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                                                      Calendar No. 173
115th Congress     }                                    {       Report
                                 SENATE
 1st Session       }                                    {      115-130

======================================================================



 
     MILITARY CONSTRUCTION, VETERANS AFFAIRS, AND RELATED AGENCIES 
                        APPROPRIATION BILL, 2018
                                _______
                                

                 July  13, 2017.--Ordered to be printed

                                _______
                                

           Mr. Moran,  from the Committee on Appropriations, 
                        submitted the following

                                 REPORT

                         [To accompany S. 1557]

    The Committee on Appropriation reports the bill (S. 1557) 
making appropriations for military construction, the Department 
of Veterans Affairs, and related agencies for the fiscal year 
ending September 30, 2018, and for other purposes, reports 
favorably thereon and recommends that the bill do pass.



Amounts in new budget authority

Total of bill as reported to the Senate.................$200,887,098,000
Amount of 2017 appropriations........................... 189,862,366,000
Amount of 2018 budget estimate.......................... 201,453,868,000
Bill as recommended to Senate compared to--
    2017 appropriations................................. +11,024,732,000
    2018 budget estimate................................    -566,770,000














                                CONTENTS

                              ----------                              
                                                                   Page
Background:
    Purpose of the Bill..........................................     4
    Committee Recommendation.....................................     4
    Overview and Summary of Bill.................................     4
Title I:
    Military Construction:
        Items of Special Interest:
            Hearings.............................................     6
            Summary of Committee Recommendations.................     6
            Reprogramming Guidelines.............................     6
            Real Property Maintenance............................     7
            Incremental Funding..................................     7
            Other Matters........................................     7
        Military Construction Overview...........................    15
        Military Construction, Army..............................    15
        Military Construction, Navy and Marine Corps.............    17
        Military Construction, Air Force.........................    19
        Military Construction, Defense-Wide......................    20
        Military Construction, Army National Guard...............    22
        Military Construction, Air National Guard................    22
        Military Construction, Army Reserve......................    23
        Military Construction, Navy Reserve......................    23
        Military Construction, Air Force Reserve.................    23
        North Atlantic Treaty Organization Security Investment 
          Program................................................    23
        Department of Defense Base Closure Account...............    24
        Family Housing Overview..................................    24
        Family Housing Operation and Maintenance, Army...........    25
        Family Housing Operation and Maintenance, Navy and Marine 
          Corps..................................................    25
        Family Housing Operation and Maintenance, Air Force......    25
        Family Housing Operation and Maintenance, Defense-Wide...    25
        Family Housing Construction, Army........................    25
        Family Housing Construction, Navy and Marine Corps.......    26
        Family Housing Construction, Air Force...................    26
        Department of Defense Family Housing Improvement Fund....    26
        Department of Defense Military Unaccompanied Housing 
          Improvement Fund.......................................    26
        Administrative Provisions................................    27
Title II:
    Department of Veterans Affairs:
        Items of Special Interest:
            Hearings.............................................    29
            Summary of Committee Recommendations.................    29
            Department Overview..................................    29
        Veterans Benefits Administration.........................    32
            Compensation and Pensions............................    33
            Readjustment Benefits................................    34
            Veterans Insurance and Indemnities...................    34
            Veterans Housing Benefit Program Fund................    35
            Vocational Rehabilitation Loans Program Account......    35
            Native American Veteran Housing Loan Program Account.    36
            General Operating Expenses, Veteran Benefits 
              Administration.....................................    37
        Veterans Health Administration...........................    41
            Medical Services.....................................    44
            Medical Community Care...............................    67
            Medical Support and Compliance.......................    69
            Medical Facilities...................................    70
            Medical and Prosthetic Research......................    71
            Medical Care Cost Recovery Collections...............    74
        National Cemetery Administration.........................    75
        Departmental Administration..............................    75
            General Administration...............................    76
            Board of Veterans Appeals............................    77
            Information Technology Systems.......................    78
            Office of Inspector General..........................    80
            Construction, Major Projects.........................    80
            Construction, Minor Projects.........................    82
            Grants for Construction of State Extended Care 
              Facilities.........................................    83
            Grants for Construction of Veterans Cemeteries.......    83
        Administrative Provisions................................    84
Title III:
    Related Agencies:
        American Battle Monuments Commission:
            Salaries and Expenses................................    88
            Foreign Currency Fluctuations........................    88
        United States Court of Appeals for Veterans Claims: 
          Salaries and Expenses..................................    89
        Department of Defense--Civil: Cemeterial Expenses, Army:
            Salaries and Expenses................................    89
        Armed Forces Retirement Home: Trust Fund.................    90
        Administrative Provisions................................    91
Title IV: Overseas Contingency Operations........................    92
Title V: General Provisions......................................    93
Program, Project, and Activity...................................    94
Compliance With Paragraph 7, Rule XVI, of the Standing Rules of 
  the 
  Senate.........................................................    94
Compliance With Paragraph 7(c), Rule XXVI of the Standing Rules 
  of the Senate..................................................    96
Compliance With Paragraph 12, Rule XXVI of the Standing Rules of 
  the Senate.....................................................    97
Budgetary Impact of Bill.........................................   105
Military Construction Project Listing by Location................   106
Overseas Contingency Operations..................................   121
Comparative Statement of Budget Authority........................   123


                               BACKGROUND

                          Purpose of the Bill

    The Military Construction, Veterans Affairs, and Related 
Agencies appropriations bill provides necessary funding for the 
planning, design, construction, alteration, and improvement of 
military facilities worldwide. It also finances the cost of 
military family housing and the U.S. share of the NATO Security 
Investment Program. In addition, the bill provides funding, 
including environmental remediation, for base closures and 
realignments authorized by law. The bill provides resources to 
the Department of Veterans Affairs for veterans benefits and 
healthcare and funding for U.S. cemeteries and battlefield 
monuments both in the United States and abroad, including the 
American Battle Monuments Commission and Arlington National 
Cemetery. Additionally, the bill funds the U.S. Court of 
Appeals for Veterans Claims and the Armed Forces Retirement 
Homes.

                        Committee Recommendation

    The Committee recommends new budget authority totaling 
$200,887,098,000 for fiscal year 2018 military construction, 
family housing, base closure, veterans healthcare and benefits, 
including fiscal year 2019 advance appropriations for veterans 
medical care and appropriated mandatories, and related 
agencies. This includes $107,723,000,000 in mandatory funding 
and $93,164,098,000 in discretionary funding. The table at the 
end of the report displays the Committee recommendation in 
comparison with the current fiscal year and the President's 
fiscal year 2018 request.

                   APPROPRIATIONS FOR FISCAL YEAR 2018
------------------------------------------------------------------------
                                                           Senate
                                 Budget request        recommendation
------------------------------------------------------------------------
New budget authority........      $201,453,868,000      $200,887,098,000
Previous advances provided          66,385,032,000        66,385,032,000
 for fiscal year 2018 for
 medical care...............
Previous advances provided         103,935,996,000       103,935,996,000
 for fiscal year 2018 for
 appropriated mandatories...
Less advances provided for         -70,699,313,000       -70,700,000,000
 fiscal year 2019 for
 medical care...............
Less advances provided for        -107,709,727,000      -107,710,000,000
 fiscal year 2019 for
 appropriated mandatories...
                             -------------------------------------------
      Total appropriations         193,365,856,000       192,798,126,000
       for fiscal year 2018.
------------------------------------------------------------------------

                      Overview and Summary of Bill

    The Military Construction, Veterans Affairs, and Related 
Agencies appropriations bill funds an array of programs that 
are vital to America's military personnel and their families, 
and to the Nations' veterans. For U.S. military forces and 
their families worldwide, the bill funds critical 
infrastructure, ranging from mission essential operational and 
training facilities to key quality-of-life facilities, 
including barracks, family housing, child care centers, 
schools, and hospitals.
    For America's 21.4 million veterans, the bill provides the 
necessary funding for veterans benefits and healthcare, from 
prescription drugs and clinical services to the construction of 
hospitals and other medical facilities throughout the Nation.
    The bill also funds veterans cemeteries in the United 
States and provides funding for four independent agencies--the 
American Battle Monuments Commission, the U.S. Court of Appeals 
for Veterans Claims, Arlington National Cemetery, and the Armed 
Forces Retirement Homes.

                                TITLE I

                         MILITARY CONSTRUCTION

                       Items of Special Interest

                                HEARINGS

    The Subcommittee on Military Construction, Veterans 
Affairs, and Related Agencies held one hearing related to the 
fiscal year 2018 military construction budget request. 
Witnesses included representatives of the Army, Navy, Marine 
Corps, Air Force, and the Office of the Secretary of Defense.

                  SUMMARY OF COMMITTEE RECOMMENDATIONS

    The fiscal year 2018 budget request for military 
construction and family housing totals $9,782,451,000. The 
Committee recommends $9,536,000,000, which is $246,451,000 
below the President's budget request.

                        REPROGRAMMING GUIDELINES

    The following reprogramming guidelines apply for all 
military construction and family housing projects. A project or 
account (including the sub-elements of an account) which has 
been specifically reduced by the Congress in acting on the 
budget request is considered to be a congressional interest 
item and as such, prior approval is required. Accordingly, no 
reprogrammings to an item specifically reduced below the 
threshold by the Congress are permitted.
    The reprogramming criteria that apply to military 
construction projects (25 percent of the funded amount or 
$2,000,000, whichever is less) continue to apply to new housing 
construction projects and to improvements over $2,000,000. To 
provide the services the flexibility to proceed with 
construction contracts without disruption or delay, the costs 
associated with environmental hazard remediation such as 
asbestos removal, radon abatement, lead-based paint removal or 
abatement, and any other legislated environmental hazard 
remediation may be excluded, provided that such remediation 
requirements could not be reasonably anticipated at the time of 
the budget submission. This exclusion applies to projects 
authorized in this budget year, as well as projects authorized 
in prior years for which construction has not been completed.
    Furthermore, in instances where prior approval of a 
reprogramming request for a project or account has been 
received from the Committee, the adjusted amount approved 
becomes the new base for any future increase or decrease via 
below-threshold reprogrammings (provided that the project or 
account is not a congressional interest item as defined above).
    In addition to these guidelines, the services are directed 
to adhere to the guidance for military construction 
reprogrammings and notifications, including the pertinent 
statutory authorities contained in Department of Defense [DoD] 
Financial Management Regulation 7000.14-R and relevant updates 
and policy memoranda.

                       REAL PROPERTY MAINTENANCE

    The Committee recommends a continuation of the following 
general rules for repairing a facility under ``Operation and 
Maintenance'' account funding:
  --Components of the facility may be repaired by replacement, 
        and such replacement may be up to current standards or 
        code.
  --Interior arrangements and restorations may be included as 
        repair, but additions, new facilities, and functional 
        conversions must be performed as military construction 
        projects.
  --Such projects may be done concurrent with repair projects, 
        as long as the final conjunctively funded project is a 
        complete and usable facility.
  --The appropriate Service Secretary shall submit a 21-day 
        notification prior to carrying out any repair project 
        with an estimated cost in excess of $7,500,000.
    The Department is directed to continue to report on the 
real property maintenance backlog at all installations for 
which there is a requested construction project in future 
budget requests. This information is to be provided on the form 
1390. In addition, for all troop housing requests, the form 
1391 is to continue to show all real property maintenance 
conducted in the past 2 years and all future requirements for 
unaccompanied housing at that installation.

                          INCREMENTAL FUNDING

    In general, the Committee supports full funding for 
military construction projects. However, it continues to be the 
practice of the Committee to provide incremental funding for 
certain large projects, despite administration policy to the 
contrary, to enable the services to more efficiently allocate 
military construction dollars among projects that can be 
executed in the year of appropriation. Therefore, the Committee 
recommends incremental funding for three projects.

                             OTHER MATTERS

    Naval Shipyard Modernization.--The Committee is concerned 
with likely impacts to Fleet readiness and operational 
availability of Navy ships and submarines in the absence of 
significant long-term improvements to public shipyard 
infrastructure and major dry dock capacity. In a 2013 report to 
Congress pursuant to the requirements in Section 2865 of the 
Fiscal Year 2012 National Defense Authorization Act (Public Law 
112-81), the Navy identified a $3,450,000,000 maintenance 
backlog comprising more than 1,000 facilities at the public 
shipyards.
    The Committee is aware that public shipyards involved in 
Navy ship maintenance face a number of challenges in completing 
maintenance on time, including unanticipated work requirements, 
workforce inexperience, workload fluctuations, and inadequate 
facilities. These challenges are exacerbated by the failing 
conditions of facilities across all four public shipyards. For 
example, Norfolk Naval Shipyard has 130 facilities in failing 
condition, including 17 mission-critical facilities. These 
deteriorated facility conditions combined with an inefficient 
and outdated layout of functions at the yards have a direct, 
negative impact on the readiness of naval forces as well as the 
life, safety and health of sailors and the civilian workforce 
at the public shipyards. At the Portsmouth Naval Shipyard, 
increasing workload is making it difficult to schedule 
necessary maintenance on its three nuclear qualified dry docks. 
Within the next 5 years, the workload at Portsmouth will exceed 
the available capacity of the dry docks. Additionally, critical 
components will reach the end of their service life soon, 
placing great strain on the ability to support maintenance on 
Los Angeles- and Virginia-class submarines. Significant 
military construction is needed to expand and modernize Dry 
Dock 1 to meet the growing maintenance requirements of the 
submarine fleet.
    The Committee also notes that while the Navy has 
prioritized dry docks and piers over other failing facilities, 
it is nevertheless taking risks in its dry dock infrastructure. 
Without significant dry dock investments, the public shipyards 
will be unable to meet the Navy's surface and subsurface 
maintenance and inactivation requirements through 2040. For 
example, at Pearl Harbor Naval Shipyard, the Navy has 
identified an urgent requirement to extend Dry Dock 3 and build 
a 500 foot-long concrete lock at the entrance of the dry dock. 
These improvements are essential to sustain Fleet readiness in 
the Pacific and provide maintenance for Virginia-class 
submarines but remain unprogrammed in the Navy's Future Years 
Defense Plan budget for military construction. Similarly, at 
Puget Sound Naval Shipyard in Washington State, the Navy has 
been forced to develop mitigation strategies to maximize the 
use of Dry Dock 1 to accommodate Los Angeles-class submarine 
availabilities and inactivations, as well as availabilities on 
all Virginia-class submarines.
    Finally, the Committee notes that the Navy is investing in 
existing facilities that may not be ideally designed, placed, 
sized or configured to support the current work processes, 
leading to inefficiencies in ship repair functions. In order 
for resources to be expended prudently for maximum benefit for 
shipyard operations, the Navy must first review industrial 
processes, logistics streams and workload distribution to 
develop a facilities plan that optimizes ship repair processes. 
Therefore, the Committee directs the Secretary of the Navy to 
submit a report by February 1, 2018, providing an engineering 
master plan for the optimal placement of facilities and major 
equipment to support ship repair functions at each public 
shipyard, including an investment strategy to address the 
infrastructure requirements at each shipyard. The report shall 
include the following elements:
  --A review of current and projected workload requirements for 
        ship repairs to assess efficiencies in the use of 
        existing facilities including consideration of new ship 
        characteristics, obsolescence of facilities, siting of 
        facilities and equipment, and various constrained 
        process flows;
  --An analysis of life cycle costs to repair and modernize 
        existing mission essential facilities versus the cost 
        to consolidate functions into modern, right-sized 
        waterfront facilities to meet current and programmed 
        future mission requirements;
  --A review of the progress made in prioritizing and funding 
        projects that facilitate implementation of the hub 
        concept for ship repair in order to improve process 
        efficiencies, and contribute to availability cost and 
        schedule reductions;
  --A Master Plan for each shipyard incorporating the results 
        of a review of industrial processes, logistics streams 
        and workload distribution required to support ship 
        repairs at each shipyard and the facilities 
        requirements to support optimized processes; and
  --An updated investment strategy planned for each public 
        shipyard, including timelines to complete the 
        masterplan for each shipyard, a list of projects and 
        brief scopes of work, and cost estimates necessary to 
        complete projects for mission essential facilities.
    Informed by the results of this study, the Committee urges 
the Navy to prioritize infrastructure investment in its 
shipyards within the Department's future years military 
construction budget planning.
    Federal, State and Local Intelligence Collaboration.--The 
Committee is aware that several States utilize National Guard 
facilities for intelligence fusion centers according to their 
respective State authorities. These centers allow Federal, 
State, local, and tribal law enforcement officials to 
collaborate and share intelligence and threat information, and 
co-locating them with National Guard facilities offers 
opportunities for cost savings. Therefore, the Committee urges 
the Department, the services, and the National Guard Bureau to 
prioritize needed workplace replacement projects, including 
Sensitive Compartmented Information Facility [SCIF] projects to 
conduct State and Federal intelligence analysis, in the fiscal 
year 2019 and future budget submissions.
    Historic Buildings.--The Committee recognizes the 
historical value of many of our Nation's military 
installations, and the need for preserving these historic sites 
for posterity. However, the Committee is also aware of the 
challenges of maintaining historical buildings, particularly 
those that are still in use today. On certain military 
installations, these historical structures are still used for 
housing and other purposes, which can lead to a struggle to 
balance maintaining hospitable living and work environments 
with preserving the historical status of the building. The 
Committee requests that the Government Accountability Office 
conduct a review that assesses historical structures or sites 
on Department installations in the United States that may be 
utilized for housing and for other purposes. The review shall 
include qualitative analysis as it relates to State and Federal 
regulatory standards for habitation, and also provide 
recommendations concerning the Department's processes and 
procedures for assessing whether certain structures or sites 
require renovation to meet State and Federal regulatory 
standards for habitation or other uses as warranted.
    DoD Installation Energy Policy.--Department of Defense 
[DoD] installation energy use accounts for nearly a quarter of 
all Federal Government energy consumption. In fiscal year 2015, 
according to DoD's Annual Energy Management Report, the 
Department spent $3,900,000 on installation energy. While DoD 
has made great strides in increasing installation energy 
efficiency and reducing overall energy consumption, more needs 
to be done to bring down the energy costs throughout the 
Department. DoD must also ramp up its efforts to enhance energy 
security on its installations through a range of actions, 
including investing in renewable energy and smart technology 
that can shield mission-critical operations from disruptions to 
the power grid. According to a January 2017 report commissioned 
by the Pew Charitable Trusts (``Power Begins at Home: Assured 
Energy for U.S. Military Bases''), DoD could enhance energy 
security on installations and save hundreds of millions of 
dollars annually by investing in microgrids and renewable 
energy systems, and by increasing energy efficiency on military 
bases. The report found that microgrid power systems are more 
reliable than the stand-alone diesel generators typically used 
for backup power and could save $8,000,000 to $20,000,000 over 
a 20-year period. The report also found that DoD could save as 
much as $1,000,000,000 a year simply by increasing the use of 
commercially available energy efficiency measures in its 
facilities. The Committee notes that military installations in 
Hawaii are among those at the forefront of DoD's efforts to 
increase energy efficiency and security, including projects to 
develop net-zero energy military housing and installation 
facilities, upgrade and retrofit systems to improve energy and 
water efficiency, and demonstrate microgrid technology. The 
Committee supports DoD's investments in energy efficiency, 
renewable energy systems, and energy security, including 
through the Energy Resilience and Conservation Investment 
Program [ERCIP]. The fiscal year 2018 ERCIP request of 
$150,000,000 provides funding for 26 projects, including 7 
energy resilience, 12 energy efficiency, 5 renewable energy, 
and 2 water conservation projects. The Committee recommends an 
increase of $15,000,000 above the request for ERCIP and 
encourages the Department to prioritize funding for energy-
related projects, including renewable energy projects, to 
mitigate risk to mission-critical assets and promote energy 
security and efficiency at military installations.
    Major Range and Test Facility Base [MRTFB].--The Committee 
recognizes the strategic importance of the key Department of 
Defense [DoD] installations, ranges and facilities that 
comprise the Major Range and Test Facility Base [MTRFB]. These 
ranges, which include Army, Navy, Air Force and Defense Agency 
facilities in more than 20 locations, are designated by DoD as 
``national assets'' because of their critical role in 
maintaining the Nation's military technological advantage. 
However, the Committee is concerned about the lack of 
investment and sustainment of these facilities. For example, 
White Sands Missile Range in New Mexico, which is the Nation's 
largest overland testing facility, has not received a military 
construction project in support of test and evaluation missions 
in over a decade. As a result, support for critical testing on 
missile systems such as the Standard Missile-2 [SM2], Patriot 
Missile system [PAC3], JASSM, CALCM, and others may be 
adversely impacted. The Barking Sands Tactical Underwater Range 
at the Pacific Missile Range Facility in Hawaii exceeded its 
20-year design service life in 2014. Key underwater cables have 
been repeatedly repaired in recent years, but the Navy has 
determined that future repairs of the seafloor cables are not 
feasible. The Air Force Development Test Center's [AFDTC] 
overall mission is to plan conduct, and evaluate testing of 
U.S. and allied nonnuclear munitions, electronic combat, target 
acquisitions, weapon delivery, base intrusion protection, and 
supporting systems. AFDTC carries out this work at Eglin Air 
Force Base, FL, whose land test areas encompass 463,000 acres, 
and water test areas cover 86,500 square miles in the Gulf of 
Mexico, the largest DoD test and training area in the world.
    In order to continue to conduct safe and robust testing of 
our military's newest munitions and systems, deployed by our 
fastest and longest-range aircraft, surface, and subsurface 
vessels, test and training range infrastructure and 
instrumentation must be modernized. The lack of needed 
investment at MRTFB facilities jeopardizes future technology 
development and threaten the Nation's ability to counter 
emerging threats. The Committee therefore directs the Secretary 
of Defense to submit a comprehensive MRTFB modernization plan 
within 180 days of enactment of this act outlining a timetable 
and specific actions for repair, replacement and renovation of 
infrastructure, equipment and instrumentation at mission-
critical facilities.
     Infrastructure to Support Third Offset Capabilities.--The 
Committee notes that the Department of Defense is increasing 
investments in a number of technology areas to support the 
Third Offset strategy, an effort to offset declining 
technological superiority over near peer rivals using targeted 
investments in advanced technologies and through the 
development of new operational concepts using existing and next 
generation systems. This includes increased funding in undersea 
warfare, robotics, directed energy, hypersonics, and precision 
munitions, among other areas. The Committee is concerned that 
these investments are not being matched by coordinated funding 
of modern research and testing infrastructure that will ensure 
that these new systems and technologies are developed and 
tested as efficiently and quickly as possible, and are deployed 
to operational forces as soon as feasible. In testimony to the 
Subcommittee on Defense, Deputy Secretary of Defense Robert 
Work acknowledged the importance of investing in this type of 
research infrastructure, although the current Future Years 
Defense Plan includes very few military construction projects 
that support research or testing activities. The Committee 
directs the Secretary of Defense to develop a plan for 
investments in research and testing infrastructure, including 
through major military construction projects that support 
development of Third Offset capabilities. The strategy should 
make clear how the infrastructure investments will be timed so 
that they are coordinated with planned programs of record. The 
Committee directs that the plan be delivered to the 
congressional defense committees no later than 1 year after the 
date of enactment of this act.
    Water Conservation on Military Installations.--The Senate 
Report accompanying H.R. 5325 (S. Rept. 114-237) included 
language highlighting the status of water use on military 
installations, the vulnerability of installations to water 
scarcity, and water conservation potential at military 
installations based on both reduced water use and cost savings. 
The report directed the Secretary of Defense to report to the 
Committees on Appropriations of both Houses of Congress on the 
current status of water demand and potential water 
conservations opportunities across U.S. military installations, 
including water usage rates, water scarcity vulnerabilities, 
water conservation potential from reduced water usage, and 
potential cost savings from water conservation technologies. 
The Committee notes that the report is currently 90 days 
overdue and directs the Secretary to provide the report no 
later than October 1, 2017.
    Sea Level Rise and Coastal Erosion.--The Committee is 
concerned about the increasingly harmful impact of sea level 
rise and flooding on facilities at DoD's coastal military 
installations, both in the United States and overseas. A June 
30, 2014, Government Accountability Office [GAO] report to 
Congress, (GAO-14-446, ``Climate Change Adaptation: DoD Can 
Improve Infrastructure Planning and Processes to Better Account 
for Potential Impacts'') assessed 15 sites at defense 
installations in the U.S. that are vulnerable to the effects of 
climate change and provided recommendations to improve 
readiness and reduce fiscal exposure for DoD.
    Among several compelling findings, GAO noted that DoD 
officials are concerned that the combination of thawing 
permafrost, decreasing sea ice, and rising sea levels on the 
Alaskan coast have increased coastal erosion at several Air 
Force radar early warning and communication installations. 
Further, Navy officials are concerned that if a storm surge 
occurs while a submarine is undergoing maintenance while 
sitting in a dry dock, substantial repair costs likely would be 
needed. Officials told GAO that if salt water floods the 
submarine's systems, it could result in severe damage.
    In a July 23, 2015, report to Congress regarding the 
security implications of climate-related risks, the Department 
noted that it had directed a global screening level assessment 
to determine installation vulnerabilities to climate-related 
security risks with the goal of identifying serious 
vulnerabilities and developing necessary adaptation strategies. 
Senate Report 114-237 accompanying the fiscal year 2017 
Military Construction, Veterans Affairs, and Related Agencies 
Appropriations Act included language directing the Secretary of 
Defense to report to the congressional defense committees not 
later than 120 days after the enactment of the act on the 
findings of that assessment. The Committee notes that the 
fiscal year 2017 Military Construction, Veterans Affairs, and 
Related Agencies Appropriations Act was signed into law on 
September 29, 2016, and that the report is currently more than 
90 days overdue. The Committee therefore directs the Secretary 
to comply with the directive not later than October 1, 2017.
    Understanding the costs associated with mitigation of 
climate vulnerabilities is essential to an accurate assessment 
of future DoD infrastructure costs. The Committee believes that 
DoD must be proactive in assessing the potential effects of 
projected climate change on the design, operation, maintenance, 
and repair of buildings; utility systems; and storm water 
management systems. DoD requires its components to manage the 
risks associated with these effects, including changes--as 
appropriate--to design and construction standards. The GAO has 
noted that extreme weather events have caused tens of millions 
of dollars in damage to DoD infrastructure and that these types 
of extreme weather events are expected to become more frequent 
or severe with climate change. The Committee expects that DoD 
will implement an effective approach to analyzing and 
addressing the potential impacts of climate change on military 
construction projects during the design phase to mitigate the 
need for future costly repair or restoration requirements.
    Therefore, the Committee directs the Comptroller General to 
undertake a study of DoD's progress in developing a means to 
account for potentially damaging weather in project design, and 
to report to the Committees on Appropriations of both Houses of 
Congress not later than 180 days after enactment of this act. 
At a minimum, the Comptroller General should answer the 
following questions:
  --What is known about the historical and projected costs for 
        facilities maintenance and repair beyond expected 
        repair costs of DoD infrastructure stemming from damage 
        or degradation caused by weather effects associated 
        with climate change?
  --What best practices has DoD adopted for incorporating 
        climate change adaptation into the design of military 
        construction or facilities sustainment, restoration, or 
        modernization projects?
  --To what extent has DoD developed a systematic process for 
        ensuring climate change or severe weather effects are 
        accounted for in the design of military construction 
        and facilities sustainment, modernization, or 
        restoration projects?
    Local Hiring in Military Construction.--In March 2015 the 
Federal Highway Administration and the Federal Transit 
Administration implemented a Local Labor Hiring Pilot Project 
which aims to increase local, low income and veteran employment 
in construction projects funded by those agencies. The pilot 
project was recently extended through 2022. The Committee 
encourages the Department of Defense to consider implementing a 
similar pilot project with respect to military construction. 
The Secretary of Defense is directed to report to the 
Congressional defense committees within 6 months of the date of 
enactment of this act on the feasibility of implementing such a 
program.
    Remotely Piloted Aircraft and Joint Use Military/Civilian 
Airports.--The Committee is concerned that many existing 
Airport Joint Use Agreements [AJUA] were not written to 
accommodate the increasing use of remotely piloted aircraft 
[RPAs]. In some instances, a long term AJUA may need 
significant modifications to allow for the use of RPAs and to 
calculate the appropriate Federal compensation. Therefore, the 
Committee directs the Secretary of Defense to conduct a review 
of the authorities needed to update AJUAs and associated 
compensation for airfields impacted by a transition to RPA 
missions, and to report such findings to the congressional 
defense committees no later than March 30, 2018.
    Special Operations Command Training Opportunities.--
Abandoned mine land and surface reclamation projects throughout 
the Nation can provide a unique environment for military 
training and range capabilities, to include mobility and 
irregular warfare opportunities for the Special Operations 
Command [SOCOM]. The Committee urges SOCOM to work with the 
National Guard Bureau and the States on the development of such 
sites to meet its unique training requirements.
    Viability of Armed Forces Reserve Centers.--The Committee 
is aware of the proposed closure of certain recently 
constructed reserve centers due to a lack of usage. This raises 
concerns about the adequacy and accuracy of the personnel and 
unit forecasting that led to the construction of such 
facilities. The Committee directs the Department of Defense to 
submit a report on the status of all reserve centers 
constructed during the last 15 years, to include those 
facilities that were built as part of the 2005 BRAC round. The 
report should include a detailed assessment of individual 
facility usage rates, identify underutilized or unutilized 
facilities, include an assessment of the cause of any 
utilization shortfalls, and include a review of any personnel 
or units re-stationed away from recently constructed 
facilities.
    Accidental window fall prevention.--The Committee is 
concerned about the risks of unintentional falls from windows 
in military family housing. Deaths and injuries often occur 
when children push against window screens or climb onto 
furniture located near an open window. Therefore, not later 
than 180 days after the date of enactment of this act, the 
Committee directs the Department of Defense to update its 
Unified Facilities Criteria [UFC] for Family Housing (UFC 4-
711-01) to require that all new and existing residential 
buildings have corrosion-resistant screens that meet the ANSI/
SMA6001 specifications for at least Medium loads, or successor 
standard; or that windows shall be equipped with window fall 
prevention screens, guards, or other devices that comply with 
ASTM F2006 or ASTM F2090, or a successor standard.
    The Committee also directs the Department of Defense, in 
updating its UFC for family housing, to: (1) specify that 
military housing privatization partners shall be required to 
include window fall prevention screens, guards, or other 
devices for military housing and shall not be allowed to seek 
waivers or exemptions; (2) conduct an oversight program to 
ensure that all military housing be equipped with window fall 
prevention screens, guards, or other devices; and (3) establish 
an awareness campaign that educates families on window fall 
risks and window fall prevention measures. The Secretary of 
each military department shall brief the Committee within 1 
year of enactment of this act on the following: (a) the extent 
to which the Secretary is in compliance with the requirements 
of the updates to UFC 4-711-01; and (b) a plan for retrofitting 
existing military family housing units that are not in 
compliance with the revised UFC 4-711-01.
    Military Construction Funding Initiatives.--The bill 
includes funding for military construction initiatives to 
address important unfunded priorities included in the 
Department of Defense's unfunded priority lists provided to 
Congress. The Committee notes that in recent years the military 
construction budget requests have been at historically low 
levels. Amounts budgeted for facility sustainment, restoration, 
and modernization are similarly low. The infrastructure 
initiatives in unfunded priority lists would ordinarily appear 
as part of the annual budget request, but were not included as 
the military construction budget remains severely constrained.
    For this reason, the Committee includes an additional 
$68,800,000 for the Army, $110,100,000 for the Navy and Marine 
Corps, $127,300,000 for the Air Force, $83,500,000 for the Army 
National Guard, $24,000,000 for the Air National Guard, 
$30,000,000 for the Army Reserve, and $35,100,000 for the Air 
Force Reserve. All additional funding is reserved for projects 
that were included in the unfunded priority lists submitted to 
Congress.
    Rescissions.--The Committee recommends an administrative 
provision rescinding prior year unobligated funds due primarily 
to project bid savings and the slow execution of projects.

                     Military Construction Overview

Appropriations, 2017....................................  $7,726,000,000
Budget estimate, 2018...................................   9,782,451,000
Committee recommendation................................   9,536,000,000

          MILITARY CONSTRUCTION ACCOUNTS--PROGRAM DESCRIPTION

    The military construction appropriation provides for 
acquisition, construction, installation, and equipment of 
temporary or permanent public works, military installations, 
facilities, and real property for the Department of Defense. 
This appropriation also provides for facilities required as 
well as funds for infrastructure projects and programs required 
to support bases and installations around the world.

                      Military Construction, Army

Appropriations, 2017....................................    $513,459,000
Budget estimate, 2018...................................     920,394,000
Committee recommendation................................     930,394,000

                        COMMITTEE RECOMMENDATION

    The Committee recommends $930,394,000 for the Army for 
fiscal year 2018. This amount is $416,935,000 above the fiscal 
year 2017 enacted level and $10,000,000 above the budget 
request. Further detail of the Committee's recommendation is 
provided in the State table at the end of this report.
    Defense Laboratory Enterprise Facilities and 
Infrastructure.--The Committee is concerned the unspecified 
minor military construction [UMMC] request is insufficient to 
support the Army Laboratories. Threats continue to emerge, 
construction costs continue to rise, and outdated laboratory 
facilities continue to age. Congress established a higher 
threshold for UMMC specifically for laboratories so that the 
services can keep up with threats that evolve faster than can 
be addressed through the normal military construction planning 
process. However, the Army has funded very few laboratory 
revitalization projects and the request for UMMC has remained 
flat. Therefore, an additional $10,000,000 is provided to 
supplement unspecified minor construction projects.
    Sunflower Army Ammunition Plant.--The Committee understands 
that the U.S. Army is currently managing the environmental 
remediation of the Sunflower Army Ammunition Plant [SFAAP] 
property in excess of 9,000 acres in DeSoto, Kansas, which was 
conveyed to Sunflower Redevelopment, LLC [SRL] through the Army 
and the General Services Administration on August 3, 2005. Ten 
years after the conveyance, on October 29, 2015, the Army 
reinforced its responsibility in writing, ``the Army is 
committed to programming the necessary resources to carry out a 
long-term clean-up and has, for execution in fiscal year 2016, 
awarded several services contracts for the short term 
requirements.'' The Army further wrote it would ``issue 
competitively sourced clean-up contracts, with Army oversight 
to ensure its Comprehensive Environmental Response, 
Compensation, and Liabilities Act [CERCLA] Sec.  120(h) 
obligation at Sunflower.'' The Army confirmed its intention 
``to conduct in-depth coordination with Sunflower 
Redevelopment, LLC [SRL] to ensure SRL's redevelopment 
priorities are synchronized with the Army managed clean-up 
activities.'' However, the Committee is disappointed to learn 
that the Army has neglected to communicate regularly with SRL 
and far less than the in-depth coordination commitment made by 
the Army. The Committee recently learned of ongoing risk 
assessments of contaminated portions of SFAAP and expects the 
Army will work in consultation and coordination with SRL to 
ensure transparency. The Committee further expects that the 
findings and recommendations of such assessment will receive 
approval from State and Federal regulators regarding allowable 
levels of contaminants including, but not limited to, 
pesticides, asbestos or other contaminants subject to 
remediation for commercial use of the property. The Committee 
directs the Secretary of the Army to deliver the assessment and 
brief the Committee on its findings and to provide a plan that 
ensures SRL's redevelopment priorities are synchronized with 
Army managed cleanup activities.
    Military Construction at Depots and Arsenals.--The 
Committee is concerned about the need to maintain critical 
investment in Army depots and arsenals. Maintaining the 
physical infrastructure of depots and arsenals, which allows 
these installations to operate at peak efficiency, is essential 
to maintaining military readiness. However, the Future Years 
Defense Program [FYDP] for military construction at Army depots 
and arsenals does not reflect the need for investment in the 
infrastructure of these facilities, with only two depot or 
arsenal military construction projects included in the most 
recent FYDP, both in fiscal year 2020. For example, the Detroit 
Arsenal which hosts the Army's Tank-automotive and Armaments 
Command [TACOM] Life Cycle Management Command and the U.S. Army 
Tank Automotive Research Development and Engineering Center, 
requires an electrical substation to meet electrical demand for 
existing missions at the installation. The Army, which included 
this project in its fiscal year 2018 list of unfunded 
priorities, noted that the Arsenal must currently rely on 
substations located outside its perimeter, presenting 
vulnerability and mission security issues. The Committee 
therefore urges the Army to prioritize and accelerate 
construction of the Detroit Arsenal substation and other 
critical arsenal and depot military construction and 
infrastructure maintenance investments within the fiscal year 
2019 FYDP.
    Badger Army Ammunition Plant.--In 2011, an Army Feasibility 
Study concluded that an offsite drinking water treatment system 
was needed as part of a comprehensive groundwater cleanup 
remedy for the former Badger Army Ammunition Plant [BAAP]. 
Accordingly, in 2015, the Town of Merrimac, Wisconsin, designed 
and approved a sanitation district required by the Army to 
support such a system, and as recently as May 2016, the Army 
noted in writing that ``design of the municipal drinking water 
system has been initiated.'' Recently, however, the Army 
reversed its plans to construct and operate the drinking water 
system. The Committee is concerned about this decision, its 
potential to delay the provision of clean drinking water to 
homes near the site, and the Army's lack of public 
communication regarding the decision.
    Therefore, the Committee expects the Army to conduct 
required human health risk assessments expeditiously, and if 
needed, use expedited contracting authorities. Additionally, 
the Committee urges the Army to hold regular public meetings to 
update and engage with local stakeholders. The Committee 
expects the Army to integrate local priorities in its 
remediation plans. Furthermore, within 90 days of the date of 
enactment of this act, the Secretary of the Army shall submit 
to the Committee a report and provide a corresponding briefing 
regarding the Army's rationale and process for approving plans 
to construct and operate a drinking water system and its 
subsequent decision to terminate such plans, as well as the 
Army's completed and planned actions for environmental 
restoration at the site.

              Military Construction, Navy and Marine Corps

Appropriations, 2017....................................  $1,021,580,000
Budget estimate, 2018...................................   1,616,665,000
Committee recommendation................................   1,565,665,000

                        COMMITTEE RECOMMENDATION

    The Committee recommends $1,565,665,000 for Navy and Marine 
Corps military construction for fiscal year 2018. This amount 
is $544,085,000 above the fiscal year 2017 enacted level and 
$51,000,000 below the budget request. Further detail of the 
Committee's recommendation is provided in the State table at 
the end of this report.
    Navy Strategic Laydown and Dispersal.--The Committee 
recognizes the inherent risk of natural and man-made hazards 
associated with the stationing of U.S. capital ships at major 
ports, and the Navy's corresponding requirement for the 
strategic dispersal of its fleet in the Pacific and Atlantic to 
mitigate that risk. During the next Future Years Defense 
Program [FYDP], the Navy will begin to expand the fleet as it 
seeks to achieve its new force structure goal of having a 355-
ship fleet. The Navy's own internal guidance on making 
decisions regarding strategic basing requires that the Navy 
consider strategic dispersal strategies and that these 
strategies be factored into homeporting decisions to limit the 
risk associated with natural disasters or man-made catastrophe. 
The Committee believes that strategic dispersal should be a key 
consideration in expanding the fleet, and that, as a first 
step, the Navy should program military construction funding for 
necessary infrastructure to achieve strategic dispersal of its 
fleet, beginning with the budget request and FYDP for fiscal 
year 2019.
    Innovative Ship Design & Technology Integration 
Collaboration Center.--The Navy has experienced numerous cost 
overruns on recent ship acquisition and development programs. 
As the Navy has been tasked by the Administration to reach a 
fleet size of 355 ships, it is essential that early stage 
design efforts are comprehensive and detailed and account for 
flexibility and adaptability in ship designs that allow for 
rapid reconfiguration, technology and modular systems 
integration, as well as design allowances for likely upgrades. 
To accomplish this will require considerable time, effort and 
strain on the Navy's ship design community. The Committee is 
concerned that the Navy has not established the infrastructure 
and associated facilities that allow for effective 
collaboration, productivity, and innovation in ship design and 
recommends that the Navy prioritize future military 
construction programs to include a facility for an Innovative 
Ship Design & Technology Integration Collaboration Center. Such 
a Collaboration Center would provide a Navy venue to bring 
together all relevant ship design personnel, technologists and 
stakeholders to ensure that all future ship, submarine and 
unmanned vehicle designs are developed in a comprehensive, 
efficient and collaborative manner to prevent extended ship 
construction timelines. The Committee directs the Navy to 
provide a report no later than March 30, 2018 detailing a plan 
to invest in infrastructure and facilities that will foster 
collaborative ship design.
    Advanced Electric Ship Testbed.--The Committee notes the 
Navy's continued development of advanced ship electric power 
systems to support the integration of high power weapons and 
sensors. The Navy's development of these technologies requires 
continued investment in its major testing ranges to ensure that 
these systems are compatible with the fleet, including new 
classes of ships. A cost-effective approach would be a land-
based demonstration site representative of an integrated ship 
power system that includes power generation, energy storage, 
power distribution, and power loads, and that provides for 
testing of high power weapons and sensors. The Committee 
directs the Navy to assess the feasibility of developing a 
land-based advanced electric ship testbed to test and evaluate 
high power weapons and systems, identifying what technologies 
the Navy must still mature to build such a testbed and the 
factors that would influence the siting of a testbed, such as 
cost, security, integrated electric grid, ability to integrate 
a weapon system on site, minimal encroachment, access to the 
open ocean for eventual operationally relevant testing. The 
Committee directs the Department to submit this report no later 
than March 30, 2018.
    Navy Yard Land Acquisition.--The Committee does not 
recommend providing $60,000,000 as requested by the Navy to 
acquire four acres of land adjacent to the Navy Yard in 
Southeast Washington, D.C., to provide an anti-terrorism force 
protection [ATFP] buffer zone. Although the Committee supports 
enhancing ATFP measures at the Navy Yard, it is concerned by 
the high price of the land acquisition and by the budget 
justification explanation that the Navy's recommended use of 
the land is for a Navy Museum. The Committee questions whether 
the Navy fully explored alternative options for the acquisition 
and use of the land, including consultation with other Federal 
agencies to evaluate the potential use of this parcel to meet 
pending land acquisition requirements for other Federal 
agencies. The Committee also notes that the proposed land 
acquisition addresses only a portion of the Navy Yard's ATFP 
deficiencies. The Secretary of the Navy is therefore directed 
to provide a report to the Committees on Appropriations of both 
Houses of Congress no later than 180 days after enactment of 
this act on a Government-wide assessment of the potential uses 
by other Federal agencies for the proposed Navy Yard land 
acquisition and a comprehensive ATFP Master Plan for the Navy 
Yard.

                    Military Construction, Air Force

Appropriations, 2017....................................  $1,491,058,000
Budget estimate, 2018...................................   1,738,796,000
Committee recommendation................................   1,569,296,000

                        COMMITTEE RECOMMENDATION

    The Committee recommends $1,569,296,000 for the Air Force 
in fiscal year 2018. This amount is $78,238,000 above the 
fiscal year 2017 enacted level and $169,500,000 below the 
budget request. Further detail of the Committee's 
recommendation is provided in the State table at the end of 
this report.
    Air Force Ballistic Missile Facilities.--The Committee is 
concerned with the deteriorating infrastructure of the ground-
based intercontinental ballistic missile [ICBM] facilities at 
Malmstrom Air Force Base [AFB], Montana; Minot AFB, North 
Dakota; and F.E. Warren AFB, Wyoming. The Missile Alert 
Facilities [MAF] at these bases are in advanced states of 
disrepair. For example, the Committee is aware that the power 
lines providing electricity to these ICBM launch facilities 
were constructed in the 1960s in conjunction with the 
deployment of the original Minuteman ICBM. In order to ensure 
these launch facilities retain a reliable source of power 
through 2075, the expected lifespan of the Ground Based 
Strategic Deterrent [GBSD] program, these power lines 
eventually will require replacement. In April 2017, the Air 
Force provided the Committee with a study that highlighted the 
need to recapitalize the MAFs. The report also noted that while 
the Air Force is developing plans to recapitalize MAFs, the Air 
Force does not have a reliable estimate of military 
construction requirements at this time.
    Infrastructure is critically important to the nuclear 
mission, and the Committee urges the Secretary of the Air Force 
to finalize MAF recapitalization requirements; upon being 
finalized, the Secretary of the Air Force is directed to 
provide these MAF recapitalization requirements to the 
Committee. The report should include an assessment of the 
reliability of existing power lines, a review of Federal 
partnerships with local electrical cooperatives to build and 
maintain power lines, and an estimate of when investments in 
electrical power will be required. The Committee also directs 
the Secretary of the Air Force to provide an assessment of the 
lessons learned in fielding the prototype Weapons Storage 
Facility at F.E. Warren, and the timeline to replace Weapons 
Storage Facilities at Malmstrom and Minot.
    Presidential Aircraft Recapitalization Complex.--The 
Committee notes that the work in progress curve submitted with 
the budget request shows that the Air Force cannot execute the 
full request of $254,000,000. Therefore, the Committee provides 
$100,000,000 for the first increment of this project.
    KC-46 Main Operating Base 4.--The Committee notes that the 
budget request included a funding wedge for the KC-46 Main 
Operating Base 4. Shortly after the budget submission, the 
Secretary of the Air Force announced that the first aircraft 
would arrive at Joint Base McGuire-Dix-Lakehurst in fiscal year 
2021 and the first aircraft will arrive at Travis Air Force 
Base in fiscal year 2023. Accordingly, the Committee provides 
funding for the specific KC-46 Main Operating Base 4 projects 
at the designated locations rather than the unspecified wedge. 
Furthermore, as a result of the Secretary of the Air Force's 
sequencing decision, the Committee defers funding on three 
associated projects at Travis Air Force Base pending further 
review, and directs the Air Force to promptly provide an 
updated schedule for these projects.
    Launch Support and Infrastructure Modernization.-- The 
Launch and Test Range System [LTRS] located at the Eastern 
Range (Patrick AFB, Cape Canaveral AS and Kennedy SC, FL) and 
the Western Range (Vandenberg AFB, CA) consists of ground based 
surveillance, navigation, flight operations and analysis, 
command and control, communications and weather assets used to 
support space missions. The mission is to provide DOD, NASA and 
commercial customers a highly reliable, integrated system to 
support spacecraft launch, ballistic missile and aeronautical 
testing. The Committee is concerned with the current state of 
space launch support and infrastructure as launch schedules 
continue to increase in tempo. The Committee directs the 
Secretary of Defense to provide a report to the congressional 
defense committees not later than 120 days after the enactment 
of this act on the plan for the implementation of launch 
support and infrastructure modernization program. The report 
shall include a description of plans and the resources needed 
to improve launch support infrastructure, utilities, support 
equipment, and range operations; a description of plans to 
streamline and normalize processes, systems, and products at 
the Eastern and Western ranges, to ensure consistency for range 
users; and recommendations for improving transparency, 
flexibility, and responsiveness in launch scheduling.

                  Military Construction, Defense-Wide


                     (INCLUDING TRANSFER OF FUNDS)

Appropriations, 2017....................................  $2,025,444,000
Budget estimate, 2018...................................   3,114,913,000
Committee recommendation................................   2,612,583,000

                        COMMITTEE RECOMMENDATION

    The Committee recommends $2,612,583,000 for projects 
considered within the Defense-Wide account in fiscal year 2018. 
This amount is $587,139,000 above the fiscal year 2017 enacted 
level and $502,330,000 below the budget request. Further detail 
of the Committee's recommendation is provided in the State 
table at the end of this report.
    Hydrant Fuel Systems in Support of Humanitarian Assistance 
and Disaster Relief Operations.--The Committee notes that the 
Department of Defense has a long history of successfully 
conducting urgently needed humanitarian assistance and disaster 
relief [HADR] missions. In recent years HADR missions have 
responded to major earthquakes, tsunamis, typhoons, hurricanes, 
floods, and the nuclear disaster in Fukushima, Japan. The 
Committee believes that hydrant fuel systems capable of 
supporting large scale fueling of heavy aircraft are an 
essential component of our HADR capability. The Committee 
encourages the services and the Defense Logistics Agency to 
prioritize construction and enhancement of these systems in 
locations that serve as staging bases for HADR operations.
    Fort Bliss Hospital Replacement.--The Committee is deeply 
concerned about the past performance of the Army Corps of 
Engineers [the Corps] in its management of major Defense Health 
Agency [DHA] construction projects. Recently, the Corps reached 
a $22,000,000 settlement with its contractors involved with the 
Irwin Army Community Hospital at Fort Riley, Kansas. The 
settlement resulted from ``design deficiencies and associated 
delays.'' Earlier this year, the Committee approved a 
$74,000,000 reprogramming request to cover cost overruns on the 
Fort Bliss Hospital replacement project. This additional 
funding was needed to cover ``design errors, design omissions, 
and settlement of contractor requests for equitable 
adjustments.'' These are two examples of a pattern of 
mismanagement and a lack of accountability from the Corps that 
raise questions about the cost estimates and the planned 
execution of major projects included in DHA's fiscal year 2018 
budget request, which represents an increase of more than 
$550,000,000 from the fiscal year 2017 enacted level. Given 
that DHA already has 45 active construction projects underway 
worldwide totaling more than $5,000,000,000, the need for 
effective and efficient project management is clear.
    The Committee is not convinced that the $251,000,000 
requested as the final increment for the Fort Bliss Hospital 
will, in fact, be the final increment. Continued delays and an 
extensive backlog of contractor claims against the Corps will 
likely result in another increment or another request to 
reprogram funds onto the project. This is a subject the 
Committee will conduct extensive oversight on in the coming 
months. As a result, the Committee provides $100,000,000 for 
Increment 8 of the Fort Bliss Hospital Replacement and directs 
the Secretary of the Army not later than 90 days after the 
enactment of this act to submit a report listing projects 
managed by the Army Corps of Engineers that resulted in a 
settlement with a contractor, to include settlement cost, 
dating back to 2010.
    Fort Leonard Wood Hospital Replacement.--The Committee 
notes that the work in progress curve submitted by the Defense 
Health Agency shows it is unable to execute the full 
$250,000,000 request in fiscal year 2018. Therefore, the 
Committee provides $100,000,000 for the first increment of this 
project.
    National Geospatial Intelligence Agency West Campus.--The 
Committee is concerned that the Administration chose to request 
funding for this project in two phases, rather than 
incrementally. The Committee notes that similar large buildings 
designed for intelligence missions for the National Security 
Agency are incrementally funded. The work in progress curve 
submitted with the budget request shows that the NGA can only 
execute a fraction of the $381,000,000, and will not take 
possession of the required land until the 4th quarter of fiscal 
year 2018. The Committee believes this is a textbook example of 
a project that should be incrementally funded. Therefore, the 
Committee provides $175,000,000 for the first increment of this 
project.

               Military Construction, Army National Guard

Appropriations, 2017....................................    $232,930,000
Budget estimate, 2018...................................     210,652,000
Committee recommendation................................     210,652,000

                        COMMITTEE RECOMMENDATION

    The Committee recommends $210,652,000 for Military 
Construction, Army National Guard for fiscal year 2018. This 
amount is $22,278,000 below the fiscal year 2017 enacted level 
and equal to the budget request. Further detail of the 
Committee's recommendation is provided in the State table at 
the end of this report.
    Army National Guard Readiness Center Transformation Plan.--
The Committee remains concerned by the deteriorating condition 
of the Army National Guard Readiness Center national portfolio 
and the Army's lack of an implementable investment plan to 
address it. In April 2017, the Army submitted a report on a 
plan to implement the National Guard's ``Affordable Readiness'' 
Transformation Plan, as required by last year's Committee 
report. However, the Army failed to include any meaningful 
investment strategy for closing the gap between the resources 
required by the ``Affordable Readiness'' scenario's 15-year 
implementation timeline and the resources currently budgeted by 
the Department over the same period. Therefore, the Committee 
directs the Army to provide a report no later than March 30, 
2018 on such an investment strategy, including detailed 
estimates of the annual resources, activities, and possible 
budgetary tradeoffs required to make progress toward the 
``Affordable Readiness'' scenario. Further, the Committee 
encourages the Department to use the National Readiness 
Portfolio to prioritize investment in facilities with low 
readiness ratings, and to examine where efficiencies and cost-
sharing can be achieved by co-locating Readiness Centers with 
other public facilities.

               Military Construction, Air National Guard

Appropriations, 2017....................................    $143,957,000
Budget estimate, 2018...................................     161,491,000
Committee recommendation................................     161,491,000

                        COMMITTEE RECOMMENDATION

    The Committee recommends $161,491,000 for Military 
Construction, Air National Guard for fiscal year 2018. This 
amount is $17,534,000 above the fiscal year 2017 enacted level 
and equal to the budget request. Further detail of the 
Committee's recommendation is provided in the State table at 
the end of this report.

                  Military Construction, Army Reserve

Appropriations, 2017....................................     $68,230,000
Budget estimate, 2018...................................      73,712,000
Committee recommendation................................      73,712,000

                        COMMITTEE RECOMMENDATION

    The Committee recommends $73,712,000 for Military 
Construction, Army Reserve for fiscal year 2018. This amount is 
$5,482,000 above the fiscal year 2017 enacted level and equal 
to the budget request. Further detail of the Committee's 
recommendation is provided in the State table at the end of 
this report.

                  Military Construction, Navy Reserve

Appropriations, 2017....................................     $38,597,000
Budget estimate, 2018...................................      65,271,000
Committee recommendation................................      65,271,000

                        COMMITTEE RECOMMENDATION

    The Committee recommends $65,271,000 for Military 
Construction, Navy Reserve for fiscal year 2018. This amount is 
$26,674,000 above the fiscal year 2017 enacted level and equal 
to the budget request. Further detail of the Committee's 
recommendation is provided in the State table at the end of 
this report.

                Military Construction, Air Force Reserve

Appropriations, 2017....................................    $188,950,000
Budget estimate, 2018...................................      63,535,000
Committee recommendation................................      63,535,000

                        COMMITTEE RECOMMENDATION

    The Committee recommends $63,535,000 for Military 
Construction, Air Force Reserve for fiscal year 2018. This 
amount is $125,415,000 below the fiscal year 2017 enacted level 
and equal to the budget request. Further detail of the 
Committee's recommendation is provided in the State table at 
the end of this report.

                   North Atlantic Treaty Organization

                      SECURITY INVESTMENT PROGRAM

Appropriations, 2017....................................    $177,932,000
Budget estimate, 2018...................................     154,000,000
Committee recommendation................................     154,000,000

                          PROGRAM DESCRIPTION

    The North Atlantic Treaty Organization [NATO] appropriation 
provides for the U.S. cost share of the NATO Security 
Investment Program for the acquisition and construction of 
military facilities and installations (including international 
military headquarters) and for related expenses for the 
collective defense of the NATO Treaty area.

                        COMMITTEE RECOMMENDATION

    The Committee recommends $154,000,000 for the North 
Atlantic Treaty Organization Security Investment Program [NSIP] 
for fiscal year 2018 as requested. This amount is $23,932,000 
below the fiscal year 2017 enacted level and equal to the 
budget request.

               Department of Defense Base Closure Account

Appropriations, 2017....................................    $240,237,000
Budget estimate, 2018...................................     255,867,000
Committee recommendation................................     255,867,000

                          PROGRAM DESCRIPTION

    Section 2711 of the National Defense Authorization Act for 
Fiscal Year 2014 (Public Law 112-239) consolidated the Base 
Closure Account 1990 and the Base Closure Account 2005 into a 
single Department of Defense Base Closure Account. The Base 
Closure Account provides for cleanup and disposal of property 
consistent with the four closure rounds required by the base 
closure acts of 1988 and 1990, and with the 2005 closure round 
required by the Defense Base Closure and Realignment Act of 
1990 (10 U.S.C. 2687 note).

                        COMMITTEE RECOMMENDATION

    The Committee recommends a total of $255,867,000 for the 
Department of Defense Base Closure Account for fiscal year 
2018. This amount is $15,630,000 above the fiscal year 2017 
enacted level and equal to the budget request. Funds provided 
for fiscal year 2018 are for environmental cleanup and ongoing 
operations and maintenance.

                        Family Housing Overview

Appropriations, 2017....................................  $1,276,289,000
Budget estimate, 2018...................................   1,407,155,000
Committee recommendation................................   1,409,437,000

              FAMILY HOUSING ACCOUNTS--PROGRAM DESCRIPTION

    The Family Housing appropriation provides funds for 
military family housing construction activities, operation and 
maintenance, the Family Housing Improvement Fund, and the 
Homeowners Assistance Program. Construction accounts provide 
funding for new construction, improvements and the Federal 
Government share of housing privatization. Operation and 
maintenance accounts fund costs associated with the maintenance 
and leasing of military family housing, including utilities, 
services, management, and furnishings.

                        COMMITTEE RECOMMENDATION

    The Committee recommends $1,409,437,000 for Family Housing 
Construction, Operations and Maintenance, and the Department's 
family housing improvement fund for fiscal year 2018. This 
amount is $133,148,000 above the fiscal year 2017 enacted level 
and $2,282,000 above the budget request.

             Family Housing Operation and Maintenance, Army

Appropriations, 2017....................................    $325,995,000
Budget estimate, 2018...................................     346,625,000
Committee recommendation................................     348,907,000

                        COMMITTEE RECOMMENDATION

    The Committee recommends $348,907,000 for family housing 
operation and maintenance, Army for fiscal year 2018. This 
amount is $22,912,000 above the fiscal year 2017 enacted level 
and $2,282,000 above the budget request.

    Family Housing Operation and Maintenance, Navy and Marine Corps

Appropriations, 2017....................................    $300,915,000
Budget estimate, 2018...................................     328,282,000
Committee recommendation................................     328,282,000

                        COMMITTEE RECOMMENDATION

    The Committee recommends $328,282,000 for family housing 
operation and maintenance, Navy and Marine Corps, in fiscal 
year 2018. This amount is $27,367,000 above the fiscal year 
2017 enacted level and equal to the budget request.

          Family Housing Operation and Maintenance, Air Force

Appropriations, 2017....................................    $274,429,000
Budget estimate, 2018...................................     318,324,000
Committee recommendation................................     318,324,000

                        COMMITTEE RECOMMENDATION

    The Committee recommends $318,324,000 for family housing 
operation and maintenance, Air Force, in fiscal year 2018. This 
amount is $43,895,000 above the fiscal year 2017 enacted level 
and equal to the budget request.

         Family Housing Operation and Maintenance, Defense-Wide

Appropriations, 2017....................................     $59,157,000
Budget estimate, 2018...................................      59,169,000
Committee recommendation................................      59,169,000

                        COMMITTEE RECOMMENDATION

    The Committee recommends $59,169,000 for family housing 
operation and maintenance, Defense-Wide, for fiscal year 2018. 
This amount is $12,000 above the fiscal year 2017 enacted level 
and equal to the budget request.

                   Family Housing Construction, Army

Appropriations, 2017....................................    $157,172,000
Budget estimate, 2018...................................     182,662,000
Committee recommendation................................     182,662,000

                        COMMITTEE RECOMMENDATION

    The Committee recommends $182,662,000 for Army Family 
Housing Construction in fiscal year 2018. This amount is 
$25,490,000 above the fiscal year 2017 enacted level and equal 
to the budget request. Further detail of the Committee's 
recommendation is provided in the State table at the end of 
this report.

           Family Housing Construction, Navy and Marine Corps

Appropriations, 2017....................................     $94,011,000
Budget estimate, 2018...................................      83,682,000
Committee recommendation................................      83,682,000

                        COMMITTEE RECOMMENDATION

    The Committee recommends $83,682,000 for Family Housing 
Construction, Navy and Marine Corps. This amount is $10,329,000 
below the fiscal year 2017 enacted level and equal to the 
budget request. Further detail of the Committee's 
recommendation is provided in the State table at the end of 
this report.

                 Family Housing Construction, Air Force

Appropriations, 2017....................................     $61,352,000
Budget estimate, 2018...................................      85,062,000
Committee recommendation................................      85,062,000

                        COMMITTEE RECOMMENDATION

    The Committee recommends $85,062,000 for Family Housing 
Construction, Air Force, in fiscal year 2018. This amount is 
$23,710,000 above the fiscal year 2017 enacted level and equal 
to the budget request. Further detail of the Committee's 
recommendation is provided in the State table at the end of 
this report.

         Department of Defense Family Housing Improvement Fund

Appropriations, 2017....................................      $3,258,000
Budget estimate, 2018...................................       2,726,000
Committee recommendation................................       2,726,000

                          PROGRAM DESCRIPTION

    The Family Housing Improvement Fund appropriation provides 
for the Department of Defense to undertake housing initiatives 
and to provide an alternative means of acquiring and improving 
military family housing and supporting facilities. This account 
provides seed money for housing privatization initiatives.

                        COMMITTEE RECOMMENDATION

    The Committee recommends $2,726,000 for the Family Housing 
Improvement Fund in fiscal year 2018. This amount is $532,000 
below the fiscal year 2017 enacted level and equal to the 
budget request.

 Department of Defense Military Unaccompanied Housing Improvement Fund

Appropriations, 2017....................................................
Budget estimate, 2018...................................        $623,000
Committee recommendation................................         623,000

                          PROGRAM DESCRIPTION

    The Military Unaccompanied Housing Improvement Fund 
appropriation provides for the Department of Defense to 
undertake housing initiatives and to provide an alternative 
means of acquiring and improving military unaccompanied housing 
and supporting facilities. This account provides seed money for 
housing privatization initiatives.

                        COMMITTEE RECOMMENDATION

    The Committee recommends $623,000 for the Military 
Unaccompanied Housing Improvement Fund in fiscal year 2018. 
This amount is equal to the budget request.

                       Administrative Provisions

    Sec. 101. The Committee includes a provision that restricts 
payments under a cost-plus-a-fixed-fee contract for work, 
except in cases of contracts for environmental restoration at 
base closure sites.
    Sec. 102. The Committee includes a provision that permits 
the use of funds for the hire of passenger motor vehicles.
    Sec. 103. The Committee includes a provision that permits 
the use of funds for defense access roads.
    Sec. 104. The Committee includes a provision that prohibits 
construction of new bases inside the continental United States 
for which specific appropriations have not been made.
    Sec. 105. The Committee includes a provision that limits 
the use of funds for purchase of land or land easements.
    Sec. 106. The Committee includes a provision that prohibits 
the use of funds to acquire land, prepare a site, or install 
utilities for any family housing except housing for which funds 
have been made available.
    Sec. 107. The Committee includes a provision that limits 
the use of minor construction funds to transfer or relocate 
activities among installations.
    Sec. 108. The Committee includes a provision that prohibits 
the procurement of steel unless American producers, 
fabricators, and manufacturers have been allowed to compete.
    Sec. 109. The Committee includes a provision that prohibits 
payments of real property taxes in foreign nations.
    Sec. 110. The Committee includes a provision that prohibits 
construction of new bases overseas without prior notification.
    Sec. 111. The Committee includes a provision that 
establishes a threshold for American preference of $500,000 
relating to architect and engineering services for overseas 
projects.
    Sec. 112. The Committee includes a provision that 
establishes preference for American contractors for military 
construction in the United States territories and possessions 
in the Pacific, and on Kwajalein Atoll, or in countries 
bordering the Arabian Gulf.
    Sec. 113. The Committee includes a provision that requires 
notification of military exercises involving construction in 
excess of $100,000.
    Sec. 114. The Committee includes a provision that permits 
funds appropriated in prior years to be available for 
construction authorized during the current session of Congress.
    Sec. 115. The Committee includes a provision that permits 
the use of expired or lapsed funds to pay the cost of 
supervision for any project being completed with lapsed funds.
    Sec. 116. The Committee includes a provision that permits 
obligation of funds from more than 1 fiscal year to execute a 
construction project, provided that the total obligation for 
such project is consistent with the total amount appropriated 
for the project.
    Sec. 117. The Committee includes a provision that permits 
the transfer of funds from Family Housing Construction accounts 
to the DoD Family Housing Improvement Fund and from Military 
Construction accounts to the DoD Military Unaccompanied Housing 
Improvement Fund.
    Sec. 118. The Committee includes a provision that provides 
transfer authority to the Homeowners Assistance Fund.
    Sec. 119. The Committee includes a provision that requires 
all acts making appropriations for military construction be the 
sole funding source of all operation and maintenance for family 
housing, including flag and general officer quarters, and 
limits the repair on flag and general officer quarters to 
$35,000 per unit per year without prior notification to the 
congressional defense committees.
    Sec. 120. The Committee includes a provision that provides 
authority to expend funds from the ``Ford Island Improvement'' 
account.
    Sec. 121. The Committee includes a provision that allows 
the transfer of expired funds to the Foreign Currency 
Fluctuation, Construction, Defense Account.
    Sec. 122. The Committee includes a provision that allows 
the reprogramming of military construction and family housing 
construction funds among projects and activities within the 
account in which they are funded.
    Sec. 123. The Committee includes a provision that prohibits 
the use of funds in this title for planning and design and 
construction of projects at Arlington National Cemetery.
    Sec. 124. The Committee includes a provision defining the 
congressional defense committees.
    Sec. 125. The Committee includes a provision providing 
additional funds for unfunded military construction priorities.
    Sec. 126. The Committee includes a provision rescinding 
unobligated balances from the Military Construction Defense-
Wide account.
    Sec. 127. The Committee includes a provision prohibiting 
the use of funds in this title to close or realign Naval 
Station Guantanamo Bay, Cuba. The provision is intended to 
prevent the closure or transfer of the installation out of the 
possession of the United States, and maintain the Naval 
Station's long-standing regional security and migrant 
operations missions.
    Sec. 128. The Committee includes a provision regarding the 
consolidation or relocation of a U.S. Air Force RED HORSE 
Squadron outside of the United States.

                                TITLE II

                     DEPARTMENT OF VETERANS AFFAIRS

                       Items of Special Interest

                                HEARINGS

    The Subcommittee on Military Construction, Veterans 
Affairs, and Related Agencies held one hearing related to the 
fiscal year 2018 and 2019 Department of Veterans Affairs [VA] 
budget request. The subcommittee heard testimony from Poonam L. 
Alaigh, M.D., Acting Under Secretary for Health, Veterans 
Health Administration, Mr. Thomas J. Murphy, Acting Under 
Secretary for Benefits, Veterans Benefits Administration, Mr. 
Ronald E. Walters, Interim Under Secretary for Memorial 
Affairs, National Cemetery Administration, and the Honorable 
David J. Shulkin, Secretary of the Department of Veterans 
Affairs.

                  SUMMARY OF COMMITTEE RECOMMENDATIONS

    The Committee recommendation includes $182,366,088,000 for 
the Department of Veterans Affairs for fiscal year 2018, 
including $103,948,996,000 in mandatory spending and 
$78,417,092,000 in discretionary spending. The Committee also 
recommends $70,700,000,000 in advance appropriations for 
veterans medical care for fiscal year 2019 and $107,710,000,000 
in advance appropriations for appropriated mandatories for 
fiscal year 2019.

                          DEPARTMENT OVERVIEW

    The Veterans Administration was established on July 21, 
1930, as an independent agency by Executive Order 5398, in 
accordance with the act of July 3, 1930 (46 Stat. 1016). This 
act authorized the President to consolidate and coordinate 
Federal agencies specially created for or concerned with the 
administration of laws providing benefits to veterans, 
including the Veterans' Bureau, the Bureau of Pensions, and the 
National Home for Disabled Volunteer Soldiers. On March 15, 
1989, the Veterans Administration was elevated to Cabinet-level 
status as the Department of Veterans Affairs.
    VA's mission is to serve America's veterans and their 
families as their principal advocate in ensuring they receive 
the care, support, and recognition they have earned in service 
to the Nation. As of September 30, 2016, there were an 
estimated 21.4 million living veterans, with 21.3 million of 
them residing in the United States and Puerto Rico. There were 
an estimated 25.1 million dependents (spouses and dependent 
children) of living veterans in the United States and Puerto 
Rico, and there were 598,000 survivors of deceased veterans 
receiving VA survivor benefits in the United States and Puerto 
Rico. Thus, approximately 47.0 million people, or 14.4 percent 
of the total estimated resident population of the United States 
and Puerto Rico, were recipients or potential recipients of 
veterans benefits from the Federal Government. VA's operating 
units include the Veterans Benefits Administration, Veterans 
Health Administration, National Cemetery Administration, and 
staff support offices.
    The Veterans Benefits Administration [VBA] provides an 
integrated program of nonmedical veterans benefits. VBA 
administers a broad range of benefits to veterans and other 
eligible beneficiaries through 56 regional offices and a 
records processing center in St. Louis, Missouri. The benefits 
provided include: compensation for service-connected 
disabilities; pensions for wartime, needy, and totally disabled 
veterans; vocational rehabilitation assistance; educational and 
training assistance; home buying assistance; estate protection 
services for veterans under legal disability; information and 
assistance through personalized contacts; and six life 
insurance programs.
    The Veterans Health Administration [VHA] develops, 
maintains, and operates a national healthcare delivery system 
for eligible veterans; carries out a program of education and 
training of healthcare personnel; conducts medical research and 
development; and furnishes health services to members of the 
Armed Forces during periods of war or national emergency. A 
system consisting of 144 VA Hospitals; 22 Health Care Centers 
[HCC]; 210 Multi-Specialty Community-Based outpatient clinics; 
527 Primary Care Community-Based outpatient clinics; 305 
Outpatient Services Sites; 135 community living centers; 115 
domiciliary residential rehabilitation treatment programs 
[DRRTP]; 300 readjustment counseling vet centers; and 80 mobile 
vet centers is maintained to meet the VA's medical mission.
    The National Cemetery Administration [NCA] provides for the 
interment of the remains of eligible deceased servicemembers 
and discharged veterans in any national cemetery with available 
grave space; permanently maintains these graves; provides 
headstones and markers for the graves of eligible persons in 
national and private cemeteries; administers the grant program 
for aid to States in establishing, expanding, or improving 
State veterans cemeteries; and provides certificates to 
families of deceased veterans recognizing their contributions 
and service to the Nation. In 2018, cemetery activities will 
encompass 136 national cemeteries, one national veterans' 
burial ground, and 33 soldiers' lots and monument sites.
    Staff support offices include the Office of Inspector 
General, Boards of Contract Appeals and Veterans Appeals, and 
General Administration offices, which support the Secretary, 
Deputy Secretary, Under Secretary for Benefits, Under Secretary 
for Health, Under Secretary for Memorial Affairs, and General 
Counsel.
    Contracting Oversight.--The Committee is concerned about 
the lack of transparency in the contract oversight process, 
given the substantial changes that are made by modifications, 
as well as the lack of visibility into contractor performance. 
For major contracts, whenever the Secretary provides notice to 
a contracted service provider that the service provider is 
failing to meet contractual obligations, VA must submit to the 
Committees on Appropriations and Veterans Affairs of both 
Houses of Congress notification of such failure, along with: an 
explanation of the reasons for providing such notice; a 
description of the effect of such failure, including with 
respect to cost, schedule, and requirements; a description of 
the actions taken by the Secretary to mitigate such failure; 
and a description of the actions taken by the contractor to 
address such failure, and no later than 45 days after the last 
day of each quarter for the duration of the contract, submit to 
the Committees a report detailing any material change or 
modifications made to the contract, if any, and a justification 
for such modifications; and publish on the Internet website of 
the Department information about the contract and the 
modifications made to the contract, if any.
    Regrettable Turnover.--The Committee is concerned the 
Department has failed to follow-up on repeated recommendations 
of the Office of Inspector General to review data on 
regrettable turnover and consider implementing measures to 
reduce such losses. Given the staffing demands on the 
Department and the challenges it faces in recruiting personnel, 
VA should work expeditiously to better understand why personnel 
leave the Department and work to mitigate such losses.
    Veterans Service Centers.--The Committee remains concerned 
that in many small communities access to information and 
resources from VA can be difficult. Private, non-profit centers 
can help bridge the gap, provide subject matter experts and 
service providers to assist in a wide-variety of circumstances, 
including but not limited to homelessness, unemployment, VA 
benefits and disability, financial assistance, VA healthcare, 
education assistance, travel assistance, and community events. 
The Committee encourages the Department to evaluate the 
feasibility of establishing a competitive grant program to 
support local Veterans Service Centers including those that 
were previously funded under the Army Reserve's Army Strong 
Community Center program. The Department is directed to report 
back to the Committees on Appropriations of both Houses of 
Congress on progress made or statutory changes needed to 
establish such a program.
    Financial Management and Health Care Delivery.--The 
Committee is aware of and fully supports the VA's Financial 
Management Business Transformation [FMBT] effort to procure a 
new core accounting and financial management system. However, a 
new system, by itself, will not likely fix the Department's 
persistent inability to reliably and accurately estimate 
budgetary needs for delivering healthcare to veterans. VA 
healthcare remains on the Government Accountability Office's 
[GAO] High Risk List in part due to the Department's inability 
to ensure its resourcing is improving veterans' timely access 
to quality healthcare services. According to the GAO report 
Managing Risks and Improving VA Health Care (GAO-17-317 High 
Risk Series): ``VA faces challenges regarding the reliability, 
transparency, and consistency of its budget estimates for 
medical services, as well as weaknesses in tracking obligations 
for medical services and estimating budgetary needs for future 
years.'' VA faced multi-billion dollar healthcare budget 
shortfalls in fiscal year 2005 and in fiscal year 2015. And 
again this year, the Department faces a budgetary failure and 
has presented Congress with an urgent need for additional 
resources in the Choice Fund to maintain the Veterans Choice 
Program and its provider network built by third party 
administrators. The Committee cannot reconcile how an Agency 
with 18 consecutive years of unmodified (``clean'') audit 
opinions on its consolidated financial statements can have such 
dysfunction. The Department is aware its data and budgeting 
system for veteran healthcare is ineffective and not scalable 
to accurately project appropriations in future years, but has 
not taken definitive action to make improvements to their 
system. The Committee requires the Department, in consultation 
with the Office of Management and Budget, to pursue a 
comprehensive healthcare modeling system and consider solutions 
and best practices from third party administrators or other 
healthcare systems as it relates to informing the Department of 
reforms to more accurately forecast the cost of healthcare for 
veterans. The Department is directed to provide an update on 
progress in this effort to the Committees on Appropriations of 
Houses of Congress within 120 days, as well as furnish 
quarterly reports on all major facets of the initiative, to 
include cooperation with an independent audit conducted by GAO.

                    Veterans Benefits Administration

Appropriations, 2017

                                                        $105,577,085,000

Advance Appropriations, 2018

                                                         103,935,996,000

Budget estimate, 2018

                                                           3,036,653,000

Committee recommendation, 2018

                                                           3,103,214,000

Budget estimate, advance appropriations, 2019

                                                         107,709,727,000
Committee recommendation, advance appropriations, 2019
                                                         107,710,000,000

                        ADMINISTRATION OVERVIEW

    The Veterans Benefits Administration [VBA] is responsible 
for the payment of compensation and pension benefits to 
eligible service-connected disabled veterans, as well as 
education benefits and housing loan guarantees.

                        COMMITTEE RECOMMENDATION

    In fiscal year 2017, the Committee provided 
$103,935,996,000 in advance appropriations for the Veterans 
Benefits Administration for fiscal year 2018. This included 
$90,119,449,000 for Compensation and pensions; $13,708,648,000 
for Readjustment benefits; and $107,899,000 for Veterans 
insurance and indemnities.
    For fiscal year 2018, the Committee recommends an 
additional $13,000,000 for Veterans insurance and indemnities. 
Additionally, the Committee recommendation includes 
$178,626,000 for the Veterans Housing Benefit Program Fund 
administrative expenses; $30,000 for the Vocational 
Rehabilitation Loans Program account, with $395,000 for 
administrative expenses; $1,163,000 for the Native American 
Veteran Housing Loan Program account; $2,910,000,000 for 
General Operating Expenses, Veterans Benefits Administration 
account. The Committee recommendation also provides 
$107,710,000,000 in advance appropriations for the Veterans 
Benefits Administration for fiscal year 2019.
    Public Law 114-223 moved the General Operating Expenses, 
Veterans Benefits Administration account from Departmental 
Administration to the Veterans Benefits Administration, its 
appropriate section within the act, with the instruction that 
the Department should place GOE,VBA in this location with the 
fiscal year 2018 request. The Committee notes this did not 
happen, and therefore, once again, instructs the Department to 
adhere to this direction with the fiscal year 2019 request.

                       COMPENSATION AND PENSIONS

                     (INCLUDING TRANSFER OF FUNDS)

Appropriations, 2017.................................... $86,083,128,000
Advance Appropriations, 2018............................  90,119,449,000
Budget estimate, advance appropriations, 2019...........  95,768,462,000
Committee recommendation, advance appropriations, 2019..  95,769,000,000

                          PROGRAM DESCRIPTION

    Compensation is payable to living veterans who have 
suffered impairment of earning power from service-connected 
disabilities. The amount of compensation is based upon the 
impact of disabilities on a veteran's earning capacity. Death 
compensation or dependency and indemnity compensation is 
payable to the surviving spouses and dependents of veterans 
whose deaths occur while on active duty or result from service-
connected disabilities. A clothing allowance may also be 
provided for service-connected veterans who use a prosthetic or 
orthopedic device. In fiscal year 2018, the Department 
estimates it will obligate $84,598,945 for payments to 
4,616,764 veterans, 419,948 survivors, and 1,137 dependents 
receiving special benefits.
    Pensions are an income security benefit payable to needy 
wartime veterans who are precluded from gainful employment due 
to nonservice-connected disabilities which render them 
permanently and totally disabled. Public Law 107-103, the 
Veterans Education and Benefits Expansion Act of 2001, restored 
the automatic presumption of permanent and total nonservice 
connected disability for purposes of awarding a pension to 
veterans age 65 and older, subject to the income limitations 
that apply to all pensioners. Death pensions are payable to 
needy surviving spouses and children of deceased wartime 
veterans. The rate payable for both disability and death 
pensions is determined on the basis of the annual income of the 
veteran or their survivors. In fiscal year 2018, the Department 
estimates that the Pensions program will provide benefits to 
289,178 veterans and 204,006 survivors totaling $5,989,847.
    The Compensation and Pensions program funds certain burial 
benefits on behalf of eligible deceased veterans. These 
benefits provide the purchase and transportation costs for 
headstones and markers, graveliners, and pre-placed crypts; and 
provide partial reimbursement for privately purchased outer 
burial receptacles. In fiscal year 2018, the Department 
estimates the Compensation and Pensions program will obligate 
$243,492,000 providing burial benefits. This funding will 
provide 37,212 burial allowances, 26,737 burial plot 
allowances, 21,222 service-connected death awards, 497,644 
burial flags, 373,895 headstones or markers, 41,759 graveliners 
or reimbursement for privately purchased outer burial 
receptacles, and 305 caskets and urns for the internment of the 
remains of veterans without next of kin.

                        COMMITTEE RECOMMENDATION

    In fiscal year 2017, the Committee provided an advance 
appropriation of $90,119,449,000 for fiscal year 2018 for the 
Compensation and Pensions account.
    The Committee recommendation includes an advance 
appropriation of $95,769,000,000 for Compensation and pensions 
for fiscal year 2019. This is $538,000 above the request to 
reflect proper rounding of a budget estimate.

                         READJUSTMENT BENEFITS

Appropriations, 2017.................................... $16,340,828,000
Advance Appropriations, 2018............................  13,708,648,000
Budget estimate, advance appropriations, 2019...........  11,832,175,000
Committee recommendation, advance appropriations, 2019..  11,832,000,000

                          PROGRAM DESCRIPTION

    The Readjustment benefits appropriation finances the 
education and training of veterans and servicemembers under 
chapters 30, 31, 32, 33, 34, 35, 36, 37, 39, 41, 42 and 43 of 
title 38, United States Code. These benefits include the All-
Volunteer Force Educational Assistance Program (Montgomery GI 
bill) and the Post 9/11 Educational Assistance Program. Basic 
benefits are funded through appropriations made to the 
readjustment benefits appropriation and by transfers from the 
Department of Defense. This account also finances vocational 
rehabilitation, specially adapted housing grants, specially 
adapted automobile grants for certain disabled veterans, and 
educational assistance allowances for eligible dependents of 
those veterans who died from service-connected causes or who 
have a total permanent service-connected disability, as well as 
dependents of servicemembers who were captured or missing in 
action.

                        COMMITTEE RECOMMENDATION

    In fiscal year 2017, the Committee provided an advance 
appropriation of $13,708,648,000 for the Readjustment Benefits 
account for fiscal year 2018.
    The Committee recommendation includes an advance 
appropriation of $11,832,000,000 for Readjustment benefits for 
fiscal year 2019. This is $175,000 below the request to reflect 
proper rounding of a budget estimate.

                   VETERANS INSURANCE AND INDEMNITIES

Appropriations, 2017....................................    $108,525,000
Advance Appropriations, 2018............................     107,899,000
Budget estimate, 2018...................................      12,439,000
Committee recommendation, 2018..........................      13,000,000
Budget estimate, advance appropriations, 2019...........     109,090,000
Committee recommendation, advance appropriations, 2019..     109,000,000

                          PROGRAM DESCRIPTION

    The Veterans insurance and indemnities appropriation 
consists of the former appropriations for military and naval 
insurance, applicable to World War I veterans; National Service 
Life Insurance, applicable to certain World War II veterans; 
servicemen's indemnities, applicable to Korean conflict 
veterans; and veterans mortgage life insurance to individuals 
who have received a grant for specially adapted housing.

                        COMMITTEE RECOMMENDATION

    In fiscal year 2017, the Committee provided an advance 
appropriation of $107,899,000 for fiscal year 2018 for the 
Veterans Insurance and Indemnities account. The recommendation 
for fiscal year 2018 also includes an additional $13,000,000. 
This is $561,000 above the request to reflect proper rounding 
of a budget estimate.
    The Committee recommendation also includes an advance 
appropriation of $109,000,000 for Veterans insurance and 
indemnities for fiscal year 2019. This is $90,000 below the 
request to reflect proper rounding of a budget estimate.

                 VETERANS HOUSING BENEFIT PROGRAM FUND

------------------------------------------------------------------------
                                                         Administrative
                                       Program account      expenses
------------------------------------------------------------------------
Appropriations, 2017................  ................      $198,856,000
Budget estimate, 2018...............  ................       178,626,000
Committee recommendation............  ................       178,626,000
------------------------------------------------------------------------

                          PROGRAM DESCRIPTION

    The Veterans housing benefit program fund provides for all 
costs associated with VA's direct and guaranteed housing loan 
programs, with the exception of the Native American veteran 
housing loan program.
    VA loan guaranties are made to servicemembers, veterans, 
reservists, and unremarried surviving spouses for the purchase 
of homes, condominiums, and manufactured homes, and for 
refinancing loans. VA guarantees part of the total loan, 
permitting the purchaser to obtain a mortgage with a 
competitive interest rate, even without a downpayment, if the 
lender agrees. VA requires a downpayment be made for a 
manufactured home. With a VA guaranty, the lender is protected 
against loss up to the amount of the guaranty if the borrower 
fails to repay the loan.

                        COMMITTEE RECOMMENDATION

    The Committee recommends such sums as may be necessary for 
funding subsidy payments, and $178,626,000 for administrative 
expenses for fiscal year 2018. Bill language limits gross 
obligations for direct loans for specially adapted housing to 
$500,000.

            VOCATIONAL REHABILITATION LOANS PROGRAM ACCOUNT

------------------------------------------------------------------------
                                                         Administrative
                                       Program account      expenses
------------------------------------------------------------------------
Appropriations, 2017................           $36,000          $389,000
Budget estimate, 2018...............            30,000           395,000
Committee recommendation............            30,000           395,000
------------------------------------------------------------------------

                          PROGRAM DESCRIPTION

    The Vocational Rehabilitation Loans Program account covers 
the cost of direct loans for vocational rehabilitation of 
eligible veterans and, in addition, includes administrative 
expenses necessary to carry out the direct loan program. Loans 
of up to $1,214 (based on the indexed chapter 31 subsistence 
allowance rate) are currently available to service-connected 
disabled veterans enrolled in vocational rehabilitation 
programs, as provided under 38 U.S.C. chapter 31, when the 
veteran is temporarily in need of additional assistance. 
Repayment is made in monthly installments, without interest, 
through deductions from future payments of compensation, 
pension, subsistence allowance, educational assistance 
allowance, or retirement pay. Virtually all loans are repaid in 
full and most in less than one year.

                        COMMITTEE RECOMMENDATION

    The Committee recommends $30,000 for program costs and 
$395,000 for administrative expenses for the Vocational 
Rehabilitation Loans Program account. The administrative 
expenses may be paid to the General Operating Expenses, 
Veterans Benefits Administration account. Bill language is 
included limiting program direct loans to $2,356,000. It is 
estimated VA will make 2,402 loans in fiscal year 2018, with an 
average amount of $981.

          NATIVE AMERICAN VETERAN HOUSING LOAN PROGRAM ACCOUNT

Appropriations, 2017....................................      $1,163,000
Budget estimate, 2018...................................       1,163,000
Committee recommendation................................       1,163,000

                          PROGRAM DESCRIPTION

    The Native American veteran housing loan program is 
authorized by 38 U.S.C. chapter 37, section 3761 to provide 
direct loans to Native American veterans living on trust lands. 
The loans are available to purchase, construct, or improve 
homes to be occupied as veteran residences or to refinance a 
loan previously made under this program in order to lower the 
interest rate. The principal amount of a loan under this 
authority generally may not exceed $424,100; however, in some 
locations this limit may be higher depending on median area 
home prices. Veterans pay a funding fee of 1.25 percent of the 
loan amount, although veterans with a service-connected 
disability are exempt from paying the fee. Before a direct loan 
can be made, the veteran's tribal organization must sign a 
memorandum of understanding with VA regarding the terms and 
conditions of the loan. The Native American Veteran Housing 
Loan Program began as a pilot program in 1993 and was made 
permanent by Public Law 109-233, the Veterans Housing 
Opportunity and Benefits Act of 2006.

                        COMMITTEE RECOMMENDATION

    The Committee recommends $1,163,000 for administrative 
expenses associated with this program. This is equal to the 
fiscal year 2017 enacted level and equal to the budget request.

      GENERAL OPERATING EXPENSES, VETERANS BENEFITS ADMINISTRATION

Appropriations, 2017....................................  $2,844,160,000
Budget estimate, 2018...................................   2,844,000,000
Committee recommendation................................   2,910,000,000

                          PROGRAM DESCRIPTION

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

                        COMMITTEE RECOMMENDATION

    The Committee recommends $2,910,000,000 for the General 
Operating Expenses, Veterans Benefits Administration account, 
which is $65,840,000 above the fiscal year 2017 enacted level 
and $66,000,000 above the budget request. The Committee has 
included bill language to make available through September 30, 
2019, up to 10 percent of the General Operating Expenses, 
Veterans Benefits Administration account.
    Disability Claims Processing.--The Committee has not only 
fully funded the budget request for claims processing in recent 
years, but has provided increases above the budget requests for 
hiring and training claims processors, bolstering the migration 
to electronic claims processing systems, and addressing the 
increasing backlog of appeals at the Board of Veterans Appeals. 
The Committee commends the Department on its efforts to reduce 
the disability claims backlog and increase the accuracy of 
claims decisions, yet the processing of disability claims 
remains a major concern of the Committee. In particular, 
progress in reducing the backlog seems to have stalled this 
year, hovering weekly between 99,000 and 90,000. The Department 
must consider processing all claims within 125 days with 98 
percent accuracy a mandate of VBA, and the Department should 
fund and staff this agency accordingly. In addition to efforts 
to ensure there is not a recurrence of a sizeable disability 
claims backlog, the Department must also ensure that proper 
staffing and resources are available to reduce the growing wait 
time and backlog of disability decisions on appeal and meet 
demand for other benefit programs. To that end, the Committee 
recommends an additional $66,000,000 to VBA, GOE to hire 
additional claims and appellate staff, as well as to increase 
staff for the Vocational Rehabilitation and Employment Program. 
The VBA may also use these resources to finance overtime 
payments, if that becomes necessary, and support increased 
resources for the Veterans Claims Intake Program [VCIP] to scan 
and convert paper files into digital records. The Committee 
will continue to assert its oversight ability by monitoring the 
key agencies involved in veteran disability claims processing--
VA, DoD, the Social Security Administration, and the Internal 
Revenue Service--these agencies as they work to better expedite 
the flow of interagency information needed to process claims in 
a timely manner. The Committee will continue to require the 
Department provide monthly updates on performance measures for 
each Regional Office.
    Financial Hardship and Bankruptcy.--The Committee continues 
to support VA programs that combat the root causes of veteran 
and dependent financial hardship, which is a known contributory 
factor to negative outcomes such as mental health issues, 
substance use disorder, and suicide. For example, disability-
related benefits not only honor the service and sacrifice of 
the veterans who receive them, but also help to replace lost 
wages and provide a critical source of economic well-being. The 
Committee is concerned by an inequity in current bankruptcy law 
that results in the inclusion of VA and DoD disability benefits 
in the calculation of a debtor's disposable income, while at 
the same time excluding Social Security disability benefits for 
non-veterans. The Department is directed to submit to the 
Committees on Appropriations and Veterans Affairs of both 
Houses of Congress a report outlining the statutory and 
legislative authority is needed to end this inequity.
    Women Veterans Participation Rates.--The Committee directs 
VA to include an analysis of trends and satisfaction rates 
among women veterans participating in the Vocational 
Rehabilitation & Employment program in the annual report to 
Congress to ensure these services are adapting to changing 
demographics of veterans and the needs of women veterans with 
disabilities.
    State Accrediting Agency Oversight.--The Committee is 
concerned current laws and regulations related to conflicting 
interests may be inadequate to identify conflicts of interest 
that can develop through the provision of meals or de minimus 
gifts to officers of State Accrediting Agencies. The Department 
is directed to conduct an assessment of the effectiveness of 38 
U.S.C. 3683 and 38 CFR 21.4005 in preventing conflicts of 
interests and submit a report to the Committees on 
Appropriations of both Houses of Congress no later than 180 
days after enactment of this act regarding the findings.
    State Approving Agencies.--Under the G.I. Bill and the 
Post-9/11 Veterans Educational Assistance Improvements Act of 
2010 (Public Law 111-377, 38 U.S.C. Ch. 36 sec. 3670) VA 
contracts with States to establish State Approving Agencies 
[SAAs] in promoting and safeguarding quality education and 
training programs for veterans, ensuring greater education and 
training opportunities for veterans, and protecting the 
integrity of the G.I. Bill. The Committee is concerned VA's 
formula for determining each SAA's allocation fails to take 
into account travel times. This is of particular concern in 
rural States where travel between school inspections can be 
costly in both time and monetary expense. The Committee 
instructs VA to ensure SAAs have sufficient resources to cover 
travel expenses and accomplish their mandate under the G.I. 
Bill.
    Rural Veterans Coordination Pilot.--Section 506 of the 
Caregivers and Veterans Omnibus Health Services Act of 2010 
(Public Law 111-163; 38 U.S.C. 523 note) established the Rural 
Veterans Coordination Pilot [RVCP] at VA. Eligible grant 
recipients are community based organizations and/or local, 
State, or tribal government entities. The pilot enabled each 
grant recipient to support local veterans in unique ways that 
will be suitable for the challenges faced at these locations. 
Upon completion of the pilot, the Department is directed to 
provide a report and recommendations to the Committee 
identifying effective models in which State and local entities 
are able to successfully coordinate multi-sector benefits for 
veterans and their families who reside in rural or underserved 
communities. The Committee urges the Department to consider 
extending the RVCP beyond its current deadline and expanding 
the program to include additional locations.
    Assessment of GI Bill Utilization.--The Committee notes the 
Department's responsibility to provide GI bill benefits to 
servicemembers as they transition to civilian life and status 
as a veterans, however the Committee believes there is an 
opportunity to increase utilization of these benefits. To 
better understand the current utilization and drive future 
decisions regarding educational benefits to veterans, the 
Committee directs the Department to conduct a comprehensive 
assessment to accurately account the number of veterans 
utilizing their educational benefits. The first report should 
analyze fiscal years 2010 to 2017, but thereafter, the 
Committee directs the Department to submit an annual report 
that tracks outcomes for Post-9/11 GI bill benefits. The report 
should include: the number of veterans who qualify for either a 
partial or the full GI bill benefit; veteran use of the GI bill 
benefit among the total number of eligible veterans; veteran 
use or transfer of unused GI bill benefit to dependents; use of 
the GI bill benefit toward 4-year, 2-year, and vocational 
educational and training programs, and distinguish the 
programs; the average dollar amount of usage; and an aggregate 
graduation rate, loan default rate, and average indebtedness by 
degree program, type of degree, and field of study. 
Additionally, the Department is encouraged to make an effort to 
gather data on the jobs attained after graduation, specifically 
whether those jobs can be reasonably said to be in the field of 
study identified in the students' education plans. The 
Department is directed to submit the first report to the 
Committees on Appropriations of both Houses of Congress no 
later than 180 days after enactment of this act.
    Education Benefits.--The Committee is concerned about the 
levels of overpayments and improper payments being paid to GI 
Bill beneficiaries. The Committee directs VA to work with 
education stakeholders to ensure that veteran educational 
benefits are paid in a timely and accurate manner and that 
efforts to recoup any overpayments or improper payments is done 
fairly and in a manner that is not overly burdensome on student 
veterans and their families. The Committee further directs VA, 
in collaboration with the Department of Defense and Department 
of Education, to provide an interagency report on the 
development and continued implementation of the Principles of 
Excellence, oversight of institutions complying with the 
Principles, and appropriate and timely accountability measures 
for educational programs receiving Federal funding. Lastly, the 
Committee directs VA to continue to reform the compliance 
survey process to allow early detection of fraudulent marketing 
or predatory recruiting practices among institutions of higher 
learning and to codify a set of tools that is sufficiently 
agile enough to curtail the behavior of scamming institutions 
that are wasting the VA education benefits of service members 
and their families.
    Education Data Collection and Sharing.--The Committee wants 
for both students and VA to be able to make more evidence-based 
decisions when it comes to veterans' education. The Committee 
directs VA to work with the Department of Education and 
Department of Defense to ensure that there is a comprehensive 
database or, at a minimum, a set of robust data-sharing 
agreements in place between Federal entities involved in the 
administration of Federal resources related to veteran 
educational attainment. The Committee further directs VA, in 
collaboration with the Department of Education and Department 
of Defense, to provide an interagency report on data-sharing 
priorities, the development and implementation of subsequent 
data-sharing agreements, and the uses and effectiveness of the 
data shared.
    Reforms to Expedite the Appeals Process.--The Committee 
directs the Secretary to fully implement the GAO's 
recommendation to improve the timeliness of VA's disability 
benefits appeals decisions and to document its progress in its 
monthly reports to the Committee on appeals claims processing 
performance. The Committee concurs with GAO's recommendations 
that VA should apply sensitivity analyses when projecting staff 
needs, develop a more timely and detailed workforce plan, 
develop a robust plan monitoring process reform, develop a 
strategy for assessing process reform, and create a schedule 
for IT improvements that takes into account plans for potential 
process reform. The Committee also supports GAO's view that any 
VA-proposed appeals process reforms be subject to a pilot test.
    Home Loan Counseling.--The Committee remains concerned 
about the percentage of veteran homeowners that are not using 
the VA home loan benefit because they were unaware of the 
program or because they were discouraged by their lender and/or 
realtor from using a VA loan. Despite significant demand among 
veterans for home buying counseling services and education, too 
few receive housing counseling or VA loan education while 
serving on active duty or after separating from the military. 
The Committee believes that in establishing the VA home loan 
benefit, Congress authorized and intended for VA to provide 
such counseling services and education in its administration of 
the program. Therefore, the Committee directs the Department to 
conduct a study to assess the feasibility of establishing a VA 
housing counseling program that would include a network of 
counselors across the country. To the extent practicable, the 
feasibility study should look at the Department of Housing and 
Urban Development's Office of Housing Counseling for 
opportunities to collaborate, including sharing expertise and 
personnel. The Department is directed to submit a report to the 
Committees on Appropriations of both Houses of Congress no 
later than 180 days after enactment of this act on the findings 
of the study.
    Benefits for Veterans with Service-Connected 
Disabilities.--The Committee notes that many veterans are 
eligible for a full discharge of their Federal student loan 
debt due to a service-connected disability, but have not 
received the benefits Congress intended. Under Section 437 of 
the Higher Education Act of 1965, borrowers who have been 
determined by the Secretary to be unemployable due to a 
service-connected condition are eligible for a full discharge 
of their liability to repay their loans and are not required to 
submit additional documentation. Beginning in April 2016, the 
Department of Education established a secure data sharing 
agreement with the Social Security Administration [SSA] to 
identify Federal student loan borrowers who also receive the 
relevant disability payments that qualify them for loan 
forgiveness under the Total and Permanent Disability [TPD] loan 
discharge program. Approximately 387,000 disabled borrowers 
were positively identified with SSA in the first set of 
matches. However, this data sharing did not include veterans 
who are also eligible for loan discharge and have submitted 
appropriate documentation to the Department. As a result, too 
many eligible veterans with severe service-connected 
disabilities have been left out of this streamlined path to 
loan discharge due to a lack of communication between the 
Department of Education, Department of Veterans Affairs, and 
Federal student loan servicers. Therefore, the Department is 
directed, in coordination with the Department of Education 
(including its student loan servicers), to make every practical 
effort to automate the application of loan discharge to 
eligible veterans using information in existing Federal 
databases at the Departments of Education and Veterans Affairs 
in a timely manner so that veterans can receive the benefits 
due under law. The Department is directed to submit a report to 
the Committees on Appropriations of both Houses of Congress no 
later than 90 days after enactment of this act on the plan of 
action for implementing this automation process.

                     Veterans Health Administration

Appropriations, 2017.................................... $65,152,027,000
Advance appropriations, 2018............................  66,385,032,000
Budget estimate, 2018...................................   3,290,000,000
Committee recommendation, 2018..........................   3,689,262,000
Budget estimate, advance appropriations, 2019...........  70,699,313,000
Committee recommendation, advance appropriations, 2019..  70,700,000,000

                        ADMINISTRATION OVERVIEW

    The Veterans Health Administration [VHA] is home to the 
United States' largest integrated healthcare system consisting 
of 144 VA Hospitals; 22 Health Care Centers [HCC]; 210 Multi-
Specialty Community-Based outpatient clinics; 527 Primary Care 
Community-Based outpatient clinics; 305 Outpatient Services 
Sites; 135 community living centers; 115 domiciliary 
residential rehabilitation treatment programs [DRRTP]; 300 
readjustment counseling vet centers; and 80 mobile vet centers.
    The Department of Veterans Affairs Medical Care Collections 
Fund [MCCF] was established by the Balanced Budget Act of 1997 
(Public Law 105-33). In fiscal year 2004, Public Law 108-199 
allowed the Department to deposit first-party and 
pharmaceutical co-payments, third-party insurance payments and 
enhanced-use collections, long-term care co-payments, 
Compensated Work Therapy Program collections, Compensation and 
Pension Living Expenses Program collections, and Parking 
Program fees into the MCCF.
    The Parking Program provides funds for the construction, 
alteration, and acquisition (by purchase or lease) of parking 
garages at VA medical facilities authorized by 38 U.S.C. 8109. 
The Secretary is required under certain circumstances to 
establish and collect fees for the use of such garages and 
parking facilities. Receipts from the parking fees are to be 
deposited into the MCCF and are used for medical services 
activities.

                        COMMITTEE RECOMMENDATION

    In fiscal year 2017, the Committee provided $66,385,032,000 
in advance appropriations for VA's medical care accounts for 
fiscal year 2018. This included $44,886,554,000 for Medical 
services, $9,409,118,000 for Medical community care, 
$6,654,480,000 for Medical support and compliance, and 
$5,434,880,000 for Medical facilities. The Committee also 
includes an Administrative Provision allowing the Department to 
carry forward into fiscal year 2018 certain amounts provided as 
an advance for fiscal year 2017.
    For fiscal year 2018, the Committee recommends an 
additional $1,923,000,000 for Medical services, $254,000,000 
for Medical community care, $100,000,000 for Medical support 
and compliance, and $707,000,000 for Medical facilities. 
Additionally, the Committee recommendation includes 
$705,262,000 for Medical and prosthetic research. Medical care 
collections are expected to be $2,507,000,000. The Committee 
recommendation also provides $70,700,000,000 in advance 
appropriations for VA's medical care accounts for fiscal year 
2019.
    Education Debt Reduction Program.--The Department is 
directed provide a breakdown of spending by VA in connection 
with the education debt reduction program of the Department 
under subchapter VII of chapter 76 of title 38, United States 
Code. The breakout shall include the following elements: (1) 
the amount spent by the Department in debt reduction payments 
during the three year period preceding the submittal of the 
report disaggregated by the medical profession of the 
individual receiving the payments; (2) a description of how the 
Department prioritizes such spending by medical profession, 
including an assessment of whether such priority reflects the 
five occupations identified in the most recent determination by 
VA OIG as having the largest staffing shortages in VHA; and (3) 
a description of the actions taken by the Secretary to increase 
the effectiveness of such spending for purposes of recruitment 
of healthcare providers to the Department, including efforts to 
more consistently include eligibility for the education debt 
reduction program in vacancy announcements of positions for 
healthcare providers at VA. The Department is directed to 
submit a report to the Committees on Appropriations of both 
Houses of Congress no later than 90 days after enactment of 
this act detailing the findings.
    Office of Patient Advocacy.--The Committee urges the 
Department to swiftly and comprehensively implement the reforms 
made to the patient advocacy program as required by the Jason 
Simcakoski Memorial and Promise Act [Title IX, Public Law 114-
198]. The law's establishment of the Office of Patient Advocacy 
will ensure that patient advocates are independent of local 
facility management, work strictly on behalf of veterans, and 
are properly trained according to national standards. 
Furthermore, the Committee believes the Inspector General's 
March 2017 audit of the patient advocacy program's fiscal year 
2015 operations [VA OIG 15-05379-146] provides additional 
evidence of the need to institute strong operational controls 
and standardization to ensure program effectiveness and the 
reliability of complaint data. Accordingly, the Department is 
directed to submit a report to the Committees on Appropriations 
of both Houses of Congress no later than 30 days after 
enactment of this act outlining progress implementing the 
relevant sections of Public Law 114-198 and the OIG 
recommendations.
    Veteran Medical Debt.--The Committee is concerned that 
despite the Department's efforts to streamline administrative 
burdens of the Veterans Choice Program, VA payments to non-VA 
healthcare providers continue to face delays, and medical bills 
continue to be inappropriately assigned to veterans rather than 
VA. Incorrectly assigned bills and delayed payments have 
resulted in medical bills going into collection and damaging 
veterans' credit. Therefore, the Committee directs the Under 
Secretary for Health to consult with the Consumer Financial 
Protection Bureau, national credit reporting agencies, and 
appropriate consumer protection stakeholders and develop an 
action plan to protect veterans from collections efforts and 
credit damage due to medical bills that should have been paid 
by VA. The Department is directed to submit a report to the 
Committees on Appropriations of both Houses of Congress no 
later than 90 days after enactment of this act on the status of 
developing an action plan.
    Cross Government Credentialing of VA Healthcare 
Providers.--In order to better facilitate active recruitment of 
individuals who served in the healthcare field for the U.S. 
Armed Forces or while on duty with the U.S. Coast Guard, the 
Committee directs VA to establish coordinating relationships 
with the appropriate personnel divisions dealing with 
separating military personnel at the Departments of Defense and 
Homeland Security. As part of this coordination, the Department 
shall determine whether establishing a formal system for 
receiving advanced notice of separating members of the armed 
forces is feasible. The Committee further directs VHA to 
conduct an internal audit of its procedures for the 
recredentialing of providers when transferring within the VHA 
system. The Committee directs VHA to institute such policies 
and procedures to ensure the speedy and timely transfer of 
licensed personnel between facilities and to remove the 
unnecessary barrier of recredentaling triggered solely by a 
provider transferring facilities.
    West Los Angeles Master Plan.--While the Committee is 
encouraged by recent progress made at the West Los Angeles VA 
Campus, the Committee continues to be concerned that 
approximately 3,000 veterans remain homeless in the Greater Los 
Angeles Area. The Committee directs VA to brief the Committees 
on Appropriations of both Houses of Congress each quarter on 
its progress toward implementing the Master Plan, ensuring that 
lease revenues are being used to benefit veterans, and 
coordinating closely with the local community.
    Corporate Planning and High Performing Networks.--Various 
documents published by VHA, such as the Blueprint for 
Excellence and the fiscal year 2016 Annual Restoring Trust in 
Veterans Health Care Report, recognize the need for creating a 
high-performing, integrated health network that includes VHA 
providers and facilities, other federally funded providers and 
facilities, and VHA-credentialed community providers and 
facilities. To date, VA has not articulated an overarching 
strategy to achieve such a goal, does not provide metrics to 
show progress towards achieving stated goals, and has no 
structure to identify accountable senior officials for such an 
effort. The Committee recognizes the complex and transformative 
nature of creating a system capable of serving veterans in the 
future requires direct and sustained VHA leadership 
involvement. To achieve this goal, the Committee directs VHA to 
form a corporate planning function patterned after high 
performing commercial healthcare delivery systems. Such 
function must include representation from VHA clinical 
leadership, and leaders from VHA offices that control, oversee, 
or manage facility investments, transition, facility 
operations, and organizational change, as well as the 
appropriate VA offices that are dedicated to the planning and 
procurement of capital infrastructure, whether built or leased 
by VA. The corporate planning function shall be responsible for 
planning and implementing a high performing, integrated health 
network. The Department is directed to submit a report to the 
Committees on Appropriations of both Houses of Congress no 
later than 180 days after enactment of this act detailing the 
corporate planning function and a plan to achieve a high-
performing, integrated health network for the next twenty 
years. At a minimum, the plan shall clearly articulate VA's 
vision of a future network, include goals VA is working towards 
to achieve the vision, Key Performance Indicators, and other 
metrics VA will use to judge success, and an organizational 
chart detailing the corporate planning function's direct 
reporting relationship to the Under Secretary of Health. The 
Committee recommends VA seek objective analysis and 
recommendations from organizations outside VA that have 
successfully created, implemented, or advised corporate 
planning functions at high-performing community healthcare 
systems. The Committee recommends VHA seek guidance from the 
leadership of the Department of Defense's Military Health 
System Facility Shared Service. Additionally, the Committee 
understands VHA is now conducting market surveys to examine how 
VHA can develop a high-performing network by looking at 
community healthcare supplies and VHA services and 
capabilities. The Department is directed to report to the 
Committees on Appropriations of both Houses of Congress the 
findings of these market surveys within 180 days of the 
completion of the surveys.

                            MEDICAL SERVICES

                     (INCLUDING TRANSFER OF FUNDS)

Appropriations, 2017.................................... $45,421,812,000
Advance appropriations, 2018............................  44,886,554,000
Budget estimate, 2018...................................   1,031,808,000
Committee recommendation, 2018..........................   1,923,000,000
Budget estimate, advance appropriations, 2019...........  49,161,165,000
Committee recommendations, advance appropriations, 2019.  49,161,000,000

                          PROGRAM DESCRIPTION

    The Medical Services account provides for medical services 
for eligible enrolled veterans and other beneficiaries in VA 
healthcare facilities, including VA medical centers and VA 
outpatient clinics.

                        COMMITTEE RECOMMENDATION

    In fiscal year 2017, the Committee provided an advance 
appropriation of $44,886,554,000 for fiscal year 2018 for the 
Medical Services account. The recommendation for fiscal year 
2018 includes an additional $1,923,000,000 which is 
$891,192,000 above the budget request. The additional 
appropriation coupled with the advance appropriation provided 
for fiscal year 2018 provides the Department with total budget 
authority of $46,809,554,000 which is $1,387,742,000 above the 
fiscal year 2017 enacted amount. In addition, VA has the 
authority to retain co-payments and third-party collections, 
estimated to total $2,507,000,000 in fiscal year 2018.
    The Committee recommendation also includes an advance 
appropriation of $49,161,000,000 for Medical services for 
fiscal year 2019. This is $165,000 below the request to reflect 
proper rounding of a budget estimate.

                          RURAL ACCESS TO CARE

    Office of Rural Health.--The Committee recommendation 
includes $20,000,000 in addition to the budget request for the 
Office Rural Health [ORH]. Through collaborations with other VA 
program offices, Federal partners, State partners, and rural 
communities, ORH works to optimize the use of available and 
emerging technologies, establish new access points to care, and 
employ strategies to increase healthcare options for all rural 
veterans. Currently, ORH identifies and implements initiatives 
that support rural clinics and rural home-based primary care, 
address barriers to access and quality of healthcare delivery 
in rural areas, develop workforce recruitment and retention 
initiatives, and accelerate and expand telehealth. ORH also 
operates Rural Health Resource Centers and works with Federal 
and non-Federal community partners to share resources and 
expand access to care for rural veterans. Given the important 
role these centers play in expanding access, the Committee 
encourages the Department to consider expanding these centers.
    ORH has played a major role in VA's overall strategy to 
combat opioid abuse by funding pilot programs through the Rural 
Health Initiative focused on pain coaching and modalities which 
increase veterans' access to alternatives to opioid-centered 
pain management. Participants of one pain coaching program--
which linked professional coaches to veteran patients for 
biweekly meetings by phone--reported a 40 percent reduction in 
pain outcomes after 1 year. Another program allowed veterans to 
utilize noninvasive modality devices to help reduce pain 
intensity. Both of these programs have shown progress but more 
must be done. The Committee encourages ORH to build upon these 
programs by replicating them at additional sites. One of the 
objectives of VHA's Pain Management Strategy policy is to 
provide for an interdisciplinary, multi-modal approach to pain 
management, and funding for these pilot programs can help VA 
apply the successes of these and other programs in furtherance 
of this objective.
    Rural Veterans Health.--The Committee notes persistent 
issues for VA health facilities in rural areas to recruit and 
retain health providers in the face of national provider 
shortages and a highly competitive environment. The Committee 
encourages the Department to consider the expanded use of 
doctors of osteopathic medicine [DOs] and physician assistants 
[PAs] through physical facilities and expanded access to 
telehealth services to address the rural health provider gap. 
Furthermore, the Committee is concerned about lack of mental 
healthcare providers, counselors, and caseworkers in rural 
areas. The criteria used by the Department in establishing the 
priority of hiring and placement of mental healthcare 
providers, counselors, and caseworkers should take into 
consideration the higher rate of facility-use in rural States 
due to lower numbers of facilities and the increased amount of 
outreach they must do with geographical barriers. To better 
understand staffing gaps that exist in rural, highly rural and 
remote areas, the Department is directed to conduct an agency-
wide assessment of the rural and highly rural healthcare 
workforce to identify geographic areas where staffing needs 
exist. The evaluation shall identify specific occupations 
within these geographic areas that are of the most need.

                          TELEHEALTH SERVICES

    Telehealth.--The Committee held an oversight hearing on May 
4, 2017, where testimony was received from experts within VA 
and the private sector on the topic of telehealth. The 
Committee is pleased to note the Department is a leader in this 
field of emerging technology and medicine. Telehealth creates a 
bridge between rural and urban centers--providers at an urban 
site can diagnose and provide a care plan for veterans hundreds 
of miles away, and therefore, VA is able to expand the 
resources of one facility by connecting those providers to 
providers in another area. Through telehealth, the Department 
has the means and flexibility to provide care to veterans who 
do not have easy access to a VA hospital or access to a VA 
hospital staffed with the care they need. Telehealth is not 
only allowing the Department to expand access to care in areas 
where services are limited, but telehealth also allows care to 
be provided more effectively and efficiently for veterans 
closer to home and also through direct in-home access. While VA 
is once again leading the healthcare industry in the expansion 
of in-home telehealth and remote patient monitoring services, 
these services are often limited by the lack of broadband 
service in remote and rural areas. In order to better leverage 
other Federal partners, the Department is directed to provide a 
report to the Committee on Appropriations of both Houses of 
Congress by January 31, 2018, regarding ongoing collaborations 
VA has with other Federal agencies in targeting remote and 
rural areas with veteran populations in order to ensure that 
grant programs administered by other Federal Agencies maximize 
coverage areas to veterans. The Committee is also aware 
telehealth has a potential for significant cost savings and 
cost avoidance for the Department, and the Department is urged 
to maintain its focus on this type of care, not only to better 
serve veterans, but also to be a good steward of its financial 
resources. The positive findings from the use of telehealth for 
mental health services is especially encouraging to the 
Committee. The Committee supports the Departments expansive use 
of telehealth for medical services and encourages VA to strive 
to be even more innovative, more expansive, more connected in 
this area. The recommendation includes the full budget request 
of $1,343,883,000 for telehealth services. This is $121,108,000 
more than fiscal year 2017.

            PREVENTING VETERAN SUICIDE AND MENTAL HEALTHCARE

    Pilot Program for Agritherapy.--An increasing number of 
States now have programs that assist veterans in starting 
farms, and many veterans turning to farming also suffer from 
Post-Traumatic Stress Disorder [PTSD]. The benefits of 
agritherapy have been reported in the news media; however 
limited research and insufficient opportunities exist to offer 
the benefits of agritherapy to those suffering from PTSD. 
Therefore, the Department is urged to consider agritherapy for 
inclusion among VA's Complementary and Alternative Medicine 
therapies. Additionally, the Committee directs no less than 
$2,000,000, made available through the Office of Rural Health, 
toward a pilot program to train veterans in agricultural 
vocations while also tending to behavioral and mental health 
needs with behavioral healthcare services and treatments from 
licensed providers at no fewer than three locations. The pilot 
locations may be sites that currently have an operational 
construct to train veterans for agricultural vocations and have 
the potential to expand operations that tend to veterans 
medical needs while creating a pathway to employment in 
agriculture related fields. The Department is directed to 
submit a report to the Committees on Appropriations of both 
Houses of Congress no later than 180 days after enactment of 
this act detailing the metrics developed to determine the value 
of agritherapy as it relates to PTSD and steps taken to carry 
out the agritherapy pilot as directed.
    Preventing Veteran Suicide.--The Committee is encouraged 
that the Secretary of Veterans Affairs has made preventing 
veteran suicide his number one clinical priority. The Committee 
supports the Department's ``Getting to Zero'' initiative, and 
the Committee is pleased to see the national implementation of 
the Recovery Engagement And Coordination for Health--Veterans 
Enhanced Treatment [REACH VET] program which uses predictive 
modeling to guide early interventions to prevent suicide for at 
risk veterans in VHA care. The Committee is grateful for those 
within the Department who work tirelessly each day to save the 
lives of veterans.
    For years, the Department has received from this Committee 
above budget request amounts for suicide prevention programs, 
yet veteran suicide rates remain steady year after year. While 
additional and targeted funding increases are important, the 
Committee remains concerned that more should be done to prevent 
veterans from taking their lives. To that end, the Committee 
held an oversight hearing on April 26, 2017, on this topic. The 
hearing discussion focused on options for supporting veterans 
that are not currently the primary means by which the 
Department aims to prevent veteran suicide, such as 
complementary and alternative treatments, job training and 
education, and family support, like marriage and family 
counseling, caregiver support, and mechanisms for connecting 
families caring for veterans in need.
    According to data compiled by the VA Office of Suicide 
Prevention, veterans experience a suicide rate 50 percent 
higher than the general population, and female veterans commit 
suicide at a rate 6 times that of their civilian counterparts. 
The Committee notes 20 percent of veterans with PTSD have a 
substance abuse disorder, and substance abuse is proven to lead 
to increased suicidal tendencies. The Committee encourages the 
prioritization of funding for substance abuse counseling based 
treatment for veterans in order to decrease suicide rates among 
veterans suffering from PTSD. On average, 20 veterans die by 
suicide a day, and only six of those 20 are users of VHA 
services.
    The Committee remains concerned about the alarming 
prevalence of suicide among rural veterans as they are more 
likely than urban veterans to commit suicide. The Committee 
urges VA to prioritize suicide prevention within rural 
communities and increase the availability of mental health 
resources available within States with great geographic 
barriers. The Committee continues to be concerned about the 
prioritization of funding for mental healthcare providers, 
counselors, and caseworkers in rural areas. The criteria used 
by the Department in establishing the priority of hiring and 
placement of mental healthcare providers, counselors, and 
caseworkers should take into consideration the higher rate of 
facility use in rural States due to lower numbers of facilities 
and the increased amount of outreach needed given geographical 
barriers. The Department is directed to provide additional 
resources to rural or highly rural medical facilities to hire 
medical and clinical personnel who support veterans with mental 
health services for the prevention of veteran suicide.
    Veteran Crisis Line.--The Committee continues to be greatly 
concerned with the continued high rate of suicide among 
veterans and the growing mental health needs of veterans. Based 
on that concern, the Committee held an oversight hearing on 
April 4, 2017, titled ``Preventing Veteran Suicide'' and a 
topic of great concern and extensive discussion at the hearing 
was the performance of VA's Veterans Crisis Line [VCL]. A 
number of recent VA Inspector General and Government 
Accountability Office [GAO] reports have highlighted serious, 
ongoing and distressing deficiencies in the operational 
performance of the VCL. (Three reports in particular: VA 
Inspector General reports Veterans Crisis Line Caller Response 
and Quality Assurance Concerns, Canandaigua, NY (14-03540-123, 
dated February 11, 2016) and Evaluation of the Veterans Health 
Administration Veterans Crisis Line (16-03985-181, dated March 
20, 2017), and the Government Accountability Office [GAO] 
report Veterans Crisis Line: Additional Testing, Monitoring, 
and Information Needed to Ensure Better Quality Service [GAO-
16-373, dated May 2016]). During the hearing, it became 
apparent the Department had not promptly implemented the 
recommendations made by these oversight agencies. For example, 
at the time of our April 4, 2017 hearing, all seven of the 
recommendations from the OIG's February 2016 report remained 
open--some of them open a full year beyond the ``target dates'' 
for completion that VHA committed to implement. Fortunately, 
and shortly after the Committee's hearing, VHA did close 6 of 
the 7 open recommendations from that OIG report. The Committee 
directs the Secretary to implement the remaining 
recommendations of the Inspector General and the GAO 
immediately and with a demonstrable and necessary sense of 
urgency. The Committee recommends an additional $10,000,000 
above the budget request to support the important work of the 
VCL.
    Suicide Data Report.--The Department's Suicide Data Report, 
2012, was an important step in understanding the prevalence, 
distribution, and risk factors for suicide. The Committee 
further directs the Secretary to conduct a new study on the 
prevalence of suicide among veterans, which shall include an 
assessment of the data provided by each State and an 
identification of which States should increase or improve data 
reporting to the Department.
    Magnetic EEG/EKG-Guided Resonance Therapy.--The Committee 
understands Magnetic EEG/EKG-guided Resonance Therapy [MERT] 
has successfully treated veterans with Post Traumatic Stress 
Disorder [PTSD], Traumatic Brain Injuries [TBI], chronic pain, 
and opiate addiction. Recent non-significant risk and non-
invasive clinical trials and pilot studies have produced 
promising results in the evolution of MERT treatment. The 
Committee encourages VA to undertake MERT pilot programs at up 
to five VA facilities of its determining to create access to 
MERT in treating larger populations of veterans suffering from 
PTSD/TBI, chronic pain, and addiction. One of these five pilot 
programs should demonstrate the viability of a mobile 
capability to provide access in rural areas.
    Marriage and Family Therapists and Licensed Professional 
Mental Health Counselors.--The Committee remains concerned 
about the number of veterans committing suicide each day, and 
is particularly concerned that of the 20 per day, 14 have not 
had contact with the Department. In an effort to increase the 
number of mental health providers at the Department able to 
provide care, the Committee encourages the Department to 
increase efforts to hire more Licensed Professional Mental 
Health Counselors [LPMHCs] and Marriage and Family Therapists 
[MFTs]. The Committee recognizes the Department has attempted 
to create qualification standards to permit the employment of 
LPMHCs and MFTs, however, the Committee is aware obstacles 
remain, given that there are still thousands of vacancies in 
mental healthcare delivery positions. The Committee strongly 
urges VA to report on the number of current vacancies that 
could be filled by MFTs and LPMHCs, as well as develop a 
strategic plan for hiring more MFTs and LPMHCs to both fill 
vacancies and also augment current mental healthcare teams 
within the Department. The Committee also recommends 
coordinating with the Office of Management and Budget to create 
an Occupational Series for LPMHCs and MFTs to permit the 
Department to more easily hire staff able to provide mental 
health services to veterans in a timely manner.
    National Center for Post-Traumatic Stress Disorder.--The 
National Center for Post-Traumatic Stress Disorder [NCPTSD] is 
the Federal Government's foremost center of expertise on 
evidence-based treatment of post-traumatic stress. The 
Committee continues to support the mission and work of the 
NCPTSD and has provided $40,000,000 to continue the center's 
advancement of the clinical care and social welfare of 
America's veterans who have experienced trauma or suffer from 
PTSD through research, education, and training in the science, 
diagnosis, and treatment of PTSD and stress-related disorders. 
In recent years, the Committee has invested in the addition of 
a brain bank for assisting researchers, and the expansion of 
the consultation program for providers so that clinicians, 
particularly those in rural areas, have access to expert advice 
on the latest evidence-based treatment for post-traumatic 
stress. The Committee directs the Department to ensure the 
NCPTSD has the appropriate number of full time staff to support 
both expansions. The Committee also directs the Department to 
submit a report to the Committees on Appropriations of both 
Houses of Congress no later than 180 days after enactment of 
this act on the activities of NCPTSD, including: (1) how the 
Center supports the implementation of evidence-based treatments 
as specified in the VA/DoD Clinical Practice Guideline for the 
Management of PTSD within veteran care at VA medical centers; 
(2) utilization of its resources and the consultation program 
by non-VA providers; (3) utilization of resources and the brain 
bank by researchers; (4) consultation and information sharing 
with other government entities; and (5) any resource or 
staffing gaps or near gaps that exist in carrying out its 
missions.
    Treatment for Post-Traumatic Stress Disorder.--One in five 
veterans with Post-Traumatic Stress Disorder have a substance 
abuse disorder, and the Department of Health and Human Services 
reports there is a connection to alcohol and substance abuse 
leading to suicidal tendencies. VA funds many substance abuse 
treatment options, but should not default to prescribing 
medicine rather than counseling and therapy, if counseling and 
therapy are available options. Overmedication has continued to 
be an issue within VA, and the impact of therapy and counseling 
for substance abuse treatment is, in many cases, reported to be 
of equal help to a veteran. The Department should prioritize 
substance abuse treatment for veterans through counseling for 
veterans struggling with substance abuse disorder given that 20 
percent of veterans with Post-Traumatic Stress Disorder have a 
substance abuse disorder and substance abuse is proven to lead 
to increased suicidal tendencies.
    The Committee is aware that patient outcomes at university- 
based medical clinics are a viable option for providing PTSD 
treatment to veterans and have shown great preliminary 
successes. As such, the Committee directs the Department to 
conduct a study to determine whether this model of care 
presents an opportunity to provide the best patient care to 
veterans. The Department is directed to submit a report to the 
Committees on Appropriations of both Houses of Congress no 
later than 180 days after enactment of this act on the 
feasibility of pursuing a pilot program at no fewer than 3 
university sites providing PTSD treatments.
    Other Than Honorable Discharge.--The Committee remains 
concerned that for many veterans with other-than-honorable 
discharges, the misconduct that precipitated that discharge may 
have been related to in-service mental health issues. After 
service in combat or other high-stress environments, or after 
experiencing military sexual trauma, service members may 
undergo behavioral changes stemming from post-traumatic stress 
disorder, traumatic brain injury, major depressive disorder, 
and operational stress. Behavioral changes may result in 
injuries, which superiors often do not recognize as symptoms of 
mental health conditions, but instead attribute to bad 
character. The Committee is pleased VA is beginning to address 
the problem by offering emergent care for up to 90 days to 
veterans with other-than-honorable discharges. However, the 
Committee believes the Department has the statutory authority 
to provide care for many of these veterans. The statutory 
requirement under 38 U.S.C. 101 and 501 excludes only former 
service members whose conduct meets specific statutory bars or 
would justify a dishonorable discharge. The statute does not 
define that conduct standard explicitly, which leaves the 
Department with authority to adopt a standard by regulation. 
The Department is directed to conduct a review to align VA 
regulatory guidelines with the statutory authority and modern 
discharge characterizations issued by the Department of 
Defense. The Department is directed to submit a report to the 
Committees on Appropriations of both Houses of Congress no 
later than 180 days after enactment of this act detailing the 
findings of the review.

                             WOMEN'S HEALTH

    Women Veterans.--Women represent 15.5 percent of today's 
active duty force and 19 percent of our National Guard and 
Reserves. Accordingly, women veterans are enrolling for VA 
healthcare at record levels. As these numbers continue to rise, 
most VA medical facilities across the country are not equipped 
to handle the specific needs of the women veterans' population. 
Therefore, the Department should continue to expand efforts 
that address the current barriers to gender-specific healthcare 
services. The Committee continues to believe VA must be poised 
to address the changing demographic of today's and tomorrow's 
veterans in order to fulfill its mission. Toward this end, the 
Committee recommendation includes an additional $20,000,000 
over the budget request for fiscal year 2018 to support gender-
specific healthcare services. The Committee also encourages the 
Department to consider a mobile healthcare pilot program, 
prioritizing rural and high need areas, to provide gender-
specific services, awareness of benefits, and outreach to women 
veterans utilizing mobile healthcare infrastructure. This 
innovative model is designed to fill the current gap in gender-
specific services as VA works to expand infrastructure and hire 
the needed staff for specialty care.
    Female Primary Care and Mental Healthcare Providers.--The 
Committee urges VA to make every effort to hire more women 
healthcare professionals and offer all women the opportunity to 
choose the gender of their primary care and mental healthcare 
providers.
    Intimate Partner Violence Program.--The VA Intimate Partner 
Violence Program expands VA's screening, prevention, and 
intervention services to veterans and strengthens collaboration 
with community partners as well as the Caregivers Support 
Program and VA programs to address homelessness. The program 
focuses on developing a culture of safety and adopts a 
holistic, trauma-informed, veteran-centered approach to 
services and support for those veterans involved in a domestic 
violence situation. In recent years, VHA has run this program 
using general funds, and at times, the program has lapsed due 
to a lack of funds. The Committee directs the Department to 
fully resource this program at $17,000,000 in fiscal year 2018 
and include it as a program of interest with budget detail in 
the justifications accompanying the fiscal year 2019 budget 
submission.

    ASSISTING HOMELESS VETERANS AND PREVENTING VETERAN HOMELESSNESS

    Assessing Homelessness in Rural Areas.--The Committee 
remains concerned about the fidelity of data on homeless and 
at-risk veterans in rural areas and directs the Department to 
identify more precise ways to obtain better and more accurate 
data for veterans in these areas. The Committee encourages VA 
to evaluate whether changes to the universal homeless screening 
clinical reminder would result in more accurate identification 
of these veterans, and to report to the Committees on 
Appropriations of both Houses of Congress actions VA is taking 
to reduce homelessness among the rural veteran population.
    Homeless Veterans Prevention Programs.--The Committee 
remains strongly supportive of VA's homeless prevention 
programs and as such the recommendation includes $1,747,784,000 
to support these programs. This total includes an additional 
$20,000,000 over the current estimate of $320,000,000 for the 
Supportive Services for Veterans Families program. The 
Department has made significant progress toward ending veteran 
homelessness. According to VA, the number of veterans 
experiencing homelessness in the U.S. has declined almost 50 
percent since 2010 and the 17 percent reduction between 2015 
and 2016 is quadruple the previous year's annual rate of 
decline. As communities nationwide reach critical junctures in 
their efforts to end veteran homelessness, occupancy in 
transitional housing programs continues to decrease. The 
Committee directs VA to continue to encourage and support 
community homeless providers to adapt to the bridge housing 
transitional housing model, emphasizing short lengths of stay 
and rapid connections to permanent supportive housing. 
Additionally, VA should use data to adapt homelessness programs 
to meet the needs of the changing homeless population and 
expand permanent supportive housing options.
    Legal Assistance for the Supportive Services for Veteran 
Families Program.--The Committee notes that university law 
schools are willing to work with veterans on a pro-bono basis 
to provide legal assistance. This can result in additional 
benefits such as training law students in veteran disability 
law and legal skills critical to providing advocacy within the 
VA system and inspiring next-generation lawyers to serve 
veterans in practice. The Committee encourages the Supportive 
Services for Veteran Families [SSVF] program to work with 
grantees to expand their legal service offerings, particularly 
in rural States where access to private legal assistance can be 
limited. Within funds provided, the Department is encouraged to 
establish one or more pilot projects to partner SSVF grantees 
with university law schools in rural areas to enhance legal 
assistance to Veterans.

                         PREVENTING DRUG ABUSE

    Oversight of Substance Inspection Programs.--The Committee 
understands the veteran population is at greater risk than the 
general population for opioid abuse and dependency. A recent 
GAO report recommended VA should ensure VAMCs have established 
an additional control procedure, such as an alternate 
controlled substance coordinator or a poll of extra inspectors, 
to help coordinators meet their responsibilities and prevent 
missed inspections. The Committee concurs with GAO's 
recommendations and directs the Secretary to fully implement 
these recommendations to improve oversight of the controlled 
substance inspection program and to document its progress.
    Opioid Safety.--The Committee supports VA's Opioid Safety 
Initiative [OSI] and encourages continued implementation at all 
VA medical facilities, as directed under Title IX of Public Law 
114-198, the Jason Simcakoski Memorial and Promise Act. A 
critical aspect of the OSI is the Opioid Therapy Risk Report 
tool, an electronic tool that helps providers manage their 
entire panel of patients prescribed pharmacotherapy for acute 
or chronic pain. It is imperative all VA providers who 
prescribe opioids use this tool consistently, including prior 
to initiating opioid therapy, to ensure safe prescribing, and 
to help prevent diversion, abuse, and double-prescribing. 
Public Law 114-198 required the Department to implement 
mandatory use of such tool for all providers prior to 
initiating opioid therapy to assess the risk for adverse 
outcomes; to implement standards with respect to the use of 
routine and random drug tests; to ensure providers use the tool 
to access the State Prescription Drug Monitoring Program 
[PDMP]; and to ensure the tool includes information identifying 
when healthcare providers access the tool and the most recent 
drug test for each veteran. The Committee also urges VA to 
further improve the timeliness of data available in the tool to 
allow a provider to have real-time access to data on a patient 
who was prescribed opioid therapy by another facility, in 
another State, or by mail order to prevent overprescribing and 
abuse potential. It is critical that VA clinicians have access 
to a patient's opioid therapy history from outside providers to 
ensure safe pain management care, as many veterans also seek 
care from providers in the community who may prescribe them 
medication. Sections 911 and 914 of Public Law 114-198 require 
the Department to ensure VA providers can access information in 
the State PDMP including by seeking to enter into memoranda of 
understanding with States to allow shared access of such 
information between VA and the States. The Department must also 
include such information in the Opioid Therapy Risk Report tool 
and require VA providers to disclose certain veteran 
information to State controlled substance or PDMPs. The 
Department is directed to submit a report to the Committees on 
Appropriations of both Houses of Congress no later than 180 
days after enactment of this act assessing compliance with 
mandatory provider use of the tool, including a timeline of 
implementation, the rate of compliance and compliance measures, 
and utilization of and reporting to State PDMPs.
    Prescription Drug Monitoring Program Utility.--Opioid 
addiction represents a major and growing epidemic in the public 
health system generally and specifically among America's 
youngest veterans. Among combat-injured veterans serving in the 
wars in Afghanistan and Iraq, post-traumatic stress disorder 
[PTSD] and co-occurring substance use disorder [SU] is common 
and found to be associated with increases in opioid addiction 
and mortality. The Department is directed to submit a report to 
the Committees on Appropriations of both Houses of Congress on 
the Department's usage of State prescription drug monitoring 
programs [PDMP] and databases used for detecting and reducing 
fraud, diversion, and abuse of prescription drugs. The report 
shall include--(A) an assessment of legal, technical, fiscal, 
privacy, or security challenges that have an impact on utility; 
(B) any recommendations for addressing challenges that impact 
the Department's access to State prescription drug monitoring 
programs in order to reduce fraud, diversion, and abuse of 
prescription drugs; and (C) an assessment of the extent to 
which VA providers use prescription drug management programs in 
delivering care and preventing prescription drug abuse.
    Opioid Therapy Clinical Practice Guidelines and Training.--
The Committee commends the Department for releasing the updated 
2017 VA/DoD Clinical Practice Guideline [CPG] for Management of 
Opioid Therapy for Chronic Pain, as required under Public Law 
114-198. The Committee is encouraged the new CPG includes 
enhanced guidance concerning contraindications and risk factors 
for opioid therapy, such as prescribing opioids and 
benzodiazepines concurrently, and for treating those with co-
occurring mental health conditions, and recommendations against 
initiating long-term opioid therapy for chronic pain. To 
continue to improve chronic pain management and access to safe, 
quality care, the Committee directs the Department to 
immediately disseminate and implement the new CPG and update 
education and training materials for all VA employees who 
prescribe opioids to include the new recommendations. The 
Department is further directed to ensure pain management teams 
at each facility certify that all healthcare professionals 
responsible for coordinating and overseeing pain management 
therapy utilize the updated CPG. To ensure all providers have 
access to most recent scientific evidence, it is critical for 
opioid prescribing guidance to be as up to date and as 
consistent as possible across Federal agencies. As such, the 
Committee directs the Department to continue to routinely 
coordinate and consult with the Centers for Disease Control and 
Prevention [CDC] and other relevant groups and Federal agencies 
on continued implementation and compliance with the CPG and 
latest scientific recommendations.
    Opioid Addiction Treatment Protocols.--The Committee 
appreciates VA's submittal of a report regarding the 
Department's ongoing review of prescription practices and 
addiction treatment protocols for opioids. According to the 
report, however, VA has failed to adopt the Substance Abuse and 
Mental Health Administration's [SAMHSA] full recommendation for 
treatment including ``all drugs approved by the Food and Drug 
Administration for the treatment of opioid abuse disorder, 
including for maintenance, detoxification, overdose reversal, 
and relapse prevention; and appropriate counseling and 
appropriate ancillary services.'' The Department is directed to 
submit a report to the Committee on Appropriations of both 
House of Congress no later than 180 days providing an update of 
this report to address VA's intent to include the full spectrum 
of prescription practices and addiction treatment protocols for 
opioids recommended by SAMHSA and prescribed in Public Law 114-
198, the Comprehensive Addiction and Recovery Act of 2016.
    Capabilities in Treating Addiction.--The Committee directs 
the Government Accountability Office to conduct a study on VA's 
capabilities and capacity to treat veterans with addiction. 
This study should include the following: (1) VA's number of 
residential rehabilitation beds and the average wait time; (2) 
the number of veterans being treated in outpatient veterans 
centers based on current VA resources; (3) the percentage of 
veterans who are referred to either non-VA outpatient or 
residential rehabilitation treatment and wait times for both 
types of treatment; (4) statistics on staffing and other 
pertinent resources to the treatment of veterans struggling 
with addiction; and (5) the availability and accessibility of 
alternative facilities capable of providing comparable care in 
rural and highly rural areas. This study should also identify 
which States are particularly in need of increased resources to 
resolve the opioid epidemic. The Committee requests an update 
on this study no later than 90 days following the enactment of 
this act and a report within 180 days.
    Dependents and Prescription Drug Monitoring Programs.--The 
Committee commends the Department for efforts to increase 
participation in State prescription drug monitoring programs 
[PDMPs]. However, the Committee is concerned that due to 
deficiencies in Veterans Information Systems and Technology 
Architecture [VistA], VA is unable to provide information to 
PDMPs on non-veteran dependents who receive VA healthcare. 
Given the continued opioid epidemic, it is important VA correct 
this deficiency. Therefore, the Committee directs the Under 
Secretary for Health, in consultation with the Assistant 
Secretary for Information and Technology and General Counsel, 
to develop a plan to enable VA to provide relevant information 
on veterans' dependents to State PDMPs. The Department is 
directed to submit a report to the Committees on Appropriations 
of both Houses of Congress no later than 180 days after 
enactment of this act detailing the plan, to include 
recommendations for additional resources or authorities 
necessary to address this issue.

                            STAFFING ISSUES

    Transition of Military Healthcare Professionals.--The 
Committee has received reports that separating military 
healthcare professionals have expressed interest in 
transitioning to work within the VA healthcare system in the 
communities in which they separate. In some cases, the 
competencies and skills of these professionals match current 
local vacancies. The Committee notes in some places local VA 
managers lack a pathway within the VA recruitment and hiring 
process to ensure these experienced professionals are able to 
be hired where they live. The requirement that separating 
military healthcare professionals be recredentialed by VA 
through its own proprietary system creates additional applicant 
burden and delay. VA is encouraged to establish a recruitment 
channel for separating military healthcare professionals to 
identify and receive expedited consideration for VA healthcare 
vacancies.
    Certified Surgical Assistant Training.--The Committee 
acknowledges VHA's positive response to language in last year's 
report regarding the potential benefits of using full-time 
surgical assistants in VHA surgical operations. The Committee 
strongly encourages the Department to follow through in the 
form of a proposal to fund Surgical Assistant education and 
certification for retiring military medics through its Office 
of Academic Affiliations helping them to provide a higher level 
of care to their fellow veterans.
    Hiring Clinical Psychologists.--The Committee understands 
VHA each year uses the services of the Association of 
Psychological Postdoctoral and Internship Centers [APPIC], a 
non-profit organization, to help select and match clinical 
psychologists for available VA internships. The Committee is 
concerned APPIC has decided to not include psychologists from 
programs accredited by the Psychological Clinical Science 
Accreditation System [PCSAS] even though VHA has just published 
new Psychologist Qualification Standards to encompass the 
graduates of PCSAS accredited programs. The Committee is 
pleased to learn VHA is working to resolve this situation to 
insure all appropriately trained and qualified psychologists 
are given equal access to VA internships. The Department is 
directed to submit a report to the Committees on Appropriations 
of both Houses of Congress no later than 90 days after 
enactment of this act on the status of this issue.
    Nursing Academic Partnerships.--The Committee encourages 
the Under Secretary for Health and the Chief Academic 
Affiliations Office to further support the VA Nursing Academic 
Partnership Programs [VANAP], expansion of the Post-
Baccalaureate Nurse Residency [PBNR], the VA Nursing Academic 
Partnerships in Graduate Education [VANAP-GE], and the 
Enhancing Academic Partnerships programs. These programs 
enhance recruitment and retention of highly trained nursing 
professionals, while elevating inter-professional education 
concentrating on behavioral health services, women's health, 
gerontology services, services for homeless veterans, and rural 
healthcare initiatives. These initiatives ensure that our 
nation's veterans and their families have access to high-
quality and appropriate care by building strong partnerships 
between academia and VA practice.
    Orthotics and Prosthetics Workforce.--The Committee is 
concerned about the sustainability of the orthotics and 
prosthetics workforce treating veterans, particularly given an 
aging workforce with imminent retirements as well as a lack of 
availability of advanced degree programs necessary to train new 
professionals. Reports indicate that up to twenty percent of 
the field's 7,100 clinicians nationwide are either past 
retirement age or within 5 years of retiring. The Committee 
recognizes the contributions made by VHA's Orthotic and 
Prosthetic Residency Program to provide rotation opportunities 
throughout the VA system but acknowledges this program alone is 
inadequate to ensure a sustainable workforce for the future, 
especially in light of the skill set necessary to provide the 
increasingly complex, state-of-the-art orthotics and 
prosthetics care for OEF/OIF veterans. The Department is 
directed to explore cost effective opportunities to grow the 
workforce pipeline in order to ensure the future orthotic and 
prosthetic workforce required by the nation's new generation of 
veterans. The Department is directed to submit a report to the 
Committees on Appropriations of both Houses of Congress no 
later than 180 days after enactment of this act detailing the 
findings.
    Partnerships with Academic Medical Institutions.--In 2015, 
the Committee included report language encouraging the 
Department to seek out public-private partnerships, 
particularly with research universities, those with and without 
medical schools, to expand its efforts related to suicide 
prevention, post-traumatic stress disorder, traumatic brain 
injury, and substance abuse disorders. The Committee continues 
to believe, as stated in report language last year, the 
Department should make broader use of existing partnering 
authority to collaborate with academic institutions, and 
further encourages VA to enter into partnerships with 
accredited medical schools and teaching hospitals for the 
mutually beneficial coordination, use, or exchange of health-
care resources with the goal of improving access to and quality 
of the hospital care and medical services furnished by the 
Department.
    Tribal Health Partnerships.--The Committee is pleased VA 
has implemented a robust series of partnerships with Indian 
Health Service facilities and tribally operated health 
facilities that operate under self-determination contracts and 
self-governance compacts with the Indian Health Service. These 
partnerships are necessary not only to extend care to the 
remote and highly rural areas where Native veterans reside but 
in some cases has also helped VA address capacity and personnel 
shortages affecting its overall beneficiary population. For 
example, to address longstanding staffing problems at the 
Wasilla Community Based Outpatient Clinic, the Alaska VA 
Healthcare System offers beneficiaries care at the Southcentral 
Foundation Benteh Nuutah Primary Care Center, a tribal facility 
in Wasilla. The Committee notes some of the initial 5-year 
partnership agreements are expiring and VA has been reluctant 
to renew them for an additional 5-year term, preferring instead 
short-term extensions. This has caused VA's tribal partners to 
question whether VA has a long-term commitment to continue 
these successful partnerships. The Committee encourages VA to 
express its commitment to maintain its tribal partnerships and 
work collaboratively with their tribal health partners on 
reimbursement formulas and terms going forward. The Committee 
notes losing these important partnerships over 
misunderstandings or contracting disagreements would have 
serious effects on VA healthcare in Alaska.
    Staffing of the Alaska VA Healthcare System.--The Committee 
continues to be concerned about chronic staffing issues within 
the Alaska VA Healthcare System. As of July 2017, the Wasilla 
Community Based Outpatient Clinic still lacks a single full 
time physician even though patient demand would justify two 
full time physicians. The Committee understands that 
recruitment and retention of medical professionals to serve in 
Alaska is difficult, but it is also worth noting that community 
hospitals and tribal health facilities in Alaska have faced and 
overcome similar difficulties. The Committee encourages VA to 
formulate a strategy to permanently fill chronic vacancies in 
the Alaska VA Healthcare System. This requires Central Office 
cooperation to ensure recruitment and retention incentives are 
readily available to these positions and that medical 
professionals offered employment are smoothly on boarded. VA 
should reach out to other healthcare organizations in Alaska to 
identify best practices for recruitment of medical 
professionals from out of State. The Fairbanks Memorial 
Hospital, for example, has expressed a willingness to partner 
with VA in addressing recruitment issues. The Committee 
encourages VA to work in collaboration with willing Alaska 
healthcare providers to encourage medical professionals to 
consider work in Alaska.
    Critical Needs Occupational Staffing Model.--It is critical 
VHA develop a staffing model so that it can better understand, 
and more quickly address, its staffing needs in critical need 
occupations. The Committee remains concerned that after nearly 
2 years, VA has failed to follow-up on repeated OIG 
recommendations to develop staffing models for critical need 
occupations, as well as set forth milestones and a timetable 
for further critical need occupations' staffing model 
development, piloting, and implementation with the urgency 
required given the importance of having adequate staff to 
appropriately care for veterans. The Committee recognizes the 
Department has put forward some effort to move forward the 
process for creating a staffing model forward but is 
disappointed with the pace. As such, the Department is directed 
to accelerate the creation of such a model so that veterans 
have access to the care they need.
    Health Professional Scholarship Program.--The Health 
Professional Scholarship Program [HPSP] provides scholarships 
to students receiving education or training in a direct or 
indirect healthcare services discipline. Awards are offered on 
a competitive basis and are exempt from Federal taxation. In 
exchange for the award, scholarship program participants agree 
to a service obligation in a VA healthcare facility. The 
Committee continues to support this program and is concerned VA 
has not fully been utilizing this program in fiscal year 2017, 
based on data from fiscal year 2016. The Committee believes 
strongly ample resources exist within the Department to ensure 
hard to fill specialties are not excluded from participation. 
In spite of this, the Committee continues to hear VA is not 
utilizing these tools in the most judicious and efficient 
manner. The Department is directed to submit a report to the 
Committees on Appropriations of both Houses of Congress no 
later than October 30, 2017, on each profession eligible to 
receive HPSP scholarship and any limitation VA is placing on 
awards. In addition, VHA is also directed to submit to the 
Committees on Appropriations of both Houses of Congress no 
later than 90 days after enactment of this act a strategic plan 
which identifies difficult to recruit occupations and outlines 
specific actions being taken to address those shortages.

                           ITEMS OF INTEREST

    Hepatitis C Treatment.--The Department has received 
targeted and significant resources for the past 2 years from 
this Committee to aggressively treat and cure veterans with 
hepatitis C, and the Committee is pleased VA has made 
significant progress doing so. The Department is to be 
commended for innovative and directed outreach to the cohort 
most likely affected by the disease, including effective 
marketing campaigns, partnerships with veteran service 
organizations, and holding weekend and after hours clinics to 
increase access to care. The Committee is aware VA has treated 
upwards of 87,000 veterans with new generation oral hepatitis C 
drugs which have a cure rate of more than 90 percent. The 
remaining cohort of veterans who have not been treated but 
potentially have the disease are the most difficult to contact 
and persuade to seek treatment, but the Committee directs VA to 
continue efforts to reach all veterans who would benefit from 
care as soon as possible.
    Due to the change in drug pricing, the Committee notes VA 
has been able to treat more veterans with significantly less 
funding than was anticipated at the time of the original 
appropriation. Given that slightly more than half of the 
funding remaining available for Hepatitis C was specifically 
fenced in statute, the Department lacks the authority to 
transfer this funding before it lapses. Therefore, the 
Committee's recommendation includes a rescission of 
$751,000,000 and appropriates back the same amount to the 
Medical Services account to ensure that this funding does not 
lapse. The Committee notes, that the Department will still have 
more than $600,000,000 in unobligated Hepatitis C funds 
originally appropriated in fiscal year 2016 and directs the 
Department to continue to aggressively fund the Hepatitis C 
program consistent with the fiscal year 2018 budget request.
    The Department is directed to continue its quarterly 
updates to the Committees on Appropriations of both Houses of 
Congress detailing the expenditures and obligations of funding 
hepatitis C treatment, the number of veterans treated, the 
number of veterans deemed cured, the projection of spending, 
the number of new starts for drug treatment, and number of 
veterans who have been cured.
    DoD and VA Prescription Drug Purchasing.--The Committee 
believes there are potential savings in combining DoD and VA 
prescription drug purchasing. A 2014 GAO report surveyed 83 
common drugs purchased by both Departments and found that if 
purchasing drugs for both Departments at the lowest DoD or VA 
price, the taxpayer could have realized a combined savings of 
$120,000,000 in 2012. GAO recommended DoD, VA, and Medicare 
align the structure, statutory parameters, and regulatory 
guidance across all Federal prescription buying programs to 
increase buying power and reduce costs. The Department is 
directed to work with the Department of Defense and submit a 
report to the Committees on Appropriations of both Houses of 
Congress no later than 180 days after enactment of this act 
detailing the feasibility of aligning their structures, 
statutory parameters, and regulatory guidance with the 
Department of Defense for their prescription buying program in 
order to increase buying power and reduce cost.
    Encouraging Public-Private Partnerships.--The Committee is 
aware of private-sector solutions and financial support that 
can effectively and efficiently develop and construct 
facilities that create greater access to care while reducing 
costs in the near and long term. The Committee encourages VA to 
pursue public-private partnerships to implement projects in 
VISN 15 and others that include but are not limited to VA 
facility leases, renovations, or construction to increase 
access to healthcare services for veterans. The Committee 
further directs VA to utilize existing and new authorities that 
permit such partnerships and potential cost-share solutions, 
such as Communities Helping Invest through Property and 
Improvements Needed for Veterans Act of 2016 and the CHIP IN 
for Vets Act of 2016. The Department is directed to submit 
reports on a quarterly basis to the Committees on 
Appropriations of both Houses of Congress regarding current and 
new projects resulting from this initiative.
    Travel Reimbursement.--The Beneficiary Travel program 
provides eligible veterans and other beneficiaries mileage 
reimbursement, common carrier (plane, train, bus, taxi, light 
rail etc.), or when medically indicated, ``special mode'' 
(ambulance, wheelchair van) transport for travel to and from VA 
healthcare, or VA authorized non-VA healthcare for which the 
veteran is eligible. The Committee appreciates recent steps to 
modernize the program's processes but remains concerned about 
the time it takes for veterans to be reimbursed. Therefore, the 
Department is directed to submit a report to the Committees on 
Appropriations of both Houses of Congress no later than 90 days 
after enactment of this act on steps taken to make the process 
to receive travel reimbursement more timely and user-friendly 
for veterans. The report should also include how filling 
vacancies in the travel office are prioritized and how the 
Department is addressing challenges with kiosks, particularly 
for veterans with disabilities such as blindness.
    Hearing Aid Specialists.--The Committee understands hearing 
loss and tinnitus are among the most common injuries facing 
veterans of the recent conflicts in Iraq and Afghanistan. 
Hearing loss can contribute to depression, heightened stress, 
fatigue, and other challenges veterans face as they reintegrate 
into civilian life. The Committee is aware of the high demand 
for healthcare services among veterans and supports the recent 
passage of legislation aimed at addressing gaps in the 
provision of care within VA by allowing the Department to hire 
hearing aid specialists. The Committee is concerned VA has not 
completed the process of developing basic qualification 
requirements, work assignments, and qualification standards 
under title 38 for this occupation. The Department is directed 
to submit a report to the Committees on Appropriations of both 
Houses of Congress no later than 90 days after enactment of 
this act detailing the progress made in developing and 
publishing this criteria and how and when VA will begin hiring 
such providers to offer such services.
    National Veterans Sports Programs and Special Events.--The 
Committee supports the continued efforts of the Department to 
provide disabled veterans and disabled members of the Armed 
Forces with unique alternative therapies such as adaptive 
sports. The Department is directed to submit a report to the 
Committees on Appropriations of both Houses of Congress no 
later than 90 days after enactment of this act on the status of 
the current adaptive sports program and recommendations for 
expansion of the program, as well as how the Department may 
better leverage grants for greater access to rural communities 
as well as possible integration into mental health alternative 
therapies. The Committee notes is has provided an additional 
$2,000,000 to support community-based qualifying sports 
programs or other events in rural locations through the Office 
of Rural Health.
    Enabling Independent Federal Investigations of VA Health 
Care.--The Committee is concerned by reports that independent 
Federal investigations into VA opioid prescribing practices 
have been hampered by the Department's inability or 
unwillingness to share information with investigators. The 
Committee places the highest priority on maintaining robust 
protections for veterans' privacy but emphasizes these 
protections are for the rights of patients, not providers. The 
Committee believes the Department should take every appropriate 
action to fully comply with investigators requests to supply 
relevant information in ongoing and future investigations by 
the Drug Enforcement Agency into potential violations of the 
Controlled Substances Act by VA employees, and inform the 
Committees on Appropriations and Veterans Affairs of both 
Houses of Congress if additional authorities are required to do 
so.
    Complementary and Integrative Health.--Expanding access to 
comprehensive pain management and complementary and integrative 
health [CIH] services is vital to improving the delivery of 
high-quality care for our veterans, especially those struggling 
with co-occurring conditions like chronic pain, mental health 
and substance use disorders. The Committee supports VA's work 
in developing a plan to expand the scope of research, 
education, delivery, and integration of CIH into the healthcare 
services provided to veterans and urges robust implementation. 
In addition, as required under Section 932 of Public Law 114-
198, VA must continue to prioritize implementation of the pilot 
program at VA medical centers, including polytrauma 
rehabilitation centers, to assess the feasibility, 
advisability, and methods of delivery of wellness-based 
programs to complement pain management and related healthcare 
services. While the Committee supports the progress being made 
to reduce misuse and abuse of opioids and to improve pain care, 
the Committee believes that consideration of VISNs or medical 
centers with a history of or current prescription rates of 
opioids inconsistent with the standards of appropriate and safe 
care should be given priority. The Committee encourages the 
Department to continue to expand access to CIH services as part 
of the VA's Whole Health System approach, and the Department is 
directed to submit a report to the Committees on Appropriations 
of both Houses of Congress on later than 90 days after 
enactment of this act on the progress of the 18 flagship 
facilities being launched to effectuate this effort.
    Antimicrobial Stewardship Program.--The Committee is aware 
that commercially proven integrated technology for infectious 
disease and pharmacy management is the industry standard for 
meeting national Antimicrobial Stewardship directives. While VA 
has successfully used these tools in a limited number of 
facilities, VA has not deployed it system wide. Therefore, the 
Committee encourages VA to implement a system wide electronic 
solution for all medical facilities that would provide 
infectious disease control monitoring, provide appropriate 
treatment and pharmacy care plans, help prevent potential 
healthcare risks, document interventions that improve patient 
care, and reduce hospital costs. These capabilities would bring 
VA into compliance with all Federal and State regulatory 
antimicrobial program directives.
    Long-Term Care.--The bill provides $8,821,657,000 as 
requested by the Department for long-term care. This includes 
the $6,073,862,000 for institutional care and $2,747,795,000 
for non-institutional care. The Committee is concerned about 
the Department's fiscal year 2018 proposal to fund more than 
$690,000,000 of non-institutional care through the Choice 
program. Should Congress not provide additional funding for the 
Choice program, the Committee directs VA to fulfill its 
obligations to non-institutional care programs as proposed in 
the original fiscal year 2018 advance appropriation request. To 
ensure proper budgetary oversight of the non-institutional care 
programs, the Department is directed to report quarterly to the 
Committees on Appropriations of both Houses of Congress on the 
quarterly demand and execution of the non-institutional 
programs. In addition, VA is directed to include in the budget 
justifications accompanying the fiscal year 2019 budget request 
detailed data on the number of veterans receiving non-
institutional care disaggregated by the appropriate medical 
care account.
    Headache Disorders Centers of Excellence.--The Committee 
recognizes that over 350,000 veterans sustained traumatic brain 
injury [TBI] during the Global War on Terror and that chronic 
migraine/post-traumatic headache is the signature symptom of 
TBI. The Committee is concerned that veterans with chronic 
migraine/post-traumatic headache often do not receive specialty 
care, and that only three VA-affiliated physicians are 
certified with training in Headache Medicine by the United 
Council for Neurological Subspecialties. The Committee 
recognizes the importance of VA centers of excellence and the 
need for VA Headache Centers of Excellence. The Committee 
provides $10,000,000 for the creation of at least five headache 
centers to be placed at the existing sites for polytrauma and 
traumatic brain injury [TBI] or at locations that the Secretary 
sees fit.
    Readjustment Counseling.--The Committee strongly supports 
readjustment counseling provided through the Departments 300 
Vet Centers, 80 mobile Vet Centers, and the Vet Center Combat 
Call Center. Vet Centers are community-based counseling centers 
that provide a wide range of social and psychological services. 
These services include: professional readjustment counseling to 
veterans and active duty servicemembers, counseling for the 
victims of military sexual trauma, bereavement counseling for 
families who experience an active duty death, substance abuse 
assessments and referrals, VBA benefit information and 
referrals to Regional Offices, and employment counseling. 
Certain services also extend to the family members as a means 
to assist in the readjustment for veterans and active duty 
servicemembers. In order to bolster readjustment counseling 
capacity across the country, the recommendation provides an 
additional $15,000,000 over the budget estimate for the Vet 
Center program. The Committee recognizes the unique 
opportunities that Vet Centers provide in collaborating and 
developing alternative treatments with other community 
organizations to create programs for veterans to share 
experiences, develop bonds, and address common challenges. 
Therefore, within the additional funding provided, the 
Committee directs $2,500,000 be utilized to develop a program 
to partner with organizations that provide outdoor experiences 
for veterans as part of a continuum of care that helps support 
veterans in developing a community of support to treat combat-
related injuries, including those related to behavioral health.
    Increased Infectious Disease Screening.--The Department is 
directed to submit a report to the Committees on Appropriations 
of both Houses of Congress no later than 180 days after 
enactment of this act on VHA's efforts to improve HIV/AIDS and 
hepatitis screening rates in traditional and non-traditional 
settings, including to what extent the Department utilizes 
innovative strategies like point-of-care testing and public 
health outreach. The Committee notes the racial disparities in 
these diseases and requests that the report include a section 
which focuses on minority groups including but not limited to, 
Native Americans, Asian Americans, Pacific Islanders, Alaska 
Natives, Native Hawaiians, and African Americans.
    Colorectal Cancer Screening.--Approximately one-third of 
eligible U.S. adults have never been screened for colorectal 
cancer despite it being the second-leading cause of cancer 
death in the United States. To help address this, in 2016, the 
United States Preventive Services Task Force [USPSTF] updated 
its recommendation for colorectal cancer screening, issuing it 
an A-grade, and included several strategies determined with 
high certainty to have a substantial net benefit and noted that 
offering choice in screening strategies may increase the number 
of screened individuals. The strategies have subsequently been 
adopted by the National Committee for Quality Assurances 
Healthcare Effectiveness Data and Information Set [HEDIS] 
measures, which are used by more than 90 percent of America's 
health plans to measure performance. TRICARE covers the 
majority of the strategies identified by USPSTF, however VA 
does not offer veterans coverage for the same options and 
covers fewer screening methodologies. To improve colorectal 
cancer screening of veterans and enhance access to the most 
updated screening technologies, the Committee directs VA to 
offer all seven USPSTF strategies now recognized in the HEDIS 
measures to all veterans enrolled in the VA health system.
    Domiciliary Program.--The Committee is concerned VA has not 
yet completed its assessment of the VA domiciliary program as 
required by Senate Report 114-237. The Committee directs VA to 
complete this assessment and within 60 days submit a formal 
report to the Committees on Appropriations of both Houses of 
Congress, with recommendations if applicable, addressing 
security gaps in the VA domiciliary program and whether the 
current program can meet the needs of veterans who are at 
heightened risk for overdose or suicide. The assessment should 
include alternatives to the domiciliary program if it is found 
that the current program cannot meet the needs of these 
veterans.
    Sleep Disorders.--The Committee recognizes the importance 
of sleep, including its impacts on PTSD, TBI, and mental 
health. The Committee supports VA considering all treatment 
options for these conditions, including ensuring proper sleep 
health. The Committee continues to recommend the Department 
assign a program manager for sleep disorders, including sleep 
apnea, which affects at least 200,000 veterans of the Persian 
Gulf War and Operations Iraqi Freedom and Enduring Freedom. The 
Department is directed to submit a report to the Committees on 
Appropriations of both Houses of Congress no later than 90 days 
after enactment of this act on the status of this 
recommendation.
    Stroke Care.--More than half of veterans are over age 65, 
putting them at an increased risk of stroke, a leading cause of 
serious, long-term disability and dementia. Immediate care is 
essential to preventing permanent disability, and it is 
critical the Department work to improve its stroke care and 
provide timely access to assessment and treatment. 
Unacceptably, there have been cases in which veterans have died 
or have suffered severe injury due to lack of timely diagnosis 
and treatment. A December 2015 report evaluating the quality of 
stroke care in VA facilities, conducted by the Department's 
Office of Inspector General, found several areas needing 
improvement, including the need to increase access to 
clinicians with stroke expertise, and the need to ensure 
compliance with current stroke care requirements at each VA 
facility's designated level. To improve access to providers 
with stroke expertise, the Committee urges VA to continue its 
efforts to implement stroke telemedicine, or telestroke, within 
VA medical centers that do not currently have around-the-clock 
neurological expertise available to veterans who suffer a 
stroke. Telestroke has proven to be beneficial in improving 
access to high quality stroke care in rural and underserved 
areas and in reducing disability and the need for long-term 
care following a stroke. The Committee also encourages the 
Department to continue to reinforce compliance with stroke care 
requirements, including prompt and thorough assessment, 
treatment, and patient education, and ensure the gathering and 
reporting of required stroke data elements, consistent with the 
recommendations in the December 2015 report.
    Prosthetic Digital Health Technology.--VA's Office of 
Rehabilitation and Prosthetic Services shall, not later than 90 
days after enactment of this act, provide a report to the 
Committees on Appropriations of both Houses of Congress, 
detailing which VA Medical Centers and Clinics this technology 
is available. In addition, the report shall include the number 
of veterans utilizing this technology, any plans for increasing 
the availability of this technology to more veterans, and any 
plans to make prosthetic related outcomes-based data collection 
standard throughout the Veterans Health Administration.
    Caregivers.--The Committee notes the robust usage of the 
post-9/11 Caregiver program with its more than 23,000 approved 
applications, as well as the consistent reviews by caregiver 
families noting that the program's stipend, respite care, 
formal training, and support structure are critical components 
to its success. Given the demonstrated success of the program, 
the Committee encourages VA to ensure the Caregiver 
coordinators at each Medical Center are fully resourced and, to 
the maximum extent possible, assigned designated Caregiver 
duties as their chief and only responsibility. In addition, the 
Committee encourages VA to examine expansion of the program 
beyond the post-9/11 population. The Committee encourages VA to 
work with the Department of Defense in order to develop and 
share best practices. The Committee recognizes many caregivers 
for severely wounded veterans are working dramatically reduced 
hours outside the home or have left the workforce completely, 
leading to financial hardship. This reduction in outside 
earnings results in difficulties meeting financial obligations, 
including student loan debt held by the caregiver. VA is 
directed to survey all caregivers currently in the program to 
identify those possessing outstanding student loan debt, 
develop a plan to monitor this issue, including future data 
collection and regular reports to the Committee, and report 
survey findings and details of the plan to the Committees on 
Appropriations of both Houses of Congress no later than 120 
days after enactment of this act and every 6 months thereafter. 
The Committee is concerned by the steep decline in requested 
funding for the Caregivers Program. Given the increasing demand 
for these services and the consistent reports and findings of 
inconsistent or inappropriate removal of veterans from the 
program, the Committee questions whether the Department's 
request is an accurate reflection of the program's true needs. 
The Committee, therefore, recommends $839,828,000, which is 
consistent with the fiscal year 2018 advance appropriation, to 
continue full operation of this essential program. The 
Committee directs the Department to implement a freeze on 
reductions or removals of veterans from the program until all 
outstanding recommendations from the Office of Inspector 
General and the Comptroller General are fully implemented.
    Veterans Transportation Service.--In order to ensure the 
Veterans Transportation Service [VTS] is improving veterans' 
access to healthcare and VA's ability to provide quality care 
in a cost effective manner, the Department is directed to 
submit a report to the Committees on Appropriations of both 
Houses of Congress no later than 90 days after enactment of 
this act outlining the progress made on these metrics. At a 
minimum, the report should include analysis of the healthcare 
costs impacted by non-emergency medical transportation, the 
impact of VTS on missed appointment rates at facilities 
utilizing the program, and VTS impact on health outcomes for 
veterans.
    Center for Compassionate Innovation.--The Committee 
understands VA has been operating a Center for Compassionate 
Innovation. The Center's stated purpose is to explore emerging 
therapies targeted to enhance veteran physical and mental well-
being when other treatments have not been successful. The 
Committee encourages VA to always be testing and researching 
new and innovative treatments that may benefit veterans' lives. 
To more fully understand these treatments, the Department is 
directed to submit a report to the Committees on Appropriations 
of both Houses of Congress no later than 180 days after 
enactment of this act with a description of the proposals the 
Center received in fiscal year 2017 and the cost and 
disposition of such proposals. Further, to the extent the 
Center undertook any projects during fiscal year 2016, the 
Committee directs VA to report on the status of those projects 
and any findings or preliminary data.
    Nurse Advice Line.--The Department is directed to pursue a 
pilot program for a nurse advice line targeting rural areas and 
highly rural areas with a large percentage of veterans. 
Licensed Registered Nurses at the call center will triage VHA-
enrolled veteran callers to the clinically appropriate care 
venue and provide appointment and cancellation services and 
information on the availability of benefits from the VA. The 
pilot should be based on and improve upon the nurse advice line 
implemented by DoD for beneficiaries under the TRICARE program. 
The pilot shall provide responsive service around-the-clock for 
callers. The Department is directed to submit a report to the 
Committees on Appropriations of both Houses of Congress no 
later than 90 days after enactment of this act, and every 90 
days thereafter, on the progress of pilot program. The reports 
shall contain information on utilization of the pilot, to 
include a description of the individuals who benefitted from 
advice under the pilot program, a description of any 
impediments in carrying out the pilot program, a description of 
any impediments encountered by individuals in seeking advice or 
services through the pilot program, a description of any cost 
savings to the Department, and an assessment of the feasibility 
and advisability of expanding the pilot program to more 
veterans.
    Gulf War Illness.--The role of the Research Advisory 
Committee on Gulf War Veterans' Illnesses [RAC] was intended to 
provide a meaningful consultative role to help shape the 
Persian Gulf War research agenda, strengthen the process by 
which the government sets its Persian Gulf War research agenda, 
and lend credibility to future research activities. However, 
concerns continue to be raised that this role has been degraded 
and compromised. The RAC charter no longer requires it to 
assess the effectiveness of Federal Gulf War research, no 
longer contains a requirement for its own staff, and its 
purview is presently limited solely to research conducted by 
the Department. Determinations by the RAC and IOM that Gulf War 
illness is physiological and not psychological should be the 
basis in determining the type of medical practitioners and 
scientific researchers needed to create a well-qualified 
membership. The Committee notes the RAC has provided no new 
recommendations since September 2014 and encourages the RAC to 
renew its efforts in studying Gulf War Illness. The Committee 
directs the Department to brief the Committee on its efforts to 
address these concerns. The Committee also continues to urge 
the Department to restore regular reporting throughout the year 
of healthcare and benefits utilization by Gulf War and post-9/
11 veterans, to publish these reports on the Department's Web 
site, and to consider for adoption the ``Recommendations for 
New VA Gulf War-Era Data Report,'' adopted by the RAC on 
February 1, 2012.
    Lung Cancer Screening.--The Committee notes with concern 
that not all veterans who are at high risk for developing lung 
cancer have access to lung cancer screening programs offered to 
Medicare beneficiaries. The Department is directed to submit a 
report to the Committees on Appropriations of both Houses of 
Congress no later than 90 days after enactment of this act 
regarding how VHA can institute a high quality program to make 
lung cancer screening broadly available to the appropriate 
veterans who are at high risk.
    Hospice Care.--From 1964 to 1975, more than nine million 
Americans served in the armed services, with more than one-
third of them having served in Vietnam. As these Vietnam-era 
veterans age, many of them are facing unique end-of-life 
challenges related to their combat experience that standard 
hospice care and palliative services are not fully equipped to 
address. These challenges include psychological and post-
traumatic stress disorders, a history of substance abuse, and 
neurological conditions resulting from toxic chemical exposure. 
While the VA provides hospice care and palliative services to 
qualified veterans, the Committee is aware that organizations 
such as the non-profit National Partnership for Hospice 
Innovation are developing programs designed to meet the 
specific end-of-life care needs for Vietnam-era veterans. The 
Committee also recognizes that such an approach could be 
beneficial to Iraq and Afghanistan combat veterans in the 
future. Therefore, VA is directed to undertake a study on the 
feasibility of implementing hospice care protocols tailored to 
the unique needs of combat veterans, including Vietnam-era 
veterans, and is encouraged to deploy a pilot program to 
develop the techniques, best practices and support mechanisms 
to serve these veterans. The Department is directed to submit a 
report to the Committees on Appropriations of both Houses of 
Congress no later than 180 days after enactment of this act on 
this effort.
    Improving Federal Burn Pits Registry.--The Committee 
provides an additional $5,000,000 for the purpose of 
implementing the recommendations included in the National 
Academies of Sciences, Engineering, and Medicine's Assessment 
of the Department of Veterans Affairs Airborne Hazards and Open 
Burn Pit Registry for improving the registry. The Department is 
directed to submit a report to the Committees on Appropriations 
of both Houses of Congress no later than 90 days after 
enactment of this act assessing the cost and timeline of 
implementation of each of the report's recommendations.

                         MEDICAL COMMUNITY CARE

Appropriations, 2017....................................  $7,246,181,000
Advance appropriations, 2018............................   9,409,118,000
Budget estimate, 2018...................................     254,000,000
Committee recommendation, 2018..........................     254,000,000
Budget estimate, advance appropriations, 2019...........   8,384,704,000
Committee recommendation, advance appropriations, 2019..   8,385,000,000

                          PROGRAM DESCRIPTION

    The Medical Community Care account provides for medical 
services for eligible enrolled veterans and other beneficiaries 
that is purchased from and provided by non-Department of 
Veterans Affairs facilities and providers, including contract 
hospitals, State homes, and outpatient services.

                        COMMITTEE RECOMMENDATION

    In fiscal year 2017, the Committee provided an advance 
appropriation of $9,409,118,000 for fiscal year 2018 for the 
Medical Community Care account. The recommendation for fiscal 
year 2018 includes an additional $254,000,000 as included in 
the budget request. The additional appropriation coupled with 
the advance appropriation provided for fiscal year 2018 
provides the Department with total budget authority of 
$9,663,118,000 which is $2,416,937,000 above the fiscal year 
2017 enacted amount.
    The Committee recommendation also includes an advance 
appropriation of $8,385,000,000 for Medical community care for 
fiscal year 2019. This is $296,000 above the request to reflect 
proper rounding of a budget estimate.
    The Future of Community Care.--The Department is directed 
to continue efforts to consolidate all types of community care 
available to veterans within one program in the Medical 
Community Care account. The Committee recognizes that the 
Committees on Veterans Affairs of both Houses of Congress have 
jurisdiction over the authorization of the consolidation, as 
well as the current Choice Program, which has been funded with 
mandatory appropriations. Once the latest round of funding 
available for the Choice Program has been expended, the 
functions of the Choice Program should be merged with the 
functions that are currently funded by and provided for under 
the Medical Community Care account, and that the consolidated 
program should be funded by this Committee. The Committee is 
aware that this would significantly increase discretionary 
spending for community care. The Committee would like to work 
with all interested parties within the Congress and the 
Administration to increase the discretionary spending limits to 
accommodate such increased future costs for a consolidated 
community care program. At the same time, the Committee directs 
the Department to maintain intense focus on responsibly 
providing care under the Choice Program, while working 
diligently to build the successor program and enable the 
consolidation of all community care under one account that 
would be funded by annual appropriations.
    Federally Qualified Health Centers in the Choice Program.--
The Committee recognizes the importance of Federally Qualified 
Health Centers in [FQHCs] in providing care to Americans across 
the country, including the most vulnerable. The Department is 
directed to submit a report to the Committees on Appropriations 
of both Houses of Congress no later than 90 days after 
enactment of this act regarding the role of FQHCs play in 
providing veterans care through the Veterans Choice Program and 
outlining opportunities for further engagement.
    Community Provider Agreements.--As illustrated by the 
success of the former Access Received Closer to Home [ARCH] 
program, community provider agreements have successfully 
benefited veterans in rural and highly rural States by 
increasing access to care and significantly shortening travel 
times. The Committee supports sustaining continuity of care for 
rural veterans through community provider agreements, based on 
previous models such as the ARCH program, to ensure veterans do 
not experience a lapse in healthcare during the transition to 
the new Choice program and any resulting integrated networks.
    Home and Community Based Services.--The Committee supports 
the Department's efforts to broaden veterans' options regarding 
long-term care support and services. As the Department realigns 
these programs under the Medical Community Care account, the 
Committee encourages VA to continue to prioritize veterans' 
preferences in receiving home based services. The Committee 
notes the positive results of pilot programs such as the 
Veterans Independence Program, a veterans-directed Home and 
Community Based Services [HCBS] grant program originally 
created as a pilot administered jointly by VA and the 
Department of Health and Human Services [HHS]. The Committee 
encourages enhanced cooperation with HHS to expand and grow 
these programs. The Department is directed to submit a report 
to the Committees on Appropriations of both Houses of Congress 
no later than 180 days after enactment of this act on the cost 
avoidance associated with various non-institutional care 
programs. The report should include information on the demand 
for HCBS among the veteran population, the number of veterans 
currently being served by each program under HCBS, and the 
Department's plans to expand the size and scope of HCBS. Given 
the success of current HCBS pilot programs, the Department 
should include a cost analysis of growing the existing pilot 
programs prior to national expansion to leverage coordination 
with HHS, in addition to detail regarding the Department's 
efforts to coordinate with HHS on HCBS in future years. Given 
that mandatory eligibility for certain types of care is 
associated with disability levels adjudicated by VBA, this 
report should also include recommendations for modernizing the 
claims process for veterans requiring long-term care.
    Non-VA Long-Term Care.--The Committee supports enabling the 
Department to enter into provider agreements with non-VA long-
term care providers, including skilled nursing facilities, in 
lieu of the current onerous Federal contracting requirements.
    Rural Health Continuity of Care.--The Committee notes the 
Access Received Closer to Home [ARCH] pilot program had been 
highly successful in some areas in providing healthcare 
services to veterans who live in the rural and highly rural 
States in which it operated, such as in northern Maine and in 
Kansas. During the pilot, VISN analysis demonstrated that more 
than 90 percent of veterans who received medical care though 
ARCH were ``completely satisfied'' with their care and cited 
significantly shortened travel and wait times to receive care. 
Further, the Committee is pleased the Department has made 
efforts to provide continuous, ARCH-like access to rural 
healthcare in northern Maine through the use of provider 
agreements. Accordingly, the Committee directs the Secretary to 
ensure that veterans who participated in the ARCH pilots 
maintain continuity of care through the use of provider 
agreements or other mechanisms.

                     MEDICAL SUPPORT AND COMPLIANCE

Appropriations, 2017....................................  $6,498,000,000
Advance appropriations, 2018............................   6,654,480,000
Budget estimate, 2018...................................     284,397,000
Committee recommendation, 2018..........................     100,000,000
Budget estimate, advance appropriation, 2019............   7,239,156,000
Committee recommendation, advance appropriation, 2019...   7,239,000,000

                          PROGRAM DESCRIPTION

    The Medical Support and Compliance account provides funds 
for management, security, and administrative expenses within 
the VA healthcare system, in addition to providing costs 
associated with the operation of VA medical centers and 
clinics, VISN offices, and the VHA Central Office in 
Washington, DC. This appropriation also covers Chief of Staff 
and Facility Director operations, quality of care oversight, 
legal services, billing and coding activities, procurement, 
financial management, security, and human resource management.

                        COMMITTEE RECOMMENDATION

    In fiscal year 2017, the Committee provided an advance 
appropriation of $6,654,480,000 for fiscal year 2018 for the 
Medical Support and Compliance account. The recommendation for 
fiscal year 2018 includes an additional $100,000,000 which is 
$184,397,000 below the budget request. The additional 
appropriation coupled with the advance appropriation provided 
for fiscal year 2018 provides the Department with total budget 
authority of $6,754,480,000 which is $256,480,000 above the 
fiscal year 2017 enacted amount.
    The Committee recommendation also includes an advance 
appropriation of $7,239,000,000 for Medical support and 
compliance for fiscal year 2019. This is $156,000 below the 
request to reflect proper rounding of a budget estimate.

                           MEDICAL FACILITIES

Appropriations, 2017....................................  $5,312,668,000
Advance appropriations, 2018............................   5,434,880,000
Budget estimate, 2018...................................   1,079,795,000
Committee recommendation, 2018..........................     707,000,000
Budget estimate, advance appropriation, 2019............   5,914,288,000
Committee recommendation, advance appropriation, 2019...   5,915,000,000

                          PROGRAM DESCRIPTION

    The Medical Facilities account provides funds for the 
operation and maintenance of the VA healthcare system's vast 
capital infrastructure. This appropriation provides for costs 
associated with utilities, engineering, capital planning, 
leases, laundry, groundskeeping, housekeeping, facility repair, 
and property disposition and acquisition.

                        COMMITTEE RECOMMENDATION

    In fiscal year 2017, the Committee provided an advance 
appropriation of $5,434,880,000 for fiscal year 2018 for the 
Medical Facilities account. The recommendation for fiscal year 
2018 includes an additional $707,000,000 which is $372,795,000 
below the budget request. The additional appropriation coupled 
with the advance appropriation provided for fiscal year 2018 
provides the Department with total budget authority of 
$6,141,880,000 which is $829,212,000 above the fiscal year 2017 
enacted amount.
    The Committee recommendation also includes an advance 
appropriation of $5,915,000,000 for Medical community care for 
fiscal year 2019. This is $712,000 above the request to reflect 
proper rounding of a budget estimate.
    Medical Facilities Leases Authorization.--The Committee 
continues to be concerned by the extensive delays in 
authorizing VA medical facilities leases, which would provide 
increased healthcare access for veterans across throughout the 
VA system and in many cases reduce inefficiencies and simplify 
veteran care by consolidating multiple existing facilities. The 
Committee is aware the Department recognizes the need for 
additional VA medical facilities and has proposed leases in its 
budget request, but budgetary challenges have prevented the 
authorization of such leases. The Committee urges the 
Department to continue working with the Office of Management 
and Budget and Congressional Budget and Veterans' Affairs 
Committees to identify a long-term solution to these budgetary 
challenges.

                    MEDICAL AND PROSTHETIC RESEARCH

Appropriations, 2017....................................    $673,366,000
Budget estimate, 2018...................................     640,000,000
Committee recommendation................................     722,262,000

                          PROGRAM DESCRIPTION

    The Medical and Prosthetic Research account provides funds 
for medical, rehabilitative, and health services research. 
Medical research supports basic and clinical studies that 
advance knowledge leading to improvements in the prevention, 
diagnosis, and treatment of diseases and disabilities. 
Rehabilitation research focuses on rehabilitation engineering 
problems in the fields of prosthetics, orthotics, adaptive 
equipment for vehicles, sensory aids and related areas. Health 
services research focuses on improving the effectiveness and 
economy of the delivery of health services.

                        COMMITTEE RECOMMENDATION

    The Committee recommends $722,262,000 for the Medical and 
Prosthetic Research account. This is $48,896,000 above the 
fiscal year 2017 enacted level and $82,262,000 above the budget 
request.
    The Committee remains highly supportive of this program, 
and recognizes its importance both in improving healthcare 
services to veterans and recruiting and retaining high quality 
medical professionals in the Veterans Health Administration.
    Through the Department's research and development program, 
VA has implemented a comprehensive research agenda to develop 
new treatments and tools for clinicians to ease the physical 
and psychological pain of men and women returning from war 
zones, to improve access to VA healthcare services, and to 
accelerate discoveries and applications, especially for 
neurotrauma, sensory loss, amputation, polytrauma, and related 
prosthetic needs. The Committee encourages VA to continue its 
research into developing novel approaches to restoring veterans 
with amputation, central nervous system injuries, loss of sight 
or hearing, or other physical and cognitive impairments to full 
and productive lives.
    Advanced Medical Device Study.--The Committee commends VA 
for its research and use of exoskeleton technology. The 
Committee is also aware of an important pilot program to 
research the home-based use and medical advantages of 
exoskeletons for spinal cord injuries [SCI]. The Committee 
notes the early success that mobility-focused exoskeleton 
technologies are having with this patient population and the 
resulting improvement in health and well-being. The Committee 
directs the Department to undertake a study on the 
appropriateness and efficacy of exoskeletons in rehabilitation 
of patients who have suffered a stroke or traumatic brain 
injury.
    Continuous Health Monitoring Technology.--The Committee has 
a longstanding interest in improving VA healthcare outcomes by 
decreasing hospital acquired complications, including reducing 
sepsis, falls, and pressure ulcers. Recent advancements in the 
ability of continuous vital signs monitoring for non-ICU 
patients have shown a tremendous potential for improved patient 
outcomes. The Committee is aware of research at the James A. 
Haley VAMC in Tampa, Florida, and the Boise VAMC in Boise, 
Idaho, that shows remarkable decreases in Medical Response Team 
[MRT] activations, Code Blue activations, ICU transfers and, 
most importantly, decreases in mortality rates following these 
activations. Furthermore, research has shown that continuous 
monitoring systems have allowed the VA to recover its 
investment in the technology within 6 months or less. All of 
the positive results show a significant decrease in length of 
patient stay which allows facilities adopting this technology 
to significantly increase the number of patients seen at the 
facility, thereby decreasing the waiting times and backlogs 
that have been of great concern to this Committee. To ensure 
VHA is benefitting from the outcomes achieved at these 
facilities and civilian facilities where continuous monitoring 
technology is deployed, the Committee urges the VA to 
expeditiously proceed with research surrounding continuous 
monitoring technologies and complete on-going projects related 
to contact-free technologies being conducted by the Health 
Services Research and Development Service [HSRD]. The 
Department is directed to submit a report to the Committees on 
Appropriations of both Houses of Congress no later than 90 days 
after enactment of this act detailing recommendations for 
increased deployment of proven continuous monitoring 
technologies within the VHA, including a proposed timeline.
    Burn Pits Research.--The Committee recommends VA continue 
conducting medical trials, using available treatments for 
pulmonary, cardiovascular, and other diseases and conditions 
related to the exposure to open air burn pits. The Department 
is directed to provide an update to the Committees on 
Appropriations of both Houses of Congress no later than 180 
days after enactment of this act on the status and progress of 
such medical trials. Furthermore, where appropriate, VA is 
encouraged to work with private and public institutions which 
have already begun to research the chronic impacts of exposure 
to burn pits in order to develop treatments for veterans 
exposed to burn pits.
    Public Access to Scientific Publications and Data.--The 
Committee commends the Department on issuing its Policy and 
Implementation Plan for Public Access to Scientific 
Publications and Digital Data from Research Funded by the 
Department of Veterans Affairs on July 23, 2015. The Department 
is directed to continue its efforts toward full implementation 
of the plan and directs an update on progress made be included 
in its fiscal year 2019 budget request.
    Geriatrics and Extended Care Services.--The Committee 
recognizes VA's growing need to prioritize research focusing on 
increasingly complex and chronic conditions of aging veterans, 
with more than half of veterans estimated to be over the age of 
65 in 2018. As VA continues to develop successful models for 
innovative and clinically integrated care for veterans with 
more than one chronic disease and declining mental and physical 
capabilities, the findings from these models should be widely 
shared to inform Federal, State and local efforts to address 
the healthcare needs of America's aging population and American 
families. The Committee urges VA to continue to support 
evidence-based clinical research that reduces costs and 
improves the quality of care for older veterans by preventing 
hospital readmissions and enhancing the ability of older 
veterans to remain in their homes and communities safely, 
independently, and comfortably, through expanded tele-medicine, 
technological advances, coordinated care, and well-designed 
long-term services and supports. The Committee also recognizes 
the important contributions the Geriatrics and Extended Care 
Services [GEC] and Geriatric Research Education and Clinical 
Centers [GRECCs] have made in developing successful innovations 
in coordinated home and community-based care that benefit older 
veterans and provide proven, successful models that can inform 
development of integrated delivery systems for non-veteran 
seniors. The Committee encourages VA to continue utilizing its 
funds to bolster its existing research programs focusing on 
aging to meet the current and future needs of the veteran 
population.
    Enewetak Atoll Registry Research.--The Committee is aware 
that thousands of veterans served on the Enewetak Atoll to 
clean up the island following its use for nuclear weapons 
testing. The Committee is also aware of many instances of 
veterans who conducted the cleanup suffering serious health 
problems, such as brittle bones, cancers, and birth defects in 
their children. The Committee urges the Department to study 
whether there is a connection between certain illnesses and the 
potential exposure of individuals to radiation related to 
service at Enewetak Atoll between January 1, 1977, and December 
31, 1980.
    Exposure to Agent Orange by Certain Navy Veterans.--Under 
the Agent Orange Act of 1991 (Public Law 102-4), most veterans 
of deployments to Vietnam between 1962 and 1975 became entitled 
to compensation for certain illnesses linked to exposure to 
Agent Orange defoliant, including the ``Blue Water'' Navy 
veterans who served in the Navy outside of the riverine and 
coastal areas. However, beginning in 2002, new Department 
interpretation of the law prevented Blue Water Navy veterans 
from collecting benefits unless they could prove to have been 
on a ship proven to have entered inland water or sailors who 
proved they had been ashore. In 2016, the Department reiterated 
its policy and added further restrictions by removing certain 
harbors that used to carry a presumption of exposure, while 
outside the VA a growing body of research supports the 
assumption of presumption of exposure. In a fact sheet 
published about the decision, VA noted only a 2011 Institute of 
Medicine study on Agent Orange exposure among Blue Water Navy 
veterans, which found that exposure at sea could not be proven, 
assuming ships followed certain best practices that veterans 
anecdotally report were regularly ignored. The Department is 
directed to submit a report to the Committees on Appropriations 
of both Houses of Congress no later than 90 days after 
enactment of this act evaluating each of the U.S. and non-U.S. 
studies on Agent Orange exposure since 1980 that are relevant 
to the question of Blue Water Navy sailors to justify the 2016 
decision.
    Cancer Moonshot Contribution.--The Committee supports the 
Beau Biden Cancer Moonshot initiative and the Department's 
contribution utilizing advances in genomic science to provide 
targeted treatment to veterans. The Department has identified 
prostate cancer, triple-negative breast cancer, and colorectal 
cancer as areas of priority. Due to the prevalence of various 
skin cancers among service members, the Committee directs that 
skin cancer be included as well.
    Overprescription Prevention Report.--The Committee is 
discouraged by multiple GAO reports retaining VHA on the 
``high-risk'' list and the unfathomable increase in polydrug 
use and narcotics prescriptions by VA related to pain 
management and mental health treatment. Specifically, 
combinations of opioid and Benzodiazepines have proven fatal 
when taken concurrently, with research demonstrating this 
phenomenon for nearly 40 years. The Committee provides $500,000 
to enter into an agreement with the National Academies of 
Sciences, Engineering, and Medicine to conduct an assessment to 
research, collect, and analyze the potential overmedication of 
veterans during fiscal years 2010-2017 that led to veterans 
deaths, veterans suicides, treatment of mental disorders, pain 
management practices, mental health staffing levels, and combat 
related trauma.
    Gulf War Illness Studies.--The Committee recommends the 
Department continue to conduct epidemiological studies 
regarding the prevalence of Gulf War illness, morbidity, and 
mortality in Persian Gulf War veterans and the development of 
effective treatments, preventions, and cures. The Committee is 
concerned by the lack of public availability of the findings of 
all research conducted by or for the Executive Branch relating 
to the health consequences of military service in the Persian 
Gulf theater of operations during the Persian Gulf War and by 
the lack of coordination by the Department in ensuring the 
public availability of this information. The Committee urges 
the Department to publish disease-specific mortality data 
related specifically to Persian Gulf War veterans. The 
Committee remains concerned by VA's ever-evolving terminology 
for the signature adverse health outcome of the Persian Gulf 
War as recognized by the Institute of Medicine [IOM]--Gulf War 
illness--and encourages the Department to utilize the term, 
``Gulf War illness,'' as IOM has recommended. The Committee 
continues to urge the Secretary to consider revising and 
updating the Clinical Practice Guideline for Chronic 
Multisymptom Illness [CMI] consistent with the July 2011 
Veterans Health Initiative, ``Caring for Gulf War Veterans,'' 
in that it, ``cannot be reliably ascribed to any known 
psychiatric disorder,'' and to focus on recent Gulf War illness 
treatment research findings and ongoing Gulf War illness 
treatment research direction. Furthermore, the Committee once 
again encourages VA to strengthen the training of primary, 
specialty, and mental healthcare providers on the Gulf War 
illness case definitions recommended by IOM.

                 MEDICAL CARE COST RECOVERY COLLECTIONS

                      MEDICAL CARE COLLECTION FUND

Appropriations, 2017....................................  $2,637,000,000
Budget estimate, 2018...................................   2,507,000,000
Committee recommendation................................   2,507,000,000

             MEDICAL CARE COLLECTION FUND--REVENUES APPLIED

Appropriations, 2017.................................... -$2,637,000,000
Budget estimate, 2018...................................  -2,507,000,000
Committee recommendation................................  -2,507,000,000

                          PROGRAM DESCRIPTION

    The Medical Care Collection Fund [MCCF] was established by 
the Balanced Budget Act of 1997 (Public Law 105-33). In fiscal 
year 2004, Public Law 108-199 allowed the Department of 
Veterans Affairs to deposit first-party and pharmacy co-
payments; third-party insurance payments and enhanced-use 
collections; long-term care co-payments; Compensated Work 
Therapy Program collections; and Parking Program fees into the 
MCCF. The Secretary of Veterans Affairs has the authority to 
transfer funds from the MCCF to the Medical Services account.

                        COMMITTEE RECOMMENDATION

    The Committee recommendation includes the authority to 
retain co-payments and third-party collections, estimated to 
total $2,507,000,000 in fiscal year 2018.

                    National Cemetery Administration

Appropriations, 2017....................................    $286,193,000
Budget estimate, 2018...................................     306,193,000
Committee recommendation................................     306,193,000

                        ADMINISTRATION OVERVIEW

    The National Cemetery Administration [NCA] was established 
in accordance with Public Law 93-94, the National Cemeteries 
Act of 1973. It has a four-fold mission: to provide for the 
interment in any national cemetery of the remains of eligible 
deceased servicemembers and discharged veterans, together with 
their spouses and certain dependents, and permanently maintain 
their graves; to provide headstones for, and to mark graves of, 
eligible persons in national, State, and private cemeteries; to 
administer the grant program for aid to States in establishing, 
expanding, or improving State veterans cemeteries; and to 
administer the Presidential Memorial Certificate Program.

                        COMMITTEE RECOMMENDATION

    The Committee recommends $306,193,000 for the National 
Cemetery Administration. This is an increase of $20,000,000 
above the fiscal year 2017 enacted level and equal to the 
budget request.
    The Committee has included bill language to make available 
through September 30, 2019, up to 10 percent of the National 
Cemetery Administration appropriation.

                      Departmental Administration

Appropriations, 2017....................................  $5,966,031,000
Budget estimate, 2018...................................   5,707,593,000
Committee recommendation................................   5,725,391,000

                        ADMINISTRATION OVERVIEW

    Departmental Administration provides for the administration 
of veterans benefits through the Veterans Benefits 
Administration [VBA], the executive direction of the 
Department, several top level supporting offices, the Board of 
Contract Appeals, and the Board of Veterans Appeals.

                        COMMITTEE RECOMMENDATION

    The Committee recommends $5,725,391,000 for Departmental 
Administration. The amount is composed of $329,891,000 for 
General administration; $166,000,000 for the Board of Veterans 
Appeals; $4,055,500,000 for Information technology systems; 
$164,000,000 for the Office of the Inspector General; 
$512,430,000 for Construction, major projects; $342,570,000 for 
Construction, minor projects; $110,000,000 for Grants for 
construction of State extended care facilities; and $45,000,000 
for Grants for the construction of State veterans cemeteries.
    Public Law 114-223 moved the General Operating Expenses, 
Veterans Benefits Administration account from Departmental 
Administration to the Veterans Benefits Administration, its 
appropriate section within the act, with the instruction that 
the Department should place GOE,VBA in this location with the 
fiscal year 2019 request. The Committee notes this did not 
happen, and therefore, once again, instructs the Department to 
adhere to this direction with the fiscal year 2019 request.

                         GENERAL ADMINISTRATION

                     (INCLUDING TRANSFER OF FUNDS)

Appropriations, 2017....................................    $345,391,000
Budget estimate, 2018...................................     346,891,000
Committee recommendation................................     329,891,000

                          PROGRAM DESCRIPTION

    The General Administration account provides funding for the 
Office of the Secretary, six assistant secretaries, and three 
independent staff offices.

                        COMMITTEE RECOMMENDATION

    The Committee recommends $329,891,000 for General 
Administration. This amount is $15,500,000 below the fiscal 
year 2017 enacted level and $17,000,000 below the budget 
request. The Committee has included bill language to make 
available through September 30, 2019, up to 10 percent of the 
General Administration appropriation.
    Filling Vacant Positions.--The Committee remains concerned 
about the length of time veterans are waiting for appointments, 
claims processing, and other essential veteran's services at 
VA. Exacerbating this problem has been VA's failure to hire 
employees for a reported 49,000 vacant positions in the 
Department. VA must do more to hire, recruit, and retain 
quality employees to provide care and services for our nation's 
veterans. The Department is directed to use the funds 
appropriated by this act to fill staff vacancies and submit a 
report to the Committees on Appropriations of both Houses of 
Congress no later than 180 days after enactment of this act, 
and each month thereafter, detailing both the progress of 
hiring and filling vacant positions and what positions remain 
vacant.
    Veterans Identification Card Act of 2015.--Public Law 114-
31 directed the Secretary of Veterans Affairs to issue an 
identification card to veterans. This bill was unanimously 
passed by Congress and signed into law on July 20, 2015. 
Unfortunately, these cards are still not available to veterans. 
The Committee directs the Department to move swiftly in making 
these cards available.

                       BOARD OF VETERANS APPEALS

Appropriations, 2017....................................    $155,596,000
Budget estimate, 2018...................................     155,596,000
Committee recommendation................................     166,000,000

                          PROGRAM DESCRIPTION

    As set forth in section 7101(a) of title 38 United States 
Code, the Board of Veterans Appeals is responsible for making 
final decisions on claims for veterans benefits presented to 
the Board for appellate review. The vast majority of the 
Board's workload derives from benefit claims initiated by the 
Veterans Benefits Administration's Regional Offices. The 
appellate process has multiple steps, most of which occur at 
the local Regional Office level. If a veteran is not satisfied 
with the Regional Office determination, he or she may appeal to 
the Board for a final agency decision. The Board adjudicates 
appeals covering all areas of veterans benefits, including: 
service connection, increased disability ratings, total 
disability ratings, pensions, insurance benefits, educational 
benefits, home loan guaranties, vocational rehabilitation, 
waivers of indebtedness, fee basis medical care, and dependency 
and indemnity compensation.

                        COMMITTEE RECOMMENDATION

    The Committee recommends $166,000,000 for the Board of 
Veterans Appeals, which is $10,404,000 above fiscal year 2017 
enacted level and the budget request. The Committee has 
included bill language to make available through September 30, 
2019, up to 10 percent of the Board of Veterans Appeals 
appropriation.
    Growing Backlog of Appeals.--The Committee remains 
concerned over the growing backlog of disability claims at all 
stages of the appeals process but is particularly concerned 
about the increase at the Board of Veterans Appeals. The fiscal 
year 2018 justification accompanying the Department's budget 
submission notes the number of cases received by the Board 
continues to grow rapidly, projected to increase by 23 percent 
from 115,847 pending appeals at the end of 2016 to 142,756 
pending appeals by the end of 2017. Each year since 1996, the 
volume of appeals received by VBA equated to 9 to 15 percent of 
the total claims completed in those years. The Committee 
understands as VBA sees increases in the number of claims, 
appeals at the Board increase proportionally. The Board notes 
that it expects the backlog to increase dramatically over the 
coming years without additional resources and legislative 
reform. To that end, the Committee recommends an additional 
$10,404,000 above the budget request for additional staffing 
needs. In addition, BVA in conjunction with VBA shall provide a 
report to the Committee on Appropriations of both Houses of 
Congress no later than January 1, 2018, outlining a 5-year 
staffing plan to ensure that the appellate backlog is addressed 
in a timely manner.

                     INFORMATION TECHNOLOGY SYSTEMS

Appropriations, 2017....................................  $4,270,259,000
Budget estimate, 2018...................................   4,055,500,000
Committee recommendation................................   4,055,500,000

                          PROGRAM DESCRIPTION

    The Information Technology [IT] Systems appropriation, 
along with reimbursements, funds the costs of all IT staff 
salaries and expenses, the operations and maintenance of all 
existing information technology systems, and the development of 
new projects and programs designed to improve the delivery of 
service to veterans. This appropriation also funds the costs 
associated with the Office of Information and Technology which 
oversees the functions highlighted above.

                        COMMITTEE RECOMMENDATION

    The Committee recommends $4,055,500,000 for the Information 
Technology Systems account. This amount is $214,759,000 below 
the fiscal year 2017 enacted level and equal to the budget 
request. The Committee recommendation includes $1,230,320,000 
for staff salaries and expenses, $2,466,650,000 for operation 
and maintenance of existing programs, and $358,530,000 for 
program development.
    The Committee has appropriated the Information Technology 
Systems account as three subaccounts. This funding structure 
enhances the Committee's ability to ensure funds are executed 
in a manner consistent with the Department's budget submission. 
The Committee has provided sufficient flexibility within the 
subaccounts by way of authorized carryover amounts and 
reprogramming authority to give the Office of Information 
Technology as much flexibility as possible to accomplish its 
mission and goals, while ensuring proper accountability and 
oversight. The Committee will continue to work with the 
Department to ensure the IT projects currently underway, as 
well as the projects planned for the future, have the resources 
needed for success.

               INFORMATION TECHNOLOGY DEVELOPMENT PROJECTS
                        [In thousands of dollars]
------------------------------------------------------------------------
                                      Fiscal year 2018      Committee
               Project                 budget request    recommendation
------------------------------------------------------------------------
Electronic Health Record [EHR]                  10,000            10,000
 Interoperability and VLER Health...
Electronic Health Record [EHR]......            39,000            39,000
Veterans Benefits Management System             59,904            59,904
 [VBMS].............................
Virtual Lifetime Electronic Record              20,968            20,968
 [VLER].............................
Veterans Customer Experience........            58,473            58,473
Other IT Systems Development........           170,185           170,185
                                     -----------------------------------
      Total Development.............           358,530           358,530
------------------------------------------------------------------------

    Electronic Health Record.--Achieving interoperability 
between the health records of the Department of Veterans 
Affairs and the Department of Defense remains one of the 
highest priorities of the Committee. The Committee believes 
from a servicemember's initial military entrance physical to 
their final interaction with VA, a seamless health record 
should follow the individual. With the Secretary's decision on 
June 5, 2017, to acquire by a sole-source contract the same 
electronic health record system as the DoD, the Committee is 
unable at the time of this printing to precisely and 
comprehensively opine on the future of the system. The 
Department has proactively offered to remain in regular contact 
about the acquisition of the new system and the needed addition 
functionalities VA will pursue to address the VA-specific 
mission. The Committee notes there is no direct request in the 
budget request this year to provide funding for an acquisition. 
Given the lack of information about the cost of a new EHR, but 
the Committee's awareness of the final cost estimate of the DoD 
acquisition, it can be assumed the VA total cost will exceed 
previous estimates for VistA Evolution. To that end, in its 
oversight capacity, the Committee will reevaluate, with the 
Committee on Appropriations of the House of Representatives, 
the constraints on the obligation or expenditure of funding for 
the new acquisition at the appropriate time.
    Additionally, the Committee remains concerned about the 
continued status of electronic health record interoperability 
between VA and DoD and whether lack of interoperability limits 
VA clinicians' ability to readily access information from DoD 
records, potentially impeding their ability to make the most 
informed decisions on treatment options, and possibly putting 
veterans' health at risk. Although VA and DoD have certified 
interoperability, there are more developed goals that can be 
realized. While several applications exist to facilitate health 
data access for clinicians, more must be done to ensure that 
the most relevant data is accessible in a user-friendly format 
to facilitate efficient clinical encounters. Both Departments 
must remain committed to working towards assuring continued VA 
and DoD interoperability as each Department adopts its new 
electronic health record system. The Committee directs VA and 
DoD to establish clear and agreed-upon metrics and goals for 
interoperability, to establish clear timeframes for meeting 
those goals, to ensure clinician feedback is sought and 
considered as the respective electronic medical record systems 
are modernized, and to update the VA/DoD Interagency Program 
Office guidance to reflect agreed-upon metrics and goals. The 
need for well-functioning, up-to-date electronic health record 
technology is absolutely critical as VA plans for a shift to a 
model of care that greatly expands its use of care in the 
community.
    Cybersecurity.--The Committee recommends the full budget 
request of $340,000,000 for the VA's Office of Information 
Security. Over the past year, the Department has been executing 
an enterprise-wide cybersecurity strategy which defines a 
comprehensive set of actions, processes, and emerging security 
technologies that will further enhance the cybersecurity of 
VA's information and assets and improve the resilience of VA 
networks. To better increase oversight and to ensure VA is 
aggressively pursuing a robust cybersecurity plan, the Chief 
Information Officer id directed submit a report to the 
Committees on Appropriations of both Houses of Congress no 
later January 1, 2018, on VA's current and future plans to 
increase security protocols across VA's networks. At a minimum, 
the CIO should include how much was obligated in in fiscal year 
2017 and estimates for fiscal year 2018 to: secure the over 
60,000 medical devices that connect to VA's network, implement 
Digital Rights Management technology, strengthen encryption 
services, and improve VA's cybersecurity workforce recruitment, 
hiring, and training. Given the sensitive nature of this topic, 
the CIO may provide this report as a briefing to the 
Committees.
    Network Capabilities.--As VA maximizes the use of 
telehealth and remote patient monitoring technology, 
particularly technology that which makes use of high-resolution 
interfaces, enhanced and modern network capability will be 
needed. In order to ensure proper budgetary resources are being 
utilized to modernize VA's healthcare networks, the Department 
is directed to include in the justifications accompanying the 
fiscal year 2019 budget request a section specific to network 
modernization, including fiscal year 2018 accomplishments.

                      OFFICE OF INSPECTOR GENERAL

Appropriations, 2017....................................    $159,606,000
Budget estimate, 2018...................................     159,606,000
Committee recommendation................................     164,000,000

                          PROGRAM DESCRIPTION

    The Office of Inspector General [OIG] was established by 
the Inspector General Act of 1978 and is responsible for the 
audit, investigation, and inspection of all Department of 
Veterans Affairs programs and operations.

                        COMMITTEE RECOMMENDATION

    The Committee recommends $164,000,000 for the Office of 
Inspector General. This is $4,394,000 above the fiscal year 
2017 enacted level and the budget request. The Committee has 
included bill language to make available through September 30, 
2019, up to 10 percent of the Office of the Inspector General 
appropriation.

                      CONSTRUCTION, MAJOR PROJECTS

Appropriations, 2017....................................    $528,110,000
Budget estimate, 2018...................................     512,430,000
Committee recommendation................................     512,430,000

                          PROGRAM DESCRIPTION

    The Construction, Major Projects account provides for 
constructing, altering, extending, and improving any of the 
facilities (including parking projects) under the jurisdiction 
or for the use of VA, including planning, architectural and 
engineering services, needs assessment, and site acquisition 
where the estimated cost of a project is more than the amount 
set forth in 38 U.S.C. 8104(a)(3)(A). Proceeds realized from 
Enhanced Use Lease activities may be deposited into the 
Construction, Major Projects and Construction, Minor Projects 
accounts.

                        COMMITTEE RECOMMENDATION

    The Committee recommends an appropriation of $512,430,000 
for the construction of major projects. This is $15,680,000 
below the fiscal year 2017 enacted level and equal the budget 
request.
    The following table reflects the President's budget request 
for major construction projects and the corresponding Committee 
recommendations.

                       MAJOR CONSTRUCTION PROJECTS
                        [In thousands of dollars]
------------------------------------------------------------------------
                                      Fiscal year 2018      Committee
      Location and description         budget request    recommendation
------------------------------------------------------------------------
Veterans Health Administration
 [VHA]:
    Livermore, CA: Realignment and             117,300           117,300
     Closure of the Livermore Campus
    Advance Planning and Design                 57,500            57,500
     Fund: Various Locations........
    Asbestos: Various Locations.....             7,500             7,500
    Major Construction Staff:                   27,500            27,500
     Various Locations..............
    Hazardous Waste: Various                    15,000            15,000
     Locations......................
    Judgement Fund: Various                     10,000            10,000
     Locations......................
    Non-Departmental Federal Entity             16,730            16,730
     Project Management Support.....
                                     -----------------------------------
      Total, VHA....................           251,530           251,530
National Cemetery Administration
 [NCA]:
    Sacremento, California: Grave               35,000            35,000
     Site Expansion.................
    Bushnell, Florida: Grave Site               51,500            51,500
     Expansion and Cemetery
     Improvement Sites..............
    Elwood, Illinois: Gravesite                 35,000            35,000
     Expansion, Phase 3.............
    Calverton, New York: Gravesite              50,000            50,000
     Expansion......................
    Phoenix, Arizona: Gravesite                 31,900            31,900
     Expansion......................
    Bridgeville, Pennslyvania:                  39,000            39,000
     Gravesite Expansion, Phase 3...
    Advance Planning and Design Fund             8,500             8,500
    NCA Land Acquisition Fund.......             5,000             5,000
                                     -----------------------------------
      Total, NCA....................           255,900           255,900
General Administration--Staff                    5,000             5,000
 Offices, Advance Planning Fund.....
                                     -----------------------------------
      Total Construction, Major                512,430           512,430
       Projects.....................
------------------------------------------------------------------------

    The Future of VA Construction.--The Committee remains 
concerned about the state of VA's major construction program. 
In the wake of the massive cost overruns at the Denver VA 
Medical Center, Congress required VA to utilize the U.S. Army 
Corps of Engineers (the Corps) as its construction agent for 
all major construction projects over $100,000,000. Bringing the 
Corps into the VA construction process has exposed major 
differences between the standardized policies, practices and 
procedures the Corps follows in the military construction world 
and the procedures for major construction and capital 
investment VA uses in practice. This has forced VA to take a 
hard look at many of its construction business practices, and 
in many cases, implement changes to adhere to Corps polices 
into order for the Corps to agree to move forward managing VA 
projects. For example, VA traditionally views a project as a 
whole campus, meaning a project will consist of multiple 
buildings with construction timelines spanning an often 
indefinite number of years. In the military construction world, 
this would be known as a master plan, which would consist of 
multiple individual projects, each of which represents a 
complete and usable building. Each military construction 
project is planned in advance, has a set scope and estimated 
cost, and specific project details reflected on a form DD 1391. 
The Committee believes the level of analysis and rigor put into 
the form DD 1391 and the Department of Defense processes for 
construction should serve as a model for VA to follow, 
particularly in light of the partnership with the Corps.
    Another Department of Defense process VA should begin to 
follow is the future years defense plan [FYDP], a document that 
lays out the military construction projects in the current 
year's budget request and the projects anticipated to be in the 
next 5 year's requests. Although always subject to change, the 
[FYDP] shows the Committee that DoD has a well-reasoned plan 
for the next few years to address its infrastructure needs. 
Contrast this with the VA's SCIP list and the differences are 
glaring. The SCIP list is monstrous, laying out all VA's 
infrastructure needs with seemingly no prioritization or 
indication of which projects VA intends to pursue first, and no 
timeline for when projects will be completed. Judging from the 
past several year's budget requests, correcting seismic 
deficiencies seems to be one of the VA's top priorities. 
However, other serious life, health, and safety projects seem 
to languish on the SCIP list. For example, the outpatient 
clinic at Hilo, Hawaii lies within a tsunami flood zone. While 
VA plans to close this facility and move to temporary space 
that veterans cite as difficult to get to and will likely 
result in a decrease in access, plans for the new permanent 
clinic remain stalled on the SCIP list, despite the fact that 
the current facility has to be closed because of the tsunami 
threat. The SCIP list also proves to be a very ineffective tool 
for the Committee to use to understand the future of VA 
construction. For example, projects move up or down the list 
from year to year without any obvious explanation to the 
Congressional staff who follow their home State project 
closely. The Committee and its staff are the primary consumers 
of the data included in VA's annual budget justifications to 
Congress, yet the SCIP list as included in the justifications 
is not a useful document. The Committee directs the Department 
to work diligently to move towards a DoD-like 5-year 
construction plan and concurrently craft a better way to 
provide construction information annually to Congress.

                      CONSTRUCTION, MINOR PROJECTS

Appropriations, 2017....................................    $372,069,000
Budget estimate, 2018...................................     342,570,000
Committee recommendation................................     342,570,000

                          PROGRAM DESCRIPTION

    The Construction, Minor Projects account provides for 
constructing, altering, extending, and improving any of the 
facilities (including parking) under the jurisdiction or for 
the use of VA, including planning, assessment of needs, 
architectural and engineering services, and site acquisition, 
where the estimated cost of a project is equal to or less than 
$10,000,000. Public Law 106-117, the Veterans Millennium Health 
Care and Benefits Act of 1999, gave VA authority to make 
capital contributions from minor construction in enhanced-use 
leases. Proceeds realized from enhanced-use lease activities 
may be deposited into the Construction, Major Projects and 
Construction, Minor Projects accounts.

                        COMMITTEE RECOMMENDATION

    The Committee recommends $342,570,000 for minor 
construction. This is $29,499,000 below the fiscal year 2017 
enacted level and equal to the budget request.
    The recommendation includes $193,610,000 for the Veterans 
Health Administration, $97,950,000 for the National Cemetery 
Administration, and $29,895,000 for the Veterans Benefits 
Administration. The Department is directed to provide an 
expenditure plan to the Committees on Appropriations of both 
Houses of Congress no later than 30 days after enactment of 
this act for the amount appropriated for minor construction.

       GRANTS FOR CONSTRUCTION OF STATE EXTENDED CARE FACILITIES

Appropriations, 2017....................................     $90,000,000
Budget estimate, 2018...................................      90,000,000
Committee recommendation................................     110,000,000

                          PROGRAM DESCRIPTION

    This account is used to provide grants to assist States in 
acquiring or constructing State home facilities for furnishing 
domiciliary or nursing home care to veterans, and to expand, 
remodel, or alter existing buildings for furnishing 
domiciliary, nursing home, or hospital care to veterans in 
State homes. The grant may not exceed 65 percent of the total 
cost of the project. Public Law 102-585 granted permanent 
authority for this program, and Public Law 106-117 provided 
greater specificity in directing VA to prescribe regulations 
for the number of beds for which grant assistance may be 
furnished. This program has been a successful partnership 
between States and VA in meeting the long-term care needs of 
elderly veterans for decades.

                        COMMITTEE RECOMMENDATION

    The Committee recommends $110,000,000 for Grants for 
construction of State extended care facilities. This is 
$20,000,000 above the budget request.
    Funding Prioritization.--The Committee continues to be 
concerned about the prioritization of funding for new State 
veterans homes. The criteria used by the Department when making 
funding decisions for new facilities should consider the unique 
needs of geographically small States that depend on just one 
facility, straining capacity and leaving those States without 
alternative facilities to care for veterans while their 
projects are pending. Similarly, the Department should also 
prioritize large rural States where veterans may live hundreds 
of miles from the next nearest facility.

             GRANTS FOR CONSTRUCTION OF VETERANS CEMETERIES

Appropriations, 2017....................................     $45,000,000
Budget estimate, 2018...................................      45,000,000
Committee recommendation................................      45,000,000

                          PROGRAM DESCRIPTION

    Public Law 105-368 amended title 38 U.S.C. 2408 and 
established authority to provide aid to States for 
establishment, expansion, and improvement of State veterans 
cemeteries, which are operated and permanently maintained by 
the States. This statutory change increased the maximum Federal 
share from 50 percent to 100 percent in order to fund 
construction costs and initial equipment expenses when the 
cemetery is established. States remain responsible for 
providing the land and for paying all costs related to 
operation and maintenance of the cemeteries, including the 
costs for subsequent equipment purchases.

                        COMMITTEE RECOMMENDATION

    The Committee recommends $45,000,000 for Grants for 
construction of State veterans cemeteries. This is equal to the 
budget request.

                       Administrative Provisions

             (INCLUDING TRANSFERS AND RESCISSIONS OF FUNDS)

    Sec. 201. The Committee includes a provision which outlines 
transfer authority and responsibilities for the Veterans 
Benefits Administration.
    Sec. 202. The Committee includes a provision which outlines 
transfer authority and responsibilities for the Veterans Health 
Administration.
    Sec. 203. The Committee includes a provision which outlines 
the use of funds appropriated for salaries and expenses.
    Sec. 204. The Committee includes a provision mandating that 
only construction funds may be used for land procurement or the 
construction of any new hospital or home.
    Sec. 205. The Committee includes a provision allowing for 
reimbursements to the Medical Services account.
    Sec. 206. The Committee includes a provision allowing for 
payments of prior year obligations.
    Sec. 207. The Committee includes a provision which allows 
for the use of funds for prior year obligations.
    Sec. 208. The Committee includes a provision which allows 
for payments from the National Service Life Insurance Fund.
    Sec. 209. The Committee includes a provision which outlines 
the use of funds from enhanced-use lease proceeds.
    Sec. 210. The Committee includes a provision which provides 
for funds for the Office of Resolution Management, the Office 
of Employment Discrimination Complaint Adjudication, the Office 
of Accountability and Whistleblower Protection, and the Office 
of Diversity and Inclusion.
    Sec. 211. The Committee includes a provision which requires 
disclosure of third-party reimbursement information.
    Sec. 212. The Committee includes a provision which allows 
for the transfer of revenue derived from enhanced-use leases 
into the construction accounts.
    Sec. 213. The Committee includes a provision which outlines 
authorized uses for Medical Services account funds.
    Sec. 214. The Committee includes a provision which allows 
funds in the Medical Care Collection Fund to be transferred 
into the Medical Services and Medical Community Care accounts.
    Sec. 215. The Committee includes a provision which allows 
eligible veterans in the State of Alaska to obtain medical care 
services.
    Sec. 216. The Committee includes a provision which allows 
for the transfer of funds into the construction accounts.
    Sec. 217. The Committee includes a provision rescinding 
funds from Medical services.
    Sec. 218. The Committee includes a provision requiring the 
Secretary of Veterans Affairs to submit quarterly financial 
reports on the Veterans Health Administration.
    Sec. 219. The Committee includes a provision outlining 
transfer authority for the Information Technology Systems 
account.
    Sec. 220. The Committee includes a provision prohibiting 
any funds to be used to contract out any functions performed by 
more than 10 employees without a fair competition process.
    Sec. 221. The Committee includes a provision allowing for 
the transfer of funds from certain accounts to the Joint 
Department of Defense/Department of Veterans Affairs Medical 
Facility Demonstration Fund, as authorized by Public Law 111-
84.
    Sec. 222. The Committee includes a provision allowing for 
the transfer of funds from certain advance appropriation 
accounts to the Joint Department of Defense/Department of 
Veterans Affairs Medical Facility Demonstration Fund, as 
authorized by Public Law 111-84.
    Sec. 223. The Committee includes a provision allowing for 
the transfer of certain funds deposited in the Medical Care 
Collections Fund to the Joint Department of Defense/Department 
of Veterans Affairs Medical Facility Demonstration Fund, as 
authorized by Public Law 111-84.
    Sec. 224. The Committee includes a provision directing a 
minimum of $15,000,000 be transferred from Medical Services, 
Medical Support and Compliance, and Medical Facilities to the 
Department of Defense/Department of Veterans Affairs Health 
Care Sharing Incentive Fund, as authorized by section 8111 of 
title 38, United States Code.
    Sec. 225. The Committee includes a provision directing the 
Department to make every effort to fund State Veterans Nursing 
Home Construction grants on the fiscal year 2017 list.
    Sec. 226. The Committee includes a provision requiring 
notification of all bid savings for major construction 
projects.
    Sec. 227. The Committee includes a provision restricting 
scope increases for major construction projects above that 
specified in the original project justification.
    Sec. 228. The Committee includes a provision requiring the 
Department to submit reports relating to the Veterans Benefits 
Administration on claims processing at Regional Offices.
    Sec. 229. The Committee includes a provision limiting the 
funding from the Medical Support and Compliance account for the 
VistA Evolution and electronic health record interoperability 
projects.
    Sec. 230. The Committee includes a provision requiring VA 
to notify the Committee 15 days prior to any organizational 
changes within VA of 25 or more FTE.
    Sec. 231. The Committee includes a provision directing 
funding for non-recurring maintenance.
    Sec. 232. The Committee includes a provision permitting the 
transfer to the Medical Services account of fiscal year 
discretionary 2018 appropriated funds.
    Sec. 233. The Committee includes a provision permitting the 
transfer of funds between GOE,VBA and BVA.
    Sec. 234. The Committee includes a provision prohibiting 
the reprogramming of funds in excess of $7,000,000 among major 
construction projects or programs.
    Sec. 235. The Committee includes a provision rescinding 
unobligated balances from the DoD-VA Health Care Sharing 
Incentive Fund.
    Sec. 236. The Committee includes a provision pertaining to 
Native Hawaiian small businesses.
    Sec. 237. The Committee includes a provision limiting 
bonuses for senior executives.
    Sec. 238. The Committee includes a provision directing the 
discontinuation of the usage of social security numbers with 
the Department of Veterans Affairs.
    Sec. 239. The Committee includes a provision pertaining to 
the certification of marriage and family therapists.
    Sec. 240. The Committee includes a provision restricting 
funds for the purpose of using groups of subject matter experts 
to evaluation compensation claims.
    Sec. 241. The Committee includes a provision prohibiting 
the transfer of funds from the Filipino Veterans Equity 
Compensation Fund to any other VA account.
    Sec. 242. The Committee includes a provision denying or 
revoking the eligibility of a healthcare provider to provide 
non-VA care for various reasons.
    Sec. 243. The Committee includes a provision relating to 
the availability of Construction, Major Projects funds.
    Sec. 244. The Committee includes a provision relating to 
the availability of Construction, Major Projects funds.
    Sec. 245. The Committee includes a provision regarding a 
childcare program.
    Sec. 246. The Committee includes a provision relating to 
the availability of chiropractic care.
    Sec. 247. The Committee includes a provision on a pilot 
program for the education and training of physician assistants.
    Sec. 248. The Committee includes a provision on coastwise 
merchant seamen.
    Sec. 249. The Committee includes a provision on fertility 
treatment and counseling for service-connected disabled 
veterans.
    Sec. 250. The Committee includes a provision rescinding 
funds from the Information Technology Systems account.
    Sec. 251. The Committee includes a provision related to a 
demand profile for healthcare services.
    Sec. 252. The Committee includes a provision regarding 
uniform access standards for healthcare services.
    Sec. 253. The Committee includes a provision regarding 
vacant, mostly vacant, or underutilized buildings and 
structures.
    Sec. 254. The Committee includes a provision ensuring 
particular ratios of veterans to full-time employment 
equivalents within any VA program of rehabilitation.
    Sec. 255. The Committee includes a provision indicating 
that no funds may be used to deny the Inspector General timely 
access to VA records and documents.
    Sec. 256. The Committee includes a provision prohibiting 
funds to be used to restrict an individual's ability to speak 
with a Member of Congress or his or her staff.
    Sec. 257. The Committee includes a provision providing 
authority for VHA to administer the National Veterans Sports 
Program.
    Sec. 258. The Committee includes a provision requiring 
certain data to be included in the budget justifications for 
the Construction, Major account.
    Sec. 259. The Committee includes a provision related to the 
Rural Veterans Coordination Pilot.
    Sec. 260. The Committee includes a provision on a national 
realignment strategy for VA facilities.
    Sec. 261. The Committee includes a provision concerning 
eligibility for burial at National Cemetery Administration 
cemeteries.
    Sec. 262. The Committee includes a provision related to 
veteran health and wellness programs.
    Sec. 263. The Committee includes a provision regarding new 
construction in the State Extended Care Facilities grant 
program.
    Sec. 264. The Committee includes a provision related to 
eligibility for certain medical services for veterans with 
other than honorable discharges.
    Sec. 265. The Committee includes a provision prohibiting 
the use of funds to interfere with the ability of veterans to 
participate in State-approved medicinal marijuana programs or 
deny services to such veterans.

                               TITLE III

                            RELATED AGENCIES

                  American Battle Monuments Commission

                                OVERVIEW

    The American Battle Monuments Commission was established by 
Congress in 1923 and is responsible for the following: 
designing, constructing, operating, and maintaining permanent 
American cemeteries in foreign countries; establishing and 
maintaining U.S. military memorials, monuments, and markers 
where American Armed Forces have served overseas since April 6, 
1917, the date of the United States entry into World War I, and 
within the United States when directed by public law; and 
controlling the design and construction of permanent U.S. 
military monuments and markers by other U.S. citizens and 
organizations, both public and private, and encouraging their 
maintenance. ABMC administers, operates, and maintains 26 
permanent American military cemeteries, 29 Federal memorial, 
monuments, and markers, and 8 non-Federal memorials located in 
15 foreign countries, the U.S. Commonwealth of the Northern 
Mariana Islands, the British Dependency of Gibraltar, and the 
United States of America.

                         SALARIES AND EXPENSES

Appropriations, 2017....................................     $75,100,000
Budget estimate, 2018...................................      75,100,000
Committee recommendation................................      79,000,000

                        COMMITTEE RECOMMENDATION

    The Committee recommends $79,000,000 for the Salaries and 
Expenses account. This amount is $3,900,000 above the fiscal 
year 2017 enacted level and the budget request. The 
recommendation includes an additional $3,900,000 to bolster the 
Commission's maintenance and infrastructure program, including 
the interpretive program. The additional funds will restore the 
reduction proposed in the budget request for this program and 
provide additional funds to accelerate the Commission's 5-year 
plan, not only to maintain the cemeteries and monuments 
honoring America's war dead, but also to preserve and 
communicate these veterans' stories of courage and sacrifice.

                     FOREIGN CURRENCY FLUCTUATIONS

    The Committee includes in the accompanying act, as proposed 
by the administration, such sums as necessary for the Foreign 
Currency Fluctuations account. Funding the account in this 
manner allows the Commission to maintain cemeteries regardless 
of the volatility of foreign currency fluctuations.

           United States Court of Appeals for Veterans Claims

                                OVERVIEW

    The United States Court of Appeals for Veterans Claims was 
established by the Veterans' Judicial Review Act of 1988. The 
Court is an independent judicial tribunal with exclusive 
jurisdiction to review decisions of the Board of Veterans 
Appeals. It has the authority to decide all relevant questions 
of law; interpret constitutional, statutory, and regulatory 
provisions; and determine the meaning or applicability of the 
terms of an action by the Secretary of Veterans Affairs. It is 
authorized to compel action by the Secretary. It is authorized 
to hold unconstitutional or otherwise unlawful and set aside 
decisions, findings, conclusions, rules, and regulations issued 
or adopted by the Secretary of Veterans Affairs, the Board of 
Veterans Appeals, or the Chairman of the Board that are found 
to be arbitrary or capricious. The Court's principal office 
location is Washington, DC; however, it is a national court, 
empowered to sit anywhere in the United States.

                         SALARIES AND EXPENSES

Appropriations, 2017....................................     $30,945,000
Budget estimate, 2018...................................      33,608,000
Committee recommendation................................      33,608,000

                        COMMITTEE RECOMMENDATION

    The Committee recommends $33,608,000 for the U.S. Court of 
Appeals for Veterans Claims. This amount is $2,663,000 above 
the fiscal year 2017 enacted level and equal to the budget 
request. The Committee recommends $800,000 to be transferred to 
the General Services Administration for the planning and design 
of a new courthouse as included in the budget request.

                      Department of Defense--Civil

                       Cemeterial Expenses, Army

                                OVERVIEW

    The Secretary of the Army is responsible for the 
administration, operation, and maintenance of Arlington 
National Cemetery and the Soldiers' and Airmen's Home National 
Cemetery. In addition to its principal function as a national 
cemetery, Arlington hosts more than 3,000 public wreath laying 
ceremonies, approximately 100 distinguished visitor honors 
wreath laying ceremonies, and approximately 4,000,000 visitors 
annually.

                         SALARIES AND EXPENSES

Appropriations, 2017....................................     $70,800,000
Budget estimate, 2018...................................      70,800,000
Committee recommendation................................      81,000,000

                        COMMITTEE RECOMMENDATION

    The Committee recommends $81,000,000 for the Salaries and 
Expenses account. This amount is $10,200,000 above both the 
fiscal year 2017 enacted level and the budget request.
    The Committee convened a field hearing at Arlington 
National Cemetery on March 29, 2017, which was a fitting and 
special place to hold the Committee's first hearing of this 
Congress. The field hearing was very informative and productive 
and carefully examined the Cemetery's current operations and 
workload, existing expansion plans, and the serious capacity 
constraints on the Cemetery in the 2040-2050 timeframe.
    The hearing identified a significant shortfall in the 
Cemetery's operating account which directly funds the 
Cemetery's day-to-day operations, salaries, maintenance, and 
expenses. The Committee determined ANC's operating account had 
been held artificially flat for a number of years, and this 
action is beginning to have deleterious effects on the 
Cemetery's performance and ability to meet its mission.
    Arlington performs over 7,000 burial services each year for 
veterans and family members and an average of 27-30 each 
weekday. With this heavy workload, ANC cannot be under-
resourced, and accordingly, the Committee has provided an 
additional $10,200,000 to correct this problem.
    This Committee will be unwavering in its support for the 
Cemetery and the successful completion of the Cemetery's truly 
unique and honored mission. Accordingly, the Secretary of the 
Army is directed to include this increase in the Cemetery's 
baseline budget and ensure future budget requests provide ample 
resources for Arlington National Cemetery.

                      Armed Forces Retirement Home

                               TRUST FUND

                                OVERVIEW

Appropriations, 2017....................................     $64,300,000
Budget estimate, 2018...................................      64,300,000
Committee recommendation................................      64,300,000

                        COMMITTEE RECOMMENDATION

    The Committee recommends authority to expend $64,300,000 
from the Armed Forces Retirement Home [AFRH] Trust Fund to 
operate and maintain the Armed Forces Retirement Home--
Washington, DC, and the Armed Forces Retirement Home--Gulfport, 
Mississippi.
    Trust Fund Solvency.--The Explanatory Statement 
accompanying H.R. 5325, the Continuing Appropriations and 
Military Construction, Veterans Affairs, and Related Agencies 
Appropriations Act, 2017, and Zika Response and Preparedness 
Act (Public Law 114-223) directed AFRH and the Department of 
Defense to submit by October 1, 2016, a proposal to ensure the 
long-term sustainability of the Trust Fund by replenishing the 
Trust Fund's revenues, not by cutting core AFRH operations. The 
Committee also requested further information regarding an in-
depth study that DoD has undertaken to develop plans to improve 
Trust Fund solvency. The Committee is disappointed to note 
neither this report nor the requested information has been made 
available as directed. AFRH and DoD are directed to deliver 
these materials as soon as possible to the Committees on 
Appropriations of both Houses of Congress.

                       Administrative Provisions

    Sec. 301. The Committee includes a provision allowing the 
relocation of a federally owned water main.
    Sec. 302. The Committee includes a provision making 
available funds as authorized by 10 U.S.C. 4727.

                                TITLE IV

                    OVERSEAS CONTINGENCY OPERATIONS

                         DEPARTMENT OF DEFENSE

    The Committee recommends title IV, Overseas Contingency 
Operations, for military construction projects related to the 
Global War on Terrorism and the European Reassurance Initiative 
that were requested by the Administration in the Fiscal Year 
2018 Overseas Contingency Operations [OCO] budget request.

                      Military Construction, Army

    The Committee recommends $139,700,000 for ``Military 
Construction, Army'', as requested in the Fiscal Year 2018 
Overseas Contingency Operations budget request, for military 
construction and planning and design in support of Overseas 
Contingency Operations and the European Reassurance Initiative.

              Military Construction, Navy and Marine Corps

    The Committee recommends $18,500,000 for ``Military 
Construction, Navy and Marine Corps'', as requested in the 
Fiscal Year 2018 Overseas Contingency Operations budget 
request, for planning and design in support of the European 
Reassurance Initiative.

                    Military Construction, Air Force

    The Committee recommends $478,030,000 for ``Military 
Construction, Air Force'', as requested in the Fiscal Year 2018 
Overseas Contingency Operations budget request, for military 
construction and planning and design in support of Overseas 
Contingency Operations and the European Reassurance Initiative.

                  Military Construction, Defense-Wide

    The Committee recommends $1,900,000 for ``Military 
Construction, Defense-Wide'', as requested in the Fiscal Year 
2018 Overseas Contingency Operations budget request, for 
planning and design in support of the European Reassurance 
Initiative.

                        Administrative Provision

    Sec. 401. The Committee includes a provision which provides 
the contingent emergency designation for the Overseas 
Contingency Operations accounts.

                                TITLE V


                           GENERAL PROVISIONS

    Sec. 501. The Committee includes a provision that prohibits 
the obligation of funds beyond the current fiscal year unless 
expressly so provided.
    Sec. 502. The Committee includes a provision that prohibits 
the use of funds for programs, projects, or activities not in 
compliance with Federal law relating to risk assessment, the 
protection of private property rights, or unfunded mandates.
    Sec. 503. The Committee includes a provision that 
encourages the expansion of E-commerce technologies and 
procedures.
    Sec. 504. The Committee includes a provision that specifies 
the congressional committees that are to receive all reports 
and notifications.
    Sec. 505. The Committee includes a provision that limits 
funds from being transferred from this appropriations measure 
to any instrumentality of the United States Government without 
authority from an appropriations act.
    Sec. 506. The Committee includes a provision regarding the 
posting of congressional reports on agency Web sites.
    Sec. 507. The Committee includes a provision prohibiting 
the use of funds to establish or maintain a computer network 
unless such network blocks the viewing, downloading, and 
exchanging of pornography, except for law enforcement 
investigation, prosecution, or adjudication activities.
    Sec. 508. The Committee includes a provision prohibiting 
the use of funds for the payment of first-class travel by an 
employee of the executive branch.
    Sec. 509. The Committee includes a provision limiting the 
construction of facilities in the United States, its 
territories, or possessions for the purposes of housing 
individuals detained at Guantanamo Bay, Cuba.

                     PROGRAM, PROJECT, AND ACTIVITY

    In fiscal year 2017, for purposes of the Balanced Budget 
and Emergency Deficit Control Act of 1985 (Public Law 99-177) 
or the Balanced Budget and Emergency Deficit Control 
Reaffirmation Act of 1987 (Public Law 100-119), the following 
information provides the definition of the term ``program, 
project, and activity'' for departments, agencies and programs 
under the jurisdiction of the Military Construction and 
Veterans Affairs, and Related Agencies subcommittee. The term 
``program, project, and activity'' shall include the most 
specific level of budget items identified in the Military 
Construction, Veterans Affairs, and Related Agencies 
Appropriations Act, 2017, the House and Senate Committee 
reports, and the conference report and accompanying joint 
explanatory statement of managers of the committee of 
conference.
    If a sequestration order is necessary, in implementing the 
Presidential order, departments, and agencies shall apply any 
percentage reduction required for fiscal year 2017 pursuant to 
the provisions of Public Law 99-177 or Public Law 100-119 to 
all items specified in the justifications submitted to the 
Committees on Appropriations of the Senate and House of 
Representatives in support of the fiscal year 2017 budget 
estimates, as amended, for such departments and agencies, as 
modified by congressional action, and in addition, for the 
Department of Defense, Military Construction, the definition 
shall include specific construction locations as identified in 
the explanatory notes.

  COMPLIANCE WITH PARAGRAPH 7, RULE XVI, OF THE STANDING RULES OF THE 
                                 SENATE

    Paragraph 7 of rule XVI requires that Committee reports 
accompanying general appropriations bills identify each 
recommended amendment which proposes an item of appropriation 
which is not made to carry out the provisions of an existing 
law, a treaty stipulation, or an act or resolution previously 
passed by the Senate during that session.
    The Committee recommends funding for the following programs 
which currently lack authorization:
Title I: Department of Defense
    Military Construction, Army
    Military Construction, Navy and Marine Corps
    Military Construction, Air Force
    Military Construction, Defense-Wide
    Military Construction, Army National Guard
    Military Construction, Air National Guard
    Military Construction, Army Reserve
    Military Construction, Navy Reserve
    Military Construction, Air Force Reserve
    North Atlantic Treaty Organization Security Investment 
Program
    Department of Defense Base Closure Account
    Family Housing Operation and Maintenance, Army
    Family Housing Operation and Maintenance, Navy and Marine 
Corps
    Family Housing Operation and Maintenance, Air Force
    Family Housing Operation and Maintenance, Defense-Wide
    Family Housing Construction, Army
    Family Housing Construction, Navy and Marine Corps
    Family Housing Construction, Air Force
    Department of Defense Family Housing Improvement Fund
    Department of Defense Military Unaccompanied Housing 
Improvement Fund
Title II: Department of Veterans Affairs
    Veterans Benefits Administration
    Veterans Health Administration
    National Cemetery Administration
    Departmental Administration
Title III: Related Agencies
    American Battle Monuments Commission
    U.S. Court of Appeals for Veterans Claims
    Cemeterial Expenses, Army
    Armed Forces Retirement Home

COMPLIANCE WITH PARAGRAPH 7(c), RULE XXVI OF THE STANDING RULES OF THE 
                                 SENATE

    Pursuant to paragraph 7(c) of rule XXVI, on July 13, 2017, 
the Committee ordered favorably reported a bill (S. 1557) 
making appropriations for military construction, the Department 
of Veterans Affairs, and related agencies for the fiscal year 
ending September 30, 2018, and for other purposes, provided, 
that the bill be subject to amendment and that the bill be 
consistent with the funding level approved by the subcommittee, 
by a recorded vote of 31-0, a quorum being present. The vote 
was as follows:
        Yeas                          Nays
Chairman Cochran
Mr. McConnell
Mr. Shelby
Mr. Alexander
Ms. Collins
Ms. Murkowski
Mr. Graham
Mr. Blunt
Mr. Moran
Mr. Hoeven
Mr. Boozman
Mrs. Capito
Mr. Lankford
Mr. Daines
Mr. Kennedy
Mr. Rubio
Mr. Leahy
Mrs. Murray
Mrs. Feinstein
Mr. Durbin
Mr. Reed
Mr. Tester
Mr. Udall
Mrs. Shaheen
Mr. Merkley
Mr. Coons
Mr. Schatz
Ms. Baldwin
Mr. Murphy
Mr. Manchin
Mr. Van Hollen

 COMPLIANCE WITH PARAGRAPH 12, RULE XXVI OF THE STANDING RULES OF THE 
                                 SENATE

    Paragraph 12 of rule XXVI requires that Committee reports 
on a bill or joint resolution repealing or amending any statute 
or part of any statute include ``(a) the text of the statute or 
part thereof which is proposed to be repealed; and (b) a 
comparative print of that part of the bill or joint resolution 
making the amendment and of the statute or part thereof 
proposed to be amended, showing by stricken-through type and 
italics, parallel columns, or other appropriate typographical 
devices the omissions and insertions which would be made by the 
bill or joint resolution if enacted in the form recommended by 
the committee.''
    In compliance with this rule, changes in existing law 
proposed to be made by the bill are shown as follows: existing 
law to be omitted is enclosed in black brackets; new matter is 
printed in italic; and existing law in which no change is 
proposed is shown in roman.

                      TITLE 38--VETERANS' BENEFITS


                       PART II--GENERAL BENEFITS

            Chapter 5--Authority and Duties of the Secretary


                   Subchapter II--Specified Functions


Sec. 523. Coordination and promotion of other programs affecting 
                    veterans and their dependents

  Pilot Program on Use of Community-Based Organizations and Local and 
  State Government Entities To Ensure That Veterans Receive Care and 
                  Benefits for Which They Are Eligible


    ``(a) Pilot Program Required.--* * *

           *       *       *       *       *       *       *

    ``[(b) Duration of Program.--The pilot program shall be 
carried out during the 2-year period beginning on the date that 
is 180 days after the date of the enactment of this Act [May 5, 
2010].]

    (b) Duration of Program.--The Secretary may not carry out 
the pilot program after September 30, 2019.

    ``(c) Program Locations.--

        ``(1) In general.--* * *

        ``(2) Considerations.--In selecting locations for the 
pilot program, the Secretary shall consider the advisability of 
selecting locations in--

            ``(A) * * *

           *       *       *       *       *       *       *

            ``(D) * * *
        (3) Additional locations.--The Secretary may expand the 
pilot program to include additional locations if the Secretary 
recommends that the pilot program be expanded in the initial 
report submitted under subsection (g)(2)(C).

           *       *       *       *       *       *       *

    ``(g) [Report on Program]  Reports._

        ``(1) In general.--Not later than September 30, 2017 
and not later than 180 days after the completion of the pilot 
program, the Secretary shall submit to Congress a report on the 
pilot program.

        ``(2) Elements.--[The report] Each report required by 
paragraph (1) shall include the following:

          ``(A) * * *

           *       *       *       *       *       *       *


          ``(C) The recommendations of the Secretary as to the 
        advisability of continuing or expanding the pilot 
        program.

           *       *       *       *       *       *       *


   Chapter 17--Hospital, Nursing Home, Domiciliary, and Medical Care


                         Subchapter I--General


Sec. 1701. Definitions

    For the purpose of this chapter--

    (1) * * *

           *       *       *       *       *       *       *

    (6) The term ``medical services'' includes, in addition to 
medical examination, treatment, and rehabilitative services, 
the following:

        (A) Surgical services.

           *       *       *       *       *       *       *

        (G) Travel and incidental expenses pursuant to section 
111 of this title.

        (H) Chiropractic services.

           *       *       *       *       *       *       *

    (8) The term ``rehabilitative services'' means such 
professional, chiropractic, counseling, and guidance services 
and treatment programs as are necessary to restore, to the 
maximum extent possible, the physical, mental, and 
psychological functioning of an ill or disabled person.

    (9) The term ``preventive health services'' means--

        (A) periodic medical and dental examinations;

           *       *       *       *       *       *       *

        (F) periodic and preventive chiropractic examinations 
and services;

        [(F)] (G) immunizations against infectious diseases, 
including each immunization on the recommended adult 
immunization schedule at the time such immunization is 
indicated on that schedule;

        [(G)] (H) prevention of musculoskeletal deformity or 
other gradually developing disabilities of a metabolic or 
degenerative nature;

        [(H)] (I) genetic counseling concerning inheritance of 
genetically determined diseases;

        [(I)] (J) routine vision testing and eye care services;

        [(J)] (K) periodic reexamination of members of likely 
target populations (high-risk groups) for selected diseases and 
for functional decline of sensory organs, together with 
attendant appropriate remedial intervention; and

        [(K)] (L) such other health-care services as the 
Secretary may determine to be necessary to provide effective 
and economical preventive health care.

           *       *       *       *       *       *       *

                                ------                                


subchapter ii--hospital, nursing home, or domiciliary care and medical 
                               treatment

Sec.
1710. Eligibility for hospital, nursing home, and domiciliary care
     * * * * * * *
1712C. Dental insurance plan for veterans and survivors and dependents 
          of veterans
1712D. Mental and behavioral health care for certain individuals 
          discharged or released from the active military, naval, or air 
          service under conditions other than honorable

Subchapter II--Hospital, Nursing Home, or Domiciliary Care and Medical 
                               Treatment


Sec. 1710. Eligibility for hospital, nursing home, and domiciliary care

                         Chiropractic Treatment


    ``(a) Requirement for Program.--* * *

           *       *       *       *       *       *       *

    ``(c) Location of Program.--(1) The program shall be 
carried out at sites designated by the Secretary for purposes 
of the program. The Secretary shall designate at least one site 
for such program in each geographic service area of the 
Veterans Health Administration. The sites so designated shall 
be medical centers and clinics located in urban areas and in 
rural areas.
            (2) The program shall be carried out at not fewer 
        than two medical centers or clinics in each Veterans 
        Integrated Service Network by not later than December 
        31, 2019, and at not fewer than 50 percent of all 
        medical centers in each Veterans Integrated Service 
        Network by not later than December 31, 2021.

           *       *       *       *       *       *       *


Sec. 1712C. Dental insurance plan for veterans and survivors and 
                    dependents of veterans

    (a) In General.--* * *

           *       *       *       *       *       *       *

    (j) Termination.--This section terminates on December 31, 
2021.

Sec. 1712D. Mental and behavioral health care for certain individuals 
                    discharged or released from the active military, 
                    naval, or air service under conditions other than 
                    honorable

  (a) In General.--Notwithstanding section 5303(a) of this 
title and subject to subsection (c), the Secretary shall 
furnish to an eligible individual covered mental and behavioral 
health care.

  (b) Eligible Individuals.--For purposes of this section, an 
eligible individual is any of the following:

      (1) An individual who--

          (A) served in the active military, naval, or air 
        service for a period of more than 180 days and was 
        deployed in a theater of combat operations, in support 
        of a contingency operation, or in an area at a time 
        during which hostilities are occurring in that area, 
        for a period of more than 30 days during such service;

          (B) was discharged or released from such service by 
        reason of committing a covered offense; and

          (C) was diagnosed by a qualified mental health care 
        provider with a mental or behavioral health condition 
        before committing the covered offense.

      (2) An individual who--

          (A) served in the active military, naval, or air 
        service for a period of more than 180 days and was 
        deployed in a theater of combat operations, in support 
        of a contingency operation, or in an area at a time 
        during which hostilities are occurring in that area, 
        for a period of more than 30 days during such service;

          (B) was discharged or released from such service by 
        reason of committing a covered offense;

          (C) is diagnosed with a mental or behavioral health 
        condition after committing such covered offense but 
        before the expiration of the five-year period beginning 
        on the later of--

            (i) the date of the enactment of this section; or

            (ii) the date on which the individual is discharged 
        or released from such service;

          (D) submits to the Secretary--

            (i) a certification from a qualified mental health 
        care provider that the provider believes such condition 
        may have led the individual to commit such offense; and

            (ii) the Certificate of Release or Discharge from 
        Active Duty (DD Form 214) of the individual; and

          (E) is determined by the Secretary pursuant to 
        subsection (c) to have had a mental or behavioral 
        health condition at the time the individual committed 
        the covered offense that contributed to the commission 
        of the offense.

  (c) Determination by Secretary.--(1) Not later than 90 days 
after receiving the information submitted under subsection 
(b)(2)(D) with respect to an individual,23 the Secretary shall 
determine whether, at the time of committing the covered 
offense, the individual had a mental or behavioral health 
condition that contributed to the commission of the offense.

      (2) If the Secretary does not make a determination under 
paragraph (1) with respect to a mental or behavioral health 
condition of an individual before the end of the 90-day period 
beginning on the date of the submittal of the information 
described in subsection (b)(2)(D), the condition is deemed to 
be a mental or behavioral health condition that contributed to 
the commission of the offense until such time as the Secretary 
makes the determination.

  (d) Initial Mental Health Screening.--(1) The Secretary may 
furnish to each individual described14 in paragraph (2) an 
initial mental health screening not later than the later of--

        (A) five years after the date of the enactment of this 
section; or

        (B) five years after the date on which the individual 
was discharged or released from the active military, naval, or 
air service.

      (2) Individuals described in this paragraph are the 
following:

            (A) Eligible individuals described in subsection 
        (b)(1).

            (B) Individuals described in subparagraphs (A), 
        (B), and (C) of subsection (b)(2).

      (3) The mental health screening provided to an individual 
under paragraph (1) shall be at no cost to the individual.

  (e) Notification of Eligibility.--The Secretary shall notify 
each eligible individual described in subsection (b)(1) about 
the eligibility of the individual for covered mental and 
behavioral health care under this section not later than the 
later of--

      (1) 180 days after the date of the enactment of this 
section; or

      (2) 180 days after the date on which the individual was 
discharged or released from the active military, naval, or air 
service.

  (f) Annual Report.--Not less frequently than annually, the 
Secretary shall submit to the Committee on Veterans' Affairs of 
the Senate and the Committee on Veterans' Affairs of the House 
of Representatives a report that includes, with respect to the 
year preceding the submittal of the report, the following:

      (1) The number of eligible individuals who were furnished 
covered mental and behavioral health care under this section.

      (2) The number of individuals who the Secretary 
determined under subsection (c) did not have a mental or 
behavioral health condition at the time of committing a covered 
offense that contributed to the commission of the offense.

      (3) The number of individuals who requested an initial 
mental health screening under subsection (d).

      (4) The number of individuals who were furnished an 
initial mental health screening under subsection (d).

  (g) Definitions.--In this section:

      (1) The term ``covered mental and behavioral health 
care'' means the same types of medical services furnished by 
the Department to individuals with service-connected mental or 
behavioral health conditions to treat such conditions.

      (2) The term ``covered offense'' means an offense for 
which an individual is discharged or separated from the active 
military, naval, or air service under conditions other than 
honorable but not a dishonorable discharge or a discharge by 
court-martial.

      (3) The term ``qualified mental health care provider'' 
means a licensed or certified health care provider whose scope 
of practice includes diagnosing mental or behavioral health 
conditions and includes physicians, psychologists, psychiatric 
nurse practitioners, physician assistants, clinical social 
workers, and licensed professional counselors.

           *       *       *       *       *       *       *


             Chapter 24--National Cemeteries and Memorials


Sec. 2402. Persons eligible for interment in national cemeteries

  (a) * * *

      (1) * * *

           *       *       *       *       *       *       *

      (9)(A) * * *

            (B) * * *

            (i) * * *

           *       *       *       *       *       *       *

            (iii) undergoing that hospitalization or treatment 
        at the expense of the United States.

      (10) Any individual--

          (A) who--

            (i) was naturalized pursuant to section 2(1) of the 
        Hmong Veterans' Naturalization Act of 2000 (Public Law 
        106-207; 8 U.S.C. 1423 note); and

            (ii) at the time of the individual's death resided 
        in the United States; or

          (B) who--

            (i) the Secretary determines served honorably with 
        a special guerrilla unit or irregular forces operating 
        from a base in Laos in support of the Armed Forces of 
        the United States at any time during the period 
        beginning February 28, 1961, and ending May 7, 1975; 
        and

            (ii) at the time of the individual's death--

                    (I) was a citizen of the United States or 
                an alien lawfully admitted for permanent 
                residence in the United States; and

                    (II) resided in the United States.

           *       *       *       *       *       *       *


            PART VI--ACQUISITION AND DISPOSITION OF PROPERTY

   Chapter 81--Acquisition and Operation of Hospital and Domiciliary 
    Facilities; Procurement and Supply; Enhanced-Use Leases of Real 
                                Property


   Subchapter III--State Home Facilities for Furnishing Domiciliary, 
                    Nursing Home, and Hospital Care


Sec. 8135. Applications with respect to projects; payments

    (a) * * *

           *       *       *       *       *       *       *

    (c)(1) * * *
        (2) Subject to [paragraphs (3) and (5)(C)] paragraphs 
(3), (4)(B), and (5)(C) of this subsection, the Secretary shall 
accord priority to applications in the following order:

           *       *       *       *       *       *       *

        (4) [The Secretary] (A) The Secretary shall establish a 
list of approved projects (including projects that have been 
conditionally approved under paragraph (6) of this subsection), 
in the order of their priority, as of August 15 of each year. 
The Secretary shall award grants in the order of their priority 
on the list during the fiscal year beginning on October 1 of 
the calendar year in which the list was made.

            (B) With respect to a project that is approved in a 
        fiscal year but for which a grant has not been awarded 
        under this subchapter in that fiscal year, the 
        Secretary may not accord a lower priority on the list 
        described in subparagraph (A) to that project in any 
        subsequent fiscal year (as compared to the priority 
        accorded that project in any previous fiscal year) 
        unless the reason for such lower priority is the 
        inclusion in such list of a project described in 
        subparagraph (A) or (B) of paragraph (2).

           *       *       *       *       *       *       *

        (7)(A) * * *

            (B) A grant may not be increased under subparagraph 
        (A) of this paragraph by more than 10 percent of the 
        amount of the grant initially awarded for such project, 
        and the amount of such grant, as increased, may not 
        exceed 65 percent of the cost of the project.


        (8) In determining under subparagraphs (D), (F), and 
(H) of paragraph (2) whether a State has a great, significant, 
or limited need for beds in connection with an application 
under subsection (a), the Secretary shall--

            (A) consider the availability and accessibility to 
        individuals in that State of private facilities 
        providing similar care to the care for which the 
        application is submitted under such subsection; and

            (B) accord a lower priority in the list established 
        under paragraph (4) to applications by States with a 
        significant number of such private facilities, as 
        determined by the Secretary.
                                ------                                


CONTINUING APPROPRIATIONS AND MILITARY CONSTRUCTION, VETERANS AFFAIRS, 
 AND RELATED AGENCIES APPROPRIATIONS ACT, 2017, AND ZIKA RESPONSE AND 
                  PREPAREDNESS ACT, PUBLIC LAW 114-223


  DIVISION A--MILITARY CONSTRUCTION AND VETERANS AFFAIRS, AND RELATED 
AGENCIES APPROPRIATIONS ACT, 2017

           *       *       *       *       *       *       *



                                TITLE II


                     DEPARTMENT OF VETERANS AFFAIRS


Administrative Provisions

           *       *       *       *       *       *       *



                     [(INCLUDING TRANSFER OF FUNDS)

    Sec. 222. Of the amounts appropriated to the Department of 
Veterans Affairs which become available on October 1, 2017, for 
``Medical Services'', ``Medical Support and Compliance'', and 
``Medical Facilities'', up to $280,802,000, plus 
reimbursements, may be transferred to the Joint Department of 
Defense-Department of Veterans Affairs Medical Facility 
Demonstration Fund, established by section 1704 of the National 
Defense Authorization Act for Fiscal Year 2010 (Public Law 111-
84; 123 Stat. 3571) and may be used for operation of the 
facilities designated as combined Federal medical facilities as 
described by section 706 of the Duncan Hunter National Defense 
Authorization Act for Fiscal Year 2009 (Public Law 110-417; 122 
Stat. 4500): Provided, That additional funds may be transferred 
from accounts designated in this section to the Joint 
Department of Defense-Department of Veterans Affairs Medical 
Facility Demonstration Fund upon written notification by the 
Secretary of Veterans Affairs to the Committees on 
Appropriations of both Houses of Congress.] Repealed.

                        BUDGETARY IMPACT OF BILL


  PREPARED IN CONSULTATION WITH THE CONGRESSIONAL BUDGET OFFICE PURSUANT TO SEC. 308(a), PUBLIC LAW 93-344, AS
                                                     AMENDED
                                            [In millions of dollars]
----------------------------------------------------------------------------------------------------------------
                                                            Budget authority                   Outlays
                                                     -----------------------------------------------------------
                                                                       Amount  in                    Amount  in
                                                       Allocation\1\      bill       Allocation\1\      bill
----------------------------------------------------------------------------------------------------------------
Comparison of amounts in the bill with the
 subcommittee allocation for 2018: Subcommittee on
 Military Construction and Veterans Affairs, and
 Related Agencies:
    Mandatory.......................................        97,618         97,618         97,272      \2\97,272
    Discretionary...................................        88,211         88,849         84,677      \2\84,683
        Security....................................         9,536         10,174             NA             NA
        Nonsecurity.................................        78,675         78,675             NA             NA
Projections of outlays associated with the
 recommendation:
    2018............................................  ..............  ............  ..............   \3\104,134
    2019............................................  ..............  ............  ..............        5,151
    2020............................................  ..............  ............  ..............        4,108
    2021............................................  ..............  ............  ..............        2,819
    2022 and future years...........................  ..............  ............  ..............        2,195
Financial assistance to State and local governments             NA            234             NA          \3\52
 forP 2018..........................................
 
----------------------------------------------------------------------------------------------------------------
\1\There is no section 302(a) allocation to the Committee on Appropriations for fiscal year 2018.
\2\Includes outlays from prior-year budget authority.
\3\Excludes outlays from prior-year budget authority.
 
NA: Not applicable.
 
NOTE.--Consistent with the funding recommended in the bill for overseas contingency operations and in accordance
  with subparagraph (A)(ii) of section 251(b)(2) of the BBEDCA of 1985, the Committee anticipates that the
  Budget Committee will provide, at the appropriate time, a 302(a) allocation for the Committee on
  Appropriations reflecting an upward adjustment of $638,000,000 in budget authority plus the associated
  outlays.


                                MILITARY CONSTRUCTION PROJECT LISTING BY LOCATION
                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                                                     Committee
                                                                                                  recommendation
                    Installation and project                          Budget         Committee      compared to
                                                                     estimate     recommendation      budget
                                                                                                     estimate
----------------------------------------------------------------------------------------------------------------
                             ALABAMA
 
ARMY:
    FORT RUCKER:
        TRAINING SUPPORT FACILITY...............................          38,000          38,000  ..............
 
                             ALASKA
 
AIR FORCE:
    EIELSON AFB:
        F-35A ADAL CONVENTIONAL MUNITIONS FACILITY..............           2,500           2,500  ..............
        F-35A AGE FACILITY / FILLSTAND..........................          21,000          21,000  ..............
        F-35A CONSOLIDATED MUNITIONS ADMIN FACILITY.............          27,000          27,000  ..............
        F-35A EXTEND UTILIDUCT TO SOUTH LOOP....................          48,000          48,000  ..............
        F-35A OSS/WEAPONS/INTEL FACILITY........................          11,800          11,800  ..............
        F-35A R-11 FUEL TRUCK SHELTER...........................           9,600           9,600  ..............
        F-35A SATELLITE DINING FACILITY.........................           8,000           8,000  ..............
        REPAIR CENTRAL HEAT/POWER PLANT BOILER PH 4.............          41,000          41,000  ..............
                                                                 -----------------------------------------------
      TOTAL, ALASKA.............................................         168,900         168,900  ..............
 
                             ARIZONA
 
ARMY:
    DAVIS-MONTHAN AFB:
        GENERAL INSTRUCTION BUILDING............................          22,000          22,000  ..............
    FORT HUACHUCA:
        GROUND TRANSPORT EQUIPMENT BUILDING.....................          30,000          30,000  ..............
NAVY:
    YUMA:
        ENLISTED DINING FACILITY & COMMUNITY BLDGS..............          36,358          36,358  ..............
                                                                 -----------------------------------------------
          TOTAL, ARIZONA........................................          88,358          88,358  ..............
 
                           CALIFORNIA
 
ARMY:
    FORT IRWIN:
        LAND ACQUISITION........................................           3,000           3,000  ..............
NAVY:
    BARSTOW:
        COMBAT VEHICLE REPAIR FACILITY..........................          36,539          36,539  ..............
    CAMP PENDLETON:
        AMMUNITION SUPPLY POINT UPGRADE.........................          61,139          61,139  ..............
    LEMOORE:
        F/A 18 AVIONICS REPAIR FACILITY REPLACEMENT.............          60,828          60,828  ..............
    MIRAMAR:
        AIRCRAFT MAINTENANCE HANGAR (INC 2).....................          39,600          39,600  ..............
    TWENTYNINE PALMS:
        POTABLE WATER TREATMENT/BLENDING FACILITY...............          55,099          55,099  ..............
AIR FORCE:
    TRAVIS AFB:
        Note: Budget request is under worldwide unspecified Air
         Force. The Secretary of the Air Force determined the
         specific projects and costs after the submission.
 
        AIRCRAFT 3-BAY MAINTENANCE HANGAR.......................  ..............         107,000        +107,000
        ALTER B811 CORROSION CONTROL HANGAR.....................  ..............  ..............  ..............
        ALTER B181/185/187 SQUAD OPS/AMU........................  ..............  ..............  ..............
        ADAL D14 FUEL CELL HANGAR...............................  ..............  ..............  ..............
DEFENSE-WIDE:
    CAMP PENDLETON:
        AMBULATORY CARE CENTER REPLACEMENT......................          26,400          26,400  ..............
        SOF MARINE BATTALION COMPANY/TEAM FACILITIES............           9,958           9,958  ..............
        SOF MOTOR TRANSPORT FACILITY EXPANSION..................           7,284           7,284  ..............
    CORONADO:
        SOF BASIC TRAINING COMMAND..............................          96,077          96,077  ..............
        SOF LOGISTICS SUPPORT UNIT ONE OPS FAC. #3..............          46,175          46,175  ..............
        SOF SEAL TEAM OPS FACILITY..............................          66,218          66,218  ..............
        SOF SEAL TEAM OPS FACILITY..............................          50,265          50,265  ..............
AIR NATIONAL GUARD:
    MARCH AFB:
        TFI CONSTRUCT RPA FLIGHT TRAINING UNIT..................          15,000          15,000  ..............
ARMY RESERVE:
    FALLBROOK:
        ARMY RESERVE CENTER.....................................          36,000          36,000  ..............
NAVY RESERVE:
    LEMOORE:
        NAVAL OPERATIONAL SUPPORT CENTER........................          17,330          17,330  ..............
                                                                 -----------------------------------------------
          TOTAL, CALIFORNIA.....................................         626,912         733,912        +107,000
 
                            COLORADO
 
ARMY:
    FORT CARSON:
        AMMUNITION SUPPLY POINT.................................          21,000          21,000  ..............
        BATTLEFIELD WEATHER FACILITY............................           8,300           8,300  ..............
AIR FORCE:
    BUCKLEY AIR FORCE BASE:
        SBIRS OPERATIONS FACILITY...............................          38,000          38,000  ..............
    FORT CARSON, COLORADO:
        13 ASOS EXPANSION.......................................          13,000          13,000  ..............
    U.S. AIR FORCE ACADEMY:
        AIR FORCE CYBERWORX.....................................          30,000          30,000  ..............
DEFENSE-WIDE:
    SCHRIEVER AFB:
        AMBULATORY CARE CENTER/DENTAL ADD./ALT..................          10,200          10,200  ..............
AIR NATIONAL GUARD:
    PETERSON AFB:
        SPACE CONTROL FACILITY..................................           8,000           8,000  ..............
                                                                 -----------------------------------------------
      TOTAL, COLORADO...........................................         128,500         128,500  ..............
 
                           CONNECTICUT
 
AIR NATIONAL GUARD:
    BRADLEY IAP:
        CONSTRUCT BASE ENTRY COMPLEX............................           7,000           7,000  ..............
 
                            DELAWARE
 
ARMY NATIONAL GUARD:
    NEW CASTLE:
        COMBINED SUPPORT MAINTENANCE SHOP.......................          36,000          36,000  ..............
 
                      DISTRICT OF COLUMBIA
 
NAVY:
    NSA WASHINGTON:
        ELECTRONICS SCIENCE AND TECHNOLOGY LABORATORY...........          37,882          37,882  ..............
        WASHINGTON NAVY YARD AT/FP..............................          60,000  ..............         -60,000
                                                                 -----------------------------------------------
      TOTAL, DISTRICT OF COLUMBIA...............................          97,882          37,882         -60,000
 
                             FLORIDA
 
ARMY:
    EGLIN AFB:
        MULTIPURPOSE RANGE COMPLEX..............................          18,000          18,000  ..............
NAVY:
    MAYPORT:
        ADVANCED WASTEWATER TREATMENT PLANT.....................          74,994          74,994  ..............
        MISSILE MAGAZINES.......................................           9,824           9,824  ..............
AIR FORCE:
    EGLIN AFB:
        F-35A ARMAMENT RESEARCH FAC ADDITION (B614).............           8,700           8,700  ..............
        LONG-RANGE STAND-OFF ACQUISITION FAC....................          38,000          38,000  ..............
    MACDILL AFB:
        KC-135 BEDDOWN OG/MXG HQ................................           8,100           8,100  ..............
DEFENSE-WIDE:
    EGLIN AFB:
        SOF SIMULATOR FACILITY..................................           5,000           5,000  ..............
        UPGRADE OPEN STORAGE YARD...............................           4,100           4,100  ..............
    HURLBURT FIELD:
        SOF COMBAT AIRCRAFT PARKING APRON.......................          34,700          34,700  ..............
        SOF SIMULATOR & FUSELAGE TRAINER FACILITY...............          11,700          11,700  ..............
AIR FORCE RESERVE:
    PATRICK AFB:
        GUARDIAN ANGEL FACILITY.................................          25,000          25,000  ..............
                                                                 -----------------------------------------------
      TOTAL, FLORIDA............................................         238,118         238,118  ..............
 
                             GEORGIA
 
ARMY:
    FORT BENNING:
        TRAINING SUPPORT FACILITY...............................          28,000          28,000  ..............
    FORT GORDON:
        ACCESS CONTROL POINT....................................          33,000          33,000  ..............
        AUTOMATION-AIDED INSTRUCTIONAL BUILDING.................          18,500          18,500  ..............
AIR FORCE:
    ROBINS AFB:
        COMMERCIAL VEHICLE VISITOR CONTROL FACILITY.............           9,800           9,800  ..............
DEFENSE-WIDE:
    FORT GORDON:
        BLOOD DONOR CENTER REPLACEMENT..........................          10,350          10,350  ..............
NAVY RESERVE:
    FORT GORDON:
        NAVAL OPERATIONAL SUPPORT CENTER........................          17,797          17,797  ..............
                                                                 -----------------------------------------------
      TOTAL, GEORGIA............................................         117,447         117,447  ..............
 
                             HAWAII
 
ARMY:
    FORT SHAFTER:
        COMMAND AND CONTROL FACILITY, INCR 3....................          90,000          90,000  ..............
NAVY:
    JOINT BASE PEARL HARBOR-HICKAM:
        SEWER LIFT STATION & RELIEF SEWER LINE..................          73,200          73,200  ..............
    KANEOHE BAY:
        LHD PAD CONVERSIONS MV-22 LANDING PADS..................          19,012          19,012  ..............
    WAHIAWA:
        COMMUNICATIONS/CRYPTO FACILITY..........................          65,864          65,864  ..............
DEFENSE-WIDE:
    KUNIA:
        NSAH KUNIA TUNNEL ENTRANCE..............................           5,000           5,000  ..............
AIR FORCE RESERVE:
    JOINT BASE PEARL HARBOR-HICKAM:
        CONSOLIDATED TRAINING FACILITY..........................           5,500           5,500  ..............
                                                                 -----------------------------------------------
      TOTAL, HAWAII.............................................         258,576         258,576  ..............
 
                              IDAHO
 
ARMY NATIONAL GUARD:
    ORCHARD TRAINING AREA:
        DIGITAL AIR/GROUND INTEGRATION RANGE....................          22,000          22,000  ..............
 
                             INDIANA
 
ARMY:
    CRANE ARMY AMMUNITION PLANT:
        SHIPPING AND RECEIVING BUILDING.........................          24,000          24,000  ..............
 
                             KANSAS
 
AIR FORCE:
    MCCONNELL AFB:
        COMBAT ARMS FACILITY....................................          17,500          17,500  ..............
 
                            KENTUCKY
 
AIR NATIONAL GUARD:
    LOUISVILLE IAP:
        ADD/ALTER RESPONSE FORCES FACILITY......................           9,000           9,000  ..............
 
                              MAINE
 
NAVY:
    KITTERY:
        PAINT, BLAST, AND RUBBER FACILITY.......................          61,692          61,692  ..............
ARMY NATIONAL GUARD:
    PRESQUE ISLE:
        NATIONAL GUARD READINESS CENTER.........................          17,500          17,500  ..............
                                                                 -----------------------------------------------
      TOTAL, MAINE..............................................          79,192          79,192  ..............
 
                            MARYLAND
 
AIR FORCE:
    JOINT BASE ANDREWS:
        PAR LAND ACQUISITION....................................          17,500          17,500  ..............
        PRESIDENTIAL AIRCRAFT RECAP COMPLEX.....................         254,000         100,000        -154,000
DEFENSE-WIDE:
    BETHESDA NAVAL HOSPITAL:
        MEDICAL CENTER ADDITION/ALTERATION INCR 2...............         123,800         123,800  ..............
    FORT MEADE:
        NSAW RECAPITALIZE BUILDING #2 INCR 3....................         313,968         313,968  ..............
ARMY NATIONAL GUARD:
    SYKESVILLE:
        NATIONAL GUARD READINESS CENTER.........................          19,000          19,000  ..............
                                                                 -----------------------------------------------
          TOTAL, MARYLAND.......................................         728,268         574,268        -154,000
 
                          MASSACHUSETTS
 
AIR FORCE:
    HANSCOM AFB:
        VANDENBERG GATE COMPLEX.................................          11,400          11,400  ..............
AIR FORCE RESERVE:
    WESTOVER ARB:
        INDOOR SMALL ARMS RANGE.................................          10,000          10,000  ..............
                                                                 -----------------------------------------------
      TOTAL, MASSACHUSETTS......................................          21,400          21,400  ..............
 
                            MINNESOTA
 
ARMY NATIONAL GUARD:
    ARDEN HILLS:
        NATIONAL GUARD READINESS CENTER.........................          39,000          39,000  ..............
 
                            MISSOURI
 
DEFENSE-WIDE:
    FORT LEONARD WOOD:
        BLOOD PROCESSING CENTER REPLACEMENT.....................          11,941          11,941  ..............
        HOSPITAL REPLACEMENT....................................         250,000         100,000        -150,000
    ST LOUIS:
        NEXT NGA WEST (N2W) COMPLEX.............................         381,000         175,000        -206,000
AIR NATIONAL GUARD:
    ROSECRANS MEMORIAL AIRPORT:
        REPLACE COMMUNICATIONS FACILITY.........................          10,000          10,000  ..............
                                                                 -----------------------------------------------
      TOTAL, MISSOURI...........................................         652,941         296,941        -356,000
 
                             NEVADA
 
AIR FORCE:
    NELLIS AFB:
        RED FLAG 5TH GEN FACILITY ADDITION......................          23,000          23,000  ..............
        VIRTUAL WARFARE CENTER OPERATIONS FACILITY..............          38,000          38,000  ..............
                                                                 -----------------------------------------------
      TOTAL, NEVADA.............................................          61,000          61,000  ..............
 
                           NEW JERSEY
 
AIR FORCE:
    JOINT BASE MCGUIRE-DIX-LAKEHURST:
        Note: Budget request is under worldwide unspecified Air
         Force. The Secretary of the Air Force determined the
         specific projects and costs after the submission.
        2-BAY GENERAL PURPOSE MIX HANGAR........................  ..............          72,000         +72,000
        ADAL B2324 REGIONAL MAINTENANCE TRAINING FACILITY.......  ..............          18,000         +18,000
        ALTER APRON AND FUEL HYDRANT............................  ..............          17,000         +17,000
        ALTER BUILDINGS FOR OPS AND TFI AMU-AMXS................  ..............           9,000          +9,000
        ADAL B1816 FOR SUPPLY...................................  ..............           6,900          +6,900
        ADAL B2319 FOR BOOM OPERATOR TRAINER....................  ..............           6,100          +6,100
        ALTER FACILITIES FOR MAINTENANCE........................  ..............           5,800          +5,800
        AEROSPACE GROUND EQUIPMENT STORAGE......................  ..............           4,100          +4,100
        ADAL B3209 FOR FUSELAGE TRAINER.........................  ..............           3,300          +3,300
        ADD TO B1837 FOR BODY TANKS STORAGE.....................  ..............           2,300          +2,300
        ADAL 1749 FOR ATGL AND LST SERVICING....................  ..............           2,000          +2,000
NAVY RESERVE:
    JOINT BASE MCGUIRE-DIX-LAKEHURST:
        AIRCRAFT APRON, TAXIWAY & SUPPORT FACILITIES............          11,573          11,573  ..............
                                                                 -----------------------------------------------
      TOTAL, NEW JERSEY.........................................          11,573         158,073        +146,500
 
                           NEW MEXICO
 
AIR FORCE:
    CANNON AFB:
        DANGEROUS CARGO PAD RELOCATE CATM.......................          42,000          42,000  ..............
    HOLLOMAN AFB:
        RPA FIXED GROUND CONTROL STATION FACILITY...............           4,250           4,250  ..............
DEFENSE-WIDE:
    CANNON AFB:
        SOF C-130 AGE FACILITY..................................           8,228           8,228  ..............
ARMY NATIONAL GUARD:
    LAS CRUCES:
        NATIONAL GUARD READINESS CENTER ADDITION................           8,600           8,600  ..............
                                                                 -----------------------------------------------
      TOTAL, NEW MEXICO.........................................          63,078          63,078  ..............
 
                            NEW YORK
 
ARMY:
    U.S. MILITARY ACADEMY:
        CEMETERY................................................          22,000          22,000  ..............
AIR NATIONAL GUARD:
    HANCOCK FIELD:
        ADD TO FLIGHT TRAINING UNIT, BUILDING 641...............           6,800           6,800  ..............
                                                                 -----------------------------------------------
      TOTAL, NEW YORK...........................................          28,800          28,800  ..............
 
                         NORTH CAROLINA
 
NAVY:
    CAMP LEJEUNE:
        BACHELOR ENLISTED QUARTERS..............................          37,983          37,983  ..............
        WATER TREATMENT PLANT REPLACEMENT HADNOT PT.............          65,784          65,784  ..............
    CHERRY POINT MARINE CORPS AIR STATION:
        F-35B VERTICAL LIFT FAN TEST FACILITY...................          15,671          15,671  ..............
DEFENSE-WIDE:
    CAMP LEJEUNE:
        AMBULATORY CARE CENTER ADDITION/ALTERATION..............          15,300          15,300  ..............
        AMBULATORY CARE CENTER/DENTAL CLINIC....................          21,400          21,400  ..............
        AMBULATORY CARE CENTER/DENTAL CLINIC....................          22,000          22,000  ..............
        SOF HUMAN PERFORMANCE TRAINING CENTER...................          10,800          10,800  ..............
        SOF MOTOR TRANSPORT MAINTENANCE EXPANSION...............          20,539          20,539  ..............
    FORT BRAGG:
        SOF HUMAN PERFORMANCE TRAINING CTR......................          20,260          20,260  ..............
        SOF SUPPORT BATTALION ADMIN FACILITY....................          13,518          13,518  ..............
        SOF TACTICAL EQUIPMENT MAINTENANCE FACILITY.............          20,000          20,000  ..............
        SOF TELECOMM RELIABILITY IMPROVEMENTS...................           4,000           4,000  ..............
    SEYMOUR JOHNSON AFB:
        CONSTRUCT TANKER TRUCK DELIVERY SYSTEM..................          20,000          20,000  ..............
AIR FORCE RESERVE:
    SEYMOUR JOHNSON AFB:
        KC-46A ADAL FOR ALT MISSION STORAGE.....................           6,400           6,400  ..............
                                                                 -----------------------------------------------
          TOTAL, NORTH CAROLINA.................................         293,655         293,655  ..............
 
                          NORTH DAKOTA
 
AIR FORCE:
    MINOT AFB:
        INDOOR FIRING RANGE.....................................          27,000          27,000  ..............
 
                              OHIO
 
AIR NATIONAL GUARD:
    TOLEDO EXPRESS AIRPORT:
        NORTHCOM--CONSTRUCT ALERT HANGAR........................          15,000          15,000  ..............
 
                            OKLAHOMA
 
AIR FORCE:
    ALTUS AFB:
        KC-46A FTU FUSELAGE TRAINER PHASE 2.....................           4,900           4,900  ..............
 
                             OREGON
 
AIR NATIONAL GUARD:
    KLAMATH FALLS IAP:
        CONSTRUCT CORROSION CONTROL HANGAR......................          10,500          10,500  ..............
        CONSTRUCT INDOOR RANGE..................................           8,000           8,000  ..............
                                                                 -----------------------------------------------
      TOTAL, OREGON.............................................          18,500          18,500  ..............
 
                         SOUTH CAROLINA
 
ARMY:
    FORT JACKSON:
        RECEPTION BARRACKS COMPLEX, PH1.........................          60,000          60,000  ..............
    SHAW AFB:
        MISSION TRAINING COMPLEX................................          25,000          25,000  ..............
DEFENSE-WIDE:
    SHAW AFB:
        CONSOLIDATE FUEL FACILITIES.............................          22,900          22,900  ..............
      TOTAL, SOUTH CAROLINA.....................................         107,900         107,900  ..............
 
                          SOUTH DAKOTA
 
AIR NATIONAL GUARD:
    JOE FOSS FIELD:
        AIRCRAFT MAINTENANCE SHOPS..............................          12,000          12,000  ..............
 
                            TENNESSEE
 
AIR NATIONAL GUARD:
    MCGHEE-TYSON AIRPORT:
        REPLACE KC-135 MAINTENANCE HANGAR AND SHOPS.............          25,000          25,000  ..............
 
                              TEXAS
 
ARMY:
    CAMP BULLIS:
        VEHICLE MAINTENANCE SHOP................................          13,600          13,600  ..............
    FORT HOOD:
        BATTALION HEADQUARTERS COMPLEX..........................          37,000          37,000  ..............
AIR FORCE:
    JOINT BASE SAN ANTONIO:
        AIR TRAFFIC CONTROL TOWER...............................          10,000          10,000  ..............
        BMT CLASSROOMS/DINING FACILITY 4........................          38,000          38,000  ..............
        BMT RECRUIT DORMITORY 7.................................          90,130          90,130  ..............
        CAMP BULLIS DINING FACILITY.............................          18,500          18,500  ..............
DEFENSE-WIDE:
    FORT BLISS:
        BLOOD PROCESSING CENTER.................................           8,300           8,300  ..............
        HOSPITAL REPLACEMENT INCR 8.............................         251,330         100,000        -151,330
NAVY RESERVE:
    FORT WORTH:
        KC130-J EACTS FACILITY..................................          12,637          12,637  ..............
                                                                 -----------------------------------------------
      TOTAL, TEXAS..............................................         479,497         328,167        -151,330
 
                              UTAH
 
AIR FORCE:
    HILL AFB:
        UTTR CONSOLIDATED MISSION CONTROL CENTER................          28,000          28,000  ..............
DEFENSE-WIDE:
    HILL AFB:
        REPLACE POL FACILITIES..................................          20,000          20,000  ..............
AIR FORCE RESERVE:
    HILL AFB:
        ADD/ALTER LIFE SUPPORT FACILITY.........................           3,100           3,100  ..............
                                                                 -----------------------------------------------
      TOTAL, UTAH...............................................          51,100          51,100  ..............
 
                            VIRGINIA
 
ARMY:
    FORT BELVOIR:
        SECURE ADMIN/OPERATIONS FACILITY, INCR 3................          14,124          14,124  ..............
    JOINT BASE LANGLEY-EUSTIS:
        AIRCRAFT MAINTENANCE INSTRUCTIONAL BLDG.................          34,000          34,000  ..............
    JOINT BASE MYER-HENDERSON:
        SECURITY FENCE..........................................          20,000          20,000  ..............
NAVY:
    DAM NECK:
        ISR OPERATIONS FACILITY EXPANSION.......................          29,262          29,262  ..............
    JOINT EXPEDITIONARY BASE LITTLE CREEK--STORY:
        ACU-4 ELECTRICAL UPGRADES...............................           2,596           2,596  ..............
    NORFOLK:
        CHAMBERS FIELD MAGAZINE RECAP PH 1......................          34,665          34,665  ..............
    PORTSMOUTH:
        SHIP REPAIR TRAINING FACILITY...........................          72,990          72,990  ..............
    YORKTOWN:
        BACHELOR ENLISTED QUARTERS..............................          36,358          36,358  ..............
DEFENSE-WIDE:
    JOINT EXPEDITIONARY BASE LITTLE CREEK--STORY:
        SOF SATEC RANGE EXPANSION...............................          23,000          23,000  ..............
    NORFOLK:
        REPLACE HAZARDOUS MATERIALS WAREHOUSE...................          18,500          18,500  ..............
    PENTAGON:
        PENTAGON CORR 8 PEDESTRIAN ACCESS CONTROL PT............           8,140           8,140  ..............
        S.E. SAFETY TRAFFIC AND PARKING IMPROVEMENTS............          28,700          28,700  ..............
        SECURITY UPDATES........................................          13,260          13,260  ..............
    PORTSMOUTH:
        REPLACE HARARDOUS MATERIALS WAREHOUSE...................          22,500          22,500  ..............
ARMY NATIONAL GUARD:
    FORT PICKETT:
        TRAINING AIDS CENTER....................................           4,550           4,550  ..............
                                                                 -----------------------------------------------
      TOTAL, VIRGINIA...........................................         362,645         362,645  ..............
 
                           WASHINGTON
 
ARMY:
    JOINT BASE LEWIS-MCCHORD:
        CONFINEMENT FACILITY....................................          66,000          66,000  ..............
    YAKIMA:
        FIRE STATION............................................          19,500          19,500  ..............
NAVY:
    INDIAN ISLAND:
        MISSILE MAGAZINES.......................................          44,440          44,440  ..............
ARMY NATIONAL GUARD:
    TURNWATER:
        NATIONAL GUARD READINESS CENTER.........................          31,000          31,000  ..............
                                                                 -----------------------------------------------
      TOTAL, WASHINGTON.........................................         160,940         160,940  ..............
 
                            WISCONSIN
 
ARMY RESERVE:
    FORT MCCOY:
        AT/MOB DINING FACILITY..................................          13,000          13,000  ..............
 
                             WYOMING
 
AIR FORCE:
    F. E. WARREN AFB:
        CONSOLIDATED HELO/TRF OPS/AMU AND ALERT FAC.............          62,000          62,000  ..............
 
                        CONUS CLASSIFIED
 
DEFENSE-WIDE:
    CLASSIFIED LOCATION:
        BATTALION COMPLEX, PH 1.................................          64,364          64,364  ..............
 
                            AUSTRALIA
 
AIR FORCE:
    DARWIN:
        APR--BULK FUEL STORAGE TANKS............................          76,000          76,000  ..............
 
                            DJIBOUTI
 
NAVY:
    CAMP LEMONIER:
        AIRCRAFT PARKING APRON EXPANSION........................          13,390          13,390  ..............
 
                             GERMANY
 
ARMY:
    STUTTGART:
        EIC: COMMISSARY.........................................          40,000          40,000  ..............
    WIESBADEN:
        EIC: ADMINISTRATIVE BUILDING............................          43,000          43,000  ..............
DEFENSE-WIDE:
    RHINE ORDNANCE BARRACKS:
        MEDICAL CENTER REPLACEMENT INCR 7.......................         106,700         106,700  ..............
    SPANGDAHLEM AB:
        SPANGDAHLEM ELEMENTARY SCHOOL REPLACEMENT...............          79,141          79,141  ..............
    STUTTGART:
        ROBINSON BARRACKS ELEM. SCHOOL REPLACEMENT..............          46,609          46,609  ..............
                                                                 -----------------------------------------------
      TOTAL, GERMANY............................................         315,450         315,450  ..............
 
                             GREECE
 
NAVY:
    SOUDA BAY:
        STRATEGIC AIRCRAFT PARKING APRON EXPANSION..............          22,045          22,045  ..............
DEFENSE-WIDE:
    SOUDA BAY:
        CONSTRUCT HYDRANT SYSTEM................................          18,100          18,100  ..............
                                                                 -----------------------------------------------
      TOTAL, GREECE.............................................          40,145          40,145  ..............
 
                              GUAM
 
NAVY:
    JOINT REGION MARIANAS:
        AIRCRAFT MAINTENANCE HANGAR #2..........................          75,233          75,233  ..............
        CORROSION CONTROL HANGAR................................          66,747          66,747  ..............
        MALS FACILITIES.........................................          49,431          49,431  ..............
        NAVY-COMMERCIAL TIE-IN HARDENING........................          37,180          37,180  ..............
        WATER WELL FIELD........................................          56,088          56,088  ..............
DEFENSE-WIDE:
    ANDERSEN AFB:
        CONSTRUCT TRUCK LOAD & UNLOAD FACILITY..................          23,900          23,900  ..............
AIR FORCE RESERVE:
    JOINT REGION MARIANAS:
        RESERVE MEDICAL TRAINING FACILITY.......................           5,200           5,200  ..............
                                                                 -----------------------------------------------
      TOTAL, GUAM...............................................         313,779         313,779  ..............
 
                              ITALY
 
AIR FORCE:
    AVIANO AB:
        GUARDIAN ANGEL OPERATIONS FACILITY......................          27,325          27,325  ..............
DEFENSE-WIDE:
    SIGONELLA:
        CONSTRUCT HYDRANT SYSTEM................................          22,400          22,400  ..............
    VICENZA:
        VICENZA HIGH SCHOOL REPLACEMENT.........................          62,406          62,406  ..............
                                                                 -----------------------------------------------
      TOTAL, ITALY..............................................         112,131         112,131  ..............
 
                              JAPAN
 
NAVY:
    IWAKUNI:
        KC130J ENLISTED AIRCREW TRAINER FACILITY................          21,860          21,860  ..............
DEFENSE-WIDE:
    IWAKUNI:
        CONSTRUCT BULK STORAGE TANKS PH 1.......................          30,800          30,800  ..............
    KADENA AB:
        SOF MAINTENANCE HANGAR..................................           3,972           3,972  ..............
        SOF SPECIAL TACTICS OPERATIONS FACILITY.................          27,573          27,573  ..............
    OKINAWA:
        REPLACE MOORING SYSTEM..................................          11,900          11,900  ..............
    SASEBO:
        UPGRADE FUEL WHARF......................................          45,600          45,600  ..............
    TORRI COMMO STATION:
        SOF TACTICAL EQUIPMENT MAINTENANCE FACILITY.............          25,323          25,323  ..............
    YOKOTA AB:
        AIRFIELD APRON..........................................          10,800          10,800  ..............
        HANGAR/AIRCRAFT MAINTENANCE UNIT........................          12,034          12,034  ..............
        OPERATIONS AND WAREHOUSE FACILITIES.....................           8,590           8,590  ..............
        SIMULATOR FACILITY......................................           2,189           2,189  ..............
                                                                 -----------------------------------------------
      TOTAL, JAPAN..............................................         200,641         200,641  ..............
 
                              KOREA
 
ARMY:
    KUNSAN AB:
        UNMANNED AERIAL VEHICLE HANGAR..........................          53,000          53,000  ..............
 
                         MARIANA ISLANDS
 
AIR FORCE:
    TINIAN:
        APR LAND ACQUISITION....................................          12,900          12,900  ..............
 
                           PUERTO RICO
 
DEFENSE-WIDE:
    PUNTA BORINQUEN:
        RAMEY UNIT SCHOOL REPLACEMENT...........................          61,071          61,071  ..............
ARMY RESERVE:
    AGUADILLA:
        ARMY RESERVE CENTER.....................................          12,400          12,400  ..............
                                                                 -----------------------------------------------
      TOTAL, PUERTO RICO........................................          73,471          73,471  ..............
 
                              QATAR
 
AIR FORCE:
    AL UDEID:
        CONSOLIDATED SQUADRON OPERATIONS FACILITY...............          15,000          15,000  ..............
 
                             TURKEY
 
ARMY:
    TURKEY VARIOUS:
        FORWARD OPERATING SITE..................................           6,400           6,400  ..............
AIR FORCE:
    INCIRLIK AB:
        DORMITORY...............................................          25,997          25,997  ..............
      TOTAL, TURKEY.............................................          32,397          32,397  ..............
 
                         UNITED KINGDOM
 
AIR FORCE:
    ROYAL AIR FORCE FAIRFORD:
        EIC RC-135 INFRASTRUCTURE...............................           2,150           2,150  ..............
        EIC RC-135 INTEL AND SQUAD OPS FACILITY.................          38,000          38,000  ..............
        EIC RC-135 RUNWAY OVERRUN RECONFIGURATION...............           5,500           5,500  ..............
    ROYAL AIR FORCE LAKENHEATH:
        CONSOLIDATED CORROSION CONTROL FACILITY.................          20,000          20,000  ..............
        F-35A 6-BAY HANGAR......................................          24,000          24,000  ..............
        F-35A F-15 PARKING......................................          10,800          10,800  ..............
        F-35A FIELD TRAINING DETACHMENT FACILITY................          12,492          12,492  ..............
        F-35A FLIGHT SIMULATOR FACILITY.........................          22,000          22,000  ..............
        F-35A INFRASTRUCTURE....................................           6,700           6,700  ..............
        F-35A SQUADRON OPERATIONS AND AMU.......................          41,000          41,000  ..............
DEFENSE-WIDE:
    MENWITH HILL STATION:
        RAFMH MAIN GATE REHABILITATION..........................          11,000          11,000  ..............
                                                                 -----------------------------------------------
      TOTAL, UNITED KINGDOM.....................................         193,642         193,642  ..............
        NATO SECURITY INVESTMENT PROGRAM........................         154,000         154,000  ..............
 
                      WORLDWIDE UNSPECIFIED
 
ARMY:
    HOST NATION SUPPORT.........................................          28,700          28,700  ..............
    MINOR CONSTRUCTION..........................................          31,500          41,500         +10,000
    PLANNING AND DESIGN.........................................          72,770          72,770  ..............
NAVY:
    PLANNING AND DESIGN.........................................         219,069         228,069          +9,000
    MINOR CONSTRUCTION..........................................          23,842          23,842  ..............
AIR FORCE:
    KC-46A MAIN OPERATING BASE 4................................         269,000  ..............        -269,000
    Note: The recommended funding is provided under Travis Air
     Force Base, CA and Joint Base McGuire-Dix-Lakehurst, NJ as
     determined by the Secretary of the Air Force.
        PLANNING AND DESIGN.....................................          97,852          97,852  ..............
        MINOR CONSTRUCTION......................................          31,400          31,400  ..............
DEFENSE-WIDE:
    CONTINGENCY CONSTRUCTION....................................          10,000  ..............         -10,000
    ENERGY RESILIENCE CONSERVATION INVESTMENT PROGRAM...........         150,000         165,000         +15,000
    PLANNING AND DESIGN:
        DEFENSE WIDE............................................          23,500          23,500  ..............
        DEFENSE HEALTH AGENCY...................................          40,220          40,220  ..............
        DEPARTMENT OF DEFENSE DEPENDENT EDUCATION...............          26,147          26,147  ..............
        DEFENSE INFORMATION SYSTEMS AGENCY......................           1,150           1,150  ..............
        DEFENSE LOGISTICS AGENCY................................          23,012          23,012  ..............
        MISSILE DEFENSE AGENCY..................................  ..............  ..............  ..............
        NATIONAL SECURITY AGENCY................................          20,000          20,000  ..............
        SPECIAL OPERATIONS COMMAND..............................          39,746          39,746  ..............
        WASHINGTON HEADQUARTERS SERVICE.........................           1,942           1,942  ..............
                                                                 -----------------------------------------------
      SUBTOTAL, PLANNING AND DESIGN.............................         175,717         175,717  ..............
    UNSPECIFIED MINOR CONSTRUCTION:
        DEFENSE-WIDE............................................           3,000           3,000  ..............
        DEPARTMENT OF DEFENSE DEPENDENT EDUCATION...............           8,000           8,000  ..............
        DEFENSE HEALTH AGENCY...................................          10,000          10,000  ..............
        DEFENSE LOGISTICS AGENCY................................           2,039           2,039  ..............
        JOINT CHIEFS OF STAFF...................................          11,490          11,490  ..............
        MISSILE DEFENSE AGENCY..................................           3,000           3,000  ..............
        NATIONAL SECURITY AGENCY................................           3,000           3,000  ..............
        SPECIAL OPERATIONS COMMAND..............................           7,384           7,384  ..............
                                                                 -----------------------------------------------
      SUBTOTAL, UNSPECIFIED MINOR CONSTRUCTION..................          47,913          47,913  ..............
 
ARMY NATIONAL GUARD:
    PLANNING AND DESIGN.........................................          16,271          16,271  ..............
    MINOR CONSTRUCTION..........................................          16,731          16,731  ..............
AIR NATIONAL GUARD:
    PLANNING AND DESIGN.........................................          18,000          18,000  ..............
    MINOR CONSTRUCTION..........................................          17,191          17,191  ..............
ARMY RESERVE:
    PLANNING AND DESIGN.........................................           6,887           6,887  ..............
    MINOR CONSTRUCTION..........................................           5,425           5,425  ..............
NAVY RESERVE:
    PLANNING AND DESIGN.........................................           4,430           4,430  ..............
    MINOR CONSTRUCTION..........................................           1,504           1,504  ..............
AIR FORCE RESERVE:
    PLANNING AND DESIGN.........................................           4,725           4,725  ..............
    MINOR CONSTRUCTION..........................................           3,610           3,610  ..............
 
                      FAMILY HOUSING, ARMY
 
OPERATION AND MAINTENANCE:
    UTILITIES ACCOUNT...........................................          60,251          60,251  ..............
    SERVICES ACCOUNT............................................           8,930           9,106            +176
    MANAGEMENT ACCOUNT..........................................          37,089          37,089  ..............
    MISCELLANEOUS ACCOUNT.......................................             400             400  ..............
    FURNISHINGS ACCOUNT.........................................          12,816          12,816  ..............
    LEASING.....................................................         148,538         150,644          +2,106
    MAINTENANCE OF REAL PROPERTY................................          57,708          57,708  ..............
    PRIVATIZATION SUPPORT COSTS.................................          20,893          20,893  ..............
                                                                 -----------------------------------------------
      SUBTOTAL, OPERATION AND MAINTENANCE.......................         346,625         348,907          +2,282
 
              FAMILY HOUSING, NAVY AND MARINE CORPS
 
OPERATION AND MAINTENANCE:
    UTILITIES ACCOUNT...........................................          62,167          62,167  ..............
    SERVICES ACCOUNT............................................          15,649          15,649  ..............
    MANAGEMENT ACCOUNT..........................................          50,989          50,989  ..............
    MISCELLANEOUS ACCOUNT.......................................             336             336  ..............
    FURNISHINGS ACCOUNT.........................................          14,529          14,529  ..............
    LEASING.....................................................          61,921          61,921  ..............
    MAINTENANCE OF REAL PROPERTY................................          95,104          95,104  ..............
    PRIVATIZATION SUPPORT COSTS.................................          27,587          27,587  ..............
                                                                 -----------------------------------------------
      SUBTOTAL, OPERATION AND MAINTENANCE.......................         328,282         328,282  ..............
 
                    FAMILY HOUSING, AIR FORCE
 
OPERATION AND MAINTENANCE:
    UTILITIES ACCOUNT...........................................          47,504          47,504  ..............
    MANAGEMENT ACCOUNT..........................................          53,464          53,464  ..............
    SERVICES ACCOUNT............................................          13,517          13,517  ..............
    FURNISHINGS ACCOUNT.........................................          29,424          29,424  ..............
    MISCELLANEOUS ACCOUNT.......................................           1,839           1,839  ..............
    LEASING.....................................................          16,818          16,818  ..............
    MAINTENANCE.................................................         134,189         134,189  ..............
    PRIVATIZATION SUPPORT COSTS.................................          21,569          21,569  ..............
                                                                 -----------------------------------------------
      SUBTOTAL, OPERATION AND MAINTENANCE.......................         318,324         318,324  ..............
 
                  FAMILY HOUSING, DEFENSE-WIDE
 
OPERATION AND MAINTENANCE:
    NATIONAL SECURITY AGENCY:
        UTILITIES...............................................             268             268  ..............
        FURNISHING..............................................             407             407  ..............
        LEASING.................................................          12,390          12,390  ..............
        MAINTENANCE OF REAL PROPERTY............................             655             655  ..............
    DEFENSE INTELLIGENCE AGENCY:
        UTILITIES...............................................           4,100           4,100  ..............
        FURNISHINGS.............................................             641             641  ..............
        LEASING.................................................          39,716          39,716  ..............
    DEFENSE LOGISTICS AGENCY:
        UTILITIES...............................................              86              86  ..............
        FURNISHINGS.............................................               6               6  ..............
        SERVICES................................................              14              14  ..............
        MANAGEMENT..............................................             319             319  ..............
        MAINTENANCE OF REAL PROPERTY............................             567             567  ..............
                                                                 -----------------------------------------------
      SUBTOTAL, OPERATION AND MAINTENANCE.......................          59,169          59,169  ..............
 
                      FAMILY HOUSING, ARMY
 
CONSTRUCTION:
    GEORGIA:
        FORT GORDON:
            FAMILY HOUSING NEW CONSTRUCTION.....................           6,100           6,100  ..............
    MASSACHUSETTS:
        NATICK SOLDIER SUPPORT CENTER (28 UNITS)................          21,000          21,000  ..............
    KOREA:
        CAMP HUMPHRIES:
            FAMILY HOUSING NEW CONSTRUCTION INC 2...............          34,402          34,402  ..............
    KWAJALEIN:
        FAMILY HOUSING NEW CONSTRUCTION (22 UNITS)..............          31,000          31,000  ..............
    GERMANY:
        SOUTH CAMP VILSECK:
            FAMILY HOUSING NEW CONSTRUCTION (36 UNITS)..........          22,445          22,445  ..............
    CONSTRUCTION IMPROVEMENTS--BAUMHOLDER (96 UNITS)............          34,156          34,156  ..............
    ITALY:
        PLANNING AND DESIGN.....................................          33,559          33,559  ..............
                                                                 -----------------------------------------------
      SUBTOTAL, CONSTRUCTION....................................         182,662         182,662  ..............
 
              FAMILY HOUSING, NAVY AND MARINE CORPS
 
CONSTRUCTION:
    MARIANA ISLANDS:
        NSA ANDERSON:
            REPLACEMENT HOUSING PHASE II........................          40,875          40,875  ..............
    BAHRAIN:
        SW ASIA:
            CONSTRUCTION OF ON-BASE GENERAL FLAG OFFICER:
                QUARTERS........................................           2,138           2,138  ..............
    CONSTRUCTION IMPROVEMENTS...................................          36,251          36,251  ..............
    PLANNING AND DESIGN.........................................           4,418           4,418  ..............
                                                                 -----------------------------------------------
      SUBTOTAL, CONSTRUCTION....................................          83,682          83,682  ..............
 
                    FAMILY HOUSING, AIR FORCE
 
CONSTRUCTION:
    CONSTRUCTION IMPROVEMENTS...................................          80,617          80,617  ..............
    PLANNING AND DESIGN.........................................           4,445           4,445  ..............
                                                                 -----------------------------------------------
      SUBTOTAL, CONSTRUCTION....................................          85,062          85,062  ..............
 
DOD MILITARY UNACCOMPANIED HOUSING IMPROVEMENT FUND.............             623             623  ..............
DOD FAMILY HOUSING IMPROVEMENT FUND.............................           2,726           2,726  ..............
 
                  BASE REALIGNMENT AND CLOSURE
 
BASE REALIGNMENT AND CLOSURE ACCOUNT............................         255,867         255,867  ..............
MILITARY CONSTRUCTION, ARMY.....................................  ..............          68,800         +68,800
MILITARY CONSTRUCTION, NAVY AND MARINE CORPS....................  ..............         110,100        +110,100
MILITARY CONSTRUCTION, AIR FORCE................................  ..............         127,300        +127,300
MILITARY CONSTRUCTION, ARMY NATIONAL GUARD......................  ..............          83,500         +83,500
MILITARY CONSTRUCTION, AIR NATIONAL GUARD.......................  ..............          24,000         +24,000
MILITARY CONSTRUCTION, ARMY RESERVE.............................  ..............          30,000         +30,000
MILITARY CONSTRUCTION, NAVY RESERVE.............................  ..............  ..............  ..............
MILITARY CONSTRUCTION, AIR FORCE RESERVE........................  ..............          35,100         +35,100
 
        RESCISSIONS FROM PRIOR YEAR UNOBLIGATED BALANCES
 
ARMY............................................................  ..............  ..............  ..............
NAVY AND MARINE CORPS...........................................  ..............  ..............  ..............
AIR FORCE.......................................................  ..............  ..............  ..............
DEFENSE-WIDE....................................................  ..............         -14,703         -14,703
AIR NATIONAL GUARD..............................................  ..............  ..............  ..............
42 USC 3374 (SEC. 135)..........................................  ..............  ..............  ..............
NATO SECURITY INVESTMENT PROGRAM................................  ..............  ..............  ..............
FAMILY HOUSING CONSTRUCTION, ARMY...............................  ..............  ..............  ..............
FAMILY HOUSING CONSTRUCTION, NAVY AND MARINE CORPS..............  ..............  ..............  ..............
FAMILY HOUSING CONSTRUCTION, AIR FORCE..........................  ..............  ..............  ..............
 
                              RECAP
 
ARMY............................................................         920,394         930,394         +10,000
        RESCISSION..............................................  ..............  ..............  ..............
NAVY AND MARINE CORPS...........................................       1,616,665       1,565,665         -51,000
        RESCISSION..............................................  ..............  ..............  ..............
AIR FORCE.......................................................       1,738,796       1,569,296        -169,500
        RESCISSION..............................................  ..............  ..............  ..............
DEFENSE-WIDE....................................................       3,114,913       2,612,583        -502,330
        RESCISSION..............................................  ..............         -14,703         -14,703
ARMY NATIONAL GUARD.............................................         210,652         210,652  ..............
        RESCISSION..............................................  ..............  ..............  ..............
AIR NATIONAL GUARD..............................................         161,491         161,491  ..............
        RESCISSION..............................................  ..............  ..............  ..............
ARMY RESERVE....................................................          73,712          73,712  ..............
        RESCISSION..............................................  ..............  ..............  ..............
NAVY RESERVE....................................................          65,271          65,271  ..............
        RESCISSION..............................................  ..............  ..............  ..............
AIR FORCE RESERVE...............................................          63,535          63,535  ..............
        RESCISSION..............................................  ..............  ..............  ..............
NATO............................................................         154,000         154,000  ..............
        RESCISSION..............................................  ..............  ..............  ..............
CHEMICAL DEMILITARIZATION CONSTRUCTION, DEFENSE-WIDE............  ..............  ..............  ..............
        RESCISSION..............................................  ..............  ..............  ..............
DOD MILITARY UNACCOMPANIED HOUSING IMPROVEMENT FUND.............             623             623  ..............
        RESCISSION..............................................  ..............  ..............  ..............
DOD FAMILY HOUSING IMPROVEMENT FUND.............................           2,726           2,726  ..............
        RESCISSION..............................................  ..............  ..............  ..............
HOMEOWNERS ASSISTANCE PROGRAM...................................  ..............  ..............  ..............
        RESCISSION..............................................  ..............  ..............  ..............
FAMILY HOUSING, ARMY............................................         529,287         531,569          +2,282
    CONSTRUCTION................................................       (182,662)       (182,662)  ..............
    OPERATION AND MAINTENANCE...................................       (346,625)       (348,907)        (+2,282)
        RESCISSION..............................................  ..............  ..............  ..............
FAMILY HOUSING, NAVY AND MARINE CORP............................         411,964         411,964  ..............
    CONSTRUCTION................................................        (83,682)        (83,682)  ..............
    OPERATION AND MAINTENANCE...................................       (328,282)       (328,282)  ..............
        RESCISSION..............................................  ..............  ..............  ..............
FAMILY HOUSING, AIR FORCE.......................................         403,386         403,386  ..............
    CONSTRUCTION................................................        (85,062)        (85,062)  ..............
    OPERATION AND MAINTENANCE...................................       (318,324)       (318,324)  ..............
        RESCISSION..............................................  ..............  ..............  ..............
FAMILY HOUSING, DEFENSE-WIDE....................................          59,169          59,169  ..............
    CONSTRUCTION................................................  ..............  ..............  ..............
    OPERATION AND MAINTENANCE...................................        (59,169)        (59,169)  ..............
        RESCISSION..............................................  ..............  ..............  ..............
BRAC............................................................         255,867         255,867  ..............
        RESCISSION..............................................  ..............  ..............  ..............
42 USC 3374 (Sec. 135)..........................................  ..............  ..............  ..............
ADMINISTRATIVE PROVISIONS.......................................  ..............         478,800        +478,800
        RESCISSION..............................................  ..............  ..............  ..............
                                                                 ===============================================
      GRAND TOTAL...............................................       9,782,451       9,536,000        -246,451
----------------------------------------------------------------------------------------------------------------


                                         OVERSEAS CONTINGENCY OPERATIONS
                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                                                     Committee
                                                                                                  recommendation
                                                                      Budget         Committee      compared to
                                                                     estimate     recommendation      budget
                                                                                                     estimate
----------------------------------------------------------------------------------------------------------------
 
                              CUBA
 
ARMY:
    GUANTANAMO BAY NAVAL STATION:
        BARRACKS................................................         115,000         115,000  ..............
 
                      WORLDWIDE UNSPECIFIED
 
ARMY:
    PLANNING AND DESIGN.........................................           9,000           9,000  ..............
AIR FORCE:
    PLANNING AND DESIGN.........................................          41,500          41,500  ..............
 
                             JORDAN
 
AIR FORCE:
    MUWAFFAQ SALTI AIR BASE:
        MUWAFFAQ SALTI AIR BASE.................................         143,000  ..............        -143,000
        AIRFIELD PAVEMENTS......................................  ..............          52,735         +52,735
        ISR SHELTERS............................................  ..............          10,000         +10,000
        CAS REVETMENTS/SUN SHADES...............................  ..............          11,168         +11,168
        DORMITORY...............................................  ..............           8,003          +8,003
        CARGO MARSHALLING YARD FACILITY.........................  ..............           1,034          +1,034
        SUPPORTING FACILITIES/UTILITIES.........................  ..............          60,060         +60,060
AIR FORCE:
    INCIRLIK AB:
        RELOCATE BASE MAIN ACCESS CONTROL POINT.................          14,600          14,600  ..............
        REPLACE PERIMETER FENCE.................................           8,100           8,100  ..............
                                                                 -----------------------------------------------
      TOTAL, OVERSEAS CONTINGENCY OPERATIONS....................         331,200         331,200  ..............
        ARMY....................................................       (124,000)       (124,000)  ..............
        AIR FORCE...............................................       (207,200)       (207,200)  ..............
 
                 EUROPEAN REASSURANCE INITIATIVE
 
    ESTONIA:
AIR FORCE:
    AMARI AIR BASE:
        POL CAPACITY PHASE II...................................           4,700           4,700  ..............
        TACTICAL FIGHTER AIRCRAFT PARKING APRON.................           9,200           9,200  ..............
 
                             HUNGARY
 
AIR FORCE:
    KECSKEMET AIR BASE:
        AIRFIELD UPGRADES.......................................          12,900          12,900  ..............
        CONSTRUCT PARALLEL TAXIWAY..............................          30,000          30,000  ..............
        INCREASE POL STORAGE CAPACITY...........................          12,500          12,500  ..............
 
                             ICELAND
 
AIR FORCE:
    KEFLAVIK:
        AIRFIELD UPGRADES.......................................          14,400          14,400  ..............
 
                             LATVIA
 
AIR FORCE:
    LIELVARDE AIR BASE:
        EXPAND STRATEGIC RAMP PARKING...........................           3,850           3,850  ..............
 
                           LUXEMBOURG
 
AIR FORCE:
    SANEM:
        ECAOS DEPLOYABLE AIRBASE SYSTEM STORAGE.................          67,400          67,400  ..............
 
                             NORWAY
 
AIR FORCE:
    RYGGE:
        REPLACE/EXPAND QUICK REACTION ALERT PAD.................          10,300          10,300  ..............
 
                             ROMANIA
 
AIR FORCE:
    CAMP TURZII:
        UPGRADE UTILITIES INFRASTRUCTURE........................           2,950           2,950  ..............
 
                            SLOVAKIA
 
AIR FORCE:
    MALACKY:
        AIRFIELD UPGRADES.......................................           4,000           4,000  ..............
        INCREASE POL STORAGE CAPACITY...........................          20,000          20,000  ..............
    SLIAC AIRPORT:
        AIRFIELD UPGRADES.......................................          22,000          22,000  ..............
 
                      WORLDWIDE UNSPECIFIED
 
ARMY:
    PLANNING AND DESIGN.........................................          15,700          15,700  ..............
NAVY:
    PLANNING AND DESIGN.........................................          18,500          18,500  ..............
AIR FORCE:
    PLANNING AND DESIGN.........................................          56,630          56,630  ..............
DEFENSE-WIDE:
    SOCOM:
        PLANNING AND DESIGN.....................................           1,900           1,900  ..............
                                                                 -----------------------------------------------
      TOTAL, EUROPEAN REASSURANCE INITIATIVE....................         306,930         306,930  ..............
          ARMY..................................................        (15,700)        (15,700)  ..............
          NAVY AND MARINE CORPS.................................        (18,500)        (18,500)  ..............
          AIR FORCE.............................................       (270,830)       (270,830)  ..............
          DEFENSE-WIDE..........................................         (1,900)         (1,900)  ..............
                                                                 ===============================================
      TOTAL, FY2018 OVERSEAS CONTINGENCY OPERATIONS.............         638,130         638,130  ..............
----------------------------------------------------------------------------------------------------------------


  COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2017 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL FOR FISCAL
                                                                        YEAR 2018
                                                                [In thousands of dollars]
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                         Senate Committee recommendation
                                                                                                                             compared with (+ or -)
                                Item                                       2017       Budget estimate     Committee    ---------------------------------
                                                                      appropriation                     recommendation        2017
                                                                                                                         appropriation   Budget estimate
--------------------------------------------------------------------------------------------------------------------------------------------------------
                   TITLE I--DEPARTMENT OF DEFENSE
 
Military Construction, Army........................................         513,459          920,394          930,394         +416,935          +10,000
Military Construction, Navy and Marine Corps.......................       1,021,580        1,616,665        1,565,665         +544,085          -51,000
Military Construction, Air Force...................................       1,491,058        1,738,796        1,569,296          +78,238         -169,500
Military Construction, Defense-Wide................................       2,025,444        3,114,913        2,612,583         +587,139         -502,330
                                                                    ------------------------------------------------------------------------------------
      Subtotal.....................................................       5,051,541        7,390,768        6,677,938       +1,626,397         -712,830
 
Military Construction, Army National Guard.........................         232,930          210,652          210,652          -22,278   ...............
Military Construction, Air National Guard..........................         143,957          161,491          161,491          +17,534   ...............
Military Construction, Army Reserve................................          68,230           73,712           73,712           +5,482   ...............
Military Construction, Navy Reserve................................          38,597           65,271           65,271          +26,674   ...............
Military Construction, Air Force Reserve...........................         188,950           63,535           63,535         -125,415   ...............
                                                                    ------------------------------------------------------------------------------------
      Subtotal,....................................................         672,664          574,661          574,661          -98,003   ...............
 
North Atlantic Treaty Organization Security Investment Program.....         177,932          154,000          154,000          -23,932   ...............
    Department of Defense Base Closure Account.....................         240,237          255,867          255,867          +15,630   ...............
                                                                    ------------------------------------------------------------------------------------
      Total, Military Construction.................................       6,142,374        8,375,296        7,662,466       +1,520,092         -712,830
                                                                    ====================================================================================
    Family Housing Operation and Maintenance, Army.................         325,995          346,625          348,907          +22,912           +2,282
    Family Housing Operation and Maintenance, Navy and Marine Corps         300,915          328,282          328,282          +27,367   ...............
    Family Housing Operation and Maintenance, Air Force............         274,429          318,324          318,324          +43,895   ...............
    Family Housing Operation and Maintenance, Defense-Wide.........          59,157           59,169           59,169              +12   ...............
                                                                    ------------------------------------------------------------------------------------
      Subtotal.....................................................         960,496        1,052,400        1,054,682          +94,186           +2,282
 
Family Housing Construction, Army..................................         157,172          182,662          182,662          +25,490   ...............
Family Housing Construction, Navy and Marine Corps.................          94,011           83,682           83,682          -10,329   ...............
Family Housing Construction, Air Force.............................          61,352           85,062           85,062          +23,710   ...............
                                                                    ------------------------------------------------------------------------------------
      Subtotal.....................................................         312,535          351,406          351,406          +38,871   ...............
 
DoD Family Housing Improvement Fund................................           3,258            2,726            2,726             -532   ...............
DoD Military Unaccompanied Housing Improvement Fund................  ...............             623              623             +623   ...............
                                                                    ------------------------------------------------------------------------------------
      Total, Family Housing........................................       1,276,289        1,407,155        1,409,437         +133,148           +2,282
                                                                    ====================================================================================
                     ADMINISTRATIVE PROVISIONS
 
Military Construction, Army (Sec. 126) (rescission)................         -29,602   ...............  ...............         +29,602   ...............
Military Construction, Navy and Marine Corps (H. Sec. 126)           ...............  ...............  ...............  ...............  ...............
 (rescission)......................................................
Military Construction, Air Force (Sec. 127) (rescission)...........         -51,460   ...............  ...............         +51,460   ...............
Military Construction, Defense-Wide--Planning and Design (Sec. 127)         -30,000   ...............  ...............         +30,000   ...............
Military Construction, Army (Sec. 125).............................          40,500   ...............          68,800          +28,300          +68,800
Military Construction, Navy and Marine Corps (Sec. 125)............         227,099   ...............         110,100         -116,999         +110,100
Military Construction, Air Force (Sec. 125)........................         149,500   ...............         127,300          -22,200         +127,300
Military Construction, Army National Guard (Sec. 125)..............          67,500   ...............          83,500          +16,000          +83,500
Military Construction, Air National Guard (Sec. 125)...............          11,000   ...............          24,000          +13,000          +24,000
Military Construction, Army Reserve (Sec. 125).....................          30,000   ...............          30,000   ...............         +30,000
Military Construction, Air Force Reserve (Sec. 125)................  ...............  ...............          35,100          +35,100          +35,100
NATO Security Investment Program (Sec. 127) (rescission)...........         -30,000   ...............  ...............         +30,000   ...............
42 USC 3374 (Sec. 128).............................................         -25,000   ...............  ...............         +25,000   ...............
Military Construction, Navy and Marine Corps (Sec. 126)............          89,400   ...............  ...............         -89,400   ...............
Military Construction, Defense-Wide (Sec. 126) (rescission)........        -141,600   ...............         -14,703         +126,897          -14,703
NATO Security Investment Program (Sec. 126)........................  ...............  ...............  ...............  ...............  ...............
Family Housing Construction, Army (Sec. 126).......................  ...............  ...............  ...............  ...............  ...............
Family Housing Construction, Navy and Marine Corps (Sec. 126)......  ...............  ...............  ...............  ...............  ...............
Family Housing Construction, Air Force (Sec. 126)..................  ...............  ...............  ...............  ...............  ...............
                                                                    ------------------------------------------------------------------------------------
      Total, Administrative Provisions.............................         307,337   ...............         464,097         +156,760         +464,097
        Appropriations.............................................        (614,999)  ...............        (478,800)       (-136,199)       (+478,800)
        Rescissions................................................       (-307,662)  ...............        (-14,703)       (+292,959)        (-14,703)
                                                                    ====================================================================================
      Total, title I, Department of Defense........................       7,726,000        9,782,451        9,536,000       +1,810,000         -246,451
        Appropriations.............................................      (8,033,662)      (9,782,451)      (9,550,703)     (+1,517,041)       (-231,748)
        Rescissions................................................       (-307,662)  ...............        (-14,703)       (+292,959)        (-14,703)
                                                                    ====================================================================================
              TITLE II--DEPARTMENT OF VETERANS AFFAIRS
 
                  Veterans Benefits Administration
 
Compensation and pensions:
    Advance from prior year........................................     (86,083,128)     (90,119,449)     (90,119,449)     (+4,036,321)  ...............
                                                                    ------------------------------------------------------------------------------------
          Subtotal, current year...................................      86,083,128       90,119,449       90,119,449       +4,036,321   ...............
 
    Advance appropriation, fiscal year 2019........................      90,119,449       95,768,462       95,769,000       +5,649,551             +538
 
Readjustment benefits:
    Advance from prior year........................................     (16,340,828)     (13,708,648)     (13,708,648)     (-2,632,180)  ...............
                                                                    ------------------------------------------------------------------------------------
          Subtotal.................................................      16,340,828       13,708,648       13,708,648       -2,632,180   ...............
 
    Advance appropriation, fiscal year 2019........................      13,708,648       11,832,175       11,832,000       -1,876,648             -175
 
Veterans insurance and indemnities:
    Advance from prior year........................................         (91,920)        (107,899)        (107,899)        (+15,979)  ...............
    Current year request...........................................          16,605           12,439           13,000           -3,605             +561
                                                                    ------------------------------------------------------------------------------------
      Subtotal.....................................................         108,525          120,338          120,899          +12,374             +561
 
    Advance appropriation, fiscal year 2019........................         107,899          109,090          109,000           +1,101              -90
 
Veterans housing benefit program fund:
    (Limitation on direct loans)...................................            (500)            (500)            (500)  ...............  ...............
    Administrative expenses........................................         198,856          178,626          178,626          -20,230   ...............
Vocational rehabilitation loans program account....................              36               30               30               -6   ...............
        (Limitation on direct loans)...............................          (2,517)          (2,356)          (2,356)           (-161)  ...............
        Administrative expenses....................................             389              395              395               +6   ...............
        Native American veteran housing loan program account.......           1,163            1,163            1,163   ...............  ...............
        General operating expenses, VBA............................       2,856,160        2,844,000        2,910,000          +53,840          +66,000
                                                                    ====================================================================================
      Total, Veterans Benefits Administration......................     107,009,205      110,746,380      110,813,214       +3,804,009          +66,834
        Appropriations.............................................      (3,073,209)      (3,036,653)      (3,103,214)        (+30,005)        (+66,561)
        Advance appropriations, fiscal year 2019...................    (103,935,996)    (107,709,727)    (107,710,000)     (+3,774,004)           (+273)
        Advances from prior year appropriations....................    (102,515,876)    (103,935,996)    (103,935,996)     (+1,420,120)  ...............
                                                                    ====================================================================================
                   Veterans Health Administration
 
Medical services:
    Advance from prior year........................................     (51,673,000)     (44,886,554)     (44,886,554)     (-6,786,446)  ...............
    Current year request...........................................       1,078,993        1,031,808        1,923,000         +844,007         +891,192
    Supplemental funding for opioid abuse prevention (Public Law             50,000   ...............  ...............         -50,000   ...............
     115-31)\1\....................................................
        Medical Services (Sec. 217) (rescission)...................      -7,246,181   ...............  ...............      +7,246,181   ...............
                                                                    ------------------------------------------------------------------------------------
      Subtotal.....................................................      45,555,812       45,918,362       46,809,554       +1,253,742         +891,192
 
    Advance appropriation, fiscal year 2019........................      44,886,554       49,161,165       49,161,000       +4,274,446             -165
Medical community care:
    Advance from prior year........................................  ...............      (9,409,118)      (9,409,118)     (+9,409,118)  ...............
    Current year request...........................................       7,246,181          254,000          254,000       -6,992,181   ...............
                                                                    ------------------------------------------------------------------------------------
      Subtotal.....................................................       7,246,181        9,663,118        9,663,118       +2,416,937   ...............
 
    Advance appropriation, fiscal year 2019........................       9,409,118        8,384,704        8,385,000       -1,024,118             +296
 
Medical support and compliance:
    Advance from prior year........................................      (6,524,000)      (6,654,480)      (6,654,480)       (+130,480)  ...............
    Current year request...........................................  ...............         284,397          100,000         +100,000         -184,397
                                                                    ------------------------------------------------------------------------------------
      Subtotal.....................................................       6,524,000        6,938,877        6,754,480         +230,480         -184,397
 
    Advance appropriation, fiscal year 2019........................       6,654,480        7,239,156        7,239,000         +584,520             -156
 
Medical facilities:
    Advance from prior year........................................      (5,074,000)      (5,434,880)      (5,434,880)       (+360,880)  ...............
    Current year request...........................................         247,668        1,079,795          707,000         +459,332         -372,795
                                                                    ------------------------------------------------------------------------------------
      Subtotal.....................................................       5,321,668        6,514,675        6,141,880         +820,212         -372,795
 
    Advance appropriation, fiscal year 2019........................       5,434,880        5,914,288        5,915,000         +480,120             +712
 
Medical and prosthetic research....................................         675,366          640,000          722,262          +46,896          +82,262
Medical care cost recovery collections:
    Offsetting collections.........................................      -2,637,000       -2,507,000       -2,507,000         +130,000   ...............
    Appropriations (indefinite)....................................       2,637,000        2,507,000        2,507,000         -130,000   ...............
                                                                    ------------------------------------------------------------------------------------
      Subtotal.....................................................  ...............  ...............  ...............  ...............  ...............
 
DoD-VA Joint Medical Funds (transfer out)..........................       (-274,731)       (-297,137)       (-297,137)        (-22,406)  ...............
DoD-VA Joint Medical Funds (by transfer)...........................        (274,731)        (297,137)        (297,137)        (+22,406)  ...............
DoD-VA Health Care Sharing Incentive Fund (Transfer out)                   (-15,000)        (-15,000)        (-15,000)  ...............  ...............
DoD-VA Health Care Sharing Incentive Fund (by transfer)                     (15,000)         (15,000)         (15,000)  ...............  ...............
                                                                    ====================================================================================
      Total, Veterans Health Administration........................      68,437,059       73,989,313       74,406,262       +5,969,203         +416,949
          Appropriations...........................................      (2,052,027)      (3,290,000)      (3,706,262)     (+1,654,235)       (+416,262)
          Rescissions..............................................  ...............  ...............  ...............  ...............  ...............
          (By transfer)............................................        (289,731)        (312,137)        (312,137)        (+22,406)  ...............
          Advance appropriations, fiscal year 2019.................     (66,385,032)     (70,699,313)     (70,700,000)     (+4,314,968)           (+687)
      Advances from prior year appropriations......................     (63,271,000)     (66,385,032)     (66,385,032)     (+3,114,032)  ...............
                                                                    ====================================================================================
                  National Cemetery Administration
 
National Cemetery Administration...................................         286,193          306,193          306,193          +20,000   ...............
 
                    Departmental Administration
 
General administration.............................................         345,391          346,891          329,891          -15,500          -17,000
Board of Veterans Appeals..........................................         156,096          155,596          166,000           +9,904          +10,404
Information technology systems.....................................       4,278,259        4,055,500        4,055,500         -222,759   ...............
Office of Inspector General........................................         160,106          159,606          164,000           +3,894           +4,394
Construction, major projects.......................................         528,110          512,430          512,430          -15,680   ...............
Construction, minor projects.......................................         372,069          342,570          342,570          -29,499   ...............
Grants for construction of State extended care facilities..........          90,000           90,000          110,000          +20,000          +20,000
Grants for the construction of veterans cemeteries.................          45,000           45,000           45,000   ...............  ...............
                                                                    ------------------------------------------------------------------------------------
      Total, Departmental Administration...........................       5,975,031        5,707,593        5,725,391         -249,640          +17,798
                                                                    ====================================================================================
                     Administrative Provisions
 
JIF rescission (Sec. 235)..........................................         -40,000   ...............         -15,000          +25,000          -15,000
General rescission (Sec. 233)......................................        -169,000   ...............  ...............        +169,000   ...............
General reduction (Sec. 234).......................................         -23,000   ...............  ...............         +23,000   ...............
Proposed mandatory disability exams language.......................  ...............          40,000   ...............  ...............         -40,000
Medical services (Sec. 217) (rescission)...........................  ...............  ...............        -751,000         -751,000         -751,000
Information technology services (Sec. 250) (rescission)              ...............  ...............         -30,000          -30,000          -30,000
 
Construction, major projects:
    Sec. 243(a) rescission (emergency).............................  ...............  ...............  ...............  ...............  ...............
    Sec. 243(b) reappropriation (emergency)........................  ...............  ...............  ...............  ...............  ...............
    Sec. 244(a) rescission.........................................  ...............  ...............         -10,000          -10,000          -10,000
    Sec. 244(b) reappropriation....................................  ...............  ...............          10,000          +10,000          +10,000
    Sec. 244(c) rescission.........................................  ...............  ...............        -410,000         -410,000         -410,000
    Sec. 244(d) reappropriation....................................  ...............  ...............         410,000         +410,000         +410,000
                                                                    ------------------------------------------------------------------------------------
      Total. Administrative Provisions.............................        -232,000           40,000         -796,000         -564,000         -836,000
                                                                    ====================================================================================
      Total, title II..............................................     181,475,488      190,789,479      190,455,060       +8,979,572         -334,419
          Appropriations...........................................     (11,363,460)     (12,380,439)     (12,841,060)     (+1,477,600)       (+460,621)
          Reappropriations.........................................  ...............  ...............        (420,000)       (+420,000)       (+420,000)
          Reappropriations (emergency).............................  ...............  ...............  ...............  ...............  ...............
          Rescissions..............................................       (-209,000)  ...............     (-1,216,000)     (-1,007,000)     (-1,216,000)
          Rescissions (emergency)..................................  ...............  ...............  ...............  ...............  ...............
          (By transfer)............................................        (289,731)        (312,137)        (312,137)        (+22,406)  ...............
Advance Appropriations, fiscal year 2019:
    (Limitation on direct loans)...................................          (3,017)          (2,856)          (2,856)           (-161)  ...............
        Advances from prior year less fiscal year 2019 advances....  ...............  ...............  ...............  ...............  ...............
        Advances from prior year less fiscal year 2019 advances....  ...............  ...............  ...............  ...............  ...............
 
                    TITLE III--RELATED AGENCIES
 
                American Battle Monuments Commission
 
Salaries and expenses..............................................          75,100           75,100           79,000           +3,900           +3,900
Foreign currency fluctuations account..............................  ...............  ...............  ...............  ...............  ...............
                                                                    ------------------------------------------------------------------------------------
      Total, American Battle Monuments Commission..................          75,100           75,100           79,000           +3,900           +3,900
                                                                    ====================================================================================
             U.S. Court of Appeals for Veterans Claims
 
Salaries and expenses..............................................          30,945           33,608           33,608           +2,663   ...............
 
                    Department of Defense--Civil
 
                     Cemeterial Expenses, Army
 
Salaries and expenses..............................................          70,800           70,800           81,000          +10,200          +10,200
 
              Armed Forces Retirement Home--Trust Fund
 
Operation and maintenance..........................................          41,300           41,300           41,300   ...............  ...............
Capital program....................................................           1,000            1,000            1,000   ...............  ...............
Payment from General Fund..........................................          22,000           22,000           22,000   ...............  ...............
                                                                    ------------------------------------------------------------------------------------
      Total, Armed Forces Retirement Home..........................          64,300           64,300           64,300   ...............  ...............
                                                                    ====================================================================================
      Total, title III.............................................         241,145          243,808          257,908          +16,763          +14,100
                                                                    ====================================================================================
             TITLE IV--OVERSEAS CONTINGENCY OPERATIONS
 
                  Overseas Contingency Operations
 
Army...............................................................  ...............         124,000          124,000         +124,000   ...............
    Additional funding for planning and design (Public Law 115-31).          39,500   ...............  ...............         -39,500   ...............
        Navy.......................................................          38,409   ...............  ...............         -38,409   ...............
    Additional funding for construction (Public Law 115-31)........          66,708   ...............  ...............         -66,708   ...............
                                                                    ------------------------------------------------------------------------------------
      Subtotal.....................................................         105,117   ...............  ...............        -105,117   ...............
 
Air Force..........................................................          11,440          207,200          207,200         +195,760   ...............
    Additional funding for construction (Public Law 115-31)........          93,000   ...............  ...............         -93,000   ...............
                                                                    ------------------------------------------------------------------------------------
      Subtotal.....................................................         104,440          207,200          207,200         +102,760   ...............
 
Defense-Wide.......................................................  ...............  ...............  ...............  ...............  ...............
Army National Guard:
    Additional funding for planning and design (Public Law 115-31).          12,000   ...............  ...............         -12,000   ...............
Air National Guard:
    Additional funding for construction (Public Law 115-31)........          13,000   ...............  ...............         -13,000   ...............
Army Reserve:
    Additional funding for planning and design (Public Law 115-31).          10,000   ...............  ...............         -10,000   ...............
Navy Reserve:
    Additional funding for construction (Public Law 115-31)........           4,525   ...............  ...............          -4,525   ...............
Air Force Reserve:
    Additional funding for planning and design (Public Law 115-31).           9,000   ...............  ...............          -9,000   ...............
                                                                    ------------------------------------------------------------------------------------
          Subtotal.................................................         297,582          331,200          331,200          +33,618   ...............
 
                  European Reassurance Initiative
 
Army...............................................................          18,900           15,700           15,700           -3,200   ...............
Navy...............................................................          21,400           18,500           18,500           -2,900   ...............
Air Force..........................................................          68,280          270,830          270,830         +202,550   ...............
    Additional funding for planning and design (Public Law 115-31).          12,300   ...............  ...............         -12,300   ...............
                                                                    ------------------------------------------------------------------------------------
      Subtotal.....................................................          80,580          270,830          270,830         +190,250   ...............
 
Defense-Wide.......................................................           5,000            1,900            1,900           -3,100   ...............
 
                      Administrative Provision
 
Military Construction, Air Force (Sec. 101, Public Law 115-31)              -12,300   ...............  ...............         +12,300   ...............
 (rescission)......................................................
                                                                    ------------------------------------------------------------------------------------
      Subtotal.....................................................         113,580          306,930          306,930         +193,350   ...............
 
                      Counterterrorism Support
 
Air Force..........................................................           8,571   ...............  ...............          -8,571   ...............
                                                                    ====================================================================================
      Total, title IV..............................................         419,733          638,130          638,130         +218,397   ...............
                                                                    ====================================================================================
      Grand total..................................................     189,862,366      201,453,868      200,887,098      +11,024,732         -566,770
          Appropriations...........................................     (19,638,267)     (22,406,698)     (22,649,671)     (+3,011,404)       (+242,973)
          Reappropriations.........................................  ...............  ...............        (420,000)       (+420,000)       (+420,000)
          Reappropriations (emergency).............................  ...............  ...............  ...............  ...............  ...............
          Rescissions..............................................       (-516,662)  ...............     (-1,230,703)       (-714,041)     (-1,230,703)
          Rescission of OCO........................................        (-12,300)  ...............  ...............        (+12,300)  ...............
          Rescissions (emergency)..................................  ...............  ...............  ...............  ...............  ...............
          Advance appropriations, fiscal year 2019.................    (170,321,028)    (178,409,040)    (178,410,000)     (+8,088,972)           (+960)
          Overseas contingency operations..........................        (432,033)        (638,130)        (638,130)       (+206,097)  ...............
      Advances from prior year appropriations......................    (165,786,876)    (170,321,028)    (170,321,028)     (+4,534,152)  ...............
      (By transfer)................................................        (289,731)        (312,137)        (312,137)        (+22,406)  ...............
      (Transfer out)...............................................       (-289,731)       (-312,137)       (-312,137)        (-22,406)  ...............
      (Limitation on direct loans).................................          (3,017)          (2,856)          (2,856)           (-161)  ...............
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\Funding for opioid abuse prevention was included in the fiscal year 2017 supplemental. In fiscal year 2018, it is provided within the amount
  recommended by the Committee.

                                                         [all]