIRTLAND AFB
ENVIRONMENTAL HEALTH FACILITY REPLACEMENT ........ . 8,600 8,600
TOTAL, NEW MEXICO ........... , ................... . 8,600 8,600
NEW YORK
ARMY
FORT HAMILTON
INFORMATION SYSTEMS FACILITY .•.................... 26,000 26,000
WATERVLIET ARSENAL
ACCESS CONTROL POINT ............ , ................ . 20,000 20,000
FORT DRUM
WELLFIED EXPANSION RESILIENCE PROJECT ............ . 27,000
AIR NATIONAL GUARD
SCHENECTADY MUNICIPAL AIRPORT
C-13O FLIGHT SIMULATOR FACILITY .................. . 10,600 10,800
AIR FORCE RESERVE
NIAGARA FALLS IAP
MAIN GATE .................................. ...... . 10,600 10,600
TOTAL, NEW YORK ................................ . 67,400 94,400
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MILITARY CONSTRUCTION
(AMOUNTS IN THOUSANDS)
BUDGET
REQUEST HOUSE
NORTH CAROLI NA
NAVY
CAMP LEJEUNE
II MEF OPERATIONS CENTER REPLACEMENT (INC. 2)., ... 42,200 42,200
CHERRY POINT MARINE CORPS AIR STATION
AIRCRAFT MAINTENANCE HANGAR ...................... . 207,897 60,000
F-35 FLIGHTLINE UTILITES MODERNIZATION PH. 2.,,.,. 113,520 30,000
TOTAL, NORTH CAROLINA .... , ................ , .... . 363,617 132,200
NORTH DAKOTA
ARMY NATIONAL GUARD
DICKERSON
NATIONAL GUARD READINESS CENTER ...... , ........... . 15,500 15,500
TOTAL, NORTH DAKOTA .......... , . , ............... . 15,500 15,500
OHIO
AIR FORCE
WRIGHT PATTERSON AFB
CHILD DEVELOPMENT CENTER ....... , ................. . 24,000
ARMY RESERVE
WRIGHT-PATTERSON AFB
AR CENTER TRAINING BUILDING/OHS .................. . 19,000 19,000
AIR FORCE RESERVE
YOUNGSTOWN AIR RESERVE STATION
ASSAULT STRIP WIDENING ..... , , ............ , , ...... . 8,700
AIR NATIONAL GUARD
CAMP PERRY
RED HORSE LOGISTICS COMPLEX., ................... ,. 7,800 7,800
TOTAL, OHIO ............. , ...................... . 26,800 59,500
OKLAHOMA
AIR FORCE
TINKER AFB
KC-46A 3-BAY DEPOT MAINTENANCE HANGAR ............ . 160,000 60,000
TOTAL, OKLAHOMA ................ , ............... . 160,000 60,000
PENNSYLVANIA
ARMY
LETTERKENNY ARMY DEPOT
FIRE STATION ....................... , ............. . 21,000 21,000
TOTAL, PENNSYLVANIA. , .......................... . 21,000 21,000
SOUTH CAROLINA
ARMY
FORT JACKSON
RECEPTION BARRACKS COMPLEX, PH2, (INC, 2) •• , .••••• 34,000 34,000
AIR NATIONAL GUARD
MCENTIRE ANGS
F-16 MISSION TRAINING CENTER ..................... . 9,800 9,800
TOTAL, SOUTH CAROLI NA .......................... . 43,800 43,800
SOUTH DAKOTA
AIR FORCE
ELLSWORTH AFB
B-21 2-BAY LO RESTORATION FACILITY, (INC. 2) ..... . 91,000 50,000
B-21 ADAL FLIGHT SIMULATOR .... ,.,,., ............. . 24,000 24,000
B-21 FIELD TRAINING DETACHMENT FACILITY .......... . 47,000 47,000
B-21 FORMAL TRAINING UNIT/AMU .................... . 70,000 70,000
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MILITARY CONSTRUCTION
(AMOUNTS IN THOUSANDS}
BUDGET
REQUEST HOUSE
B-21 MISSION OPERATIONS PLANNING FACILITY ........ . 36,000 36,000
B-21 WASHRACK & MAINTENANCE HANGAR .............. . 65,000 65,000
AIR NATIONAL GUARD
JOE FOSS FIELD
F-16 MISSION TRAINING CENTER ..................... . 9,800 9,800
TOTAL, SOUTH DAKOTA ............................ . 342,800 301,800
TEXAS
ARMY
CAMP BULLIS
VEHICLE MAINTENANCE SHOP ......................... . 10,000
AIR FORCE
JOINT BASE SAN ANTONIO
BMT RECRUIT DORMITORY 7 .......................... . 141,000 40,000
BMT RECRUIT DORMITORY 8 (INC. 3} ................ .. 31,000 31,000
LACKLAND AFB
CHILD DEVELOPMENT CENTER ......................... . 22,000
SHEPPARD AFB
CHILD DEVELOPMENT CENTER ......................... . 20,000 20,000
DEFENSE-WIDE
JOINT BASE SAN ANTONIO
AMBULATORY CARE CENTER PHASE 4 ................... . 35,000 35,000
TOTAL, TEXAS ................... , ............... . 227,000 158,000
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MILITARY CONSTRUCTION
(AMOUNTS IN THOUSANDS)
BUDGET
REQUEST HOUSE
UTAH
AIR FORCE
HILL AFB
GBSD ORGANIC SOFTWARE SUSTAIN CENTER (INC. 2) ... . 31,000 31,000
TOTAL, UTAH ........................ ............ . 31,000 31,000
VIRGINIA
NAVY
NORFOLK
SUBMARINE PIER 3 (INC. 2) ........................ . 88,923 88,923
PORTSMOUTH
DRY DOC SALTWATER SYSTEM FOR CVN-78 .............. . 156,380 30,000
QUANTICO
VECHICLE INSPECTION AND VISITOR CONTROL CENTER ... . 42,850 42,850
WARGAMING CENTER (INC. 2) ................... , .... . 30,500 30,500
DEFENSE-WIDE
FORT BELVOIR
VETERINARY TREATMENT FACILITY REPLACEMENT ........ . 29,800 29,800
PENTAGON
CONSOLIDATED MAINTENANCE COMPLEX (RRMC) .......... . 20,000 20,000
FORCE PROTECTION PERIMETER ENHANCEMENTS .......... . 8,608 8,608
PUBLIC WORKS SUPPORTS FACILITY ................... . 21,935 21,935
ARMY NATIONAL GUARD
TROUTVILLE
COMBINED SUPPORT MAINTENANCE SHOP ADDITION ....... . 6,900 6,900
NATIONAL GUARD READINESS CENTER ADDITION ......... . 6,100 6,100
-~~M~-~ ......... _ - M - M - .. - ..........
TOTAL, VIRGINIA ........................ ........ . 411,998 285,616
WASHINGTON
DEFENSE-WIDE
OAK HARBOR
ACCIDENTAL CLINIC ....... , ............ , . , ........ . 59,000 59,000
TOTAL, WASHINGTON ........................ ...... . 59,000 59,000
WISCONSIN
ARl1Y RESERVE
FORT MCCOY
TRANSIENT TRAINING BN HO •.••••.....•.•.•....•••• ..• 12,200 12,200
AIR NATIONAL GUARD
TRUAX FIELD
F-35 3-BAY SPECIALIZED HANGAR .................... . 31,000 31,000
MEDICAL READINESS FACILITY ....................... . 13,200 13,200
TOTAL, WISCONSIN ........ , ...................... . 56,400 56,400
WYOMING
AIR NATIONAL GUARD
CHEYENNE MAP
COMBINED VEHICLE MAINTENANCE & ASE COMPLEX, ...... . 13,400 13,400
TOTAL, WYOl1ING ........................ ......... . 13,400 13,400
AUSTRALIA
AIR FORCE
DARWIN
SQUADRON OPERATIONS FACILITY ..................... . 7,400 7,400
TINDAL
AIRCRAFT MAINTENANCE SUPPORT FACILITY ..... ,, ..... . 6,200 6,200
SQUADRON OPERATIONS FACILITY ........ , ........... ,. 8,200 8,200
TOTAL, AUSTRALIA ............. , .......... , , ..... . 21,800 21,800
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MILITARY CONSTRUCTION
(AMOUNTS IN THOUSANDS)
BUDGET
REQUEST HOUSE
BELGIUM
ARMY
SHAPE HQ
COMMAND AND CONTROL FACILITY ..................... . 16,000 16,000
DEFENSE-WIDE
CHIEVRES AB
EUROPE WEST DISTRICT SUPERINTENDENT'S OFFICE ..... . 15,000 15,000
TOTAL, BELG I UM ....................... .......... . 31,000 31,000
GERMANY
ARMY
EAST CAMP GRAFENWOEHR
EDI: BARRACKS AND DINNING FACILITY ........•...... 103,000 50,000
SMITH BARRACKS
INDOOR SMALL ARMS RANGE ....................... ... . 17,500 17,500
LIVE FIRE EXERCISE SHOOTHOUSE ............•........ 16,000 16,000
AIR FORCE
SPANGDAHLEM AB
F/A-22 LO/COMPOSITE REPAIR FACILITY ....•.......... 22,625 22,625
DEFENSE-WIDE
RAMSTEIN AB
RAMSTEIN MIDDLE SCHOOL., ....... , .•.•...........•.. ______ ..
93,000
_____ 93,000
TOTAL, GERMANY., ........ , .. , .•........ ,.,, ..... . 252,125
-- .. ·--------
199,125
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MILITARY CONSTRUCTION
(AMOUNTS IN THOUSANDS)
BUDGET
REQUEST HOUSE
GREECE
NAVY
SOUDA BAY
EDI: JOINT MOBILITY PROCESSING CENTER ............ . 41,650
TOTAL, GREECE ................ ,., ............. ,,. 41,650
GUAM
NAVY
ANDERSEN AFB
AVIATION AOM!N BUILDING .......................... . 50,890 50,890
JOINT REGION MARIANAS
BACHELOR ENLISTED QUARTERS H (INC. 2) ......... ,. ,. 43,200 43,200
4TH MARINES REGIMENT FACILITIES .................. . 109,507 80,000
COMBAT LOGISTICS BATALLION-4 FACILITY ........... ,. 92,710 92,710
CONSOLI DATED ARMORY ... , .......................... . 43,470 43,470
INFANTRY BATTALION COMPANY HQ ................... ,. 44,100 44,100
MARINE EXPEDITIONARY BRIGADE ENABLERS ... , ..... , .. . 88,830 86,830
PRINCIPAL END ITEM (PEI) WAREHOUSE., ............ ,. 47,110 47,110
X-RAY WHARF BERTH 2 .............. , ............ , .. . 103,800 51,900
JOINT COMMUNICATION UPGRADE (INC. 2) ... , .... , . , . ,. 84,000 84,000
AIR FORCE
JOINT REGION MARIANAS
AIRFIELD DAMAGE REPAIR WAREHOUSE ................. . 30,000 30,000
HAYMAN MUNITIONS STORAGE IGLOOS, MSA2 .. , ......... . 9,824 9,824
MUNITIONS STORAGE IGLOOS IV ...... , .............. ,. 55,000 55,000
ARMY NATIONAL GUARD
BARRIGADA
NATIONAL GUARD READINESS CENTER ADDITION .... , ... ,. 34,000 34,000
--~-#_,..,_,..,_ .... --- . --........
TOTAL, GUAM ..... , ... , .......................... . 814,441 733,034
HUNGARY
AIR FORCE
KECSKEMET AIR BASE
ERI: CONSTRUCT PARALLEL TAXIWAY .................. . 38,650 38,650
ERI: CONSTRUCT AIRFIELD UPGRADES ... , ............ ,. 20,564 20,564
TOTAL, HUNGARY ................................. . 59,214 59,214
JAPAN
NAVY
YOKOSUKA
PIER 5 (BERTHS 2 AND 3) (INC. 3) ................. . 15,292 15,292
SHIP HANDLING & COMBAT TRAINING FACILITIES ....... . 49,900 49,900
AIR FORCE
KADENA AIR BASE
AIRFIELD DAMAGE REPAIR FACILITY .................. . 38,000 38,000
HELICOPTER RESCUE OPS MAINTENANCE HANGAR ......... . 168,000 44,000
REPLACE MUNITIONS STRUCTURES ..................... . 26,100 26,100
MISAWA AIR BASE
AIRFIELD DAMAGE REPAIR FACILITY .................. . 25,000 25,000
YOKOTA AB
CONSTRUCT CATM FACILITY., ... , .................... . 25,000 25,000
C-130J CORROSION CONTROL HANGAR .................. . 67,000 67,000
DEFENSE-WIDE
IWAKUNI
FUEL PIER ...................... ,, ................ . 57,700 57,700
KADENA AIR BASE
TRUCK UNLOAD FACILITIES ................ , ......... . 22,300 22,300
OPERATIONS SUPPORT FACILITY ...................... . 24,000 24,000
MISAWA AIR BASE
ADDITIVE INJECTION PUMP AND STORAGE SYSTEM ....... . 6,000 6,000
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MILITARY CONSTRUCTION
(AMOUNTS IN THOUSANDS)
BUDGET
REQUEST HOUSE
YOKOTA AB
HANGAR/ AMU ....................... ................ . 108,253 23,000
TOTAL, JAPAN ....................... ............ . 632,545 423,292
PUERTO RICO
DEFENSE-WIDE
PUNTA BORINQUEN
RAMEY UNIT SCHOOL REPLACEMENT .................... . 84,000 84,000
TOTAL, PUERTO RICO ....................... ...... . 84,000 84,000
SPAIN
AIR FORCE
MORON
EDI: HOT CARGO PAO ......... , ..................... . 8,542 8,542
TOTAL, SPAIN .................... , ................ . 8,542 8,542
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MILITARY CONSTRUCTION
(AMOUNTS IN THOUSANDS)
BUDGET
REQUEST HOUSE
UNITED KINGDOM
AIR FORCE
RAF FAIRFORD
EDI: CONSTRUCT DABS-FEV STORAGE ... , ........ , ..... . 94,000 94,000
ROYAL AIR FORCE LAKENHEATH
F-35A MUNITION INSPECTION FACILITY ............... . 31,000 31,000
F-35A WEAPONS LOAD TRAINING FACILITY ............. . 49,000 49,000
DEFENSE-WIDE
RAF LAKENHEALTH
HOSPITAL REPLACEMENT-TEMPORARY FACILITIES ..... , .. , 19,283 19,283
MENWITH HILL STATION
RAFMH MAIN GATE REHABILITATION ................... . 20,000 20,000
___ .,,.,.,. _____
TOTAL, UNITED KINGDOM ........................ .. . ------------
213,283 213,283
WORLDWIDE CLASSIFED
ARMY
FORWARD OPERATING SITE ........................ ... . 31,000 31,000
.... -- - ----.... - - -- -- - - ...... - -
TOTAL, WORLDWIDE CLASSIFIED ................. ,.,. 31,000 31,000
NATO SECURITY INVESTMENT PROGRAM ........ ,., .......... . 205,853 205,853
WORLDWIDE UNSPECIFIED
ARMY
HOST NATION SUPPORT .............. , ........ , , ... , ... . 27,000 27,000
PLANNING AND DESIGN ..... , ...................... , ... . 124,649 154,649
MINOR CONSTRUCTION ........................ .... , .... . 35,543 60,543
SUBTOTAL, ARMY ........................ ......... . ------------
187,192
------------
242,192
NAVY
PLANNING AND DESIGN ..................... , .......... . 363,252 413,252
MINOR CONSTRUCTION ........................ ... , ..... . 56,435 81,435
SUBTOTAL, NAVY ........................ ......... .
·----------- ----------···
419,687 494,687
AIR FORCE
PLANNING AND DESIGN ......... , ........... , ........ , .. 229,301 279,301
MINOR CONSTRUCTION ......... , ....................... . 58,884 83,884
SUBTOTAL, AIR FORCE ......... , .......... , ....... .
------------ ---·--------
288,185 363,185
DEFENSE-WIDE
ENERGY RESILIENCE AND CONSERVATION INVESTMENT
PROGRAl1 ........................ , ..... ,.,, ........ . 246,600 382,980
PLANNING ANO DESIGN
DEFENSE-WIDE ..................... , ............ , .. . 14,194 14,194
DEFENSE-WIDE ERCIP ..... , . , .... , ................. , . 40,150 40,150
DEFENSE INTELLIGENCE AGENCY ..................... . 11,000 11,000
DEFENSE LOGISTICS AGENCY ......... , ........ , ...... . 20,862 20,862
DEFENSE HEALTH AGENCY ........................ .... . 35,099 35,099
DEPARTMENT OF DEFENSE EDUCATION AGENCY ......... , .. 13,317 13,317
NATIONAL SECURITY AGENCY ... , .............. , ...... . 83,840 83,840
SPECIAL OPERATIONS COMMAND ..................... , .. 20,576 20,576
THE JOINT STAFF ........................ ...... , ... . 2,000 2,000
WASHINGTON HEADQUARTERS SERVICES .... , ............ . 5,275 5,275
INDOPACOM ........................ ................ , 15,000
SUBTOTAL, DEFENSE-WIDE ........... ,, ........ ,., .. 492,913 644,293
UNSPECIFIED MINOR CONSTRUCTION
DEFENSE-WIDE
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MILITARY CONSTRUCTION
(AMOUNTS IN THOUSANDS)
BUDGET
REQUEST HOUSE
DEFENSE-WIDE .................................. ... . 3,000 3,'000
DEFENSE LOGISTICS AGENCY ......................... . 6,66B 6,668
DEPARTMENT OF DEFENSE EDUCATION AGENCY ........... . B,000 8,000
MISSILE DEFENSE AGENCY ........................... . 4,435 4,435
NATIONAL SECURITY AGENCY ......................... . 12,000 12,000
U.S., SPECIAL OPERATIONS COMMAND ................. . 21,746 21,746
THE JOINT STAFF .................................. . 5,615 5,615
SUBTOTAL, UNSPECIFIED MINOR CONSTRUCTION ..... ,,, 61,464 61,464
ARMY NATIONAL GUARD
PLANNING AND DESIGN ................................ . 22,000 72,000
MINOR CONSTRUCTION ................................. . 39,471 52,471
AIR NATIONAL GUARD
PLANNING AND DESIGN ................................ . 18,402 28,402
MINOR CONSTRUCTION ................................. . 29,06B 44,068
ARMY RESERVE
PLANNING AND DESIGN ................................ . 7,167 12,167
MINOR CONSTRUCTION ................................. . 14,544 22,044
NAVY RESERVE
PLANNING ANO DESIGN ................................ . 6,005 13,005
MINOR CONSTRUCTION .............•.............•.•.... 2,359 B,359
AIR FORCE RESERVE
PLANNING ANO DESIGN ................................ . 5,830 12,330
MINOR CONSTRUCTION .......•.................•........ ...... _________
15,444 ...... ,. ________
26,444
SUBTOTAL, WORLDWIDE UNSPECIFIED ..•.................. 2,131,223 2,898,603
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MILITARY CONSTRUCTION
(AMOUNTS IN THOUSANDS)
BUDGET
REQUEST HOUSE
FAMILY HOUSING, ARMY
ITALY
VICENZA
FAMILY HOUSING NEW CONSTRUCTION ................. . 92,304 92,304
PLANNING AND DESIGN .................................. . 7,545 7,545
SUBTOTAL, CONSTRUCTION ......................... . 99,849 99,849
OPERATION AND MAINTENANCE
UT! LITI ES ACCOUNT .................................. . 43,772 43,772
SERVICES ACCOUNT ................................... . 8,277 B,277
MANAGEMENT ACCOUNT ................................. . 42,850 42.850
MISCELLANEOUS ACCOUNT .............................. . 556 556
FURNISHINGS ACCOUNT ................................ . 18,077 18,077
LEASING ................................... ......... . 12B,110 128,110
MAINTENANCE OF REAL PROPERTY ....................... . 111,181 111,181
PRIVATIZATION SUPPORT COSTS ................ ,, ...... . 38,404 38,404
SUBTOTAL, OPERATIONS AND MAINTENANCE ........... .
----------- .. -.... ------- --
391,227 391,227
FAMILY HOUSING, NAVY AND MARINE CORPS
JAPAN
YOKOSUKA
CONSTRUCTION PLANNING ANO DESIGN ................. . 71,884 71,884
PLANNING ANO DESIGN, ................................. , 3,634 3,634
PLANNING AND DESIGN FOR USMC/DPRI ................... . 2,098 2,098
SUBTOTAL, CONSTRUCTION ... ,, .............. ,.,,,,. 77,616 77,616
OPERATION AND MAINTENANCE
UTILITIES ACCOUNT. , ........................... , .... . 56,271 56,271
SERVICES ACCOUNT ................................... . 17,637 17,637
MANAGEMENT ACCOUNT ................... , ............. . 54,083 54,083
MISCELLANEOUS ACCOUNT .............................. . 285 285
FURNISHINGS ACCOUNT ....................... , ........ . 16,537 16,537
LEASING ................................... ......... . 62,567 62,567
MAINTENANCE OF REAL PROPERTY .............. , ........ . 95,417 95,417
PRIVATIZATION SUPPORT COSTS ........................ . 54,544 54,544
SUBTOTAL, OPERATION ANO MAINTENANCE ........... . 357,341 357,341
FAMILY HOUSING, AIR FORCE
JAPAN
YOKOTA AB
CONSTRUCTION IMPROVEMENTS (45 UNITS) ............. . 49,258 49,25B
WARNER ROBBINS AFB
MHPI PROJECT RESTRUCTURE ......................... . 6,000 6,000
OFFUTT AFB
MHPI PROJECT RESTRUCTURE ......................... . 50,000 50,000
PLANNING AND DESIGN .................................. . 10,458 10,458
SUBTOTAL, CONSTRUCTION ......................... .
------------ ------------
115,716 115,716
OPERATION AND MAINTENANCE
UTILITIES ACCOUNT .................................. . 43,668 43,668
MANAGEMENT ACCOUNT ................................. . 70,062 70,062
SERVICES ACCOUNT ................................... . B, 124 8,124
FURNISHINGS ACCOUNT ...... , ......................... . 26,842 26,842
MISCELLANEOUS ACCOUNT .............................. . 2,200 2,200
LEASING .................. , .................... , .... . 9,520 9,520
MAINTENANCE OF REAL PROPERTY ....................... . 141,754 141,754
PRIVATIZATION SUPPORT COSTS ....... , ................ . 23,275 23,275
SUBTOTAL, OPERATION AND MAINTENANCE ............ .
------------
325,445
------------
325,445
FAMILY HOUSING, DEFENSE-WIDE
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MILITARY CONSTRUCTION
(AMOUNTS IN THOUSANDS)
BUDGET
REQUEST HOUSE
OPERATION AND MAINTENANCE
NATIONAL SECURITY AGENCY
UTILITIES ACCOUNT .........•. , .................... . 14 14
FURNISHINGS ACCOUNT .....•.•.............. ......... 83 83
LEASING ....................... .......... , ........ . 13,387 13,387
MAINTENANCE OF REAL PROPERTY •..................... 49 49
DEFENSE INTELLIGENCE AGENCY
UTILITIES ACCOUNT ............. , .•.........•....... 4,166 4,166
FURNISHINGS ACCOUNT ....................... , ...... . 656 656
LEASING ....................... ...... , ..... ,, •. ,.,, ____ ., 31,430
_______ 31,430
-- ...... - .. ---- ..
SUBTOTAL, OPERATION AND MAINTENANCE ...•......... 49,785 49,785
DOD FAMILY HOUSING IMPROVEMENT FUND .....•......... , .. . 6,081 6,081
DOD MILITARY UNACCOMPANIED HOUSING IMPROVEMENT FUND .. . 494 494
BASE REALIGNMENT AND CLOSURE
BASE REALIGNMENT AND CLOSURE ACCOUNT ................ . 284,639 564,639
TOTAL, BASE REALIGNMENT AND CLOSURE ....•.....•... 284,639 564,639
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MILITARY CONSTRUCTION
(AMOUNTS IN THOUSANOS)
BUDGET
REQUEST HOUSE
ADMINISTRATIVE PROVISIONS
UNFUNDED REQUIREMENTS· BARRACKS
MILITARY CONSTRUCTION, ARMY (Sec. 129) ..•••....•.•.... 90,200
MILITARY CONSTRUCTION, ARMY NATIONAL GUARD (Sec. 129). 24,800
MILITARY CONSTRUCTION, ARMY RESERVE (Sec. 129) ....... . 122,200
SUBTOTAL, UNFUNDED REQUIREMENTS - BARRACKS ..... . 237,200
MILITARY CONSTRUCTION, MILITARY INSTALLATION
RESILIENCE (Sec. 127) .............•......•.......•.. 100,000
CHILD DEVELOPMENT CENTERS (Sec. 12B) ..........•...•.•• 147,000
MILITARY CONTRUCTION, ARMY NATIONAL GUARD A
TRANSFORMATION PLAN (Sec. 131) .................... .. 100,000
MILITARY CONSTRUCTION, NATURAL DISASTER (Sec.132) .... . 162,966
MILITARY CONSTRUCTION, NAVY AND MARINE CORPS • SIOP
UNSPECIFIED WORLDWIDE (Sec. 130) .........••......... 225,000
COST TO COMPLETE PROJECTS - SERVICES
MILITARY CONSTRUCTION, ARMY (Sec. 125) ............... . 54,200
MILITARY CONSTRUCTION, AIR FORCE (Sec. 125) ..•......•. 50,100
MILITARY CONSTRUCTION, ARMY RESERVE (Sec. 125) ...... . 14,000
FAMILY HOUSING CONSTRUCTION, ARMY (Sec. 125) .••....... 31,500
SUBTOTAL, COST TO COMPLETE PROJECT •..........•....••.. 149,800
ADMINISTRATIVE TOTAL. ................................ . 1,121,966
------------ ---===
GRAND TOTAL..................................... 9,847,031 10,918,400
===== ============
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FULL COMMITTEE VOTES
Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results
of each roll call vote on an amendment or on the motion to report, together with the names of those voting
for and those voting against, are printed below:
Roll Call I
Date: June 30, 2021
Measure: Military Construction, Veterans Affairs, and Related Agencies Bill, FY 2022
Motion by: Mr. Gonzales
Description of Motion: To prohibit the use of funds to close or realign Naval Station, Guantanamo Bay
and prohibit the use of funds to renovate, expand, or construct a facility in the continental United States in
order to house individuals who have been detained at Naval Station, Guantanamo Bay.
Results: Not Adopted 25 yeas to 32 nays
Members Voting Yea Members Voting Nay
Mr. Aderholt Mr. Aguilar
Mr. Calvert Mr. Bishop
Mr. Carter Mrs. Bustos
Mr.Cline Mr. Cartwright
Mr.Cole Mr. Case
Mr. Crist Ms. Clark
Mr. Diaz-Balart
Mr. Cuellar
Mr. Fleischmann
Mr. Fortenberry Ms. DeLauro
Mr. Garcia Mr. Espaillat
Mr. Gonzales Ms. Frankel
Ms. Granger Mr.Harder
Dr. Harris Ms. Kaptur
Mrs. Hinson Mr.Kilmer
Mr. Joyce Mrs. Kirkpatrick
Mr. Moolenaar Mrs. Lawrence
Mr. Newhouse Ms. Lee of California
Mr.Palazzo
Mrs. Lee of Nevada
Mr. Reschenthaler
Mr.Rogers Ms.McCollum
Mr. Rutherford Ms.Meng
Mr.Simpson Ms. Pingree
Mr. Stewart Mr. Pocan
Mr. Valadao Mr. Price
Mr.Womack Mr. Quigley
Ms. Roybal-Allard
Mr. Ruppersberger
Mr. Ryan
Mrs. Torres
Mr. Trone
Ms. Underwood
Ms. Wasserman Schultz
Mrs. Watson Coleman
Ms. Wexton
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126
FULL COMMITTEE VOTES
Pursuant to the provisions of clause 3(b) of rule Xlll of the House ofRepre«icntativos, the results
of each roll call vote on an amendment or on the motion to report, together with the names of those voting
for and those voting against, are printed below:
RollCall2
Date: June 30, 2021
Measure: Military Construction, Veterans Affairs, and Related Agencies Bill, FY 2022
Motion by: Ms. Kaptur
Description of Motion: To report the.bill to the House, as amended.
Results: Adopted 33 yeas to 24 nays
Members Voting Yea Members Voting Nay
Mr.Aguilar Mr. Aderholt
Mr. Bishop Mr. Calvert
Mrs. Bustos Mr. Carter
Mr. Cartwright Mr.Cline
Mr.Case Mr.Cole
Ms.Clark Mr. D!az-Balart
Mr. Crist Mr. Fleischmann
Mr. Cuellar Mr. Fortenberry
Ms.DeLauro Mr. Garcia
Mr.~aillat Mr. Gonzales
Ms. Frankel Ms. Granger
Mr.Harder Dr. Harris
Ms. Kaptur Mrs.Hinson
Mr. Kilmer Mr.Joyce
Mrs. Kirkpatrick Mr. Moolenaar
Mrs. Lawrence Mr. Newhouse
Ms. Lee of California Mr. Palazzo
Mrs. Lee of Nevada Mr. Reschenthaler
Ms.McCol!um Mr.Roaers
Ms.Meng Mr. Rutherford
Ms.Pingree Mr.Simpson
l'v1r. Pocan Mr. Stewart
Mr. Price Mr. Valadao
Mr.Quigley Mr. Womack
Ms. Roybe.1-Allard
Mr. Ruppersberger
Mr.Rym
Mrs. Torre«i
Mr. Trone
Ms. Underwood
Ms. WB3scrmm Schultz
Mrs. Watson Coleman
Ms. Wexton
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COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2021
ANO BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 2022
Jkt 045008
(Amounts in thousands)
FY 2021 FY 2022 Bill vs. Bill vs.
Enacted Request Bi 11 Enacted Request
PO 00000
TITLE I · DEPARTMENT OF DEFENSE
Frm 00127
Mil tary Construction, Army ........................... 628,900 834,692 898,692 +269,792 +64,000
Mil tary Construction, Navy and Marine Corps .......... 1,716,144 2,368,352 1,937,428 +221,284 -430,924
Mil tary Construction, Air Force ...................... 616,156 2,102,690 1,893,690 +1,277,534 -209,000
Mil tary Construction, Defense-Wide ................... 2,041,909 1,957,289 2,023,416 -18,493 +66, 127
-------------- -------------- -------------- -------------- --------------
Fmt 6659
Total , Active components ........................ 5,003,109 7,263,023 6,753,226 +1, 750,117 -509,797
Military Construction, Army National Guard ........... . 349,437 257,103 335,603 -13, 834 +78,500
Military Construction, Air National Guard ............ . 64,214 197,770 246,770 +182,556 +49,000 127
Sfmt 6602
Military Construction, Army Reserve .................. . 88,337 64,911 77,411 -10,926 +12,500
Military Construction, Navy Reserve .................. . 70,995. 71,804 84,804 +13,809' +13,000
Military Construction, Air Force Reserve ............. . 23,117' 78,374 104,574, +81 ,457 +26,200
----------------------------- -------------- --------------~ --------------
E:\HR\OC\HR081.XXX
Total, Reserve components ...................... . 596,100 , 669,962 849,162 +253,062 +179,200
North Atlantic Treaty Organization Security Investment
Program ................................ ............ . 173,030 205,853 205,853 +32,823
Department of Defense Base Closure Account ........... . 480,447 284,639 564,639 +84,192 +280,000-
Total, Military Construction ................... .
--------------
6,252,686
--------------
8,423,477
- ------------ -------------- --------------
8,372,880 +2, 120,194 -50,597
Family Housing Construction, Army .................... . 119,400 99,849 99,849 -19,551
HR081
Family Housing Operation and Maintenance, Army ....... . 352,342 391,227 391,227 +38,885
Family Housing Construction, Navy and Marine Corps ... . 42,897- 77,616 77,616 +34,719
Family Housing Operation and Maintenance, Navy and
Mari ne Corps ................................ ....... . 346,493 357,341 357,341 +10,848
Insert offset folio 25 here 43379A.018
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AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 2022
Jkt 045008
(Amounts in thousands)
FY 2021 FY 2022 Bill vs. Bill vs.
Enacted Request Bill Enacted Request
PO 00000 Family Housing Construction, Air Force ............... . 97,214 115,716 115,716 +18,502
Family Housing Operation and Maintenance, Air Force .. . 317,021 325,445 325,445 +8,424
Family· Housing Operation and Maintenance, Defense-Wide 54,728 49,785 49,785 -4,943
Frm 00128
Department of Defense Family Housing Improvement Fund. 5,897 6,081 6,081 +184
Department of Defense Military Unaccompanied Housing
Improvement Fund .............. ·............•......... 600 494 494 -106
Total, Family Housing .......................... .
--------------
1,336,592
---~---------- -------------- -------------- --------------
1,423,554 1,423,554 +86,962
Fmt 6659 Administrative Provisions
Unfunded Requirements - Barracks: 128
Sfmt 6602
Military Construction, Army (Sec. 129) ............... . 233,000 90,200 -142,800 +90,200
Military Construction, Navy and Marine Corps (Sec.
124) ............................................... . 73,100 -73,100
Military Construction, Air Force (Sec. 124) ......... . 60,000 -60,000
E:\HR\OC\HR081.XXX
Military Construction, Army National Guard (Sec. 129). 49,835 24,800 -25,035 +24,800
Military Construction, Air National Guard ( Sec. 124) 29,500 -29,500
Military Construction, Army Reserve (Sec. 129) .... . 122,200 +122,200 +122,200
Military Construction, Air Force Reserve (Sec. 124) .. . 25,000 -25,000
Military Construction, Air Force ( Sec. 126)
(rescission) ........................................ . -9,975 +9,975
Military Construction Defense-Wide (Sec. 126)
( rescission) ....................................... . -29,838 +29,838
Family Housing Support and Management Costs (Sec.129). 60,000 -60,000
HR081
Military Construction, Military Installation
Resilience (Sec. 127) .............................. . 15,000 100,000 +85,000 +100,000
Child Development Centers (Sec. 128) ................. . 32,200 147,000 +114,800 +147,000
Military Construction, Defense-Wide (Sec 134)
Insert offset folio 133 here 45008.004
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ANO BUDGET REQUESTS ANO AMOUNTS RECOMMENDED IN THE BILL FOR 2022
Jkt 045008
(Amounts in thousands)
FY 2021 FY 2022 Bill vs. Bill VS.
Enacted Request Bill Enacted Request
PO 00000 (rescission) ....................................... . -131,000 +131 ,000
Military Construction, Army National Guard A
Transformation Plan (Sec. 131) ..................... . 100,000 +100,000 +100,000
Frm 00129
Military Construction, Natural Disaster (Sec. 132) ... . 162,966 +162,966 +162,966
Department of Defense Base Closure Account ........... . -50,000 +50,000
Military Construction, Navy and Marine Corps• SIOP
Unspecified Worldwide (rescission) ................ . -48,000 +48,000
Military Construction, Navy and Marine Corps• SIOP
Fmt 6659
Unspecified Worldwide (Sec. 130) ................... . 225,000 +225,000 +225, 000
-------------- -------------- -------------- --------------
Subtotal, Unfunded Requirements Services ..... . 308,822 972,166 +663,344 +972, 166
129
Sfmt 6602
Cost to Complete Projects• Services:
Military Construction, Army (H. Sec. 125) .....•....... 48,000 54,200 +6,200 +54,200
Military Construction, Navy and Marine Corps (H. Sec.
126) ............................................... . 37,700 -37,700
E:\HR\OC\HR081.XXX
Military Construction, Air Force (Sec. 125) .•.•....... 75,700 50,100 -25,600 +50, 100
Military Construction, Army Reserve (Sec. 125) ....... . 14,000 +14,000 +14,000
Family Housing Construction, Army (H. Sec. 125) ...... . 4,500 31,500 +27,000 +31 ,500
Subtotal, Cost to Complete Projects• Services .. 165,900 149,800 -16, 100 +149,800
----- ......
Total, Administrative Provisions ............... . 474,722 1 , 121 , 966 +647,244 +1, 121,966
HR081
Total, title I, Department of Defense .......... . 8,064,000 9,847,031 10,918,400 +2,854,400 +1 ,071,369
Appropriations ............................. . (8,332,813) (9,847,031) (10,918,400) (+2,585,587) (+1,071,369)
Rescissions .................... : ........... . (--268, 813) (+268,813)
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AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 2022
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(Amounts in thousands)
FY 2021 FY 2022 Bill vs. Bill vs.
Enacted Request Bill Enacted Request
PO 00000 TITLE II - DEPARTMENT OF VETERANS AFFAIRS
Frm 00130
Veterans Benefits Administration
Compensation and pensions:
Budget year appropriations ....................... . 6,110,252 7,347,837 7,347,837 +1,237,585
Advance from prior year appropriations .......... .. 118,246,975
Fmt 6659
130,227,650 130,227,650 +11,980,675
Subtotal, Compensation and pensions available
in fi seal year 2022 ........................ . 124,357,227 137,575,487 137,575,487 +13,218,260
130
Sfmt 6602
Advance appropriations, FY 2023 .................. . 130,227,650 147,569,474 147,569,474 +17,341,824
Less appropriations from prior year advances .. , .. . -118,246,975 -130,227,650 -130,227,650 -11,980,675
Total, Compensation and pensions appropriated
E:\HR\OC\HR081.XXX
in this bi 11 ............................... . 136,337,902 154,917,311 154,917,311 +18,579,409
Readjustment benefits:
Advance from prior year appropriations ........... . 12,578,965 14,946,618 14,946,618 +2,367,653
Subotal, Readjustment benefits available in
fi seal year 2022 ............. , , ............ . 12,578,965 14,946,618 14,946,618 +2,367,653
Advance appropriations, FY 2023 .................. . 14,946,618 8,906,851 8,906,851 -6,039,767
HR081
Less appropriations from prior year advances ..... . -12,578,965 -14, 946,618 -14,946,618 -2,367,653
Total, Readjustment benefits appropriated in
this bi 11 ................................ .. . 14,946,618 8,906,851 8,906,851 -6,039,767
Insert offset folio 28 here 43379A.021
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ANO BUDGET REQUESTS ANO AMOUNTS RECOMMENDED IN THE BILL FOR 2022
Jkt 045008
(Amounts in thousands)
FY 2021 FY 2022 Bill vs. Bill vs.
Enacted Request Bi 11 Enacted Request
PO 00000
Veterans insurance and indemnities:
Budget year appropriations ...................... . 2,148 -2, 148
Frm 00131
Advance from prior year appropriations ........... . 129,224 136,950 136,950 +7,726
Subtotal, Veterans insurance and indemnities
available in fiscal year 2022 .............. . 131,372 136,950 136,950 +5,578
Fmt 6659
Advance appropriations, FY 2023 .................. . 136,950 109,865 109,865 -27,085
Less appropriations from prior year advances ..... . -129,224 -136, 950 -136,950 -7,726
Total, Veterans insurance and indemnities 131
Sfmt 6602
appropriated in this bill .................. . 139,098 109,865 109,865 -29,233
Veterans housing benefit program fund:
Credit subsidy:
E:\HR\OC\HR081.XXX
Direct ................................ • • • • •. • • -18,000 -41,000 -41,000 -23,000
Guaranteed ................................ ... . 1,681,000 2,822,000 2,822,000 +1 ,141 ,000
Subtotal (Credit subsidy) ...................... .
------~----
1,663,000
--------- -~-- ---- ----~---- w----- --~- -- ----~~·---~
2,781,000 2,781,000 +1 ,118,000
(Limitation on direct loans) ..................... . (500) (500) (500)
Administrative expenses .......................... . 204,400 229,500 229,500 +25, 100
Vocational rehabilitation loans program account ...... . 34 3 3 -31
(Limitation on direct loans) .................... .. (2,470) (1,663) (1,663) (-807)
HR081
Administrative expenses .......................... . 424 429 429 +5
Native American veteran housing loan program account .. 1,186 1,186 1,400 +214 +214
General operating expenses, VBA ...................... . 3,180,000 3,423,000 3,419,400 +239,400 -3,600
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AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 2022
Jkt 045008
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FY 2021 FY 2022 Bill vs. Bill vs.
Enacted Request Bill Enacted Request
PO 00000
Total, Veterans Benefits Administration ........ . 156,472,662 170,369,145 170,365,759 +13,893,097 -3,386
Budget year appropriations ................. . ( 11 , 161 , 444) (13,782,955) (13,779,569) ( +2, 618,125) (-3,386)
Frm 00132
Advance appropriations, FY 2023 ............ . (145,311,218) ( 156 , 586 , 190) (156,586,190) (+11 ,274,972)
Advances from prior year appropriations ......... (130,955,164) (145,311,218) (145,311,218) (+14,356,054)
Veterans Health Administration
Fmt 6659 Medical services (MS):
Budget year appropriations ....................... . 497,468 100,000 -397,468 +100,000
Advance from prior year appropriations ........... . 56,158,015 58,897,219 58,897,219 +2,739,204 132
Sfmt 6602
- ................... .. - .............. "' - ---- ....... "' ..... --- .......... "'"' ..
Total, MS available in fiscal year 2022 ........ . 56,655,483 58,897,219 58,997,219 +2,341 ,736 +100,000
Advance appropriations, FY 2023 .................. . 58,897,219 70,323,116 70,323,116 +11 ,425,897
E:\HR\OC\HR081.XXX
Medical community care (MCC)
Budget year appropriations ............... , ....... . 1,380,800 3,269,000 3,269,000 +1 ,888,200
Advance from prior year appropriations ........... . 17,131,179 20,148,244,..
_________ 20,148,244 +3,017,065
..... _... _____ _ ............. ---- ................. -...
Total, MCC available in fiscal year 2022 ....... . 18,511,979 23,417,244 23,417,244 +4,905,265
Advance appropriations, FY 2023 .................. . 20,148,244 24,156,659 24,156,659 +4,008,415
Medical support and compliance (MSC):
HR081
Budget year appropriations .... , .................. . 300,000 -300,000
Advance from prior year appropriations .......... . 7,914,191 8,403,117 8,403,117 +488,926
--- ..... -...... ____ ,..,,. .... ----- ........ ----- .......
Total, MSC available in fiscal year 2022 ..... . 8,214,191 8,403,117 8,403,117 +188,926
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AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 2022
Jkt 045008
(Amounts in thousands)
FY 2021 FY 2022 Bill vs. Bill vs.
Enacted Request Bill Enacted Request
PO 00000
Advance appropriations, FY 2023 ...... , .. , , ....... . 8,403,117 9,673,409 9,673,409 +1 ,270,292
Medical facilities (MF):
Frm 00133
Budget year appropriations ...................... . 150,000 -150,000
Advance from prior year appropriations ........... . 6,433,265 6,734,680 6,734,680 +301,415
Total, MF available in fiscal year 2022 ...... .
--------- --------- --------- --------
Fmt 6659
6,583,265 6,734,680 6,734,680 +151,415
Advance appropriations, FY 2023 .................. . 6,734,680 7,133,816 7,133,816 +399, 136
Medical and prosthetic research ...................... . 815,000 882,000 902,000 +87,000 +20,000 133
Sfmt 6602
Medical care cost recovery collections:
Offsetting collections ...................... ..... . -4,403,000 -3,386,000 -3,386,000 +1,017,000
Appropriations (indefinite) ...................... . 4,403,000 3,386,000 3,386,000 -1,017,000
E:\HR\OC\HR081.XXX
Medical Care Collections Fund (MCCF) (transfer out)
(Sec. 21 4) ......... , ...................... , ........ . (-784,000) (-623, 000) (-623,000) (+161,000)
Medical Community Care and Medical Services (by
transfer) (Sec. 214) ...................... ......... . (784,000) (623,000) (623,000) (-161,000)
VA medical funds (transfer out) (Sec. 219) ........... . (-322,932) (-379,009) (-379, 009) (-56,077)
HR081
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AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 2022
Jkt 045008
(Amounts in thousands)
FY 2021 FY 2022 Bill vs. Bill vs.
Enacted Request Bill Enacted Request
PO 00000 DoD-VA Joint Medical Facility Demonstration Fund (by
transfer) (Sec. 219) .. , ................ ,,, ......... . (322,932) (379,009) (379,009) (+56,077)
MCCF to DoD-VA Joint Medical Facility Demonstration
Frm 00134
Fund (transfer out) (Sec. 221) ..................... . (-18,000) (-17,000) (•17,000) (+1 ,000)
DoD-VA Joint Medical Facility Demonstration Fund (by
transfer) (Sec. 221) ............................... . (18,000) (17,000) (17,000) (-1,000)
VA Medical Care Funds (transfer out) (Sec. 222) ...... . (-15,000) (-15,000) (-15,000)
DoD-VA Health Care Sharing Incentive Fund (by
Fmt 6659
transfer) (Sec. 222) ............................... . (15,000) (15,000) (15,000)
Total, Veterans Health Administration .......... .
-------------- -------------- -------------- -------------- --------------
97,326,528 115,438, 000 115,558,000 +18,231 ,472 +120,000
Budget year appropriations ................. . (3,143,268) <4 , 1s1 , ooo l (4,271,000) (+1, 127,732) (+120,000) 134
Sfmt 6602
Advance appropriations (FY 2023), .......... . (94,183,260) (111,287,000) (111,287,000) (+17, 103,740)
Advances from prior year appropriations ........ . (87,636,650) (94,183,260) (94,183,260) (+6,546,610)
(By transfer) ......... , , ............... , ....... . (1,139,932) (1,034,009) (1,034,009) (-105,923)
(Transfer out) ................................ . . (-1,139,932) ( -1 , 034 , 009) (-1,034,009) (+105,923)
E:\HR\OC\HR081.XXX
HR081
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ANO BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 2022
Jkt 045008
(Amounts in thousands)
FY 2021 FY 2022 Bill vs. Bill vs.
Enacted Request Bill Enacted Request
PO 00000 National Cemetery Administration
National Cemetery Administration ... ,, ................ . 352,000 394,000 392,000 +40,000 -2,000
Frm 00135
Departmental Administration
General administration ............................... . 365,911 401,200 396,911 +31,000 -4,289
Board of Veterans Appeals ................. , .......... . 196,000 228,000 228,000 +32,000
Information Technology Systems (IT Systems) .......... . 4,912,000 4,842,800 4,842,800
Fmt 6659
-69,200
Veterans Electronic Health Record (EHR) .............. . 2,627,000 2,663,000 2,637,000 +10,000 -26,000
Office of Inspector General ......................... , . 228,000 239,000 239,000 +11,000
Construction, major projects ..................... , ... . 1,316,000 1,611,000 1,611,000 +295,000
Construction, minor projects ......................... . 390,000 553,000 553,000 +163,000 135
Sfmt 6602
Grants for construction of State extended care
facilities ................................ ......... . 90,000 90,000 +90,000
Grants for the construction of Veterans cemeteries ... . 45,000 45,000 47,097 +2,097 +2,097
Asset Infrastructure Review Commission ............... . 5,000 5,000 +5,000
E:\HR\OC\HR081.XXX
-------------- -------------- _____ M ________ ~-----~-------
Total, Departmental Administration ............. . 10,169,911 10,588,000 10,649,808 +479,897 +61,808
HR081
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AND BUDGET REQUESTS ANO AMOUNTS RECOMMENDED IN THE BILL FOR 2022
Jkt 045008
(Amounts in thousands)
FY 2021 FY 2022 Bill vs. Bill vs.
Enacted Request Bill Enacted Request
PO 00000 Administrative Provisions
Medical Support and Compliance (rescission) (Sec. 254) -15,000 +15,000
Frm 00136
DOD-VA Health Care Sharing Incentive Fund (Sec. 253)
(rescission) ...................... ................. .
Veterans Electronic Health Record (Sec. 254)
(rescission) ...................... ................. . -20,000 +20,000
Medical and Prosthetic Research (Sec. 254)
Fmt 6659
(rescission) ...................... ................. . -20,000 +20,000
Board of Veterans Appeals (Sec. 253) (rescission) .... .
National Cemetery Administration (Sec. 253)
(rescission) ...................... ................. . 136
Sfmt 6602
Medical Services (Sec. 254) (rescission) ............. . -100,000 +100,000
Information Technology Systems (Sec. 254) (rescission) -37,500 +37,500
General Administration (Sec. 254) (rescission) ....... . -12,000 +12,000
General Operating Expenses, VBA (Sec. 254)
E:\HR\OC\HR081.XXX
(rescission) ...................... ................. . -16,000 +16,000
Construction, Minor Projects (Sec. 254) (rescission) .. -35,700 +35,700
Total, Administrative Provisions. -256,200 +256,200
HR081
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AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 2022
Jkt 045008
(Amounts in thousands)
FY 2021 FY 2022 Bill vs. Bill vs.
Enacted Request Bill Enacted Request
PO 00000 ============== ============== ============== ============== ==============
Total, title II, Department of Veterans Affairs. 264,064,901 296,789, 145 296,965,567 +32,900,666 +176,422
Frm 00137
Budget year appropriations ................. . {24,826,623) {28,915,955) {29,092,377) (+4,265,754) (+176,422)
Rescissions ................................ . (-256, 200) (+256,200)
Advance Appropriations, FY23:
(Mandatory) .............................. . (145,311,218) ( 156,586,190) (156,586, 190) (+11, 274,972)
(Discretionary) .......................... .
Fmt 6659
(94,183,260) (111 , 287,000) (111,287,000) (+17, 103,740)
(By transfer) ................................ .. . ( 1 , 139 , 932) (1,034,009) (1,034,009) (-105,923)
(Transfer out) ................................ . . ( -1 , 139,932) (-1,034,009) (-1,034,009) (+105,923)
(Limitation on direct loans) ................... . (2,970) (2,163) (2,163) (-807)
Advances from prior year appropriations: 137
Sfmt 6602
(Mandatory) ................................ .. . (130, 955, 164) (145,311,218) (145,311,218) (+14,356,054)
(Discretionary) .............................. . (87,636,650) (94,183,260) (94,183,260) {+6,546,610)
Total , available this fi seal year .............. . 243,162, 237 268,410,433 268,586,855 +25,424,618 +176,422
E:\HR\OC\HR081.XXX
(Mandatory) ................................ . (138,730,564) (155,440,055) (155,440,055) (+16,709,491)
(Discretionary) ............................ . (104,431,673) (112,970,378) (113,146,800) (+8, 715,127) (+176, 422)
HR081
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AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 2022
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FY 2021 FY 2022 Bill vs. Bill vs.
Enacted Request Bill Enacted Request
PO 00000 TITLE III - RELATED AGENCIES
American Battle Monuments Commission
Frm 00138
Salaries and expenses ................................ . 84,100 84,800 88,100 +4,000 +3,300
U.S. Court of Appeals for Veterans Claims
Fmt 6659
Salaries and expenses ................................ . 37,100 41,700 41,700 +4,600
Department of Defense - Civil
138
Sfmt 6602
Cemeterial Expenses, Army
Salaries and expenses ................................ . 81,815 87,000 87,000 +5, 185
Construction ................................ ......... . 141,000 141,000 +141,000
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Total, Cemeterial Expenses, Army ............... . 81,815 228,000 228,000 +146, 185
Armed Forces Retirement Home - Trust Fund
Operation and maintenance ............................ . 44,300 43,000 43,000 -1,300
Capital program ................................ ...... . 9,000 7,300 9,000 +1,700
Payment from General Fund ............................ . 22,000 25,000 25,000 +3,000
Total, Armed Forces Retirement Home ............ . 75,300 75,300 77,000 +1,700 +1, 700
============== ==========~=== ============== ============== ==============
HR081
Total, title III, Related Agencies ............. . 278,315 429,800 434,800 +156,485 +5,000
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FY 2021 FY 2022 Bill vs. Bill vs.
Enacted Request Bill Enacted Request
PO 00000
TITLE IV - OVERSEAS CONTINGENCY OPERATIONS
Frm 00139
Overseas Contingency Operations
European Deterrence/ Reassurance Initiative
Fmt 6659 Military Construction, Army .......................... . 16,111 -16,111
Military Construction, Navy and Marine Corps ......... . 70,020 -70,020
Military Construction, Air Force ..................... . 263,869 -263,869 139
Sfmt 6602
Military Construction, Defense-Wide .................. .
Subtotal, European Deterrence/ Reassurance
Initiative ................................ ... . 350,000 -350,000
============== ============== ============== ============== ==============
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Total, Overseas Contingency Operations ......... . 350,000 -350,000
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PO 00000 TITLE V - GENERAL PROVISIONS
Medical Services (Sec. 514) (transfer out) (emergency) (-167,000) (+167,000)
Frm 00140
Veterans Benefits Administration, General Operating
Expenses (Sec. 514) (by transfer) (emergency) ...... . (140,000) (-140,000)
National Cemetery Administration (Sec. 514) (by
transfer) (emergency) .............................. . (26,000) (-26,000)
Board of Veterans Appeals (Sec. 514) (by transfer)
Fmt 6659
(emergency) ................................ ........ . (1,000} (-1,000)
Medical Services transfer out (Sec.515) (emergency) .. . (-243, 000) (+243,000)
Veterans Benefits Administration, General Operating
Expenses (Sec. 515) {by transfer) {emergency) ...... . (198,000) ( 198,000) 140
Sfmt 6602
Information Technology Systems (Sec.515) (by transfer)
(emergency) ........... , ............ , ... , ........... , (45,000) (-45,000)
Medical Services transfer out (Sec. 517) (emergency) .. (-100,000) (+100,000)
Medical Community Care (Sec. 517) (by transfer)
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(emergency} ................................ ........ . (100,000) (-100,000)
============== ============== ============== ==============
Total, title V, General Provisions ......... , ... .
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PO 00000 OTHER APPROPRIATIONS
CONTINUING APPROPRIATIONS ACT, 2021 AND OTHER
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EXTENSIONS ACT (P.L. 116-159 DIV A)
Medical Services transfer to Canteen Service Revolving
Fund (transfer out) (emergency) .................... . (-140,000) (+140,000)
Canteen Service Revolving Fund (by transfer)
Fmt 6659
(emergency) ...................... .................. . (140,000) (-140,000)
=--========-==
Total, Continuing Appropriations Act, 2021 and 141
Sfmt 6602
Other Extensions ...................... ....... .
============== ============== ============== ============== ==============
E:\HR\OC\HR081.XXX
Total, Other Appropriations ................... ..
HR081
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FY 2021 FY 2022 Bill vs. Bill vs.
Enacted Request Bill Enacted Request
PO 00000 Grand total . , ............... , ...................... .. . 272,757,216 307,065,976 308,318,767 +35,561,551 +1,252,791
Budget year appropriations ...................... . . (33,437,751) (39,192,786) (40, 445,577) (+7,007,826) (+1,252,791)
Rescissions .......... , .......... , .......... , ..... . (-525, 013) (+525,013)
Frm 00142
Advance appropriations, FY23 ..................... . (239,494,478) (267,873,190) (267,873,190) (+28,378,712)
Overseas contingency operations ... ,, ............. . (350,000) (-350,000)
Advances from prior year appropriations .............. . (218,591,814) (239,494,478) (239,494,478) (+20,902,664)
(By transfer) .............. , ...................... ... . (1,139,932) (1,034,009) (1,034,009) (-105, 923)
(Transfer out) .................... , ............... , .. . (-1,139,932)
Fmt 6659
(-1,034,009) (-1,034,009) (+105,923)
(By transfer) (emergency) ...................... ...... . (650,000) (-650,000)
(Transfer out) (emergency) .................... , ...... . (-650,000) (+650,000)
(Limitation on direct loans) ...................... ... . (2,970) (2,163) (2,163) (-807)
142
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HR081
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143
MINORITY VIEWS
The Military Construction, Veterans Affairs, and Related Agen-
cies Appropriations Bill, 2022, includes funding for Veterans pro-
grams, military construction projects, military family housing, and
the Southern Expansion project at Arlington National Cemetery.
We strongly support the funding provided for child development
centers and barracks projects. We also note with appreciation the
funding for many important military construction, resilience, and
environmental remediation projects, including for PFAS contamina-
tion cleanup at closed military installations.
We support the funding provided for Veterans’ programs, espe-
cially for mental health, suicide prevention, homelessness, gender-
specific care for women veterans, and research. We also support
the funding for the Electronic Health Record Modernization Initia-
tive and the strong oversight mechanisms included in bill and re-
port language.
We are concerned the bill does not include previously enacted
provisions regarding the Naval Station Guantanamo Bay and the
use of military construction funds to build or renovate a facility on
U.S. soil to house detainees currently held at Guantanamo Bay. In
various forms, these provisions have been included in the bill since
December 2009. We believe these provisions provide protections to
the American people and support our national security interests in
the Caribbean and Latin America.
We also are concerned that the funding in the bill is not part of
a framework that appropriately and adequately allocates funds be-
tween defense and non-defense program. No one wants the impor-
tant programs for Servicemembers, their families, and veterans to
be held up by larger funding debates.
Despite our concerns, we appreciate the Majority’s willingness to
address Member priorities in the bill and report. The Sub-
committee has a long-standing tradition of bipartisanship, and we
will continue to work in good faith with our colleagues as we pro-
ceed through the appropriations process. By working together, we
can best address the needs of our Nation’s military and its Vet-
erans and reach an agreement on funding for the Military Con-
struction, Veterans Affairs, and Related Agencies for fiscal year
2022.
KAY GRANGER.
JOHN R. CARTER.
Æ
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