department of veterans affairs · department of veterans affairs veterans health administration...

DEPARTMENT OF VETERANS AFFAIRS

VETERANS HEALTH ADMINISTRATIONFederal Funds

MEDICAL SERVICES

For necessary expenses for furnishing, as authorized by law, inpatient and outpatientcare and treatment to beneficiaries of the Department of Veterans Affairs and veteransdescribed in section 1705(a) of title 38, United States Code, including care andtreatment in facilities not under the jurisdiction of the Department, and includingmedical supplies and equipment, bioengineering services, food services, and salariesand expenses of healthcare employees hired under title 38, United States Code, aidto State homes as authorized by section 1741 of title 38, United States Code, assist-ance and support services for caregivers as authorized by section 1720G of title 38,United States Code, loan repayments authorized by section 604 of the Caregiversand Veterans Omnibus Health Services Act of 2010 (Public Law 111–163; 124 Stat.1174; 38 U.S.C. 7681 note), monthly assistance allowances authorized by section322(d) of title 38, United States Code, grants authorized by section 521A of title38, United States Code, and administrative expenses necessary to carry out sections322(d) and 521A of title 38, United States Code, and hospital care and medical ser-vices authorized by section 1787 of title 38, United States Code; [$750,000,000,which shall be in addition to funds previously appropriated under this heading thatbecome available on October 1, 2018; and, in addition, $51,411,165,000]$56,158,015,000, plus reimbursements, shall become available on October 1, [2019]2020, and shall remain available until September 30, [2020] 2021: Provided, That,of [the] such amount [made available on October 1, 2019, under this heading],$1,500,000,000 shall remain available until September 30, [2021] 2022: Providedfurther, That, notwithstanding any other provision of law, the Secretary of VeteransAffairs shall establish a priority for the provision of medical treatment for veteranswho have service-connected disabilities, lower income, or have special needs:Provided further, That, notwithstanding any other provision of law, the Secretaryof Veterans Affairs shall give priority funding for the provision of basic medicalbenefits to veterans in enrollment priority groups 1 through 6: Provided further,That, notwithstanding any other provision of law, the Secretary of Veterans Affairsmay authorize the dispensing of prescription drugs from Veterans Health Adminis-tration facilities to enrolled veterans with privately written prescriptions based onrequirements established by the Secretary: Provided further, That the implementationof the program described in the previous proviso shall incur no additional cost tothe Department of Veterans Affairs: Provided further, That the Secretary of VeteransAffairs shall ensure that sufficient amounts appropriated under this heading formedical supplies and equipment are available for the acquisition of prosthetics de-signed specifically for female veterans. (Military Construction, Veterans Affairs,and Related Agencies Appropriations Act, 2019.)

Special and Trust Fund Receipts (in millions of dollars)

2020 est.2019 est.2018 actualIdentification code 036–0160–0–1–703

2842847,868Balance, start of year ....................................................................0100..................................–7,380Permanent reduction adjustment ..................................................0198..................................–216Reconciliation adjustment .............................................................0198

284284272Balance, start of year ................................................................0199Receipts:

Current law:440436433Pharmaceutical Co-payments, MCCF ....................................1130

127122112Medical Care Collections Fund, Third Party Prescription

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

111Enhanced-use Lease Proceeds, MCCF ...................................1130446354293Fee Basis 3rd Party MCCF .....................................................1130185180174First Party Collections, MCCF ................................................1130

2,6382,4592,446Third Party Collections, MCCF ...............................................1130444Parking Fees, MCCF ...............................................................1130

666660Compensated Work Therapy, MCCF ........................................1130332MCCF, Long-term Care Copayments ......................................1130223Payments from Compensation and Pension, MCCF ...............1140

3,9123,6273,528Total current law receipts ..................................................1199

3,9123,6273,528Total receipts .............................................................................1999

4,1963,9113,800Total: Balances and receipts .....................................................2000Appropriations:

Current law:–3,912–3,627–3,515Medical Care Collections Fund ..............................................2101

..................................–1Rounding adjustment ....................................................................5098

284284284Balance, end of year ..................................................................5099

Program and Financing (in millions of dollars)


Obligations by program activity:20,94019,00518,252Outpatient care .........................................................................00017,7037,6197,397Inpatient care ............................................................................00027,2496,8225,537Mental health care ....................................................................00043,8153,6413,573Long-term care ..........................................................................00057,9697,5087,182Pharmacy ..................................................................................00063,9013,6093,347Prosthetics care ........................................................................0007765697655Dental care ................................................................................0008735706697Rehabilitation ...........................................................................0009599601541Homeless Grants .......................................................................0010229221205Readjustment Counseling .........................................................0011700489476Caregivers (Title I) P.L. 111–163 ...............................................0012

..................................66Prior-Year Recoveries ................................................................0013337329.................CHAMPVA (VA Portion) ...............................................................0015143135P.L. 113–146, Sec. 301 ..............................................................0023

..................................2P.L. 113–146, Prior Year Recoveries ..........................................0029

54,95651,27847,965Total operating expenses ...............................................................00914021,1811,008Outpatient care .........................................................................0101158467443Inpatient care ............................................................................0102308984Mental health care ....................................................................010357169160Long-term care ..........................................................................0104185350Pharmacy ..................................................................................0105175148Dental care ................................................................................0107102827Rehabilitation ...........................................................................0108144Readjustment Counseling .........................................................0109

6932,0421,824Total Capital Investment ...............................................................0191

55,64953,32049,789Total direct obligations ..................................................................0799137137108Medical Services (Reimbursable) ..............................................0801

55,78653,45749,897Total new obligations, unexpired accounts ....................................0900

Budgetary resources:Unobligated balance:

1,0141,3872,055Unobligated balance brought forward, Oct 1 .........................1000..................................67Recoveries of prior year unpaid obligations ...........................1021

1,0141,3872,122Unobligated balance (total) ......................................................1050Budget authority:

Appropriations, discretionary:.................7501,974Appropriation ....................................................................1100

3,4493,2563,226Appropriations transferred from other acct [036–5287] ....1121

..................................–751Unobligated balance of appropriations permanently

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

3,4494,0064,449Appropriation, discretionary (total) .......................................1160Advance appropriations, discretionary:

51,41149,16144,887Advance appropriation ..................................................1170

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

1172


1172

..................................–68Advance appropriations transferred to other accounts[036–0162] ..................................................................

1172

51,18648,94144,605Advanced appropriation, discretionary (total) ...................1180Spending authority from offsetting collections, discretionary:

135135106Collected ...........................................................................1700222Change in uncollected payments, Federal sources ............1701

137137108Spending auth from offsetting collections, disc (total) .........175054,77253,08449,162Budget authority (total) .............................................................190055,78654,47151,284Total budgetary resources available ..............................................1930

Memorandum (non-add) entries:.................1,0141,387Unexpired unobligated balance, end of year ..........................1941

Change in obligated balance:Unpaid obligations:

8,0646,6236,969Unpaid obligations, brought forward, Oct 1 ..........................300055,78653,45749,897New obligations, unexpired accounts ....................................3010

..................................333Obligations ("upward adjustments"), expired accounts ........3011–53,793–52,016–49,138Outlays (gross) ......................................................................3020

..................................–67Recoveries of prior year unpaid obligations, unexpired .........3040

..................................–1,371Recoveries of prior year unpaid obligations, expired .............3041

10,0578,0646,623Unpaid obligations, end of year .................................................3050Uncollected payments:

–8–6–6Uncollected pymts, Fed sources, brought forward, Oct 1 ........3060–2–2–2Change in uncollected pymts, Fed sources, unexpired ..........3070

967

MEDICAL SERVICES—Continued

Program and Financing—Continued


..................................2Change in uncollected pymts, Fed sources, expired ..............3071

–10–8–6Uncollected pymts, Fed sources, end of year .............................3090Memorandum (non-add) entries:

8,0566,6176,963Obligated balance, start of year ............................................310010,0478,0566,617Obligated balance, end of year ..............................................3200

Budget authority and outlays, net:Discretionary:

54,77253,08449,162Budget authority, gross .........................................................4000Outlays, gross:

47,28245,84443,067Outlays from new discretionary authority ..........................40106,4826,1436,030Outlays from discretionary balances .................................4011

53,76451,98749,097Outlays, gross (total) .............................................................4020Offsets against gross budget authority and outlays:

Offsetting collections (collected) from:–41–41–41Federal sources .................................................................4030–94–94–155Non-Federal sources .........................................................4033

–135–135–196Offsets against gross budget authority and outlays (total) ....4040Additional offsets against gross budget authority only:

–2–2–2Change in uncollected pymts, Fed sources, unexpired .......4050..................................90Offsetting collections credited to expired accounts ...........4052

–2–288Additional offsets against budget authority only (total) ........4060

54,63552,94749,054Budget authority, net (discretionary) .........................................407053,62951,85248,901Outlays, net (discretionary) .......................................................4080

Mandatory:Outlays, gross:

292941Outlays from mandatory balances ....................................410154,63552,94749,054Budget authority, net (total) ..........................................................418053,65851,88148,942Outlays, net (total) ........................................................................4190

In 2020, the Administration requests an additional $4.6 billion over the2020 advance appropriation of $75.6 billion for the Department of VeteransAffairs (VA) Medical Care program, consisting of four appropriations:Medical Services, Medical Community Care, Medical Support and Com-pliance, and Medical Facilities. Each year, VA updates its budget estimatesto incorporate the most recent data on health care utilization rates, actualprogram experience, and other factors, such as economic trends in unem-ployment and inflation. As a result of these updates, the adjusted budgetestimates more accurately reflect the projected medical demands of veteransenrolled in the VA health care system. In 2020, the Budget supports imple-mentation of the VA Maintaining Internal Systems and Strengthening In-tegrated Outside Networks (MISSION) Act of 2018 (P.L. 115–182) andprovides veterans greater choice on where they receive their health-care—whether at VA or through a private healthcare provider. The Budgetconsolidates all veterans' community care programs into a single program,reducing bureaucracy and making it easier for veterans to navigate theirhealthcare needs. As part of the MISSION Act, the Budget supports VA'sbrand new urgent care benefit and expansion of the Caregivers programto include eligible veterans who incurred or aggravated a serious injury inthe line of duty before September 11, 2001. Expansion of the Caregiversprogram would coincide with new information technology (IT) updatesnecessary to effectively manage the program.

For 2021, the Budget requests $87.6 billion in advance appropriationsfor VA Medical Care. This request for advance appropriations fulfills theAdministration's commitment to provide reliable and timely resources tosupport the delivery of accessible and high-quality medical services forveterans.

With the resources requested for 2020 and 2021, VA will provide thehighest quality health care services for veterans. VA estimates it will treat7.1 million patients in 2020 and 7.1 million patients in 2021. OperationEnduring Freedom, Operation Iraqi Freedom, and Operation New Dawn(OEF/OIF/OND) veterans are expected to be 1,102,752 in 2020 (15.6percent of the total) and 1,174,404 in 2021 (16.5 percent of the total).

Medical Care Collections Fund (MCCF).—VA estimates collections ofnearly $3.6 billion in 2019 and $3.9 billion in 2020, representing about

five percent of available Medical Care resources in both years. VA has theauthority to collect inpatient and outpatient co-payments, medication co-payments, and nursing home co-payments; authority for certain incomeverification; authority to recover third-party insurance payments fromveterans for nonservice-connected conditions; and authority to collectrevenue from enhanced use leases. These collections also include thosecollected from the Compensated Work Therapy Program, Compensationand Living Expenses Program, and the Parking Program.

Medical Services.—For Medical Services, the Budget reflects the follow-ing discretionary appropriation funding: the 2019 enacted advance appro-priation of $49.2 billion, together with $750 million provided by the Energyand Water, Legislative Branch, and Military Construction and VeteransAffairs Appropriations Act, 2019 (P.L. 115–244); the 2020 advance appro-priation of $51.4 billion; and the 2021 advance appropriation request of$56.2 billion. This appropriation provides for a comprehensive, integratedhealth care delivery system that addresses the needs of eligible veteransand beneficiaries in VA facilities and through non-VA, or community care,providers, including medical centers, outpatient clinic facilities, contracthospitals, State homes, and outpatient programs on a fee basis. Hospitaland outpatient care is also provided by the private sector for certain depend-ents and survivors of veterans under the Civilian Health and Medical Pro-grams for the Department of Veterans Affairs (CHAMPVA). In additionto this funding, the Budget reflects balances from mandatory fundingprovided in section 801 of the Veterans Choice Act (P.L. 113–146): $47million in unobligated balances remained available at the start of 2019.

WORKLOAD

Estimated obligations and workload for seven categories of health careservices are shown below: outpatient care, inpatient care, mental healthcare, long term services and supports, prosthetics care, dental care, andrehabilitation care. In addition, estimated obligations and workload arealso shown for six programs: CHAMPVA and other dependent programs,readjustment counseling, Caregivers, pharmacy, the Camp Lejeune FamilyMember program, and State Home programs.

Outpatient care.—Obligations for 2020 are estimated to be $21,342million in the Medical Services account and $6,629 million in the MedicalCommunity Care account for this health service category, which includesfunding for ambulatory care in VA hospital-based and community-basedclinics.

Estimated operating levels are:2020 est.2019 est.2018 actualVisits

88,300,77687,126,00786,115,777VA .........................................................................................................27,124,43727,340,91724,310,319Community Care ...................................................................................

117,425,213114,466,924110,426,096Total .....................................................................................................

Inpatient care.—Obligations for 2020 are estimated to be $7,861 millionin the Medical Services account, and $3,167 million in the Medical Com-munity Care account.

Estimated operating levels are:2020 est.2019 est.2018 actualPatients Treated350,482350,470350,586Acute Hospital, Medicine ......................................................................

4,4244,7635,142Acute Hospital, Neurology .....................................................................86,12289,32292,723Acute Hospital, Surgery ........................................................................

187,152183,074177,761Acute Hospital (Community Care) ........................................................1,0691,2121,333Subacute (Intermediate) ......................................................................

629,249628,841627,545Total .....................................................................................................

Mental health care.—Obligations for 2020 are estimated to be $7,279million in the Medical Services account and $249 million in the MedicalCommunity Care account for the inpatient, residential, and outpatient careof veterans with conditions related to mental illness, including alcohol anddrug problems. Mental health services and operations ensure the availabilityof a range of services, from treatment of a variety of common mental healthconditions in primary care to more intensive interventions in specialtymental health programs for more severe and persisting mental health con-ditions. Specialty services such as evidence-based psychotherapies, intensiveoutpatient programs, residential rehabilitation treatment, and inpatient careare available to meet the range of veterans' needs.

THE BUDGET FOR FISCAL YEAR 2020968 Veterans Health Administration—ContinuedFederal Funds—Continued

Estimated operating levels are:2020 est.2019 est.2018 actualAverage Daily Census

2,0682,1592,248Acute Psychiatry ...................................................................................537527496Acute Psychiatry (Community Care) .....................................................

5,6995,7035,701Residential Recovery Programs ............................................................

8,3048,3898,445Total .....................................................................................................

Long term services and supports (LTSS).—Obligations for 2020 are es-timated to be $3,872 million in the Medical Services account and $2,724million in the Medical Community Care account for the care of veteranresidents in VA- and community-operated long-term care programs. VAoffers a spectrum of geriatric and extended care services to veterans enrolledin its health care system. The spectrum of long-term care services includesnon-institutional and institutional services. All VA medical centers providehome- and community-based long-term care programs. The patient-focusedapproach supports veterans who wish to live safely at home in their owncommunities for as long as possible.

Estimated operating levels are:2020 est.2019 est.2018 actualLTSS Facility-Based Services: Average Daily Census

8,6998,8148,929VA Community Living Center (Nursing Home) .......................................10,75410,2979,809Community Nursing Home ....................................................................

19,45319,11118,738Total .....................................................................................................

2020 est.2019 est.2018 actualLTSS Home & Community-Based Services: Visits/Procedures894,102920,725945,237Community Adult Day Health Care .......................................................92,12897,777103,643Community Residential Care ................................................................

584,308576,136563,974Home Hospice Care ..............................................................................264,556274,395282,244Home Respite Care ...............................................................................

1,643,5791,739,3131,830,065Home Telehealth ...................................................................................1,870,6861,840,6371,798,749Home-Based Primary Care ...................................................................

14,065,14113,408,76412,523,524Homemaker/Home Health Aide Programs .............................................1,927,7531,906,1931,901,229Purchased Skilled Home Care ...............................................................

20,26720,27820,339Spinal Cord Injury Home Care ...............................................................16,83815,58314,625State Adult Day Health Care .................................................................92,849107,023122,005VA Adult Day Health Care .....................................................................

21,472,20820,906,82320,105,634Total .....................................................................................................

Prosthetics care.—Obligations in the Medical Services account for 2020are estimated to be $3,901 million for veterans. Prosthetic and SensoryAids Service is an integrated delivery system designed to provide medicallyprescribed prosthetic and sensory aids, medical devices, assistive aids, re-pairs and services to eligible disabled veterans to maximize their independ-ence and enhance their quality of life. This includes, but is not limited to,artificial limbs, hearing aids, and home oxygen; items that improve access-ibility such as ramps and vehicle modifications, wheelchairs and mobilityaids; and devices surgically placed in the veteran, such as stents.

Dental care.—Obligations for 2020 are estimated to be $782 million inthe Medical Services account and $248 million in the Medical CommunityCare account for the treatment of veterans who require dental care. Dentalcare services are provided to eligible veterans with a "medical conditionnegatively impacted by poor dentition." These patients may include poorlycontrolled diabetic patients, patients with head or neck cancer, organtransplant patients, and others. Veterans with a 100-percent service-connec-ted disability are eligible for comprehensive dental care as needed. In addi-tion, homeless veterans enrolled in certain residential treatment programsare also eligible for dental treatment.

Estimated operating levels are:2020 est.2019 est.2018 actualProcedures5,013,7724,916,2454,776,921VA .........................................................................................................738,697679,137594,052Community Care ...................................................................................

5,752,4695,595,3825,370,973Total .....................................................................................................

Rehabilitation.—Obligations for 2020 are estimated to be $782 millionin the Medical Services account and $248 million in the Medical Com-munity Care account for the provision of rehabilitative care, includingBlind Rehabilitation and Spinal Cord Injury programs. These services in-clude inpatient and outpatient blind and vision rehabilitation programs,adjustment to blindness counseling, patient and family education, and as-sistive technology. The mission of Spinal Cord Injury and Disorders(SCI/D) services is to promote the health, independence, quality of life andproductivity of individuals with spinal cord injury and disorders through

efficient delivery of acute rehabilitation, psychological, social, vocational,medical and surgical care, professional training, as well as patient andfamily education.

Estimated operating levels are:2020 est.2019 est.2018 actualAverage Daily Census

159160161Rehabilitative Medicine ........................................................................251251252Blind Rehabilitation .............................................................................759761760Spinal Cord Injury .................................................................................

1,1721,1721,173Total .....................................................................................................

Civilian Health and Medical Program of the Department of VeteransAffairs (CHAMPVA) and other Dependent Programs.—Obligations for2020 are estimated to be $337 million in the Medical Services account and$1,465 million in the Medical Community Care account for pharmacy andmedical service personnel for CHAMPVA and other dependent programs.

Estimated operating levels are:2020 est.2019 est.2018 actualUnique Patients

11,70012,30013,236CHAMPVA In-house Treatment Initiative (CITI) .....................................412,000379,700364,664CHAMPVA (excluding CITI) ....................................................................

3,9003,7003,259Foreign Medical Program (medical only) ..............................................250250223Foreign Compensation & Pension Exams ..............................................905905904Spina Bifida Health Care Benefits Program .........................................

428,755396,855382,286Total .....................................................................................................

Readjustment Counseling.—Obligations in the Medical Services accountfor 2020 are estimated to be $230 million. This program provides readjust-ment counseling services at VA Vet Centers. Vet Centers are community-based counseling centers that provide a wide range of social and psycholo-gical services to include: professional readjustment counseling to veteranswho have served in a combat zone, military sexual trauma counseling, be-reavement counseling for families who experience an active duty death,substance abuse assessments and referral, medical referral, Veterans Bene-fits Administration (VBA) benefits explanation and referral, and employ-ment counseling. Services are also extended to the family members of eli-gible veterans for issues related to military service and the readjustmentof those veterans.

Estimated operating levels are:2020 est.2019 est.2018 actualVisits2,470,0002,287,0002,118,000Total .....................................................................................................

Caregivers (Title I) Programs.—Obligations in the Medical Servicesaccount for 2020 are estimated to be $700 million. The Caregivers andVeterans Omnibus Health Services Act of 2010 (P.L. 111–163), authorizedVA to provide assistance and support services for Caregivers of eligibleveterans. This program provides a wide range of services for primarycaregivers to include: a monthly personal caregiver stipend, respite care,access to mental health services, beneficiary travel, and health care benefitsthrough the existing CHAMPVA Program.

Estimated operating levels are:2020 est.2019 est.2018 actual

$583$436$385Caregiver Stipend (dollars in millions) .................................................

35,14026,90124,412Participants in the Program of Comprehensive Assistance for Family

Caregivers ........................................................................................

Pharmacy.—Obligations in the Medical Services account for 2020 areestimated to be $7,987 million for pharmacy costs. VA's use of medicationtherapies is a fundamental underpinning of how VA delivers health caretoday. VA's primary focus is on diagnosis and treatment in an ambulatoryenvironment and home environment basis with institutional care as themodality of last resort.

Estimated operating levels are:2020 est.2019 est.2018 actualNumber of 30-day Prescriptions (in millions)

295291288Total .....................................................................................................

Camp Lejeune Family Member Program.—Obligations in the MedicalCommunity Care account for 2020 are estimated to be $1 million for theCamp Lejeune Family Member program. The Honoring America's Veteransand Caring for Camp Lejeune Families Act of 2012 (P.L. 112–154) exten-ded eligibility for VA hospital care and medical services to certain veteranswho were stationed at Camp Lejeune, North Carolina, for at least 30 daysbetween 1957 and 1987. Family members of such veterans who resided,

969DEPARTMENT OF VETERANS AFFAIRSVeterans Health Administration—Continued

Federal Funds—Continued

MEDICAL SERVICES—Continued

or were in utero, at Camp Lejeune for at least 30 days during that periodare eligible for reimbursement of hospital care and medical services for 15specified illnesses and conditions, and VA is the payer of last resort.

State Home Programs.—Obligations in the Medical Community Careaccount for 2020 are estimated to be $1,514 million for State Home Pro-grams. State Veterans Homes are facilities approved by VA that a Statehas established primarily for the care of Veterans disabled by age, disease,or otherwise, who, because of such disability, are incapable of earning aliving. VA pays a per diem to States for the care of eligible veterans, butthe per diem rates are different for each of the three levels of care offered:Nursing Home Care, Domiciliary Care, or Adult Day Health Care (ADHC).

2020 est.2019 est.2018 actualPatients Treated33,08632,80532,528State Home Nursing .............................................................................5,3265,2925,275State Home Domiciliary ........................................................................

504948Average Daily Census (ADHC) ...............................................................

Public Law 113–146, Veterans Choice Act, Section 801.— The VeteransAccess, Choice, and Accountability Act of 2014 (P.L. 113–146) ("VeteransChoice Act") was enacted on August 7, 2014. The 2020 Budget supportscontinued implementation of the Veterans Choice Act and the Administra-tion's goal of providing timely, high-quality health care for our Nation'sveterans. The Veterans Choice Act provided $5 billion in mandatoryfunding in section 801 to increase veterans' access to health care by hiringmore physicians and staff and improving the VA's physical infrastructure.Obligations in the Medical Services account for 2020 are estimated to be$14 million for section 301 activities.

Estimated obligations in the Medical Services account are:2020 est.2019 est.2018 actual

373737FTE ...........................................................................................................2020 est.2019 est.2018 actualDollars in Millions

002Prior Year Recoveries ............................................................................143135Section 301 ..........................................................................................

143137Total .....................................................................................................

Object Classification (in millions of dollars)


Direct obligations:Personnel compensation:

22,22220,93219,690Full-time permanent .............................................................11.1666Full-time permanent - P.L. 113–146, Sec. 801 ......................11.1

471443418Other than full-time permanent ............................................11.32,5572,4092,265Other personnel compensation ..............................................11.5

111Other personnel compensation - P.L. 113–146, Sec. 801 .......11.5

25,25723,79122,380Total personnel compensation ...........................................11.98,4427,8287,285Civilian personnel benefits ........................................................12.1

111Civilian personnel benefits - P.L. 113–146, Sec. 801 ................12.11,1651,1201,076Travel & Transportation of Persons ............................................21.0

232221Transportation of things ............................................................22.0539514477Rent, Communications & Utilities .............................................23.210107Printing and reproduction .........................................................24.0

6,0795,0364,489Other contractual services ........................................................25.262327Other contractual serv. - P.L. 113–146, Sec. 801 ......................25.2

12,78612,28511,526Supplies & Materials .................................................................26.06922,0411,823Equipment .................................................................................31.0

111Land and structures ..................................................................32.0640640600Grants, Subsidies & Contributions ............................................41.0

888Insurance claims and indemnities ............................................42.0..................................66Prior-year Recoveries .................................................................44.0..................................2Prior Year Recoveries - P.L. 113–146, Sec. 801 .........................44.0

55,64953,32049,789Direct obligations ..................................................................99.0137137108Reimbursable obligations .....................................................99.0

55,78653,45749,897Total new obligations, unexpired accounts ............................99.9

Employment Summary


261,433249,570238,664Direct civilian full-time equivalent employment ............................1001613613484Reimbursable civilian full-time equivalent employment ...............2001

✦

MEDICAL COMMUNITY CARE

For necessary expenses for furnishing health care to individuals pursuant to chapter17 of title 38, United States Code, at non-Department facilities, [$1,000,000,000]$4,521,400,000, which shall be in addition to funds previously appropriated underthis heading that become available on October 1, [2018] 2019, and shall remainavailable until September 30, 2021; and, in addition, [$10,758,399,000]$17,131,179,000, plus reimbursements, shall become available on October 1, [2019]2020, and shall remain available until September 30, [2020] 2022 [: Provided,That, of the amount made available on October 1, 2019, under this heading,$2,000,000,000 shall remain available until September 30, 2021]. (Military Con-struction, Veterans Affairs, and Related Agencies Appropriations Act, 2019.)



Obligations by program activity:6,6292,4283,278Ambulatory ................................................................................0001248134150Dental .......................................................................................0002

3,1672,4392,088Inpatient ...................................................................................00031,0529971,031LTSS: Facility Based Services ....................................................00041,672898819LTSS: Home & Community Based Services .................................000524920030Mental Health ............................................................................0006

1,4651,3871,345CHAMPVA & Other Dependent Programs ....................................00071,5141,4191,312State Home Programs ................................................................0008

111Camp Lejeune, Veterans Families ..............................................0009..................................256Prior Year Recoveries .................................................................0013



300491470Unobligated balance brought forward, Oct 1 .........................1000..................................256Recoveries of prior year unpaid obligations ...........................1021..................................1Recoveries of prior year paid obligations ...............................1033

300491727Unobligated balance (total) ......................................................1050Budget authority:

Appropriations, discretionary:4,5211,000419Appropriation ....................................................................1100446354272Appropriations transferred from other acct [036–5287] ....1121

4,9671,354691Appropriation, discretionary (total) .......................................1160Advance appropriations, discretionary:



1172

10,7308,3589,383Advanced appropriation, discretionary (total) ...................118015,6979,71210,074Budget authority (total) .............................................................190015,99710,20310,801Total budgetary resources available ..............................................1930

Memorandum (non-add) entries:.................300491Unexpired unobligated balance, end of year ..........................1941





..................................–588Recoveries of prior year unpaid obligations, expired .............3041

4,7993,0652,508Unpaid obligations, end of year .................................................3050Memorandum (non-add) entries:






Offsetting collections (collected) from:..................................–1Federal sources .................................................................4030..................................–131Non-Federal sources .........................................................4033

..................................–132Offsets against gross budget authority and outlays (total) ....4040Additional offsets against gross budget authority only:

..................................131Offsetting collections credited to expired accounts ...........4052


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

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

..................................132Additional offsets against budget authority only (total) ........4060

15,6979,71210,074Budget authority, net (discretionary) .........................................407014,2639,3469,308Outlays, net (discretionary) .......................................................408015,6979,71210,074Budget authority, net (total) ..........................................................418014,2639,3469,308Outlays, net (total) ........................................................................4190

The Medical Community Care appropriation provides funding for com-munity care services to eligible veterans, which has been an essential partof the Department of Veterans Affairs (VA) health care system for decades.

The Budget reflects the following discretionary appropriation fundingfrom 2019 through 2021: the 2019 enacted advance appropriation of $8.4billion, together with an additional $1.0 billion as provided by the Energyand Water, Legislative Branch, and Military Construction and VeteransAffairs Appropriations Act, 2019 (Public Law 115–244); the 2020 advanceappropriation request of $10.8 billion and additional funding of $4.5 billionin support of the VA Maintaining Internal Systems and Strengthening In-tegrated Outside Networks (MISSION) Act of 2018 (Public Law 115–182);and the 2021 advance appropriation request of $17.1 billion. The VAMISSION Act of 2018 provides eligible veterans greater choice in wherethey receive their care.

The 2021 request for advance appropriation fulfills the Administration'scommitment to provide reliable and timely resources to support the deliveryof accessible and high-quality medical services for veterans.



Direct obligations:14,4838,4758,742Other Contractual Services ........................................................25.21,5141,4281,312State Homes ..............................................................................41.0

..................................256Prior Year Recoveries .................................................................44.0


✦

MEDICAL SUPPORT AND COMPLIANCE

For necessary expenses in the administration of the medical, hospital, nursinghome, domiciliary, construction, supply, and research activities, as authorized bylaw; administrative expenses in support of capital policy activities; and administrativeand legal expenses of the Department for collecting and recovering amounts owedthe Department as authorized under chapter 17 of title 38, United States Code, andthe Federal Medical Care Recovery Act (42 U.S.C. 2651 et seq.), $98,800,000,which shall be in addition to funds previously appropriated under this heading thatbecome available on October 1, 2019; and, in addition, [$7,239,156,000]$7,914,191,000, plus reimbursements, shall become available on October 1, [2019]2020, and shall remain available until September 30, [2020] 2021: Provided, That,of the amount made available on October 1, [2019] 2020, under this heading,[$100,000,000] $300,000,000 shall remain available until September 30, [2021]2022. (Military Construction, Veterans Affairs, and Related Agencies AppropriationsAct, 2019.)



Obligations by program activity:4,5784,4664,219VA Medical Centers & Other Field Activities ..............................0001203192182VISN Headquarters ....................................................................0002940859785VHA Central Office .....................................................................0003

..................................19Consolidated Patient Account Centers ......................................0004179175171Office of Informatics & Analytics ...............................................0005888666Employee Education Service Center ...........................................0008

260254277VHA Service Center ....................................................................00092020.................Consolidated Mail Outpatient Pharmacies ................................0013997National Center for Patient Safety .............................................0014

850763745Community Care ........................................................................0016177173187VHA Member Services ................................................................0017

885Readjustment Counseling .........................................................001933.................P.L. 113–146, Section 301/302 Activities ..................................0026

..................................1P.L. 113–146 Prior Year Recoveries ...........................................0030

7,3157,0086,664Total operating expenses ...............................................................0091

454342VAMCs & Other Field Activities ..................................................0102111VHA Service Center ....................................................................0109111VHA Member Services ................................................................0117

474544Total Capital Investment ...............................................................0191

7,3627,0536,708Total direct program ......................................................................0293

7,3627,0536,708Total direct obligations ..................................................................0799191930Medical Support and Compliance (Reimbursable) ....................0801



6211191Unobligated balance brought forward, Oct 1 .........................1000Budget authority:

Appropriations, discretionary:99.................103Appropriation ....................................................................1100

..................................–1Appropriations transferred to other accts [036–0142] .......1120

99.................102Appropriation, discretionary (total) .......................................1160Advance appropriations, discretionary:



1172

.................–211.................Advance appropriations permanently reduced ..............1174


191929Collected ...........................................................................1700..................................1Change in uncollected payments, Federal sources ............1701


Memorandum (non-add) entries:962111Unexpired unobligated balance, end of year ..........................1941






–3–3–2Uncollected pymts, Fed sources, brought forward, Oct 1 ........3060..................................–1Change in uncollected pymts, Fed sources, unexpired ..........3070





6,5056,2345,716Outlays from new discretionary authority ..........................4010684658871Outlays from discretionary balances .................................4011


Offsetting collections (collected) from:–19–19–30Federal sources .................................................................4030

..................................–8Non-Federal sources .........................................................4033


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





.................61Outlays from mandatory balances ....................................41017,3097,0046,728Budget authority, net (total) ..........................................................41807,1706,8796,550Outlays, net (total) ........................................................................4190

Medical Support and Compliance finances the expenses of management,security, and administration of the Department of Veterans Affairs (VA)healthcare system through the operation of VA medical centers, other fa-cilities, Veterans Integrated Service Network offices and facility director



MEDICAL SUPPORT AND COMPLIANCE—Continued

offices, chief of staff operations, quality of care oversight, legal services,billing and coding activities, procurement, financial management, and hu-man resource management.

For Medical Support and Compliance, the Budget reflects the followingdiscretionary appropriation funding from 2019 through 2021: the 2019enacted advance appropriation of $7.2 billion, together with a reductionof $211 million to reflect the rescission of funds provided by the Energyand Water, Legislative Branch, and Military Construction and VeteransAffairs Appropriations Act, 2019 (Public Law 115–244); the 2020 advanceappropriation request of $7.2 billion and additional funding of $98.8 millionin support of the VA Maintaining Internal Systems and Strengthening In-tegrated Outside Networks (MISSION) Act of 2018 (Public Law 115–182);and the 2021 advance appropriation request of $7.9 billion. In addition tothis funding, the Budget reflects balances from mandatory funding providedin section 801 of the Veterans Access, Choice, and Accountability Act of2014 (Public Law 113–146): $16 million in unobligated balances remainedavailable at the start of 2019.

The 2021 advance appropriations request fulfills the Administration'scommitment to provide reliable and timely resources to support the deliveryof accessible and high-quality medical services for veterans.




3,5543,4733,327Full-time permanent .............................................................11.1111Full-time permanent - Choice Act, P.L. 113–146, Sec. 801 ....11.1

767460Other than full-time permanent ............................................11.3409399382Other personnel compensation ..............................................11.5

4,0403,9473,770Total personnel compensation ...........................................11.91,4641,4091,332Civilian personnel benefits ........................................................12.1

636159Travel & Transportation of Persons ............................................21.0141414Transportation of things ............................................................22.0

108105102Communications, utilities, and miscellaneous charges ............23.3232322Printing and reproduction .........................................................24.0

1,4911,3401,261Other contractual services ........................................................25.2

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

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

1029996Medical supplies and materials ................................................26.0464443Equipment .................................................................................31.0111Land and structures ..................................................................32.0888Insurance claims and indemnities ............................................42.0



Employment Summary



✦

DOD-VA HEALTH CARE SHARING INCENTIVE FUND



Obligations by program activity:222214DOD-VA health care sharing incentive fund ..............................0001


706244Unobligated balance brought forward, Oct 1 .........................1000..................................2Recoveries of prior year unpaid obligations ...........................1021


Appropriations, discretionary:151515Appropriations transferred from other acct [097–0130] ....1121

Advance appropriations, discretionary:

151515Advance appropriations transferred from other accounts[036–0160] ..................................................................

1173

303030Budget authority (total) .............................................................19001009276Total budgetary resources available ..............................................1930



152335Unpaid obligations, brought forward, Oct 1 ..........................3000222214New obligations, unexpired accounts ....................................3010

–30–30–24Outlays (gross) ......................................................................3020..................................–2Recoveries of prior year unpaid obligations, unexpired .........3040

71523Unpaid obligations, end of year .................................................3050Memorandum (non-add) entries:

152335Obligated balance, start of year ............................................310071523Obligated balance, end of year ..............................................3200


303030Budget authority, gross .........................................................4000Outlays, gross:

303024Outlays from discretionary balances .................................4011303030Budget authority, net (total) ..........................................................4180303024Outlays, net (total) ........................................................................4190

The purpose of the Department of Defense-Veterans Affairs Health CareSharing Incentive Fund, often referred to as the Joint Incentive Fund (JIF),is to enable the Departments to carry out a program to identify and provideincentives to implement creative sharing initiatives at the facility, intra-regional and nationwide levels. The JIF promotes collaboration and newapproaches to problem solving to enable the Departments to improve thecoordination of health care services. The Departments have established thefund and developed processes and criteria to solicit and select projects.Section 721 of the National Defense Authorization Act for Fiscal Year2003, Public Law 107–314, established the fund and requires the Depart-ments to establish a joint incentive program. In 2020, each Secretary shallcontribute a minimum of $15 million to the fund after the appropriation isenacted.



Direct obligations:333Personnel compensation: Full-time permanent .........................11.1

12127Advisory and assistance services ..............................................25.1331Supplies and materials .............................................................26.0443Equipment .................................................................................31.0

222214Total new obligations, unexpired accounts ............................99.9

Employment Summary


202023Direct civilian full-time equivalent employment ............................1001

✦

MEDICAL FACILITIES

For necessary expenses for the maintenance and operation of hospitals, nursinghomes, domiciliary facilities, and other necessary facilities of the Veterans HealthAdministration; for administrative expenses in support of planning, design, projectmanagement, real property acquisition and disposition, construction, and renovationof any facility under the jurisdiction or for the use of the Department; for oversight,engineering, and architectural activities not charged to project costs; for repairing,altering, improving, or providing facilities in the several hospitals and homes underthe jurisdiction of the Department, not otherwise provided for, either by contract orby the hire of temporary employees and purchase of materials; for leases of facilities;and for laundry services; [$90,180,000, which shall be in addition to funds previouslyappropriated under this heading that become available on October 1, 2018; and, inaddition, $6,141,880,000] $6,433,265,000, plus reimbursements, shall becomeavailable on October 1, [2019] 2020, and shall remain available until September30, [2020] 2021: Provided, That, of [the] such amount [made available on October


1, 2019, under this heading], $250,000,000 shall remain available until September30, [2021] 2022. (Military Construction, Veterans Affairs, and Related AgenciesAppropriations Act, 2019.)



Obligations by program activity:824739663Engineering & Environmental Management Services ................0002

1,256867858Engineering Service ...................................................................0003142124108Grounds Maintenance & Fire Protection ....................................0004802752901Leases .......................................................................................0005

..................................30Non-Recurring Maintenance ......................................................0007233233233Operating Equipment Maintenance & Repair ............................0008363636Other Facilities Operation Support ............................................0009

1,151762761Plant Operation .........................................................................0011523523523Recurring Maintenance & Repair ..............................................0012163163163Textile Care Processing & Management .....................................0013213201190Transportation ...........................................................................0014

..................................7Prior-Year Recoveries ................................................................0023

.................13.................P.L. 113–146, Leases ................................................................002621.................P.L. 113–146, Sec. 301 ..............................................................0029

..................................15P.L. 113–146, Prior year Recoveries ...........................................0030

5,3454,4144,488Total operating expenses ...............................................................0091233527Engineering & Environmental Management Services ................0102152418Engineering Service ...................................................................0103475Grounds Maintenance & Fire Protection ....................................0104

117281.................Leases .......................................................................................01051,1761,7601,589Non-Recurring Maintenance ......................................................0106

121814Operating Equipment Maintenance & Repair ............................0107586Other Facilities Operation Support ............................................0108

253930Plant Operation .........................................................................0109111713Recurring Maintenance & Repair ..............................................0110324938Textile Care Processing & Management .....................................0111586Transportation ...........................................................................0122

..................................1P.L. 113–146, Leases ................................................................0125

..................................9P.L. 113–146, Non-Recurring Maintenance ...............................0127

.................2.................P.L. 113–146, Section 301 .........................................................0128

1,4252,2481,756Total capital investment ................................................................0191

6,7706,6626,244Total direct obligations ..................................................................0799181817Medical Facilities (Reimbursable) .............................................0801



1,1821,07852Unobligated balance brought forward, Oct 1 .........................1000..................................21Recoveries of prior year unpaid obligations ...........................1021..................................1Recoveries of prior year paid obligations ...............................1033

1,1821,07874Unobligated balance (total) ......................................................1050Budget authority:

Appropriations, discretionary:.................8901,782Appropriation ....................................................................1100

Advance appropriations, discretionary:6,1425,9145,435Advance appropriation ..................................................1170


1172

..................................68Advance appropriations transferred from other accounts[036–0160] ..................................................................

1173




Memorandum (non-add) entries:5151,1821,078Unexpired unobligated balance, end of year ..........................1941






















60129207Outlays from mandatory balances ....................................4101Offsets against gross budget authority and outlays:

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

Additional offsets against gross budget authority only:


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

60129206Outlays, net (mandatory) ...........................................................41706,1036,7667,248Budget authority, net (total) ..........................................................41806,3896,8305,512Outlays, net (total) ........................................................................4190

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

For Medical Facilities, the Budget reflects the following discretionaryappropriation funding from 2019 through 2021: the 2019 advance appro-priation of $5.9 billion and an annual appropriation of $890 million providedin the Energy and Water, Legislative Branch, and Military Constructionand Veterans Affairs Appropriations Act, 2019 (P.L. 115–244); the 2020advance appropriationof $6.1 billion; and the 2021 advance appropriationrequest of $6.4 billion. In addition to this funding, the Budget reflects bal-ances from mandatory funding provided in section 801 of the VeteransAccess, Choice, and Accountability Act of 2014 (P.L. 113–146): $21 mil-lion in unobligated balances remained available at the start of 2019.

The 2021 advance appropriation request fulfills the Administration'scommitment to provide reliable and timely resources to support the deliveryof accessible and high-quality medical services for veterans.




1,2981,2621,197Full-time permanent .............................................................11.1272625Other than full-time permanent ............................................11.3

150146138Other personnel compensation ..............................................11.5

1,4751,4341,360Total personnel compensation ...........................................11.9539514486Civilian personnel benefits ........................................................12.1484542Travel & Transportation of Persons ............................................21.0181817Transportation of things ............................................................22.0

1,4221,3701,276Rent, Communications & Utilities .............................................23.2.................13.................Rent, Communications & Utilities - P.L. 113–146, Sec. 801 .......23.2

1,461652728Other Contractual Services ........................................................25.221.................Other Contractual Services - P.L. 113–146, Sec. 801 ................25.2

361348339Supplies & Materials .................................................................26.041112109Equipment .................................................................................31.0



MEDICAL FACILITIES—Continued

Object Classification—Continued


1,3842,1341,836Lands & Structures ...................................................................32.0.................210Lands & Structures - P.L. 113–146, Sec. 801 ............................32.0

191919Insurance claims and indemnities ............................................42.0..................................7Prior Year Recoveries .................................................................44.0..................................15P.L. 113–146, Section 801 - Prior Year Recoveries ....................44.0



Employment Summary



✦

MEDICAL AND PROSTHETIC RESEARCH

For necessary expenses in carrying out programs of medical and prosthetic researchand development as authorized by chapter 73 of title 38, United States Code,[$779,000,000] $762,000,000, plus reimbursements, [shall] to remain availableuntil September 30, [2020] 2021 [: Provided, That of the amount made availableunder this heading, $27,000,000 shall remain available until September 30, 2023:Provided further, That the Secretary of Veterans Affairs shall ensure that sufficientamounts appropriated under this heading are available for prosthetic research spe-cifically for female veterans, and for toxic exposure research]. (Military Construc-tion, Veterans Affairs, and Related Agencies Appropriations Act, 2019.)



Obligations by program activity:298303289Bio-medical laboratory science research ...................................0001117114106Rehabilitation research .............................................................000211812399Health services research ...........................................................0003251278212Clinical science research ..........................................................0004

784818706Total operating expenses ...............................................................0091

784818706Total direct obligations ..................................................................0799555627Medical and Prosthetic Research (Reimbursable) .....................0801

839874733Total new obligations, unexpired accounts ....................................0900


10514596Unobligated balance brought forward, Oct 1 .........................1000..................................32Recoveries of prior year unpaid obligations ...........................1021..................................1Recoveries of prior year paid obligations ...............................1033


Appropriations, discretionary:762779722Appropriation ....................................................................1100

Spending authority from offsetting collections, discretionary:555526Collected ...........................................................................1700

..................................1Change in uncollected payments, Federal sources ............1701

555527Spending auth from offsetting collections, disc (total) .........1750817834749Budget authority (total) .............................................................1900922979878Total budgetary resources available ..............................................1930




..................................2Obligations ("upward adjustments"), expired accounts ........3011–801–791–672Outlays (gross) ......................................................................3020



425387304Unpaid obligations, end of year .................................................3050

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

..................................–1Change in uncollected pymts, Fed sources, unexpired ..........3070






580578352Outlays from new discretionary authority ..........................4010221213320Outlays from discretionary balances .................................4011

801791672Outlays, gross (total) .............................................................4020Offsets against gross budget authority and outlays:






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


762779722Budget authority, net (discretionary) .........................................4070746736644Outlays, net (discretionary) .......................................................4080762779722Budget authority, net (total) ..........................................................4180746736644Outlays, net (total) ........................................................................4190

For 2020, the total budgetary resources of over $2 billion is comprisedof $762 million in direct appropriations, $648 million in medical caresupport such as physicians' pay, utilities and other overhead, $570 millionin Federal grants and other non-Federal resources, and $55 million in reim-bursements. The Department of Veterans Affairs' (VA) research programwill support 3,165 full time equivalents through direct appropriations andreimbursable resources. These combined resources will support 2,200 re-search projects.

This account is an intramural research program with outstanding successleading to critical clinical achievements that improve the health and qualityof life for veterans and the Nation. As a health research program focusedexclusively on the needs of veterans, VA research continues to play a vitalrole in the care and rehabilitation of our men and women who have servedin uniform. Building on more than 90 years of discovery and innovationengaging veterans as research volunteers, VA research has a proud trackrecord of transforming VA healthcare by bringing new evidence-basedtreatments and technologies into everyday clinical care. In 2020, VA willcontinue to invest in several cross-cutting clinical priorities, includingsuicide prevention, opioid safety and pain management, post-traumaticstress disorder (PTSD), traumatic brain injury (TBI), mental health, andGulf War Illness. VA research has led the way in developing effectivetreatments, behavioral interventions, and devices in clinical trials. Theseinvestments support VA's strong track record of facilitating the implement-ation of research findings directly into clinical practice.

SUMMARY OF PROGRAM RESOURCES

[in millions of dollars]2020 est.2019 est.2018 actual

762779722Medical and prosthetic research appropriation ........................................648618544VA Medical Care Support ..........................................................................570570570Other Federal and Non-Federal Resources ................................................555627Reimbursements ......................................................................................

2,0352,0231,863Total program resources ...............................................................




248243233Full-time permanent .............................................................11.1


887Other than full-time permanent ............................................11.3554Other personnel compensation ..............................................11.5

261256244Total personnel compensation ...........................................11.9969588Civilian personnel benefits ........................................................12.1555Employee travel .........................................................................21.0111Communications, utilities, and miscellaneous charges ............23.311.................Printing and reproduction .........................................................24.0

343362281Other services from non-Federal sources ..................................25.2373937Supplies and materials .............................................................26.0405950Equipment .................................................................................31.0

784818706Direct obligations ..................................................................99.0555627Reimbursable obligations .....................................................99.0


Employment Summary



✦

JOINT DEPARTMENT OF DEFENSE-DEPARTMENT OF VETERANS AFFAIRS MEDICAL

FACILITY DEMONSTRATION FUND



Obligations by program activity:459437427Joint DOD-VA Medical Facility Demonstration Fund (Direct) .......0001

171715Joint DOD-VA Medical Facility Demonstration Fund

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




Appropriations, discretionary:888Appropriations transferred from other acct [036–0167] ....1121

127113116Appropriations transferred from other acct [097–0130] ....1121171717Appropriations transferred from other acct [036–5287] ....1121

152138141Appropriation, discretionary (total) .......................................1160Advance appropriations, discretionary:


1173


1173


1173


1173

306294290Advanced appropriation, discretionary (total) ...................1180Spending authority from offsetting collections, discretionary:

161815Collected ...........................................................................1700474450446Budget authority (total) .............................................................1900482462454Total budgetary resources available ..............................................1930










427407366Outlays from new discretionary authority ..........................4010

454265Outlays from discretionary balances .................................4011






The Department of Veterans Affairs (VA) and the Department of Defense(DOD) will each contribute funding to the Joint Department of Defense-Department of Veterans Affairs Medical Facility Demonstration Fund,established by section 1704 of Public Law 111–84, the National DefenseAuthorization Act for Fiscal Year 2010. This funding will support thecontinuing operations of the Captain James A. Lovell Federal Health CareCenter (FHCC), which opened on December 20, 2010. In 2019 and 2020,VA expects to transfer funds from the Medical Services, Medical Com-munity Care, Medical Support and Compliance, Medical Facilities, andInformation Technology Systems accounts, while DOD expects to transferfunds from the Defense Health Program account.



Direct obligations:195186177Personnel compensation: Full-time permanent .........................11.1606060Civilian personnel benefits ........................................................12.1

..................................4Travel and transportation of persons .........................................21.0101010Communications, utilities, and miscellaneous charges ............23.3909083Advisory and assistance services ..............................................25.1797066Supplies and materials .............................................................26.0929Equipment .................................................................................31.0

201918Land and structures ..................................................................32.0



Employment Summary


2,1722,1722,113Direct civilian full-time equivalent employment ............................1001

✦

MEDICAL CARE COLLECTIONS FUND



Budgetary resources:Budget authority:

Appropriations, discretionary:3,9123,6273,515Appropriation (special or trust fund) .................................1101

–3,449–3,256–3,226Appropriations transferred to other accts [036–0160] .......1120–17–17–17Appropriations transferred to other accts [036–0169] .......1120

–446–354–272Appropriations transferred to other acct [036–0140] ........1120...................................................Budget authority, net (total) ..........................................................4180...................................................Outlays, net (total) ........................................................................4190

The Department of Veterans Affairs has the authority to collect co-pay-ments, which are deposited into the Medical Care Collections Fund (MCCF)account. As allowed by the provisions of the appropriations Act, these re-ceipts are transferred to Medical Services, Medical Community Care, andthe Joint Department of Defense-Department of Veterans Affairs MedicalFacility Demonstration Fund (Joint Demonstration Fund) where they remainavailable until expended for the purposes of the account. In 2018, over$3.5 billion was collected in the MCCF account and transferred to Medical



MEDICAL CARE COLLECTIONS FUND—Continued

Services, Medical Community Care, and the Joint Demonstration Fund toprovide healthcare to our veterans. These collections consist of co-paymentsfrom veterans for inpatient, outpatient, and nursing home care, and pre-scribed medications; third-party insurance payments from veterans fornonservice-connected conditions; and collections from enhanced-use leases,the Compensated Work Therapy Program, Compensation and Living Ex-pensed Program, and the Parking Program.

✦

CANTEEN SERVICE REVOLVING FUND



Obligations by program activity:345331356Reimbursable operating expenses .............................................0801171165177Reimbursable direct operations ................................................0802

111011Reimbursable capital investment: Sales program: Purchase of

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



17437Unobligated balance brought forward, Oct 1 .........................100022.................Recoveries of prior year unpaid obligations ...........................1021


Spending authority from offsetting collections, mandatory:537517512Collected ...........................................................................1800

..................................–1Change in uncollected payments, Federal sources ............1801

537517511Spending auth from offsetting collections, mand (total) .......1850556523548Total budgetary resources available ..............................................1930




–538–518–521Outlays (gross) ......................................................................3020–2–2.................Recoveries of prior year unpaid obligations, unexpired .........3040

253852Unpaid obligations, end of year .................................................3050Uncollected payments:

–2–2–3Uncollected pymts, Fed sources, brought forward, Oct 1 ........3060..................................1Change in uncollected pymts, Fed sources, unexpired ..........3070



Budget authority and outlays, net:Mandatory:


525506455Outlays from new mandatory authority .............................4100131266Outlays from mandatory balances ....................................4101


Offsetting collections (collected) from:–537–517–512Non-Federal sources .........................................................4123

Additional offsets against gross budget authority only:..................................1Change in uncollected pymts, Fed sources, unexpired .......4140

119Outlays, net (mandatory) ...........................................................4170...................................................Budget authority, net (total) ..........................................................4180

119Outlays, net (total) ........................................................................4190

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

Financing.—Operations will be financed from current revenues.



Reimbursable obligations:Personnel compensation:

213205221Full-time permanent .............................................................11.1555Other than full-time permanent ............................................11.3

218210226Total personnel compensation ...........................................11.9464649Civilian personnel benefits ........................................................12.1333Travel and transportation of persons .........................................21.0111Transportation of things ............................................................22.0555Other services from non-Federal sources ..................................25.2

251241260Supplies and materials .............................................................26.03..................................Equipment .................................................................................31.0


Employment Summary


3,5503,5003,420Reimbursable civilian full-time equivalent employment ...............2001

✦

VETERANS CHOICE FUND



Obligations by program activity:22725063Veterans Choice Fund - Administrative .....................................00013553,6084,493Veterans Choice Fund - Program ...............................................0002

.................53Emergency Non-VA Care ............................................................0004

5823,8634,559Direct program activities, subtotal ................................................0091..................................124Capital Investment ....................................................................0109

5823,8634,683Total new obligations, unexpired accounts ....................................0900


7824,6451,732Unobligated balance brought forward, Oct 1 .........................1000..................................295Recoveries of prior year unpaid obligations ...........................1021..................................1Recoveries of prior year paid obligations ...............................1033

7824,6452,028Unobligated balance (total) ......................................................1050Budget authority:

Appropriations, mandatory:..................................7,300Appropriation ....................................................................1200..................................7,300Budget authority (total) .............................................................1900

7824,6459,328Total budgetary resources available ..............................................1930Memorandum (non-add) entries:

2007824,645Unexpired unobligated balance, end of year ..........................1941


2,4832,1801,784Unpaid obligations, brought forward, Oct 1 ..........................30005823,8634,683New obligations, unexpired accounts ....................................3010

–2,317–3,560–3,992Outlays (gross) ......................................................................3020..................................–295Recoveries of prior year unpaid obligations, unexpired .........3040

7482,4832,180Unpaid obligations, end of year .................................................3050Memorandum (non-add) entries:

2,4832,1801,784Obligated balance, start of year ............................................31007482,4832,180Obligated balance, end of year ..............................................3200


..................................7,300Budget authority, gross .........................................................4090Outlays, gross:

..................................476Outlays from new mandatory authority .............................41002,3173,5603,516Outlays from mandatory balances ....................................4101





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

..................................7,300Budget authority, net (mandatory) ............................................41602,3173,5603,991Outlays, net (mandatory) ...........................................................4170


..................................7,300Budget authority, net (total) ..........................................................41802,3173,5603,991Outlays, net (total) ........................................................................4190

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

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

Public Law 115–46, the VA Choice and Quality Employment Act of2017, provided $2.1 billion in mandatory funding for the Veterans ChoiceFund, to remain available until expended. In 2018, Public Law 115–96provided $2.1 billion more in mandatory funding, to remain available untilexpended; and Public Law 115–182, the MISSION Act, provided an addi-tional $5.2 billion in mandatory funding, to remain available without fiscalyear limitation. The MISSION Act provides flexibility of Veterans ChoiceFund dollars beginning on March 1, 2019, authorizing permanent authorityfor other uses. In addition, the MISSION Act sunset the Choice Programin June 2019 and established the new Veterans Community Care Program.



Direct obligations:.................1824Transportation of things ............................................................22.0

5823,6654,124Other contract services .............................................................25.2.................87116Supplies and materials .............................................................26.0.................93124Equipment .................................................................................31.0..................................295Prior-year Recoveries .................................................................44.0

5823,8634,683Total new obligations, unexpired accounts ............................99.9

Employment Summary


..................................1Direct civilian full-time equivalent employment ............................1001

✦

Trust Funds

GENERAL POST FUND, NATIONAL HOMES



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

Current law:262522General Post Fund, National Homes, Deposits .......................1130

333General Post Fund, National Homes, Interest on

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

292825Total current law receipts ..................................................1199

292825Total receipts .............................................................................1999

312825Total: Balances and receipts .....................................................2000Appropriations:

Current law:–27–26–25General Post Fund, National Homes ......................................2101

42.................Balance, end of year ..................................................................5099



Obligations by program activity:242319Religious, recreational, and entertainment activities ................0001111Therapeutic residence maintenance ..........................................0003





Appropriations, mandatory:272625Appropriation (special or trust fund) .................................1201

141138132Total budgetary resources available ..............................................1930Memorandum (non-add) entries:

116114112Unexpired unobligated balance, end of year ..........................1941








2222.................Outlays from new mandatory authority .............................4100..................................20Outlays from mandatory balances ....................................4101

222220Outlays, gross (total) .............................................................4110272625Budget authority, net (total) ..........................................................4180222220Outlays, net (total) ........................................................................4190

Memorandum (non-add) entries:7190108Total investments, SOY: Federal securities: Par value ...............5000527190Total investments, EOY: Federal securities: Par value ...............5001

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



Direct obligations:111Travel and transportation of persons .........................................21.011.................Communications, utilities, and miscellaneous charges ............23.3666Other services from non-Federal sources ..................................25.2

151412Supplies and materials .............................................................26.0221Equipment .................................................................................31.0


✦


Trust Funds

BENEFITS PROGRAMSFederal Funds

COMPENSATION AND PENSIONS

(INCLUDING TRANSFER OF FUNDS)

For the payment of compensation benefits to or on behalf of veterans and a pilotprogram for disability examinations as authorized by section 107 and chapters 11,13, 18, 51, 53, 55, and 61 of title 38, United States Code; pension benefits to or onbehalf of veterans as authorized by chapters 15, 51, 53, 55, and 61 of title 38, UnitedStates Code; and burial benefits, the Reinstated Entitlement Program for Survivors,emergency and other officers' retirement pay, adjusted-service credits and certificates,payment of premiums due on commercial life insurance policies guaranteed underthe provisions of title IV of the Servicemembers Civil Relief Act (50 U.S.C. App.541 et seq.) and for other benefits as authorized by sections 107, 1312, 1977, and2106, and chapters 23, 51, 53, 55, and 61 of title 38, United States Code,[$2,994,366,000, which shall be in addition to funds previously appropriated underthis heading that become available on October 1, 2018, to remain available untilexpended; and, in addition, $109,017,152,000] $116,801,316,000, [shall] to becomeavailable on October 1, [2019] 2020, and shall remain available until expended:Provided, That not to exceed [$18,047,000] $18,147,000 of the amount madeavailable [for fiscal year 2020] under this heading shall be reimbursed to "GeneralOperating Expenses, Veterans Benefits Administration", and "Information Techno-logy Systems" for necessary expenses in implementing the provisions of chapters51, 53, and 55 of title 38, United States Code, the funding source for which is spe-cifically provided as the "Compensation and Pensions" appropriation: Providedfurther, That such sums as may be earned on an actual qualifying patient basis, shallbe reimbursed to "Medical Care Collections Fund" to augment the funding of indi-vidual medical facilities for nursing home care provided to pensioners as authorized.(Military Construction, Veterans Affairs, and Related Agencies Appropriations Act,2019.)



Obligations by program activity:95,04386,94978,862Veterans ....................................................................................01017,7467,3336,925Survivors ...................................................................................0102

102,78994,28285,787Compensation sub-total ................................................................0191

102,78994,28285,787Other compensation expenses .......................................................0200222221Chapter 18 ................................................................................0201

138131123Clothing allowance ....................................................................0202171716Misc assistance (EAJ, SAFD) ......................................................0203

1,5491,180896Medical exam pilot program ......................................................0204773OBRA payment to VBA and IT ....................................................0205

1,7331,3571,059Total other compensation expenses ...............................................0291

104,52295,63986,846Total compensation .......................................................................02933,4923,3843,373Veterans ....................................................................................03021,8961,8451,844Survivors ...................................................................................0303

5,3885,2295,217Pensions sub total .........................................................................0391111113Reimbursements to GOE, IT and VHA .........................................0401

5,3995,2405,230Total pensions ...............................................................................0492111Caskets and Urns ......................................................................0501

504826Burial allowance .......................................................................0502222121Burial plots ...............................................................................0503

11611076Service-connected deaths .........................................................0504222219Burial flags ...............................................................................0505756196Headstones and markers ...........................................................05067511Graveliners ................................................................................0508

395731Pre-Place Crypts ........................................................................0509

332325281Total burial program ......................................................................0591

110,253101,20492,357Total new obligations, unexpired accounts (object class 42.0) .......0900


1,6562,0983,830Unobligated balance brought forward, Oct 1 .........................1000..................................13Recoveries of prior year unpaid obligations ...........................1021..................................493Recoveries of prior year paid obligations ...............................1033


Appropriations, mandatory:.................2,994.................Appropriation ....................................................................1200

Advance appropriations, mandatory:109,01795,76890,119Advance appropriation ..................................................1270

.................2,000.................Advance appropriations transferred from otheraccounts .......................................................................

1273

109,01797,76890,119Advanced appropriation, mandatory (total) ......................1280109,017100,76290,119Budget authority (total) .............................................................1900110,673102,86094,455Total budgetary resources available ..............................................1930

Memorandum (non-add) entries:4201,6562,098Unexpired unobligated balance, end of year ..........................1941


8,4267,446163Unpaid obligations, brought forward, Oct 1 ..........................3000110,253101,20492,357New obligations, unexpired accounts ....................................3010


9,4958,4267,446Unpaid obligations, end of year .................................................3050Memorandum (non-add) entries:

8,4267,446163Obligated balance, start of year ............................................31009,4958,4267,446Obligated balance, end of year ..............................................3200



99,10190,68081,068Outlays from new mandatory authority .............................410010,0839,5443,993Outlays from mandatory balances ....................................4101





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

109,017100,76290,119Budget authority, net (mandatory) ............................................4160109,184100,22484,568Outlays, net (mandatory) ...........................................................4170109,017100,76290,119Budget authority, net (total) ..........................................................4180109,184100,22484,568Outlays, net (total) ........................................................................4190

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

2020 est.2019 est.2018 actual

Enacted/requested:109,017100,76290,119Budget Authority .......................................................................109,184100,22484,568Outlays ......................................................................................

Legislative proposal, subject to PAYGO:–265..................................Outlays ......................................................................................

Total:109,017100,76290,119Budget Authority .......................................................................108,919100,22484,568Outlays ......................................................................................

WORKLOAD2020 est.2019 est2018 actual

Compensation Completed Claims:1,322,1341,277,7011,241,821Rating ......................................................................................................2,283,8492,370,2652,559,352Other Claims ............................................................................................

Pension Completed Claims:133,831134,709134,977Rating ......................................................................................................353,386344,268379,348Other Non-Rating Claims .........................................................................

For 2021, the Budget requests $116,801,316,000 in advance appropri-ations for Compensation and Pensions. This request satisfies the requirementcreated by the Consolidated and Further Continuing Appropriations Act,2015 (P.L. 113–235) and prevents our Nation's veterans from being ad-versely affected by budget delays.

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

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

THE BUDGET FOR FISCAL YEAR 2020978 Benefits ProgramsFederal Funds

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

Adjusted Compensation Act of 1924, as amended;(b) a special allowance (38 U.S.C. 1312) to dependents of certain veterans

who died after December 31, 1956, but who were not fully and currentlyinsured under the Social Security Act; and

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

of Veterans Affairs (VA) to perform income matches for certain compens-ation recipients.

In accordance with Public Law 97–377, the Reinstated Entitlement Pro-gram for Survivors (REPS) program restores Social Security benefits tocertain surviving spouses or children of veterans who died of service-con-nected causes.

Legislation is proposed to provide a cost-of-living adjustment comparableto the annual Social Security increase to recipients of disability compensa-tion, dependency and indemnity compensation, and clothing allowances.The increase, effective with payments made on January 1, 2020, is expectedto be 2.2 percent.

AVERAGE NUMBER OF COMPENSATION CASES AND PAYMENTS2020 est.2019 est2018 actual

Veterans:5,033,1134,849,1744,652,973Cases ...................................................................................................$18,883$17,931$16,949Average payment per case, per year .....................................................$95,042$86,949$78,862Total obligations (in millions) ...............................................................

Survivors:443,407431,839417,532Cases ...................................................................................................$17,469$16,981$16,585Average payment per case, per year .....................................................$7,746$7,333$6,925Total obligations (in millions) ...............................................................

Chapter 18:1,1391,1451,151Children ...............................................................................................

$19,349$18,933$18,417Average payment per case, per year .....................................................$22$22$21Total obligations (in millions) ...............................................................

Clothing allowance:165,993160,614155,108Number of veterans ..............................................................................

$833$815$793Average payment per case, per year .....................................................$138$131$123Total obligations (in millions) ...............................................................

Special Allowance for Dependents:212121Cases ...................................................................................................

$3,132$3,065$2,981Average benefit ....................................................................................$0$0$0Total obligations (in millions) ...............................................................

Equal Access to Justice Act:3,2073,1203,033Cases ...................................................................................................

$5,429$5,312$5,168Average benefit ....................................................................................$17$17$16Total Obligations (in millions) ..............................................................

REPS:568Cases ...................................................................................................

$11,467$11,466$11,465Average benefit ....................................................................................$0$0$0Total Obligations (in millions) ..............................................................

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

An automatic annual cost-of-living increase comparable to the annualsocial security increase is provided for those pensioners in the improvedprogram and to parents receiving dependency and indemnity compensation.The increase, effective with payments made on January 1, 2020, is expectedto be 2.2 percent.

AVERAGE NUMBER OF PENSION CASES AND PAYMENTS2020 est.2019 est.2018 actual

Veterans:256,470258,434267,261Cases ...................................................................................................$13,619$13,096$12,619Average payment per case, per year .....................................................$3,493$3,384$3,373Total obligations (in millions) ...............................................................

Survivors:187,362189,371195,588Cases ...................................................................................................$10,117$9,742$9,428Average payment per case, per year .....................................................$1,896$1,845$1,844Total obligations (in millions) ...............................................................

Burial benefits in 2019 provided for: (a) the payment of an allowance of$780 (plus transportation charges where death occurs under VA care) toreimburse, in part, the burial and funeral expense of an eligible deceased

veteran; (b) the payment of $780 for a plot allowance where an eligibleveteran is not buried in a national cemetery or other cemetery under thejurisdiction of the United States; (c) the payment of a burial allowance ofup to $2,000 when a veteran dies as a result of a service-connected disabil-ity; (d) furnishing a flag to drape the casket of each deceased veteran entitledthereto; (e) furnishing a headstone or marker for the grave of a veteran and,in certain cases, eligible dependents; and (f) authority to provide outerburial receptacles in the National Cemetery Administration.

NUMBER OF BURIAL BENEFITS2020 est.2019 est.2018 actual

27,57226,95826,702Burial allowance .......................................................................................29,67729,01528,384Burial allowances for deaths in Dept. facility ...........................................27,09026,48623,594Burial plot ................................................................................................43,77441,90840,148Service-connected deaths ........................................................................

455,515461,805477,005Burial flags ..............................................................................................358,221359,336344,245Headstones and markers ..........................................................................10,94810,98210,521Graveliners ...............................................................................................42,932102,75477,692Preplaced crypts .......................................................................................

411390370Caskets and Urns .....................................................................................

COMPENSATION AND PENSIONS

(Legislative proposal, subject to PAYGO)



Obligations by program activity:

–7..................................Prohibition of entitlement to VA's IU benefit for individuals

serving in the Reserve Components ......................................0101

–233..................................Clarify evidentiary threshold for ordering VA examinations ........0104

–34..................................Round-down the computation of the annual COLA for

service-connected compensation and DIC for five years ........0109

–274..................................Compensation sub-total ................................................................0191

–274..................................Total compensation .......................................................................0293

6..................................Reissue VA Benefit Payments to all Victims of Fiducaiary

Misuse ...................................................................................0301

6..................................Pensions sub total .........................................................................0391

6..................................Total pensions ...............................................................................0492

1..................................Spousal and Dependent Inscriptions on Veteran Headstones and

Markers .................................................................................0501

2..................................VA to provide OBR's for each new casketed gravesite in VA

cemetary that receives grant from VCGP ...............................0505

3..................................Total burial program ......................................................................0591

–265..................................Total new obligations, unexpired accounts (object class 42.0) .......0900Memorandum (non-add) entries:

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


–265..................................New obligations, unexpired accounts ....................................3010265..................................Outlays (gross) ......................................................................3020


Outlays, gross:–265..................................Outlays from mandatory balances ....................................4101

...................................................Budget authority, net (total) ..........................................................4180–265..................................Outlays, net (total) ........................................................................4190

Prohibition of Entitlement to VA's Individual Unemployability Benefitfor Individuals Serving in the Reserve Components. VA seeks to amend38 U.S.C. section 1163 to prohibit entitlement to total disability ratings forcompensation based on individual unemployability if the individual isconcurrently performing duties in the reserve components and receivingactive service pay from such duty. Benefit savings are estimated to be $6.7million in 2020, $81.8 million over five years, and $302.7 million over tenyears.

Allow for Electronic Decision Notification, and Other Communications.VA seeks to amend provisions in 38 U.S.C. sections 7105 and 5104 tospecifically allow for electronic notification of result of initial benefits re-view/determinations. VA also seeks to amend 38 U.S.C. section 101, up-dating definitions to allow for electronic communication between VA,

979DEPARTMENT OF VETERANS AFFAIRSBenefits Programs—Continued


COMPENSATION AND PENSIONS—Continued

veterans, claimants, and other entities, where practicable, in the course ofadjudicating claims. These changes are necessary to allow VA, veterans,and claimants to utilize modern electronic methods of communication todeliver timely and efficient decisions on claims. No benefits costs are asso-ciated with this proposal.

VA Schedule for Rating Disability (VASRD) Effective Dates. VA seeksto amend 38 U.S.C. section 1155 so that, when VASRD is readjusted, suchchanges would apply to any new or pending claims and may include actionto decrease an existing evaluation. VA's current practice is that, when thereare changes to VASRD, an increased evaluation for a disability cannot begranted under the old rating criteria; in addition, a disability evaluationcannot be decreased under the new rating criteria unless there has been ademonstrated improvement in the condition. This proposal would reducethe administrative burden of having adjudicators apply the old and newsets of criteria to claims and make VASRD easier to understand and applyfor veterans and their representatives. VA would not adjust veterans' ratingsdownward on its own initiative, but would adjust ratings accordingly uponthe veteran's request. This proposal would result in savings; however, in-sufficient data are available to estimate if savings would be significant.

Modernize VA's Records Management Program. VA seeks to amend title38, U.S.C. by creating a new section 5707 to codify VBA's procedureswith respect to imaged source paper files, input records, reports, or otherdocuments under the Records Control Schedule required by title 44, U.S.C.No benefit costs are associated with this proposal.

Clarify Evidentiary Threshold for Ordering VA Examinations. VA seeksto amend 38 U.S.C. section 5103A(d)(2) to clarify the evidentiary thresholdat which VA, under its duty to assist obligation in section 5103A, is requiredto request a medical examination for compensation claims. This proposalaims to eliminate delays in claims processing by establishing a more reas-onable policy in determining when a VA examination is warranted inconnection with a claim for compensation. In recent years, the courts haveheld that evidence necessary to satisfy the requirements of 38 U.S.C. section5103(A)(d)(2) is much lower than VA or Congress contemplated. Thisproposed change would require, in general, the existence of objectiveevidence of an in-service event, injury, or disease to trigger VA's duty torequest an examination under 38 U.S.C. section 5103(A)(d)(2). Benefitsavings are estimated to be $233.1 million in 2020, $1.3 billion over fiveyears, and $2.8 billion over ten years.

Elimination of Payment of Benefits to the Estates of Deceased NehmerClass Members and to the Survivors of Certain Class Members. VA seeksto amend 38 U.S.C. section 1116 to eliminate payment of benefits to theestates of deceased Nehmer class members and to survivors of certain classmembers when such benefits are the result of presumptions of serviceconnection established pursuant to section 1116 for diseases associatedwith exposure to certain herbicide agents. This proposal would prevent theallocation of extensive resources to claims not contemplated by Congressand avoids potential for creating or substantially adding to VA's backlog.No benefits costs are associated with this proposal.

Attendance at Transition Assistant Program (TAP) or Access to eBenefitsMeets the Requirements to Notify Veterans by Letter of VA Benefits andServices. VA seeks to amend 38 U.S.C. section 6303(b) to authorize VAto use TAP and eBenefits to notify each transitioning veteran by the mosteffective means available, including electronic communication or notifica-tion in writing, of all VA benefits and services for which they may be eli-gible. Currently, statute requires VA to send each veteran a letter with be-nefits information and to contact in-person or by telephone veterans whodo not have a high school education or equivalent at the time of dischargeor release. For those Veterans discharged or separated without a high-schooldiploma, this proposal would also eliminate the requirement for VA tomake in-person or telephone contact regarding their eligibility for benefits,except in instances where they did not attend a TAP briefing or were notreceiving information through eBenefits. No benefit costs are associatedwith this proposal.

Automatic Annual Cost-of-Living Adjustments (COLA) for DisabilityCompensation and Dependency and Indemnity Compensation (DIC). VAseeks to amend 38 U.S.C. sections 1104, 1303, and 5312 to provide for theannual COLA to be made automatically by law each year in the rates ofdisability compensation and DIC. The amendment would also provide forautomatic COLA for clothing allowance and the additional compensationfor dependents. No benefits costs are associated with this proposal.

Extend the Authority for Operations of the Manila VA Regional Office.VA seeks to extend the authority currently provided by 38 U.S.C. section315(b) to maintain the operations of the Manila Regional Office toDecember 31, 2023. No benefit costs are associated with this proposal.

Round-Down of the Computation of the Cost of Living Adjustment (COLA)for Service-Connected Compensation and Dependency and IndemnityCompensation (DIC) for Five Years. VA seeks to amend 38 U.S.C. sections1104(a) and 1303(a) to round-down COLA computations from 2020 to2024. Savings are estimated to be $34.3 million in 2020 and $637.6 millionover five years. This proposal would reinstate the round-down for fiveyears; however, the cumulative effect of rounding-down COLAs for fiveyears will total $2.0 billion in savings over ten years.

Reimbursement of Credentialing Costs. VA seeks to amend 38 U.S.C.section 5729 to collect a reasonable fee necessary to offset the costs ofperforming background and other investigations needed for credentialingaccredited attorneys and claims agents before they can access the automatedVBA records of claimants whom they represent. No benefit costs are asso-ciated with this proposal.

Reissue VA Benefit Payments to all Victims of Fiduciary Misuse. VAseeks to amend 38 U.S.C. section 6107, which authorizes VA to reissuebenefits to a beneficiary if the beneficiary's VA-appointed fiduciary misusesthe beneficiary's benefits. This proposal would ensure equal treatment ofall beneficiaries who are victims of misuse regardless of the nature andscope of the fiduciary's business or the fiduciary's relationship with thebeneficiary. Benefit costs are estimated to be $6.2 million in 2020, $34.0million over five years, and $77.0 million over ten years.

Allow VA Contractors and Vendors Access to Federal Tax Return Inform-ation for Purposes of Assisting in the Administration of Certain VA BenefitPrograms and Maintaining the Systems that VA uses to Administer thesePrograms. VA seeks to amend 26 U.S.C. 6103(l)(7)(A) and (B) in orderto allow VA contractors and vendors access to tax return information thatis disclosed to VA. Under this proposal, VA personnel would continue tomake determinations of entitlement for income-based programs and otherdiscretionary decisions based upon the Federal tax information. However,VA could rely on contractors and vendors to help develop and maintainthe information technology systems VA uses to administer needs-basedprograms. This proposal would eliminate the need for VA to create acomplex information technology solution to mitigate contractor access toVA systems and benefits-related documents that contain tax information.No benefits costs are associated with this proposal.

Remove Annual Income from Net Worth Calculation. VA seeks to amend38 U.S.C. sections 1522 and 1543 to remove the requirement that VAconsider annual income in its net worth determinations. VA's intent withthis proposal is to allow more fair and consistent net-worth calculationsand to promote pension automation with respect to net worth calculations.Benefit costs are estimated to be insignificant.

Authorize VA to Rely on Unearned and Earned Income InformationSupplied by the IRS and Earned Income Information Available from theSSA for Purposes of Determining Eligibility for its Needs-Based PensionProgram, and Eliminate the Need for VA to Independently Verify the In-formation. VA seeks to amend 38 U.S.C. 5317(b) and (e) to authorize VAto rely on information it obtains from the Internal Revenue Service (IRS)and Social Security Administration (SSA) when making initial pensioneligibility determinations. VA also proposes to remove the requirementthat VA independently verify the information. No benefits costs are asso-ciated with this proposal.

THE BUDGET FOR FISCAL YEAR 2020980 Benefits Programs—ContinuedFederal Funds—Continued

Authorize VA to Pay a Flat Rate for the Costs of Domestic Transportationof a Deceased Veteran to a National Cemetery. VA seeks to amend 38U.S.C. section 2308 to authorize VA to pay a one-time, inflation-indexed,flat-rate benefit for the domestic transportation of a deceased veteran to anational cemetery. This would allow VA to automate adjudication andpayment of these claims, providing more timely benefits to survivorswithout requiring them to prove their actual expenses during a difficultand vulnerable period of transition. No benefit costs are associated withthis proposal.

Extension of Reduced Pension for Certain Veterans and SurvivorsCovered by Medicaid Plans for Services. VA seeks to amend 38 U.S.C.section 5503(d) to extend through September 30, 2029, the limit to $90 inpension payable to certain recipients of Medicaid-covered nursing homecare. This authority protects pension payments from being applied to thecost of the recipient's nursing home care. Public Law 115–182, section509, last extended this authority to September 30, 2028. Benefit savingswould not occur until 2029; therefore, savings would be $0 over the firstfive years. Estimated savings over ten years are $245.1 million.

Spousal and Dependent Inscriptions on Veteran Headstones and Markers.VA seeks to amend 38 U.S.C. section 2306 to allow VA to inscribe, iffeasible and upon request, on a Government-furnished headstone ormarker for placement on a gravesite in a non-VA cemetery informationabout the veteran's spouse or dependent child. The proposed applicabilitydate would be to add such an inscription for the headstones and markersof veterans whose date of death is on or after January 1, 2015. Benefit costsare estimated to be $868 thousand in 2020, $4.0 million over five years,and $7.8 million over ten years.

Authorization to Provide Outer Burial Receptacles (OBR) for State andTribal Organization Cemeteries. VA proposes to amend 38 U.S.C. 2306to provide an outer burial receptacle (OBR) benefit for any casketedgravesite for eligible veterans and their family members interred in Stateand tribal veterans cemeteries that received grant funding through VA'sVeterans Cemetery Grants Program. This would ensure parity for the OBRbenefit for eligible individuals in any cemetery that has a mission to provideburial for veterans and their eligible dependents, and would alleviate theadditional financial burden on the families of veterans to purchase an OBRif they choose to bury the veteran or an eligible family member in a Stateor tribal veterans cemetery. Mandatory costs are estimated to be $1.9 millionin 2020, $13.5 million over five years, and $36.2 million over ten years.

Authorization to Pay Cost of Transporting Unclaimed Remains of Veter-ans to a VA-funded State or Tribal Organization Cemetery. VA seeks toamend title 38 U.S.C. section 2308 to expand the provision of the transport-ation allowance to cover those unclaimed remains of veterans transportedto a VA-funded veterans cemetery owned by a State or Tribal organization.Currently, VA is only authorized to provide an allowance for the cost oftransporting the remains to the nearest VA national cemetery. Benefit costsare estimated to be insignificant.

Burial Benefit Eligibility Requirement for Other-Than-DishonorableService for Deaths in Active Service. VA seeks to amend title 38 U.S.C.section 2402(a)(1) to require that a servicemember who dies in active ser-vice must have been serving under conditions other than dishonorable tobe eligible for burial in a national cemetery. This proposal would alsoamend title 38 U.S.C. section 2306(b)(4)(A) and (g)(2) to impose the samerequirement for eligibility for a memorial headstone or marker and amendtitle 38 U.S.C. section 2301(d) to do the same for eligibility for a burialflag. No benefit costs are associated with this proposal.

Expansion of Eligibility for Government-Furnished Headstone, Markeror Medallion for Medal of Honor Recipients. VA seeks to amend 38 U.S.C.section 2306 to allow VA to furnish or replace a headstone, marker, ormedallion for the grave of an eligible Medal of Honor recipient, regardlessof the recipient's dates of service, date of death, or location. Benefit costsare estimated to be insignificant.

✦

READJUSTMENT BENEFITS

For the payment of readjustment and rehabilitation benefits to or on behalf ofveterans as authorized by chapters 21, 30, 31, 33, 34, 35, 36, 39, 41, 51, 53, 55, and61 of title 38, United States Code, [$14,065,282,000] $12,578,965,000, to remainavailable until expended and to become available on October 1, [2019] 2020:Provided, That expenses for rehabilitation program services and assistance whichthe Secretary is authorized to provide under subsection (a) of section 3104 of title38, United States Code, other than under paragraphs (1), (2), (5), and (11) of thatsubsection, shall be charged to this account. (Military Construction, Veterans Affairs,and Related Agencies Appropriations Act, 2019.)



Obligations by program activity:744695515Sons and daughters ..................................................................0101159141102Spouses .....................................................................................0102

903836617Total education and training .........................................................0191810793790Vocational rehabilitation training ..............................................0201750695641Subsistence allowance ..............................................................0202164154136Automobiles and adaptive equipment .......................................0203129122107Housing Grants .........................................................................0204

111Housing Technology Grants .......................................................0205

1,8541,7651,675Total special assistance to disabled veterans ...............................0291636147Work study .................................................................................0301242421Payments to States ...................................................................0302

11,54111,32310,835All-volunteer assistance: Basic benefits and all other ..............0303444Tuition Assistance .....................................................................0305111Licensing and Certification .......................................................0306

14117Reporting fees ...........................................................................030711.................Reimbursement to GOE .............................................................0308663Contract Counseling ..................................................................0309

11,65411,43110,918Total All-volunteer assistance and other .......................................0391

14,41114,03213,210Total direct obligations ..................................................................079991012Veterans and servicepersons supplementary benefits ...............0802

858794Chapter 1606 reservists benefits ..............................................0803202123Chapter 1606 reservists supplementary benefits ......................0804

.................33Chapter 1607 reservists benefits ..............................................0805939188Chapter 33 DoD Reimbursements .............................................0807

207212220Total reimbursable obligations ......................................................0899



2,6256,8256,081Unobligated balance brought forward, Oct 1 .........................1000..................................3Recoveries of prior year unpaid obligations ...........................1021..................................241Recoveries of prior year paid obligations ...............................1033


Appropriations, mandatory:Advance appropriations, mandatory:


.................–2,000.................Advance appropriations transferred to otheraccounts .......................................................................

1272

14,0659,83213,709Advanced appropriation, mandatory (total) ......................1280Spending authority from offsetting collections, mandatory:

207212221Collected ...........................................................................180014,27210,04413,930Budget authority (total) .............................................................190016,89716,86920,255Total budgetary resources available ..............................................1930

Memorandum (non-add) entries:2,2792,6256,825Unexpired unobligated balance, end of year ..........................1941


813641131Unpaid obligations, brought forward, Oct 1 ..........................300014,61814,24413,430New obligations, unexpired accounts ....................................3010



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





READJUSTMENT BENEFITS—Continued





11,0036,6076,705Outlays from new mandatory authority .............................41003,4387,4656,212Outlays from mandatory balances ....................................4101






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

14,0659,83213,709Budget authority, net (mandatory) ............................................416014,23413,86012,455Outlays, net (mandatory) ...........................................................417014,0659,83213,709Budget authority, net (total) ..........................................................418014,23413,86012,455Outlays, net (total) ........................................................................4190

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


Enacted/requested:14,0659,83213,709Budget Authority .......................................................................14,23413,86012,455Outlays ......................................................................................

Legislative proposal, subject to PAYGO:–27..................................Outlays ......................................................................................

Total:14,0659,83213,709Budget Authority .......................................................................14,20713,86012,455Outlays ......................................................................................

WORKLOAD—Vocational Rehabilitation and Employment2020 est.2019 est.2018 actual

79,15978,37679,975Evaluation and planning ..........................................................................104,761103,724105,841Rehabilitation services .............................................................................26,19825,93926,468Employment services status .....................................................................12,21912,09811,978Vocational/educational counseling ...........................................................

WORKLOAD—Education2020 est.2019 est.2018 actual381,140373,667314,621Original claims .........................................................................................

3,853,7483,778,1843,171,356Adjustments/supplemental claims ...........................................................

For 2021, the Budget requests $12,578,965,000 in advance appropriationsfor Readjustment Benefits. This request satisfies the requirement createdby the Consolidated and Further Continuing Appropriations Act, 2015(P.L. 113–235) and prevents our Nation's veterans from being adverselyaffected by budget delays.

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

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

All volunteer force educational assistance (Montgomery GI Bill).—PublicLaw 98–525, enacted October 19, 1984, established two new educationalprograms: an assistance program for veterans who enter active duty duringthe period beginning July 1, 1985; and an assistance program for certain

members of the Selected Reserve. Public Law 108–375 established a pro-gram to provide educational assistance to members of the reserve compon-ents called or ordered to active service in response to a war or nationalemergency declared by the President or the Congress, in recognition of thesacrifices that those members make in answering the call to duty. The Re-adjustment Benefit appropriation pays the basic benefit allowance for vet-erans, except for certain Post-Vietnam Era Veterans Education participantswho transferred to the Montgomery GI Bill program. Supplementary edu-cational assistance, Post-Vietnam Era Veterans Education converters, re-servists, and the National Call to Service Program are financed by paymentsfrom the Department of Defense.

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

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

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

CASELOAD AND AVERAGE COST DATA2020 est.2019 est.2018 actual

Chapter 33:691,821699,162708,069Number of trainees ...............................................................................$16,522$15,994$15,074Average cost per trainee .......................................................................

$11,431$11,182$10,674Total cost (in millions) .................................................................

Chapter 30:19,28222,54526,441Number of trainees ...............................................................................

$10,242$10,065$9,876Average cost per trainee .......................................................................

$197$227$261Total cost (in millions) .................................................................

Chapter 1606:42,58144,71648,690Number of trainees ...............................................................................$2,474$2,421$2,369Average cost per trainee .......................................................................


Chapter 1607:0696696Number of trainees ...............................................................................

$0$4,651$4,498Average cost per trainee .......................................................................


Chapter 35 Sons and Daughters:99,77695,32290,263Number of trainees ...............................................................................$7,460$7,292$5,701Average cost per trainee (in dollars) ....................................................


Chapter 35 Wives and Widow(ers):23,28321,18519,497Number of trainees ...............................................................................$6,811$6,663$5,214Average cost per trainee (in dollars) ....................................................


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

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

$0$0$206Total cost (in millions) ......................................................................


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


Chapter 31:27,34427,07327,738Rehabilitation, Evaluation, Planning and Service cases ......................96,38195,42797,770Number of trainees ...............................................................................

$16,177$15,590$14,642Average cost per trainee (in dollars) ....................................................

$1,559$1,488$1,432Total cost (in millions) .................................................................

Specially Adapted Housing Grants.—Specially adapted housing grantsare provided to certain severely disabled veterans. In 2019, the maximumgrant amount is $85,645. Veterans who suffer service-connected blindnessor who have lost the use of both upper extremities can receive up to$17,130.

Specially Adapted Housing Assistive Technology Grants.—Under theVeterans Benefits Act of 2010 (P.L. 111–275), VA may provide grants ofup to $200,000 per fiscal year to individuals or entities for the developmentof specially adapted housing assistive technologies and limits to $1 millionthe aggregate amount of such grants VA may award in any fiscal year.

Automobile Grants and Adaptive Equipment.—Certain disabled veteransare provided with automobile grants with the associated approved adaptiveequipment. An allowance is provided to certain service-disabled veteransand servicemembers toward the purchase price of an automobile. Themaximum allowance increased to $21,058.69 in 2019 under The VeteransBenefits Act of 2010 (P.L. 111–275) and will continue to increase basedon the CPI-U. Adaptive equipment and the maintenance and replacementof such equipment is also provided.


Housing grants:2,8752,8502,609Number of housing grants ....................................................................

$44,926$42,895$41,027Average cost per grant .........................................................................


553Number of housing technology grants ..................................................$200,000$200,000$199,936Average cost per grant .........................................................................

$1$1$.6Total cost (in millions) .................................................................

Automobiles or other conveyances:2,4252,4252,057Number of conveyances ........................................................................

$21,398$20,909$20,431Average benefit ....................................................................................

$52$51$42Obligations (in millions) ..............................................................

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

7,2477,2477,085Number of items ...................................................................................$15,538$14,323$13,203Average benefit ....................................................................................

$113$104$94Obligations (in millions) ..............................................................

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

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

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

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

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

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

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



14,41114,03213,209Direct obligations: Grants, subsidies, and contributions ...............41.0207212221Reimbursable obligations .....................................................99.0


READJUSTMENT BENEFITS




Obligations by program activity:–28..................................VA Cap for Flight Training at Public Schools ..............................0102

1..................................Approve Prep Courses for License and Certification Exams ........0103–1..................................COLA Round-Down ....................................................................01041..................................Restore Entitlement ...................................................................0106

–27..................................Direct program activities, subtotal ................................................0191

–27..................................Total direct obligations ..................................................................0799

–27..................................Total new obligations, unexpired accounts (object class 41.0) .......0900Memorandum (non-add) entries:

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


–27..................................New obligations, unexpired accounts ....................................301027..................................Outlays (gross) ......................................................................3020



READJUSTMENT BENEFITS—Continued




Outlays, gross:–27..................................Outlays from mandatory balances ....................................4101

...................................................Budget authority, net (total) ..........................................................4180–27..................................Outlays, net (total) ........................................................................4190

Require an Individual to Make an Election to Receive Educational Assist-ance under the Montgomery GI Bill Active Duty (MGIB-AD) Program.VA seeks to amend 38 U.S.C. section 3011(c)(1) to require an individualto make an election to receive MGIB-AD educational assistance beforethe Department of Defense (DoD) can begin the $100 pay reduction. Al-though this proposal would not directly impact VA's mandatory Readjust-ment Benefits account, it would decrease the amount withheld from basicpay of servicemembers and deposited into the general fund of the Treasuryas a miscellaneous/proprietary receipt. Treasury's receipts are counted asa negative outlay; therefore, reduced collections results in an increase inFederal outlays. VA estimates this proposal would increase Federal outlaysby $50.7 million in 2020, $196.8 million over five years, and $300.3 millionover ten years.

Prevent VA from Providing Unlimited Amounts of Payment for FlightTraining at Public Schools. VA seeks to amend 38 U.S.C. section 3313(c)to add a new section (j) to impose tuition and fee payment caps at institu-tions of higher learning with flight training programs and establish a max-imum allowable fee structure for all VA-funded flight programs. Benefitsavings are estimated to be $27.9 million in 2020, $148.6 million over fiveyears, and $326.9 million over ten years.

Approve Preparatory Courses of Licensing and Certification Exams forGI Bill Benefits. VA seeks to amend 38 U.S.C. section 3002(3)(B) to adda preparatory course for a test that is required to enter into, maintain, oradvance in a given vocation or profession. Benefit costs are estimated tobe $1.2 million in 2020, $5.8 million over five years, and $11.4 millionover ten years.

Round-Down of the Computation of the Cost-of-Living Adjustment(COLA) for Certain Education Programs for Ten Years. VA seeks to amend38 U.S.C. sections 3015(h) and 3564 to round-down COLA computationsfrom 2020 to 2029. This proposal would require that such increases berounded down to the next lower whole dollar. Benefit savings are estimatedto be $1.3 million in 2020, $13.2 million over five years, and $54.3 millionover ten years.

Allow for Extension of a Period of Employment Services under Chapter31. VA seeks to amend 38 U.S.C. section 3105(b)(1) to allow a period ofemployment services to be extended for up to six months for a total of 24months, if needed, to accomplish rehabilitation. The extended period ofservice would increase the veteran's marketability and employment options.No benefit costs are associated with this proposal.

Restoration of Entitlement to Chapter 31 Assistance for Veterans Affectedby School Closure or Disapproval. VA seeks to amend 38 U.S.C. 3699 toextend the restoration of entitlement to educational assistance for veteransaffected by school closure or disapproval, implemented by section 109 ofthe Howard W. Colmery Veterans Educational Assistance Act of 2017(Forever GI Bill), to apply to vocational rehabilitation programs providedunder chapter 31. Benefit costs are estimated to be $571 thousand in 2020,$1.8 million over five years, and $3.6 million over ten years.

Eliminate Certain Provisions that Limit the Amount of Specially AdaptedHousing (SAH) Assistance to Pay for Construction of an Adapted Home.VA seeks to amend 38 U.S.C. section 2102(a) to eliminate an element ofthe statutory formula that reduces the amount of grant funds otherwiseavailable to an eligible veteran to construct an adapted housing unit. Benefitcosts are estimated to be insignificant.

Authorize the Secretary to Collect Overpayments of Grant Funds Madeunder Chapter 21. VA seeks to amend 38 U.S.C. section 2102 to explicitlyauthorize the Secretary to collect overpayments made to any veteran orother entity in connection with the acquisition or delivery of SpeciallyAdapted Housing (SAH). This proposed authority is consistent with VA'sauthority under 38 U.S.C. section 3685 to collect overpayments made inconnection with its education programs. Benefit savings are estimated tobe insignificant.

Extension of Authority for Specially Adapted Housing Assistive Techno-logy (SAH-AT) Grant Program. VA seeks to amend 38 U.S.C. section2108(g) to extend the authority of the Secretary to administer the SAHAssistive Technology (SAH-AT) grant program through September 30,2024. Section 203 of Public Law 111–275 (Veterans Benefits Act of 2010)established the SAH-AT grant program with a sunset date of September30, 2016. Section 122 of Public Law 115–251 last extended this authoritythrough September 30, 2020. Benefit costs associated with this proposalare $0 in 2020, $4 million over five years, and $4 million over ten years.

✦

VETERANS INSURANCE AND INDEMNITIES

For military and naval insurance, national service life insurance, servicemen's in-demnities, service-disabled veterans insurance, and veterans mortgage life insuranceas authorized by chapters 19 and 21 [,] of title 38, United States Code,[$111,340,000] $146,844,000, to remain available until expended, of which$129,224,000 [which] shall become available on October 1, [2019] 2020 [, andshall remain available until expended]. (Military Construction, Veterans Affairs,and Related Agencies Appropriations Act, 2019.)



Obligations by program activity:434442VMLI Death Claims ....................................................................0011927188Payment to Service-Disabled Veterans Insurance ......................0012

135115130Total direct expenses .....................................................................0100



..................................3Unobligated balance brought forward, Oct 1 .........................1000Budget authority:

Appropriations, mandatory:18.................12Appropriation ....................................................................1200

Advance appropriations, mandatory:111109108Advance appropriation ..................................................1270





–135–121–124Outlays (gross) ......................................................................3020





135115120Outlays from new mandatory authority .............................4100.................64Outlays from mandatory balances ....................................4101


Offsetting collections (collected) from:–6–6–7Non-Federal sources .........................................................4123129109120Budget authority, net (total) ..........................................................4180129115117Outlays, net (total) ........................................................................4190


WORKLOAD2020 est.2019 est.2018 actual749,870780,350772,305Policy service actions ...............................................................................293,700342,400399,615Collections ................................................................................................31,85031,86028,791Disability claims .......................................................................................

148,680158,540155,905Insurance awards .....................................................................................

For 2021, the Budget requests $129,224,000 in advance appropriationsfor Veterans Insurance and Indemnities. This request satisfies the require-ment created by the Consolidated and Further Continuing AppropriationsAct, 2015 (P.L. 113–235) and prevents our Nation's veterans from beingadversely affected by budget delays.

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

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

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

Payment to Service-Disabled Veterans Insurance Fund (S-DVI).—Pay-ments are made to the S-DVI fund to supplement the premiums and otherreceipts of the fund in amounts necessary to pay claims on insurancepolicies issued to veterans with service-connected disabilities.

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

POLICIES AND INSURANCE IN FORCE2020 est.2019 est.2018 actualVMLI Policies

2,7302,6702,614Number of Policies ...........................................................................$381$370$354Amount of Insurance (dollars in millions) ........................................



132113126Direct obligations: Insurance claims and indemnities ...................42.0324Reimbursable obligations .....................................................99.0


✦

FILIPINO VETERANS EQUITY COMPENSATION FUND




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


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

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

This fund was established under the Consolidated Security, Disaster As-sistance, and Continuing Appropriations Act of 2009 (P.L. 110–329), tomake payments to eligible persons who served in the Philippines during

World War II. Payments were subsequently authorized by the Congress inthe American Recovery and Reinvestment Act of 2009 (P.L. 111–5). Ori-ginal funding of $198,000,000 was supplemented by a transfer of$67,000,000 authorized by Public Law 111–212 that remains availableuntil expended. Payments to citizens of the United States are $15,000.Payments to non-U.S. citizens are $9,000.

✦

GENERAL OPERATING EXPENSES, VETERANS BENEFITS ADMINISTRATION

For necessary operating expenses of the Veterans Benefits Administration, nototherwise provided for, including hire of passenger motor vehicles, reimbursementof the General Services Administration for security guard services, and reimburse-ment of the Department of Defense for the cost of overseas employee mail,[$2,956,316,000] $3,000,000,000: Provided, That expenses for services and assist-ance authorized under paragraphs (1), (2), (5), and (11) of section 3104(a) of title38, United States Code, that the Secretary of Veterans Affairs determines are neces-sary to enable entitled veterans: (1) to the maximum extent feasible, to becomeemployable and to obtain and maintain suitable employment; or (2) to achievemaximum independence in daily living, shall be charged to this account: Providedfurther, That, of the funds made available under this heading, not to exceed 10 percentshall remain available until September 30, [2020] 2021. (Military Construction,Veterans Affairs, and Related Agencies Appropriations Act, 2019.)



Obligations by program activity:2,4272,4092,419Compensation and pensions .....................................................0010224230227Education ..................................................................................0011245225231Vocational rehabilitation and counseling ..................................0012

111Insurance ..................................................................................0013212015Housing .....................................................................................00148271.................Transition and Economic Development ......................................0015

3,0002,9562,893Total direct obligations ..................................................................07991,5681,206915Compensation and pensions .....................................................0801

11.................Education ..................................................................................0802323329Insurance ..................................................................................0804

156156125Housing .....................................................................................0805

1,7571,3961,069Total reimbursable obligations ......................................................0899



282860Unobligated balance brought forward, Oct 1 .........................1000

..................................26Unobligated balance transfers between expired and unexpired

accounts ...........................................................................1012


Appropriations, discretionary:3,0002,9562,910Appropriation ....................................................................1100

..................................7Appropriations transferred from other acct [036–1122] ....1121

3,0002,9562,917Appropriation, discretionary (total) .......................................1160Spending authority from offsetting collections, discretionary:

1,7571,3961,069Collected ...........................................................................17004,7574,3523,986Budget authority (total) .............................................................19004,7854,3804,072Total budgetary resources available ..............................................1930

Memorandum (non-add) entries:..................................–82Unobligated balance expiring ................................................1940









4,7574,3523,986Budget authority, gross .........................................................4000



GENERAL OPERATING EXPENSES, VETERANS BENEFITS ADMINISTRATION—Continued



Outlays, gross:4,1633,7373,288Outlays from new discretionary authority ..........................4010526724601Outlays from discretionary balances .................................4011


Offsetting collections (collected) from:–1,757–1,396–1,075Federal sources .................................................................4030

–1,757–1,396–1,075Offsets against gross budget authority and outlays (total) ....4040Additional offsets against gross budget authority only:


3,0002,9562,917Budget authority, net (discretionary) .........................................40702,9323,0652,814Outlays, net (discretionary) .......................................................40803,0002,9562,917Budget authority, net (total) ..........................................................41802,9323,0652,814Outlays, net (total) ........................................................................4190

General Operating Expenses, Veterans Benefits Administration.—Thetotal cost of administering veterans insurance programs is funded throughdirect appropriations to this account and through reimbursements from theinsurance trust fund. This appropriation provides for the Department's topmanagement direction and administrative support, including fiscal, person-nel, and legal services, as well as for the administration of veteran benefits.

Note.—Reflects FTE treated as reimbursements in all years and the effectsof Credit Reform, per Public Law 101–508.




1,2981,3291,303Full-time permanent .............................................................11.1408398388Other personnel compensation ..............................................11.5

1,7061,7271,691Total personnel compensation ...........................................11.9559550540Civilian personnel benefits ........................................................12.1

111Benefits for former personnel ....................................................13.0322530Travel and transportation of persons .........................................21.0552Transportation of things ............................................................22.0

135131124Rent ..........................................................................................23.1212120Rental payments to others ........................................................23.2171716Communications, utilities, and miscellaneous charges ............23.3332Printing and reproduction .........................................................24.0

489448445Other services from non-Federal sources ..................................25.2887Supplies and materials .............................................................26.0

231914Equipment .................................................................................31.0111Insurance claims and indemnities ............................................42.0

3,0002,9562,893Direct obligations ..................................................................99.01,7571,3961,069Reimbursable obligations .....................................................99.0


Employment Summary


22,50122,48921,761Direct civilian full-time equivalent employment ............................10011,3981,4101,200Reimbursable civilian full-time equivalent employment ...............2001

✦

SERVICE-DISABLED VETERANS INSURANCE FUND



Obligations by program activity:303028Capital investment ....................................................................0801

125124117Death claims .............................................................................0802776All other .....................................................................................0803

212015Payments to GOE and IT ............................................................0804




Spending authority from offsetting collections, mandatory:190169176Collected ...........................................................................1800200191188Total budgetary resources available ..............................................1930




–183–181–161Outlays (gross) ......................................................................3020








–67–68.................Non-Federal sources .........................................................4123–26–25.................Non-Federal sources .........................................................4123

–190–169–176Offsets against gross budget authority and outlays (total) ....4130–712–15Outlays, net (mandatory) ...........................................................4170

...................................................Budget authority, net (total) ..........................................................4180–712–15Outlays, net (total) ........................................................................4190

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

OPERATING COSTS

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

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

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

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

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

POLICIES AND INSURANCE IN FORCE2020 est.2019 est.2018 actual278,159277,881277,063Number of policies (EOY) ..........................................................................$2,967$2,946$2,911Insurance in force (dollars in millions) (EOY) ...........................................

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

Operating results and financial condition.—Since premium and otherreceipts are insufficient to cover operations, the fund continues to projectliabilities in excess of assets. The deficit is expected to reach an estimated$1,450 million by September 30, 2019. The expected deficit is financedby additional funds from the above-mentioned Veterans Insurance and In-demnities appropriations.




Reimbursable obligations:303028Investments and loans ..............................................................33.0

153151138Insurance claims and indemnities ............................................42.0


✦

VETERANS REOPENED INSURANCE FUND



Obligations by program activity:141719Death claims .............................................................................0801111Dividends ..................................................................................0802445All other .....................................................................................0803









–20–26–28Outlays (gross) ......................................................................3020









Offsetting collections (collected) from:–3–4–5Interest on Federal securities ............................................4121–1–1–1Non-Federal sources .........................................................4123–1–1–1Non-Federal sources .........................................................4123

–5–6–7Offsets against gross budget authority and outlays (total) ....4130152021Outlays, net (mandatory) ...........................................................4170

...................................................Budget authority, net (total) ..........................................................4180152021Outlays, net (total) ........................................................................4190



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

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

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

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

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

the amount of insurance in force:

POLICIES AND INSURANCE IN FORCE2020 est.2019 est.2018 actual

4,8776,2687,902Number of policies ...............................................................................$48$61$84Insurance in force (dollars in millions) .................................................

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



Reimbursable obligations:172023Insurance claims and indemnities ............................................42.0222Interest and dividends ..............................................................43.0


✦

SERVICEMEMBERS' GROUP LIFE INSURANCE FUND



Obligations by program activity:782782759Premium payments ...................................................................0801

..................................2Payments to carrier ...................................................................0802332Payment to GOE .........................................................................0803

785785763Total new obligations, unexpired accounts (object class 41.0) .......0900



Spending authority from offsetting collections, mandatory:785785763Collected ...........................................................................1800786786764Total budgetary resources available ..............................................1930



785785763New obligations, unexpired accounts ....................................3010–785–785–763Outlays (gross) ......................................................................3020



784784763Outlays from new mandatory authority .............................410011.................Outlays from mandatory balances ....................................4101


Offsetting collections (collected) from:–785–785–763Non-Federal sources .........................................................4123



Memorandum (non-add) entries:111Total investments, SOY: Federal securities: Par value ...............5000



SERVICEMEMBERS' GROUP LIFE INSURANCE FUND—Continued



111Total investments, EOY: Federal securities: Par value ...............5001

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

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

✦

VETERANS HOUSING BENEFIT PROGRAM FUND

For the cost of direct and guaranteed loans, such sums as may be necessary tocarry out the program, as authorized by subchapters I through III of chapter 37 oftitle 38, United States Code: Provided, That such costs, including the cost of modi-fying such loans, shall be as defined in section 502 of the Congressional Budget Actof 1974: Provided further, That, during fiscal year [2019] 2020, within the resourcesavailable, not to exceed $500,000 in gross obligations for direct loans are authorizedfor specially adapted housing loans.

In addition, for administrative expenses to carry out the direct and guaranteed loanprograms, [$200,612,000] $200,377,391. (Military Construction, Veterans Affairs,and Related Agencies Appropriations Act, 2019.)



Obligations by program activity:Credit program obligations:

61.................Direct loan subsidy ................................................................0701.................108416Loan guarantee subsidy ........................................................0702.................105Reestimates of direct loan subsidy .......................................0705.................84Interest on reestimates of direct loan subsidy .......................0706.................37470Reestimates of loan guarantee subsidy ................................0707.................33147Interest on reestimates of loan guarantee subsidy ................0708

201201149Administrative expenses .......................................................0709

2073981,191Total new obligations, unexpired accounts ....................................0900



Appropriations, mandatory:61971,042Appropriation ....................................................................1200

2073981,221Budget authority (total) .............................................................19002073981,221Total budgetary resources available ..............................................1930



..................................1Unpaid obligations, brought forward, Oct 1 ..........................30002073981,191New obligations, unexpired accounts ....................................3010

–207–398–1,192Outlays (gross) ......................................................................3020Memorandum (non-add) entries:

..................................1Obligated balance, start of year ............................................3100



201201149Outlays from new discretionary authority ..........................4010Offsets against gross budget authority and outlays:


Additional offsets against gross budget authority only:..................................5Offsetting collections credited to expired accounts ...........4052

201201179Budget authority, net (discretionary) .........................................4070201201144Outlays, net (discretionary) .......................................................4080

Mandatory:61971,042Budget authority, gross .........................................................4090

Outlays, gross:6197416Outlays from new mandatory authority .............................4100

..................................627Outlays from mandatory balances ....................................4101

61971,043Outlays, gross (total) .............................................................41102073981,221Budget authority, net (total) ..........................................................41802073981,187Outlays, net (total) ........................................................................4190

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


Direct loan levels supportable by subsidy budget authority:18165Acquired Direct Loans ...............................................................11500136311Vendee Direct Loans ..................................................................115004

54476Total direct loan levels ..............................................................115999Direct loan subsidy (in percent):

17.776.337.94Acquired Direct Loans ...............................................................1320018.51–5.47–26.49Vendee Direct Loans ..................................................................132004

11.60–1.452.20Weighted average subsidy rate ..................................................132999Direct loan subsidy budget authority:

31.................Acquired Direct Loans ...............................................................1330013–2.................Vendee Direct Loans ..................................................................133004

6–1.................Total subsidy budget authority ..................................................133999Direct loan subsidy outlays:

31.................Acquired Direct Loans ...............................................................1340013–2.................Vendee Direct Loans ..................................................................134004

.................18.................Acquired and Vendee Loan Reestimates ....................................134005

617.................Total subsidy outlays .................................................................134999Direct loan reestimates:

.................72Acquired Direct Loans ...............................................................135001

.................22Vendee Direct Loans ..................................................................135004

.................7.................Acquired and Vendee Loan Reestimates ....................................135005

.................164Total direct loan reestimates .....................................................135999

Guaranteed loan levels supportable by subsidy budget authority:158,024153,753153,866Housing Guaranteed Loans .......................................................215001

158,024153,753153,866Total loan guarantee levels .......................................................215999Guaranteed loan subsidy (in percent):

–.300.070.27Housing Guaranteed Loans .......................................................232001

–.300.070.27Weighted average subsidy rate ..................................................232999Guaranteed loan subsidy budget authority:

–474108415Housing Guaranteed Loans .......................................................233001

–474108415Total subsidy budget authority ..................................................233999Guaranteed loan subsidy outlays:

–475108415Housing Guaranteed Loans .......................................................234001

–475108415Total subsidy outlays .................................................................234999Guaranteed loan reestimates:

.................–3,417–1,853Housing Guaranteed Loans .......................................................235001

.................–7.................Guaranteed Loan Sale Securities—Vendee ...............................235002

.................–3,424–1,853Total guaranteed loan reestimates ............................................235999

Administrative expense data:201201179Budget authority .......................................................................3510201201149Outlays from new authority .......................................................3590

Veterans Affairs (VA) Housing Program Account.—The housing programhelps eligible veterans, active duty personnel, surviving spouses, andmembers of the Reserves and National Guard purchase, retain, and adapthomes in recognition of their service to the Nation. When a borrower pur-


chases a home, the program operates by substituting the Federal Govern-ment's guaranty for a down payment that might otherwise be required.

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

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

greater than $56,250, but not more than $144,000;(d) 25 percent of the loan amount for loans of $144,001 to $453,100;

or(e) for certain loans in excess of $453,100, the guaranty will be the

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

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

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

WORKLOAD

[In thousands]2020 est.2019 est.2018 actual

613630648Construction and valuation ..................................................................135012741204Loan processing ...................................................................................290259231Loan service and claims .......................................................................



Direct obligations:201201149Other services from non-Federal sources ..................................25.2

61971,042Grants, subsidies, and contributions ........................................41.0

2073981,191Total new obligations, unexpired accounts ............................99.9

VETERANS HOUSING BENEFIT PROGRAM FUND


Expansion of the Assets Included in the Veterans Housing Benefit Pro-gram Fund. This proposal would revise 38 U.S.C. 3722 to authorize theDepartment of Veterans Affairs (VA) to deposit into the Veterans HousingBenefit Program Fund fees collected from lenders that use VA's automatedunderwriting system (AUS). Revised section 3722 would further allowthose collected fees to be used to help offset VA's AUS maintenance andenhancement cost. The proposal would increase Federal fee collectionsfrom lenders by $22.5 million in 2020 and $224.7 million over 10 years.The fee collections are based on a new $50 fee per loan and 449,461 newloan guarantees annually. No benefit costs are associated with this proposal.

Extend Vendee Loan Program and Change Mandatory Vendee Thresholdsto Discretionary Targets. This proposal would extend through September30, 2024, the Secretary's requirement to sell properties VA acquires throughforeclosure with vendee financing and change the current mandatory finan-cing thresholds to non-mandatory performance targets. Public Law 115–251,Section 125, extended VA's mandatory requirement to sell between 50 to85 percent of its VA-owned foreclosed homes with vendee lending throughSeptember 30, 2019. VA seeks to extend its authority to sell optionallybetween 50 and 85 percent of VA-owned foreclosed homes with vendeelending by changing the current mandatory vendee lending thresholds tonon-mandatory performance targets. The proposal would not affect market

demand for vendee loan financing and no loan subsidy costs are associatedwith this proposal.

✦

HOUSING DIRECT LOAN FINANCING ACCOUNT



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

137Property management/other expense ........................................0004

138Direct program activities, subtotal ................................................0091Credit program obligations:

54476Direct loan obligations ..........................................................0710232121Payment of interest to Treasury .............................................0713

.................2.................Negative subsidy obligations ................................................0740

..................................2Downward reestimates paid to receipt accounts ...................0742

.................23Interest on downward reestimates ........................................0743

777232Direct program activities, subtotal ................................................0791



.................9088Unobligated balance brought forward, Oct 1 .........................1000

.................–90–74Unobligated balances applied to repay debt .........................1023

..................................14Unobligated balance (total) ......................................................1050Financing authority:

Borrowing authority, mandatory:7274106Borrowing authority ...........................................................1400

..................................–8Borrowing authority applied to repay debt ........................1422

727498Borrowing authority, mandatory (total) .................................1440Spending authority from offsetting collections, mandatory:

375169Collected ...........................................................................1800

–31–50–51Spending authority from offsetting collections applied to

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

6118Spending auth from offsetting collections, mand (total) .......18507875116Budget authority (total) .............................................................19007875130Total budgetary resources available ..............................................1930

Memorandum (non-add) entries:..................................90Unexpired unobligated balance, end of year ..........................1941


11.................Unpaid obligations, brought forward, Oct 1 ..........................3000787540New obligations, unexpired accounts ....................................3010

–78–75–39Outlays (gross) ......................................................................3020


11.................Obligated balance, start of year ............................................3100111Obligated balance, end of year ..............................................3200

Financing authority and disbursements, net:Mandatory:

7875116Budget authority, gross .........................................................4090Financing disbursements:

787539Outlays, gross (total) .............................................................4110Offsets against gross financing authority and disbursements:

Offsetting collections (collected) from:–6–19–9Federal sources: Payments from program account ............4120

..................................–6Interest on uninvested funds ............................................4122–29–29–51Interest and principal received on loans ...........................4123–2–3–3Cash sale of properties .....................................................4123

–37–51–69Offsets against gross budget authority and outlays (total) ....4130

412447Budget authority, net (mandatory) ............................................41604124–30Outlays, net (mandatory) ...........................................................4170412447Budget authority, net (total) ..........................................................41804124–30Outlays, net (total) ........................................................................4190

Status of Direct Loans (in millions of dollars)


Position with respect to appropriations act limitation on obligations:54476Direct loan obligations from current-year authority ...................1111



HOUSING DIRECT LOAN FINANCING ACCOUNT—Continued

Status of Direct Loans—Continued


54476Total direct loan obligations ..................................................1150

Cumulative balance of direct loans outstanding:337307342Outstanding, start of year .........................................................121054476Disbursements: Direct loan disbursements ...............................1231

–16–16–41Repayments: Repayments and prepayments .............................1251–1–1.................Write-offs for default: Direct loans ............................................1263

374337307Outstanding, end of year .......................................................1290

Balance Sheet (in millions of dollars)

2018 actual2017 actualIdentification code 036–4127–0–3–704

ASSETS:Federal assets:

9188Fund balances with Treasury .....................................................1101Investments in U.S. securities:

207Receivables, net ....................................................................110655Non-Federal assets: Receivables, net ............................................1206

Net value of assets related to post-1991 direct loans receivable:307342Direct loans receivable, gross ....................................................14012021Interest receivable .....................................................................140223Foreclosed property ....................................................................1404

3033Allowance for subsidy cost (-) ....................................................1405

359399Net present value of assets related to direct loans ................1499...........................1Other Federal assets: Other assets ................................................1901

475500Total assets ...............................................................................1999LIABILITIES:

Federal liabilities:1...........................Accounts payable .......................................................................2101

463489Debt ...........................................................................................2103610Other ..........................................................................................2105

Non-Federal liabilities:......................................................Accounts payable .......................................................................2201

51Other ..........................................................................................2207

475500Total liabilities ...........................................................................2999NET POSITION:

......................................................Cumulative results of operations ...................................................3300

475500Total liabilities and net position .....................................................4999

✦

HOUSING GUARANTEED LOAN FINANCING ACCOUNT



Obligations by program activity:974844657Losses on defaulted loans .........................................................000216179Payment to trustee reserve ........................................................0005

143123110Property sales expense ..............................................................00091089384Property management expense ..................................................0010

431Property improvement expense ..................................................001120186Loans acquired ..........................................................................0012

..................................29Refunds .....................................................................................0013

1,2651,098896Direct program activities, subtotal ................................................0091Credit program obligations:

1,8201,5921,367Default claim payments on principal ....................................0711474..................................Negative subsidy obligations ................................................0740

.................3,1822,327Downward reestimates paid to receipt accounts ...................0742

.................312142Interest on downward reestimates ........................................0743

2,2945,0863,836Direct program activities, subtotal ................................................0791



9,39211,04411,086Unobligated balance brought forward, Oct 1 .........................1000..................................8Recoveries of prior year paid obligations ...............................1033

9,39211,04411,094Unobligated balance (total) ......................................................1050Financing authority:

Spending authority from offsetting collections, mandatory:4,6554,5324,681Collected ...........................................................................1800


4,6554,5324,682Spending auth from offsetting collections, mand (total) .......185014,04715,57615,776Total budgetary resources available ..............................................1930




–3,551–6,422–4,748Outlays (gross) ......................................................................3020


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




4,6554,5324,682Budget authority, gross .........................................................4090Financing disbursements:

3,5516,4224,748Outlays, gross (total) .............................................................4110Offsets against gross financing authority and disbursements:

Offsetting collections (collected) from:.................–178–1,032Payments from program account ......................................4120

–56–49–7Recoveries from DLFA ........................................................4120–834–817–227Interest on uninvested funds ............................................4122

–2,031–1,978–2,021Funding fees .....................................................................4123–1,734–1,510–1,391Cash sale of properties .....................................................4123

..................................–11Redemption of Properties/Other income and

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

–4,655–4,532–4,689Offsets against gross budget authority and outlays (total) ....4130Additional offsets against financing authority only (total):



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

..................................7Additional offsets against budget authority only (total) ........4150–1,1041,89059Outlays, net (mandatory) ...........................................................4170

...................................................Budget authority, net (total) ..........................................................4180–1,1041,89059Outlays, net (total) ........................................................................4190

Status of Guaranteed Loans (in millions of dollars)


Position with respect to appropriations act limitation oncommitments:

158,024153,753153,866Guaranteed loan commitments from current-year authority .......2111

158,024153,753153,866Total guaranteed loan commitments .....................................215043,61542,43642,467Guaranteed amount of guaranteed loan commitments .................2199

Cumulative balance of guaranteed loans outstanding:758,061664,358603,631Outstanding, start of year .........................................................2210158,024153,753153,866Disbursements of new guaranteed loans ..................................2231–62,670–57,579–91,056Repayments and prepayments ..................................................2251

Adjustments:

–1,820–1,592–1,367Terminations for default that result in acquisition of

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

–1,010–879–716Terminations for default that result in claim payments ........2263

850,585758,061664,358Outstanding, end of year .......................................................2290

Memorandum:

215,686192,320168,656Guaranteed amount of guaranteed loans outstanding, end of

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




11,33411,393Fund balances with Treasury .....................................................1101Investments in U.S. securities:

74350Receivables, net ....................................................................110613...........................Non-Federal assets: Receivables, net ............................................1206

Net value of assets related to post-1991 acquired defaultedguaranteed loans receivable:

...........................14Accounts receivable from foreclosed property ............................1504


666726Foreclosed property ....................................................................1504

666740Net present value of assets related to defaulted guaranteedloans .................................................................................

1599

12,08712,483Total assets ...............................................................................1999LIABILITIES:

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

3,3541,871Other liabilities ..........................................................................2105Non-Federal liabilities:

291307Accounts payable .......................................................................22018,44210,305Non-federal liabilities for loan guarantees ................................2204

12,08712,483Total liabilities ...........................................................................2999NET POSITION:


12,08712,483Total liabilities and net position .....................................................4999

✦

HOUSING LIQUIDATING ACCOUNT



Obligations by program activity:

334Capital investments, guaranteed claims payment and other

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


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

..................................1Recoveries of prior year unpaid obligations ...........................1021

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

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

..................................2Unobligated balance (total) ......................................................1050Budget authority:


–5–7–9Capital transfer of spending authority from offsetting

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

333Spending auth from offsetting collections, mand (total) .......1850335Total budgetary resources available ..............................................1930



..................................1Unpaid obligations, brought forward, Oct 1 ..........................3000334New obligations, unexpired accounts ....................................3010


Memorandum (non-add) entries:..................................1Obligated balance, start of year ............................................3100



33.................Outlays from new mandatory authority .............................4100..................................4Outlays from mandatory balances ....................................4101


Offsetting collections (collected) from:–1–1–1Loan repayments and prepayments ..................................4123–1–1–1Sale of homes, cash ..........................................................4123–2–3–3Interest collection on Veteran liability debts .....................4123–4–5–7Principal collection on Veteran liability debts ...................4123




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

–5–7–9Budget authority, net (mandatory) ............................................4160–5–7–9Outlays, net (mandatory) ...........................................................4170–5–7–9Budget authority, net (total) ..........................................................4180–5–7–9Outlays, net (total) ........................................................................4190

Memorandum (non-add) entries:140140140Total investments, SOY: non-Fed securities: Market value .........5010

140140140Total investments, EOY: non-Fed securities: Market value .........5011



Cumulative balance of direct loans outstanding:.................12Outstanding, start of year .........................................................1210.................–1–1Repayments: Repayments and prepayments .............................1251

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

Status of Guaranteed Loans (in millions of dollars)


Cumulative balance of guaranteed loans outstanding:122345Outstanding, start of year .........................................................2210–6–11–21Repayments and prepayments ..................................................2251

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

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


Memorandum:

2510Guaranteed amount of guaranteed loans outstanding, end of

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

Addendum:Cumulative balance of defaulted guaranteed loans that result

in loans receivable:121620Outstanding, start of year .....................................................2310

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

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

81216Outstanding, end of year ...................................................2390



ASSETS:11Federal assets: Fund balances with Treasury .................................1101

Non-Federal assets:140139Investments in non-Federal securities, net ................................1201

11Receivables, net ........................................................................120612Direct loans, gross .........................................................................1601

3735Interest receivable .........................................................................1602–28–35Allowance for estimated uncollectible loans and interest (-) .........1603

102Value of assets related to direct loans .......................................16991620Defaulted guaranteed loans, gross ................................................1701

–15–18Allowance for estimated uncollectible loans and interest (-) .........170311Foreclosed property ........................................................................1706

23Value of assets related to loan guarantees ................................1799


Non-Federal liabilities:11Accounts payable .......................................................................2201

276259Liabilities for loan guarantees ...................................................2204


–123–114Cumulative results of operations ...................................................3300




Direct obligations:111Land and structures ..................................................................32.0223Investments and loans ..............................................................33.0


✦

NATIVE AMERICAN VETERAN HOUSING LOAN PROGRAM ACCOUNT

For administrative expenses to carry out the direct loan program authorized bysubchapter V of chapter 37 of title 38, United States Code, [$1,163,000] $1,163,000.



NATIVE AMERICAN VETERAN HOUSING LOAN PROGRAM ACCOUNT—Continued

(Military Construction, Veterans Affairs, and Related Agencies Appropriations Act,2019.)

VOCATIONAL REHABILITATION LOANS PROGRAM ACCOUNT

For the cost of direct loans, [$39,000] $57,729, as authorized by chapter 31 oftitle 38, United States Code: Provided, That such costs, including the cost of modi-fying such loans, shall be as defined in section 502 of the Congressional Budget Actof 1974: Provided further, That funds made available under this heading are availableto subsidize gross obligations for the principal amount of direct loans not to exceed[$2,037,000] $2,008,232.

In addition, for administrative expenses necessary to carry out the direct loanprogram, [$396,000] $401,880, which may be paid to the appropriation for "Gen-eral Operating Expenses, Veterans Benefits Administration". (Military Construction,Veterans Affairs, and Related Agencies Appropriations Act, 2019.)




.................21Reestimates of direct loan subsidy .......................................0705

.................1.................Interest on reestimates of direct loan subsidy .......................0706222Administrative expenses .......................................................0709





Appropriations, mandatory:.................21Appropriation ....................................................................1200




1..................................Unpaid obligations, brought forward, Oct 1 ..........................3000253New obligations, unexpired accounts ....................................3010

–2–4–3Outlays (gross) ......................................................................3020

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

1..................................Obligated balance, start of year ............................................310011.................Obligated balance, end of year ..............................................3200



222Outlays from new discretionary authority ..........................4010Mandatory:

.................21Budget authority, gross .........................................................4090Outlays, gross:

.................21Outlays from new mandatory authority .............................4100243Budget authority, net (total) ..........................................................4180243Outlays, net (total) ........................................................................4190

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


Direct loan levels supportable by subsidy budget authority:994Native American Direct Loans ...................................................115002221Vocational Rehabilitation ..........................................................115003

11115Total direct loan levels ..............................................................115999Direct loan subsidy (in percent):

–5.23–11.89–20.22Native American Direct Loans ...................................................1320022.871.901.26Vocational Rehabilitation ..........................................................132003

–3.76–9.38–15.92Weighted average subsidy rate ..................................................132999Direct loan subsidy budget authority:

–1–1–1Native American Direct Loans ...................................................133002

–1–1–1Total subsidy budget authority ..................................................133999Direct loan subsidy outlays:

–1–1–1Native American Direct Loans ...................................................134002

–1–1–1Total subsidy outlays .................................................................134999Direct loan reestimates:

.................22Native American Direct Loans ...................................................135002

.................22Total direct loan reestimates .....................................................135999

Administrative expense data:221Budget authority .......................................................................3510221Outlays from new authority .......................................................3590

The Native American Veteran Housing Loan program provides directloans to veterans living on trust lands under 38 U.S.C. chapter 37, section3761. These loans are available to purchase, construct, or improve homesto be occupied as the veteran's residence. This program began as a pilot in1993 and was made permanent on June 15, 2006, through Public Law109–233.

The Vocational Rehabilitation Loan Program provides temporary loansto cover the costs of subsistence, tuition, books, supplies, and equipmentin conjunction with service-connected disability benefits provided to veter-ans participating in the Department of Veterans Affairs' Vocational Rehab-ilitation and Counseling Program as authorized by chapter 31 of title 38,United States Code. Repayment of these loans is made in monthly install-ments, without interest, through deductions from future payments of com-pensation, pension, subsistence allowance, educational assistance allowance,or retired pay.




.................32Grants, subsidies, and contributions ........................................41.0


✦

NATIVE AMERICAN DIRECT LOAN FINANCING ACCOUNT




994Direct loan obligations ..........................................................0710233Payment of interest to Treasury .............................................0713

..................................1Property Expenses .................................................................0715111Negative subsidy obligations ................................................0740



443Unobligated balance brought forward, Oct 1 .........................1000..................................–1Unobligated balances applied to repay debt .........................1023

442Unobligated balance (total) ......................................................1050Financing authority:

Borrowing authority, mandatory:897Borrowing authority ...........................................................1400



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

444Spending auth from offsetting collections, mand (total) .......1850121311Budget authority (total) .............................................................1900161713Total budgetary resources available ..............................................1930




–12–13–9Outlays (gross) ......................................................................3020


111Obligated balance, start of year ............................................3100


111Obligated balance, end of year ..............................................3200




Offsetting collections (collected) from:.................–2–2Federal sources .................................................................4120

–4–3–4Non-federal sources - Repayments and prepayments of

principal .......................................................................4123

–3–3–2Non-Federal sources - Interest received on loans ..............4123

–7–8–8Offsets against gross budget authority and outlays (total) ....4130

553Budget authority, net (mandatory) ............................................4160551Outlays, net (mandatory) ...........................................................4170553Budget authority, net (total) ..........................................................4180551Outlays, net (total) ........................................................................4190






–3–4–3Repayments: Repayments and prepayments .............................1251





54Fund balances with Treasury .....................................................1101Investments in U.S. securities:

22Receivables, net ....................................................................1106Net value of assets related to post-1991 direct loans receivable:

6160Direct loans receivable, gross ....................................................140122Interest receivable .....................................................................140233Other assets ..............................................................................1405

6665Net present value of assets related to direct loans ................1499


Federal liabilities:7169Federal liabilities debt ...............................................................210322Other liabilities ..........................................................................2105




✦

TRANSITIONAL HOUSING DIRECT LOAN FINANCING ACCOUNT



Obligations by program activity:111Direct program activity ..............................................................0001



445Unobligated balance brought forward, Oct 1 .........................1000Financing authority:

Spending authority from offsetting collections, mandatory:11.................Collected ...........................................................................1800555Total budgetary resources available ..............................................1930



11.................Unpaid obligations, brought forward, Oct 1 ..........................3000111New obligations, unexpired accounts ....................................3010

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


11.................Obligated balance, start of year ............................................3100111Obligated balance, end of year ..............................................3200


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

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

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





Position with respect to appropriations act limitation on obligations:959595Limitation available from carry-forward ....................................1121

–95–95–95Unobligated limitation carried forward .....................................1143

Cumulative balance of direct loans outstanding:444Outstanding, start of year .........................................................1210




ASSETS:55Federal assets: Fund balances with Treasury .................................1101

44Net value of assets related to post-1991 direct loans receivable:Direct loans receivable, gross ....................................................

1401


Federal liabilities:55Debt ...........................................................................................210344Loan Guaranty/Other Liabilities .................................................2105

99Total liabilities ...........................................................................2999


✦

VOCATIONAL REHABILITATION DIRECT LOAN FINANCING ACCOUNT




222Direct loan obligations ..........................................................0710


Budgetary resources:Financing authority:

Borrowing authority, mandatory:221Authority to borrow (indefinite) .........................................1400



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

..................................1Spending auth from offsetting collections, mand (total) .......1850222Budget authority (total) .............................................................1900222Total budgetary resources available ..............................................1930


222New obligations, unexpired accounts ....................................3010



VOCATIONAL REHABILITATION DIRECT LOAN FINANCING ACCOUNT—Continued



–2–2–2Outlays (gross) ......................................................................3020




Offsetting collections (collected) from:–2–2–2Repayments and prepayments of principal .......................4123








–2–2–1Repayments: Repayments and prepayments .............................1251





Investments in U.S. securities:......................................................Investments US Securities .....................................................1104

11Net value of assets related to post-1991 direct loans receivable:Direct loans receivable, gross ....................................................

1401


11Federal liabilities: Debt ..................................................................2103


✦

Trust Funds

POST-VIETNAM ERA VETERANS EDUCATION ACCOUNT




626262Unobligated balance brought forward, Oct 1 .........................1000626262Total budgetary resources available ..............................................1930



111Unpaid obligations, brought forward, Oct 1 ..........................3000





This account was established under Public Law 94–502, Veterans' Edu-cation and Employment Assistance Act, 1976. This program consists ofvoluntary contributions by eligible servicemembers and matching contri-butions provided by the Department of Defense and provides educationalassistance payments to participants who entered the service after December

31, 1976. Chapter 32, title 38, U.S.C. Section 901 is a non-contributoryprogram with educational assistance provided by the Department of De-fense. Public Law 99–576, enacted October 28, 1986, closed the programpermanently for new enrollments effective March 31, 1987. The estimatedactivity in the fund follows:

CONTRIBUTIONS, PARTICIPANTS, DISENROLLMENTS, REFUNDS AND TRAINEES2020 est.2019 est.2018 actual

$143$150$157Total program obligations (in thousands) .................................................606467Number of disenrollments ........................................................................

$133$140$147Total refunds (in thousands) ....................................................................$2,194$2,194$2,194Average Refund ........................................................................................

222Total trainees ............................................................................................$9$9$10Total trainee cost (in thousands) ..............................................................

$5,044$4,792$4,904Average trainee cost .................................................................................110Section 901 trainees .................................................................................

$1$1$0Total Section 901 trainee cost (in thousands) ..........................................$1,000$1,000$0Average Section 901 trainee cost .............................................................

✦

NATIONAL SERVICE LIFE INSURANCE FUND



1,8702,3242,851Balance, start of year ....................................................................0100Receipts:

Current law:526652NSLI Fund, Premium and Other Receipts ...............................113096123130NSLI Fund, Interest ................................................................1140

148189182Total current law receipts ..................................................1199

148189182Total receipts .............................................................................1999

2,0182,5133,033Total: Balances and receipts .....................................................2000Appropriations:

Current law:–148–189–182National Service Life Insurance Fund ....................................2101–403–454–527National Service Life Insurance Fund ....................................2103

–551–643–709Total current law appropriations .......................................2199

–551–643–709Total appropriations ..................................................................2999

1,4671,8702,324Balance, end of year ..................................................................5099



Obligations by program activity:372447491Death claims .............................................................................0001

122Disability claims .......................................................................0002838297Matured endowments ................................................................0003273535Cash surrenders ........................................................................0004353737Dividends ..................................................................................0005131730Interest paid on dividend credits and deposits .........................0006111411Payment to general operating expenses ....................................0007

542634703Total operating expenses ...............................................................0091898Capital investment: Policy loans ...............................................0201

550643711Total direct obligations ..................................................................0799212629Death claims .............................................................................0801556Matured endowments ................................................................0803122Cash surrenders ........................................................................0804222Dividends ..................................................................................0805111Interest paid on dividend credits and deposits .........................0806111Payment to general operating expenses ....................................0807




..................................2Recoveries of prior year unpaid obligations ...........................1021Budget authority:

Appropriations, mandatory:148189182Appropriation (special or trust fund) .................................1201403454527Appropriation (previously unavailable) .............................1203

551643709Appropriations, mandatory (total) .........................................1260Spending authority from offsetting collections, mandatory:

303741Collected ...........................................................................1800












Offsetting collections (collected) from:–30–37–41Non-Federal sources .........................................................4123551643709Budget authority, net (total) ..........................................................4180671722776Outlays, net (total) ........................................................................4190

Memorandum (non-add) entries:2,3763,0153,604Total investments, SOY: Federal securities: Par value ...............50001,8532,3763,015Total investments, EOY: Federal securities: Par value ...............5001


This fund was established in 1940. It is for the World War II servicemem-bers' and veterans' insurance program. Over 22 million policies were issuedunder this program. Activity of the fund reflects a declining claim workload.The trend in the number and amount of policies in force is shown as follows:

POLICIES AND INSURANCE IN FORCE2020 est.2019 est.2018 actual127,397163,997203,807Number of policies ....................................................................................$1,604$2,077$2,598Insurance in force (dollars in millions) .....................................................

This fund is operated on a commercial basis to the extent possible. Theincome of the fund is derived from premium receipts, interest on invest-ments, and payments which are made to the fund from the Veterans Insur-ance and Indemnities appropriation.

Assets of the fund, which are largely invested in special interest-bearingTreasury securities and in policy loans, are expected to decrease from anestimated $2,531 million as of September 30, 2019 to $2,012 million as ofSeptember 30, 2020. The actuarial estimate of policy obligations as ofSeptember 30, 2020, totals $1,948 million, leaving a balance of $64 millionfor contingency reserves.

Status of Funds (in millions of dollars)


Unexpended balance, start of year:2,4863,0193,613Balance, start of year ................................................................0100

2,4863,0193,613Total balance, start of year ........................................................0999Cash income during the year:

Current law:Receipts:

526652NSLI Fund, Premium and Other Receipts ...........................1130303741National Service Life Insurance Fund ................................113096123130NSLI Fund, Interest ............................................................1150

178226223Income under present law .............................................1199

178226223Total cash income .................................................................1999Cash outgo during year:

Current law:–701–759–817National Service Life Insurance Fund [029–25–8132–0] .......2100

–701–759–817Outgo under current law ...................................................2199

–701–759–817Total cash outgo (-) ...................................................................2999

Surplus or deficit:–619–656–724Excluding interest .....................................................................3110

96123130Interest ......................................................................................3120

–523–533–594Subtotal, surplus or deficit ....................................................3199

–523–533–594Total change in fund balance ....................................................3999Unexpended balance, end of year:

1101104Uninvested balance (net), end of year .......................................41001,8532,3763,015National Service Life Insurance Fund ........................................4200

1,9632,4863,019Total balance, end of year .........................................................4999



Direct obligations:898Investments and loans ..............................................................33.0

484566625Insurance claims and indemnities ............................................42.0596878Interest and dividends ..............................................................43.0



✦

UNITED STATES GOVERNMENT LIFE INSURANCE FUND



.................12Balance, start of year ....................................................................0100

.................12Total: Balances and receipts .....................................................2000Appropriations:

Current law:.................–1–1United States Government Life Insurance Fund .....................2103

..................................1Balance, end of year ..................................................................5099



Obligations by program activity:.................1.................Death claims .............................................................................0001..................................1Other costs ................................................................................0007

.................11Total new obligations, unexpired accounts ....................................0900


Appropriations, mandatory:.................11Appropriation (previously unavailable) .............................1203.................11Budget authority (total) .............................................................1900.................11Total budgetary resources available ..............................................1930


211Unpaid obligations, brought forward, Oct 1 ..........................3000.................11New obligations, unexpired accounts ....................................3010..................................–1Outlays (gross) ......................................................................3020




.................11Budget authority, gross .........................................................4090Outlays, gross:

..................................1Outlays from mandatory balances ....................................4101

.................11Budget authority, net (total) ..........................................................4180

..................................1Outlays, net (total) ........................................................................4190



Trust Funds—Continued

UNITED STATES GOVERNMENT LIFE INSURANCE FUND—Continued


This fund was established in 1919 to receive premiums and pay claimson insurance issued under the provisions of the War Risk Insurance Act.The general decline in the activity of the fund is indicated in the followingtable:


0020Number of policies ....................................................................................$0$.016$.1Insurance in force (dollars in millions) .....................................................

The fund is operated on a commercial basis to the extent possible. Theincome of the fund is derived from interest on investments. EffectiveJanuary 1, 1983, premiums were discontinued because reserves held in thefund were adequate to meet future liabilities of the program.

Assets of the fund, which are largely invested in interest-bearing securitiesand policy loans, are estimated to decrease from $2.0 million as ofSeptember 30, 2019, to $1.7 million as of September 30, 2020, as an in-creasing number of policies mature through death or disability. The actuarialevaluation of policy obligations as of September 30, 2020, totals $1.2million, leaving a balance of $.4 million for contingency reserves.

Status of Funds (in millions of dollars)


Unexpended balance, start of year:223Balance, start of year ................................................................0100

223Total balance, start of year ........................................................0999Cash outgo during year:

Current law:

..................................–1United States Government Life Insurance Fund

[029–25–8150–0] ............................................................2100

..................................–1Outgo under current law ...................................................2199

..................................–1Total cash outgo (-) ...................................................................2999Surplus or deficit:

..................................–1Excluding interest .....................................................................3110

..................................–1Subtotal, surplus or deficit ....................................................3199

..................................–1Total change in fund balance ....................................................3999Unexpended balance, end of year:

...................................................Uninvested balance (net), end of year .......................................4100222United States Government Life Insurance Fund .........................4200

222Total balance, end of year .........................................................4999



Direct obligations:.................1.................Insurance claims and indemnities ............................................42.0..................................1Interest and dividends ..............................................................43.0

.................11Total new obligations, unexpired accounts ............................99.9

✦

VETERANS SPECIAL LIFE INSURANCE FUND



Obligations by program activity:143146147Death claims .............................................................................0801111213Cash surrenders ........................................................................0802151924Dividends ..................................................................................0803171818All other .....................................................................................0804786Payments to insurance account ................................................0805455Capital investment ....................................................................0806



9841,1011,210Unobligated balance brought forward, Oct 1 .........................1000Budget authority:



8091104Spending auth from offsetting collections, mand (total) .......18501,0641,1921,314Total budgetary resources available ..............................................1930

Memorandum (non-add) entries:8679841,101Unexpired unobligated balance, end of year ..........................1941



–196–220–223Outlays (gross) ......................................................................3020


–16–16–18Uncollected pymts, Fed sources, brought forward, Oct 1 ........3060..................................2Change in uncollected pymts, Fed sources, unexpired ..........3070







Offsetting collections (collected) from:–52–60–70Interest on Federal securities ............................................4121–9–10–12Non-Federal sources .........................................................4123

–17–19–22Non-Federal sources .........................................................4123–2–2–2Non-Federal sources .........................................................4123


..................................2Change in uncollected pymts, Fed sources, unexpired .......4140116129117Outlays, net (mandatory) ...........................................................4170

...................................................Budget authority, net (total) ..........................................................4180116129117Outlays, net (total) ........................................................................4190

Memorandum (non-add) entries:1,3571,4871,603Total investments, SOY: Federal securities: Par value ...............50001,2421,3571,487Total investments, EOY: Federal securities: Par value ...............5001


This fund finances the payment of claims on life insurance policies issuedbefore January 3, 1957, to veterans who served in the Armed Forces sub-sequent to April 1, 1951. No new policies can be issued.

Benefit program:Death claims.—Represents payments to designated beneficiaries.Cash surrenders.—A policyholder may terminate his or her insurance

by cashing in the policy for its cash value.Dividends.—Policyholders participate in the distribution of annual di-

vidends.All other.—Classified in this category are payments to policyholders

who: (a) hold endowment policies which have matured; (b) have pur-chased total disability income coverage and subsequently become dis-abled; and (c) are paid interest on dividend credits and deposits.The following table reflects the decrease in the number of policies and

the amounts of insurance in force:


70,88280,67790,488Number of policies ....................................................................................$1,070$1,206$1,336Insurance in force (dollars in millions) .....................................................

Financing.—Payments from this fund are financed primarily frompremium receipts and interest on investments.

THE BUDGET FOR FISCAL YEAR 2020996 Benefits Programs—ContinuedTrust Funds—Continued



Reimbursable obligations:455Investments and loans ..............................................................33.0

164169169Insurance claims and indemnities ............................................42.0293439Interest and dividends ..............................................................43.0


✦

DEPARTMENTAL ADMINISTRATIONFederal Funds

CONSTRUCTION, MAJOR PROJECTS

For constructing, altering, extending, and improving any of the facilities, includingparking projects, under the jurisdiction or for the use of the Department of VeteransAffairs, or for any of the purposes set forth in sections 316, 2404, 2406 and chapter81 of title 38, United States Code, not otherwise provided for, including planning,architectural and engineering services, construction management services, mainten-ance or guarantee period services costs associated with equipment guaranteesprovided under the project, services of claims analysts, offsite utility and stormdrainage system construction costs, and site acquisition, where the estimated costof a project is more than the amount set forth in section 8104(a)(3)(A) of title 38,United States Code, or where funds for a project were made available in a previousmajor project appropriation, [$1,127,486,000] $1,235,200,000, of which[$647,486,000] $1,036,600,000 shall remain available until September 30, [2023]2024, and of which [$480,000,000] $198,600,000 shall remain available until ex-pended, of which [$400,000,000] $35,000,000 shall be available for seismic im-provement projects and seismic program management activities, including for projectsthat would otherwise be funded by the Construction, Minor Projects, Medical Facil-ities or National Cemetery Administration accounts: Provided, That except for ad-vance planning activities, including needs assessments which may or may not leadto capital investments, and other capital asset management related activities, includingportfolio development and management activities, and investment strategy studiesfunded through the advance planning fund and the planning and design activitiesfunded through the design fund, including needs assessments which may or maynot lead to capital investments, [and salaries and associated costs of the residentengineers who oversee those capital investments funded through this account andcontracting officers who manage specific major construction projects, and] fundsprovided for the purchase, security, and maintenance of land for the NationalCemetery Administration through the land acquisition line item, funds provided forconstruction of gravesite expansion projects at existing National Cemeteries, andlegal expenses incurred for programs and activities funded by this account, noneof the funds made available under this heading shall be used for any project that hasnot been notified to Congress through the budgetary process or that has not beenapproved by the Congress through statute, joint resolution, or in the explanatorystatement accompanying such Act and presented to the President at the time of en-rollment: Provided further, That such sums as may be necessary shall be availableto reimburse the "General Administration" account for payment of salaries and ex-penses of all Office of Construction and Facilities Management employees to supportthe full range of capital infrastructure services provided, including minor construc-tion and leasing services: Provided further, That funds made available under thisheading for fiscal year [2019] 2020, for each approved project shall be obligated:(1) by the awarding of a construction documents contract by September 30, [2019]2020; and (2) by the awarding of a construction contract by September 30, [2020]2021: Provided further, That the Secretary of Veterans Affairs shall promptly submitto the Committees on Appropriations of both Houses of Congress a written reporton any approved major construction project for which obligations are not incurredwithin the time limitations established above: Provided further, That notwithstandingthe requirements of section 8104(a) of title 38, United States Code, amounts madeavailable under this heading for seismic improvement projects and seismic programmanagement activities shall be available for the completion of both new and existingseismic projects of the Department. (Military Construction, Veterans Affairs, andRelated Agencies Appropriations Act, 2019.)



Obligations by program activity:1,8201,2111,150Medical programs .....................................................................0001187256168National cemeteries ..................................................................0002

101311Staff offices ..............................................................................0005

2,0171,4801,329Total direct obligations ..................................................................0799



2,1831,4861,655Unobligated balance brought forward, Oct 1 .........................1000..................................628Adjustment of unobligated bal brought forward, Oct 1 .........1020..................................137Recoveries of prior year unpaid obligations ...........................1021


Appropriations, discretionary:1,2352,177815Appropriation ....................................................................1100

..................................–420Unobligated balance of appropriations permanently

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

1,2352,177395Appropriation, discretionary (total) .......................................11601,2352,177395Budget authority (total) .............................................................19003,4183,6632,815Total budgetary resources available ..............................................1930










1,2352,177395Budget authority, gross .........................................................4000Outlays, gross:

234412244Outlays from new discretionary authority ..........................40101,8219001,116Outlays from discretionary balances .................................4011

2,0551,3121,360Outlays, gross (total) .............................................................40201,2352,177395Budget authority, net (total) ..........................................................41802,0551,3121,360Outlays, net (total) ........................................................................4190

The Construction, Major Projects appropriation funds construction pro-jects currently costing more than $20 million. Funding is requested tocomplete seven previously funded projects in San Juan, PR; Bay Pines,FL; Manhattan, NY; Louisville, KY; Riverside, CA; Western New York;and Bayamon, PR and four ongoing projects in Alameda, CA; San Diego,CA; West Los Angeles, CA; and Reno, NV. In addition, three expansionsat existing national cemeteries in Dallas, TX; Houston, TX; and Bourne,MA will be funded. Funds are also requested for salaries and associatedexpenses for staff for the Office of Construction and Facilities Managementand to support advance planning and design activities, seismic correction,and asbestos abatement.

$244 million of funds appropriated in 2016 and $117.3 million of fundsappropriated in 2018 are not reflected in the available balance in the tables.These funds will become available for use once the Department of VeteransAffairs meets the specific conditions required by law (P.L. 114–113 and115–141) and the funds are made available by the Treasury.



Direct obligations:242424Other services from non-Federal sources ..................................25.2242424Other goods and services from Federal sources ........................25.3

1,9691,4321,281Land and structures ..................................................................32.0

2,0171,4801,329Direct obligations ..................................................................99.0


✦

997DEPARTMENT OF VETERANS AFFAIRSDepartmental Administration

Federal Funds

CONSTRUCTION, MINOR PROJECTS

For constructing, altering, extending, and improving any of the facilities, includingparking projects, under the jurisdiction or for the use of the Department of VeteransAffairs, including planning and assessments of needs which may lead to capital in-vestments, architectural and engineering services, maintenance or guarantee periodservices costs associated with equipment guarantees provided under the project,services of claims analysts, offsite utility and storm drainage system constructioncosts, and site acquisition, or for any of the purposes set forth in sections 316, 2404,2406 and chapter 81 of title 38, United States Code, not otherwise provided for,where the estimated cost of a project is equal to or less than the amount set forth insection 8104(a)(3)(A) of title 38, United States Code, [$649,514,000] $398,800,000,to remain available until September 30, [2023] 2024, along with unobligated bal-ances of previous "Construction, Minor Projects" appropriations which are herebymade available for any project where the estimated cost is equal to or less than theamount set forth in such section: Provided, That funds made available under thisheading shall be for: (1) repairs to any of the nonmedical facilities under the juris-diction or for the use of the Department which are necessary because of loss ordamage caused by any natural disaster or catastrophe; and (2) temporary measuresnecessary to prevent or to minimize further loss by such causes. (Military Construc-tion, Veterans Affairs, and Related Agencies Appropriations Act, 2019.)



Obligations by program activity:456699269Medical programs .....................................................................000110617688National cemeteries ..................................................................0002354848Regional offices ........................................................................0003433533Staff offices ..............................................................................0004

.................1148Choice Act, P.L. 113–146, Sec. 801 ...........................................0005





Appropriations, discretionary:399800772Appropriation ....................................................................1100399800772Budget authority (total) .............................................................1900

1,0941,6641,352Total budgetary resources available ..............................................1930Memorandum (non-add) entries:

..................................–2Unobligated balance expiring ................................................1940454695864Unexpired unobligated balance, end of year ..........................1941


1,232904948Unpaid obligations, brought forward, Oct 1 ..........................3000640969486New obligations, unexpired accounts ....................................3010




1,1941,232904Unpaid obligations, end of year .................................................3050Memorandum (non-add) entries:

1,232904948Obligated balance, start of year ............................................31001,1941,232904Obligated balance, end of year ..............................................3200




640603413Outlays, gross (total) .............................................................4020Mandatory:

Outlays, gross:383867Outlays from mandatory balances ....................................4101

399800772Budget authority, net (total) ..........................................................4180678641480Outlays, net (total) ........................................................................4190

The Construction, Minor Projects appropriation funds construction pro-jects costing equal to or less than $20 million. This account is used to im-prove the infrastructure of medical facilities and other Department-owned

facilities to reduce the risk to patient life and safety, correct code deficien-cies, and improve national cemeteries and regional and staff offices.




625949468Land and structures ..................................................................32.0


✦

GRANTS FOR CONSTRUCTION OF STATE EXTENDED CARE FACILITIES

For grants to assist States to acquire or construct State nursing home and domicil-iary facilities and to remodel, modify, or alter existing hospital, nursing home, anddomiciliary facilities in State homes, for furnishing care to veterans as authorizedby sections 8131 through 8137 of title 38, United States Code, [$150,000,000]$90,000,000, to remain available until expended. (Military Construction, VeteransAffairs, and Related Agencies Appropriations Act, 2019.)



Obligations by program activity:135501346Grants for construction of state extended care facilities ...........0001



11345992Unobligated balance brought forward, Oct 1 .........................1000.................528Recoveries of prior year unpaid obligations ...........................1021







–333–177–103Outlays (gross) ......................................................................3020.................–5–28Recoveries of prior year unpaid obligations, unexpired .........3040





23.................Outlays from new discretionary authority ..........................4010331174103Outlays from discretionary balances .................................4011

333177103Outlays, gross (total) .............................................................402090150685Budget authority, net (total) ..........................................................4180

333177103Outlays, net (total) ........................................................................4190

The Grants for Construction of State Extended Care Facilities programis authorized by sections 8131 through 8137 of title 38, United States Code.It is a shared program between States and the Department of Veterans Af-fairs (VA), whereby VA provides no more than 65 percent of the fundingfor new construction of State home facilities, furnishing of domiciliary ornursing home care to veterans, and expansion, remodeling, or alteration ofexisting State home facilities. The State is responsible for providing theremaining 35 percent of funding.

✦

THE BUDGET FOR FISCAL YEAR 2020998 Departmental Administration—ContinuedFederal Funds—Continued

GRANTS FOR CONSTRUCTION OF VETERANS CEMETERIES

For grants to assist States and tribal organizations in establishing, expanding, orimproving veterans cemeteries as authorized by section 2408 of title 38, UnitedStates Code, $45,000,000, to remain available until expended. (Military Construction,Veterans Affairs, and Related Agencies Appropriations Act, 2019.)



Obligations by program activity:454550Grants for construction of state veterans cemeteries ................0001



745Unobligated balance brought forward, Oct 1 .........................1000334Recoveries of prior year unpaid obligations ...........................1021


Appropriations, discretionary:454545Appropriation ....................................................................1100555254Total budgetary resources available ..............................................1930




–94–47–46Outlays (gross) ......................................................................3020–3–3–4Recoveries of prior year unpaid obligations, unexpired .........3040





2424.................Outlays from new discretionary authority ..........................4010702346Outlays from discretionary balances .................................4011


✦

GENERAL ADMINISTRATION


For necessary operating expenses of the Department of Veterans Affairs, not oth-erwise provided for, including administrative expenses in support of Department-wide capital planning, management and policy activities, uniforms, or allowancestherefor; not to exceed $25,000 for official reception and representation expenses;hire of passenger motor vehicles; and reimbursement of the General Services Ad-ministration for security guard services, [$355,897,000] $369,200,000, of whichnot to exceed 10 percent shall remain available until September 30, [2020] 2021:Provided, That funds provided under this heading may be transferred to "GeneralOperating Expenses, Veterans Benefits Administration". (Military Construction,Veterans Affairs, and Related Agencies Appropriations Act, 2019.)



Obligations by program activity:369361344General administration .............................................................0014424382338General administration, reimbursable program ........................0806





accounts ...........................................................................1012

.................520Unobligated balance (total) ......................................................1050Budget authority:


..................................1Appropriations transferred from other acct [036–0152] ....1121

369356337Appropriation, discretionary (total) .......................................1160Spending authority from offsetting collections, discretionary:


424382338Spending auth from offsetting collections, disc (total) .........1750793738675Budget authority (total) .............................................................1900793743695Total budgetary resources available ..............................................1930

Memorandum (non-add) entries:..................................–8Unobligated balance expiring ................................................1940..................................5Unexpired unobligated balance, end of year ..........................1941






–34–34–15Uncollected pymts, Fed sources, brought forward, Oct 1 ........3060..................................–30Change in uncollected pymts, Fed sources, unexpired ..........3070..................................11Change in uncollected pymts, Fed sources, expired ..............3071












..................................–11Additional offsets against budget authority only (total) ........4060


General Administration.—Includes departmental executive direction,departmental support offices, the Office of General Counsel, and the Officeof Accountability and Whistleblower Protection. The Pershing Hall Re-volving Fund was created to operate and manage Pershing Hall, an assetof the United States, located in Paris, France. All operating expenses forPershing Hall are borne by the revolving fund and all receipts generatedby the operation of Pershing Hall are deposited in the revolving fund.




219208187Full-time permanent .............................................................11.1845Other personnel compensation ..............................................11.5

227212192Total personnel compensation ...........................................11.9706763Civilian personnel benefits ........................................................12.1755Travel and transportation of persons .........................................21.0

191820Rental payments to others ........................................................23.2443Communications, utilities, and miscellaneous charges ............23.3

385359Other services from non-Federal sources ..................................25.2

999DEPARTMENT OF VETERANS AFFAIRSDepartmental Administration—Continued


GENERAL ADMINISTRATION—Continued

Object Classification—Continued


311Supplies and materials .............................................................26.0111Equipment .................................................................................31.0



Employment Summary


1,9271,7641,634Direct civilian full-time equivalent employment ............................10011,2091,054886Reimbursable civilian full-time equivalent employment ...............2001

✦

BOARD OF VETERANS APPEALS

For necessary operating expenses of the Board of Veterans Appeals,[$174,748,000] $182,000,000, of which not to exceed 10 percent shall remainavailable until September 30, [2020] 2021. (Military Construction, Veterans Affairs,and Related Agencies Appropriations Act, 2019.)



Obligations by program activity:188181152Board of Veterans' Appeals .......................................................0014




accounts ...........................................................................1012



..................................–7Appropriations transferred to other acct [036–0151] ........1120

182175154Appropriation, discretionary (total) .......................................1160191190170Total budgetary resources available ..............................................1930





–177–170–143Outlays (gross) ......................................................................3020







The mission of the Board of Veterans' Appeals (Board or BVA), as setforth in 38 U.S.C. 7101(a) is to conduct hearings and consider and disposeof appeals properly before the Board in a timely manner. The Board's goalis to issue quality decisions in compliance with the requirements of thelaw, including the precedential decisions of the United States Court ofAppeals for Veterans Claims and other federal courts. The Board makes

final decisions on behalf of the Secretary on appeals from decisions of theagencies of original jurisdiction with the Department of Veterans Affairsoffices. The Board reviews all appeals for entitlement to veterans' benefits,including claims for service connection, increased disability ratings, totaldisability ratings, pension, insurance benefits, educational benefits, homeloan guaranties, vocational rehabilitation, dependency and indemnitycompensation, and healthcare delivery. The Veterans Appeals Improvementand Modernization Act of 2017, enacted on August 23, 2017, became ef-fective on February 19, 2019. This law reformed the current appeals processand replaced it with a new, simpler process that uses easy to understandlanguage and gives veterans choice and control of their appeal.





12712898Total personnel compensation ...........................................11.9393530Civilian personnel benefits ........................................................12.1111Travel and transportation of persons .........................................21.0538Rental payments to others ........................................................23.2

161414Other services from non-Federal sources ..................................25.2..................................1Grants, subsidies, and contributions ........................................41.0


Employment Summary


1,1251,125920Direct civilian full-time equivalent employment ............................1001

✦

OFFICE OF INSPECTOR GENERAL

For necessary expenses of the Office of Inspector General, to include informationtechnology, in carrying out the provisions of the Inspector General Act of 1978 (5U.S.C. App.), [$192,000,000] $207,000,000, of which not to exceed 10 percentshall remain available until September 30, [2020] 2021. (Military Construction,Veterans Affairs, and Related Agencies Appropriations Act, 2019.)



Obligations by program activity:207199171Office of Inspector General (Direct) ...........................................0101

207199171Total direct program ......................................................................0192




accounts ...........................................................................1012


Appropriations, discretionary:207192164Appropriation ....................................................................1100207192164Budget authority (total) .............................................................1900207199180Total budgetary resources available ..............................................1930

Memorandum (non-add) entries:..................................–2Unobligated balance expiring ................................................1940..................................7Unexpired unobligated balance, end of year ..........................1941



–204–165–167Outlays (gross) ......................................................................3020..................................–2Recoveries of prior year unpaid obligations, expired .............3041


552119Obligated balance, start of year ............................................3100


585521Obligated balance, end of year ..............................................3200





This appropriation provides for carrying out the independent oversightresponsibilities of the Inspector General Act of 1978. This oversight in-cludes Department of Veterans Affairs (VA)-wide audit, investigation,health care inspection, and management support functions to identify andreport weaknesses and deficiencies that create conditions for actual or po-tential fraud and other criminal activity, mismanagement, and waste in VAprograms and operations. The audit function plans and conducts internalprogrammatic and financial audits and evaluations of all facets of VA op-erations. The health care inspection function performs legislatively man-dated medical care quality assurance reviews and oversight of VA healthcare programs. The investigative function performs criminal and adminis-trative investigations of improper and illegal activities involving VA oper-ations, personnel, beneficiaries, and other parties.





126121102Total personnel compensation ...........................................11.9454437Civilian personnel benefits ........................................................12.1776Employee Travel .........................................................................21.0783Rental payments to GSA ............................................................23.1312Communications, utilities, and miscellaneous charges ............23.3


207199171Direct obligations ..................................................................99.0


Employment Summary


1,000975849Direct civilian full-time equivalent employment ............................1001

✦

INFORMATION TECHNOLOGY SYSTEMS


For necessary expenses for information technology systems and telecommunica-tions support, including developmental information systems and operational inform-ation systems; for pay and associated costs; and for the capital asset acquisition ofinformation technology systems, including management and related contractualcosts of said acquisitions, including contractual costs associated with operationsauthorized by section 3109 of title 5, United States Code, [$4,103,000,000]$4,343,000,000, plus reimbursements: Provided, That [$1,199,220,000]$1,204,238,000 shall be for pay and associated costs, of which not to exceed 3 percentshall remain available until September 30, [2020] 2021: Provided further, That[$2,523,209,000] $2,737,482,000 shall be for operations and maintenance, of whichnot to exceed 5 percent shall remain available until September 30, [2020] 2021:Provided further, That [$380,571,000] $401,280,000 shall be for informationtechnology systems development, and shall remain available until September 30,[2020] 2021: Provided further, That amounts made available for salaries and ex-penses, operations and maintenance, and information technology systems develop-ment may be transferred among the three subaccounts after the Secretary of VeteransAffairs submits notice thereof to [requests from] the Committees on Appropriationsof both Houses of Congress [the authority to make the transfer and an approval is

issued] : Provided further, That amounts made available for the "InformationTechnology Systems" account for development may be transferred among projectsor to newly defined projects: Provided further, That no project may be increased ordecreased by more than [$1,000,000] $3,000,000 of cost prior to submitting noticethereof [a request] to the Committees on Appropriations of both Houses of Congress[to make the transfer and an approval is issued, or absent a response, a period of30 days has elapsed: Provided further, That the funds made available under thisheading for information technology systems development shall be for the projects,and in the amounts, specified under this heading in the joint explanatory statementaccompanying this Act]. (Military Construction, Veterans Affairs, and RelatedAgencies Appropriations Act, 2019.)



Obligations by program activity:401427420Development .............................................................................0001

2,7342,6222,398Operations and maintenance ....................................................00021,2001,2281,167Administrative and salaries ......................................................0003

.................2594P.L. 113–146, Sec. 801 - IT Support ..........................................0004

4,3354,3024,079Total direct obligations ..................................................................0799..................................11Development .............................................................................0801..................................16Operations and maintenance ....................................................0802..................................19Administrative and salaries ......................................................0803

7363.................IT Systems, Reimbursable obligations .......................................0804





..................................17Recoveries of prior year unpaid obligations ...........................1021


Appropriations, discretionary:4,3434,1034,056Appropriation ....................................................................1100

–8–8–8Appropriations transferred to other accts [036–0169] .......1120

4,3354,0954,048Appropriation, discretionary (total) .......................................1160Spending authority from offsetting collections, discretionary:

736346Collected ...........................................................................17004,4084,1584,094Budget authority (total) .............................................................19004,4084,3654,332Total budgetary resources available ..............................................1930





















INFORMATION TECHNOLOGY SYSTEMS—Continued






7363111Outlays from mandatory balances ....................................41014,3354,0954,048Budget authority, net (total) ..........................................................41803,9864,0974,173Outlays, net (total) ........................................................................4190

The Information Technology (IT) Systems appropriation funds IT servicessuch as systems development and performance, operations and maintenance,information security, and customer support. This appropriation enables theeffective and efficient delivery of services to the Nation's largest healthcarenetwork, as well as the veterans benefits and corporate business lineswithin the Department of Veterans Affairs (VA).

Development.—The Office of Information & Technology invests inprojects designed to improve the delivery of VA services and benefits forveterans and their families. This account also supports improvements inthe Community Care Program, modernizations to veterans benefits andappeals processing, as well as the divestiture of legacy IT systems.

Operations and Maintenance.—The Office of Information & Technologypurchases, maintains, manages, and supports all the computer, phone,telecommunication, and data systems equipment and infrastructure for allVA facilities.




736761687Full-time permanent .............................................................11.1..................................6Full-time permanent - Choice Act, P.L. 113–146, Sec. 801 ....11.1

736761693Total personnel compensation ...........................................11.9248256231Civilian personnel benefits ........................................................12.1

..................................2Civilian personnel benefits -Choice Act, P.L. 113–146, Sec.

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

779Travel and transportation of persons .........................................21.01,1501,046963Communications, utilities, and miscellaneous charges ............23.3

.................417Communications/utilities - Choice Act, P.L. 113–146, Sec.

801 ........................................................................................23.3

1,6181,6611,594Other services from non-Federal sources ..................................25.2

.................314Other services from non-Federal -Choice Act, P.L. 113–146, Sec.

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

353128Supplies and materials .............................................................26.0.................14Supplies and materials - Choice Act, P.L. 113–146, Sec. 801 ....26.0

541515473Equipment .................................................................................31.0.................1750Equipment - Choice Act, P.L. 113–146, Sec. 801 .......................31.0..................................1Land and structures - Choice Act, P.L. 113–146, Sec. 801 ........32.0



Employment Summary



✦

VETERANS ELECTRONIC HEALTH RECORD

For activities related to implementation, preparation, development, interface,management, rollout, and maintenance of a Veterans Electronic Health Recordsystem, including contractual costs associated with operations authorized by section3109 of title 5, United States Code, and salaries and expenses of employees hiredunder titles 5 and 38, United States Code, [$1,107,000,000] $1,603,000,000, toremain available until September 30, [2021] 2022 [: Provided, That the Secretaryof Veterans Affairs shall submit to the Committees on Appropriations of both Houses

of Congress quarterly reports detailing obligations, expenditures, and deploymentimplementation by facility: Provided further, That the funds provided in this accountshall only be available to the Office of the Deputy Secretary, to be administered bythat Office: Provided further, That none of the funds made available under thisheading may be obligated in a manner inconsistent with deployment schedulesprovided to the Committees on Appropriations unless the Secretary of VeteransAffairs provides notification to the Committees on Appropriations of such changeand an approval is issued]. (Military Construction, Veterans Affairs, and RelatedAgencies Appropriations Act, 2019.)



Obligations by program activity:1,106720487EHR Contract .............................................................................000118715551PMO Support .............................................................................000233541239Infrastructure Readiness ...........................................................0003

1,6281,287577Total new obligations, unexpired accounts ....................................0900


25205.................Unobligated balance brought forward, Oct 1 .........................1000Budget authority:

Appropriations, discretionary:1,6031,107782Appropriation ....................................................................11001,6281,312782Total budgetary resources available ..............................................1930

Memorandum (non-add) entries:.................25205Unexpired unobligated balance, end of year ..........................1941


756437.................Unpaid obligations, brought forward, Oct 1 ..........................30001,6281,287577New obligations, unexpired accounts ....................................3010

–1,345–968–140Outlays (gross) ......................................................................3020

1,039756437Unpaid obligations, end of year .................................................3050Memorandum (non-add) entries:

756437.................Obligated balance, start of year ............................................31001,039756437Obligated balance, end of year ..............................................3200



769531140Outlays from new discretionary authority ..........................4010576437.................Outlays from discretionary balances .................................4011

1,345968140Outlays, gross (total) .............................................................40201,6031,107782Budget authority, net (total) ..........................................................41801,345968140Outlays, net (total) ........................................................................4190

The Veterans Electronic Health Care Record appropriation funds neces-sary expenses related to the development and deployment of a new veteranselectronic health record (EHR) system. This new EHR will allow the De-partment of Veterans Affairs (VA) to move toward a single common healthrecord that has full integration between the Department of Defense andVA, as well as community providers. From the veteran perspective, thenew system will provide a single, accurate, lifetime health record whileimproving patient care and safety.



Direct obligations:305.................Personnel compensation: Full-time permanent .........................11.183.................Civilian personnel benefits ........................................................12.1461Travel and transportation of persons .........................................21.0

.................3.................Rental payments to GSA ............................................................23.11,4551,156556Other services from non-Federal sources ..................................25.2

1109Other goods and services from Federal sources (FTE to OIT) ......25.37125Other goods and services from Federal sources (FTE to VHA) .....25.3

12091.................Other goods and services from Federal sources ........................25.3.................16Equipment .................................................................................31.0

3..................................Land and structures ..................................................................32.0

1,6281,287577Direct obligations ..................................................................99.0

1,6281,287577Total new obligations, unexpired accounts ............................99.9


Employment Summary


231170.................Direct civilian full-time equivalent employment ............................1001

✦

NATIONAL CEMETERY ADMINISTRATION

For necessary expenses of the National Cemetery Administration for operationsand maintenance, not otherwise provided for, including uniforms or allowancestherefor; cemeterial expenses as authorized by law; purchase of one passenger motorvehicle for use in cemeterial operations; hire of passenger motor vehicles; and repair,alteration or improvement of facilities under the jurisdiction of the National CemeteryAdministration, [$315,836,000] $329,000,000, of which not to exceed 10 percentshall remain available until September 30, [2020] 2021. (Military Construction,Veterans Affairs, and Related Agencies Appropriations Act, 2019.)



222Balance, start of year ....................................................................0100

222Total: Balances and receipts .....................................................2000

222Balance, end of year ..................................................................5099



Obligations by program activity:329319309Operations and maintenance ....................................................0201



117Unobligated balance transfers between expired and unexpired

accounts ...........................................................................1012



Spending authority from offsetting collections, discretionary:..................................1Collected ...........................................................................1700














Offsetting collections (collected) from:..................................–1Federal sources .................................................................4030

..................................–1Offsets against gross budget authority and outlays (total) ....4040329315306Budget authority, net (total) ..........................................................4180293331295Outlays, net (total) ........................................................................4190

The mission of the National Cemetery Administration is to honor veteranswith final resting places in national shrines and with lasting tributes thatcommemorate their service to our Nation. The National Cemetery Admin-istration's vision is to serve all veterans and their families with the utmostdignity, respect, and compassion. Every national cemetery will be a placethat inspires visitors to understand and appreciate the service and sacrificeof our Nation's veterans. There are a number of related programs managedby the National Cemetery Administration including: 1) burying eligibleveterans and their family members in national cemeteries and maintainingthe graves and their environs as national shrines; 2) administering grantsto States and Tribal organizations in establishing, expanding, improving,or operating veterans cemeteries; 3) providing headstones and markers forthe graves of eligible veterans; 4) providing medallions commemoratingthe veterans's service that may be affixed to the privately purchased head-stones or markers for veterans interred in private cemeteries; 5) providingpresidential memorial certificates to family and friends of deceased veterans,recognizing the veterans' contribution and service to the Nation; 6)providing graveliners or partial reimbursement for a privately purchasedouter burial receptacle for each new grave in open national cemeteries ad-ministered by the National Cemetery Administration; 7) providing reim-bursement caskets and urns for veterans' remains when there are no nextof kin and insufficient resources; and 8) recording First Notice of VeteranDeaths into the Department of Veterans Affairs electronic files to ensuretimely termination of benefits and next-of-kin notification of possible enti-tlement to survivor benefits.

The National Cemetery Administration also reflects budget informationfor the National Cemetery Gift Fund and the National Cemetery Adminis-tration Facilities Operation Fund. Through the Gift Fund, the Secretary isauthorized to accept gifts and bequests which are made for the purpose ofbeautifying national cemeteries or are determined to be beneficial to suchcemeteries, or are made for the purpose of the operation, maintenance, orimprovement of the National Memorial Cemetery of Arizona.




126121115Full-time permanent .............................................................11.1555Other than full-time permanent ............................................11.3

131126120Total personnel compensation ...........................................11.9484744Civilian personnel benefits ........................................................12.1443Travel and transportation of persons .........................................21.0222Transportation of things ............................................................22.0333Rent ..........................................................................................23.1111Rental payments to others ........................................................23.2


10510299Other services from non-Federal sources ..................................25.2131312Supplies and materials .............................................................26.07711Equipment .................................................................................31.0111Land and structures ..................................................................32.0


Employment Summary


2,0081,9411,865Direct civilian full-time equivalent employment ............................1001

✦

SUPPLY FUND



Obligations by program activity:320320535Reimbursable program-COGS-Merchandizing ...........................0801345345243Reimbursable program-Other-Operations .................................080220208Reimbursable program-COGS-Printing and publications ..........0803



SUPPLY FUND—Continued



43743729Reimbursable program-Other ....................................................0804

916934717Reimbursable program-Equipment-Procurement services and

distribution ...........................................................................0805





Spending authority from offsetting collections, mandatory:2,1002,1001,200Collected ...........................................................................1800


2,1002,1001,118Spending auth from offsetting collections, mand (total) .......18502,3442,3001,732Total budgetary resources available ..............................................1930






–923–923–1,005Uncollected pymts, Fed sources, brought forward, Oct 1 ........3060..................................82Change in uncollected pymts, Fed sources, unexpired ..........3070


–77234–169Obligated balance, start of year ............................................3100–813–77234Obligated balance, end of year ..............................................3200



1,9951,995.................Outlays from new mandatory authority .............................4100848671,293Outlays from mandatory balances ....................................4101


Offsetting collections (collected) from:–2,100–2,100–1,090Federal sources .................................................................4120


–2,100–2,100–1,200Offsets against gross budget authority and outlays (total) ....4130Additional offsets against gross budget authority only:

..................................82Change in uncollected pymts, Fed sources, unexpired .......4140–2176293Outlays, net (mandatory) ...........................................................4170

...................................................Budget authority, net (total) ..........................................................4180–2176293Outlays, net (total) ........................................................................4190

Under the provisions of 38 U.S.C. 8121, the Supply Fund is responsiblefor the operation and maintenance of a supply system for the Departmentof Veterans Affairs (VA). In this capacity, it provides policy and oversightto VA's acquisition and logistics programs, and provides best value acquis-ition of goods and services through its National Acquisition Center, DenverAcquisition and Logistics Center, Service and Distribution Center, Tech-nology Acquisition Center and Strategic Acquisition Center. Operating asan intra-governmental revolving fund without fiscal year limitations, theSupply Fund is financed by revenue from fees on acquisitions of supplies,equipment, and services for both VA and other Government agency cus-tomers.



Reimbursable obligations:13413498Personnel compensation: Full-time permanent .........................11.1

..................................32Civilian personnel benefits ........................................................12.1151511Travel and transportation of persons .........................................21.0

.................107Rental payments to GSA ............................................................23.1101813Communications, utilities, and miscellaneous charges ............23.311118Printing and reproduction .........................................................24.0



Employment Summary


1,1351,115957Reimbursable civilian full-time equivalent employment ...............2001

✦

FRANCHISE FUND



Obligations by program activity:1,0941,0791,062Franchise Fund (Reimbursable) ................................................0801




Spending authority from offsetting collections, discretionary:1,0941,079891Collected ...........................................................................1700


1,0941,079933Spending auth from offsetting collections, disc (total) .........17501,1181,1031,086Total budgetary resources available ..............................................1930




–1,090–1,064–906Outlays (gross) ......................................................................3020..................................–38Recoveries of prior year unpaid obligations, unexpired .........3040








1,0901,064906Outlays, gross (total) .............................................................4020Offsets against gross budget authority and outlays:

Offsetting collections (collected) from:–1,094–1,079–891Federal sources .................................................................4030

Additional offsets against gross budget authority only:..................................–42Change in uncollected pymts, Fed sources, unexpired .......4050

–4–1515Outlays, net (discretionary) .......................................................4080...................................................Budget authority, net (total) ..........................................................4180

–4–1515Outlays, net (total) ........................................................................4190

The Department of Veterans Affairs (VA) Franchise Fund was establishedunder the authority of the Government Management Reform Act of 1994and the VA and Housing and Urban Development and Independent Agen-cies Act of 1997. VA was selected by the Office of Management and Budgetin 1996 as one of the six executive branch agencies to establish a franchisefund pilot program. Created as a revolving fund, the VA Franchise Fundbegan providing common administrative support services to the VA and


other Government agencies in 1997 on a fee-for-service basis. In 2006,under the Military Quality of Life and Veterans Affairs AppropriationsAct (Public Law 109–114), permanent status was conferred upon the VAFranchise Fund. The Franchise Fund concept is intended to increase com-petition for Government administrative services, resulting in lower costsand higher quality.



Reimbursable obligations:150135109Personnel compensation: Full-time permanent .........................11.1494436Civilian personnel benefits ........................................................12.1233Travel and transportation of persons .........................................21.0999Rental payments to GSA ............................................................23.1


717716692Other services from non-Federal sources ..................................25.2893Supplies and materials .............................................................26.0

252985Equipment .................................................................................31.0


Employment Summary


2,1401,9281,383Reimbursable civilian full-time equivalent employment ...............2001

✦

ADMINISTRATIVE PROVISIONS

(INCLUDING TRANSFER OF FUNDS)SEC. 201. Any appropriation for fiscal year [2019]2020 for "Compensation and

Pensions", "Readjustment Benefits", and "Veterans Insurance and Indemnities" maybe transferred as necessary to any other of the mentioned appropriations: Provided,That, before a transfer may take place, the Secretary of Veterans Affairs shall [re-quest from]submit notice thereof to the Committees on Appropriations of bothHouses of Congress [the authority to make the transfer and such Committees issuean approval, or absent a response, a period of 30 days has elapsed].

(INCLUDING TRANSFER OF FUNDS)SEC. 202. Amounts made available for the Department of Veterans Affairs for

fiscal year [2019] 2020, in this or any other Act, under the "Medical Services","Medical Community Care", "Medical Support and Compliance", and "MedicalFacilities" accounts may be transferred among the accounts: Provided, That [anytransfers among the "Medical Services", "Medical Community Care", and "MedicalSupport and Compliance" accounts of 1 percent or less of the total amount appropri-ated to the account in this or any other Act may take place subject to notificationfrom the Secretary of Veterans Affairs to the Committees on Appropriations of bothHouses of Congress of the amount and purpose of the transfer: Provided further,That any transfers among the "Medical Services", "Medical Community Care", and"Medical Support and Compliance" accounts in excess of 1 percent, or exceedingthe cumulative 1 percent for the fiscal year, may take place only after the Secretaryrequests from the Committees on Appropriations of both Houses of Congress theauthority to make the transfer and an approval is issued: Provided further, That anytransfers to or from the "Medical Facilities" account may take place only after theSecretary requests from the Committees on Appropriations of both Houses of Con-gress the authority to make the transfer and an approval is issued] before a transfermay take place, the Secretary of Veterans Affairs shall submit notice thereof to theCommittees on Appropriations of both Houses of Congress of the amount and purposeof the transfer.

SEC. 203. Appropriations available in this title for salaries and expenses shall beavailable for services authorized by section 3109 of title 5, United States Code; hireof passenger motor vehicles; lease of a facility or land or both; and uniforms or al-lowances therefore, as authorized by sections 5901 through 5902 of title 5, UnitedStates Code.

SEC. 204. No appropriations in this title (except the appropriations for "Construc-tion, Major Projects", and "Construction, Minor Projects") shall be available for thepurchase of any site for or toward the construction of any new hospital or home.

SEC. 205. No appropriations in this title shall be available for hospitalization orexamination of any persons (except beneficiaries entitled to such hospitalization orexamination under the laws providing such benefits to veterans, and persons receivingsuch treatment under sections 7901 through 7904 of title 5, United States Code, or

the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C.5121 et seq.)), unless reimbursement of the cost of such hospitalization or examina-tion is made to the "Medical Services" account at such rates as may be fixed by theSecretary of Veterans Affairs.

SEC. 206. Appropriations available in this title for "Compensation and Pensions","Readjustment Benefits", and "Veterans Insurance and Indemnities" shall be availablefor payment of prior year accrued obligations required to be recorded by law againstthe corresponding prior year accounts within the last quarter of fiscal year [2018]2019.

SEC. 207. Appropriations available in this title shall be available to pay prior yearobligations of corresponding prior year appropriations accounts resulting from sec-tions 3328(a), 3334, and 3712(a) of title 31, United States Code, except that if suchobligations are from trust fund accounts they shall be payable only from "Compens-ation and Pensions".

(INCLUDING TRANSFER OF FUNDS)SEC. 208. Notwithstanding any other provision of law, during fiscal year [2019]

2020, the Secretary of Veterans Affairs shall, from the National Service Life Insur-ance Fund under section 1920 of title 38, United States Code, the Veterans' SpecialLife Insurance Fund under section 1923 of title 38, United States Code, and theUnited States Government Life Insurance Fund under section 1955 of title 38, UnitedStates Code, reimburse the "General Operating Expenses, Veterans Benefits Admin-istration" and "Information Technology Systems" accounts for the cost of adminis-tration of the insurance programs financed through those accounts: Provided, Thatreimbursement shall be made only from the surplus earnings accumulated in suchan insurance program during fiscal year [2019] 2020 that are available for dividendsin that program after claims have been paid and actuarially determined reserves havebeen set aside: Provided further, That if the cost of administration of such an insur-ance program exceeds the amount of surplus earnings accumulated in that program,reimbursement shall be made only to the extent of such surplus earnings: Providedfurther, That the Secretary shall determine the cost of administration for fiscal year[2019] 2020 which is properly allocable to the provision of each such insuranceprogram and to the provision of any total disability income insurance included inthat insurance program.

SEC. 209. Amounts deducted from enhanced-use lease proceeds to reimburse anaccount for expenses incurred by that account during a prior fiscal year for providingenhanced-use lease services, may be obligated during the fiscal year in which theproceeds are received.

(INCLUDING TRANSFER OF FUNDS)SEC. 210. Funds available in this title or funds for salaries and other administrative

expenses shall also be available to reimburse the Office of Resolution Management,the Office of Employment Discrimination Complaint Adjudication, [the Office ofAccountability and Whistleblower Protection,] and the Office of Diversity and In-clusion for all services provided at rates which will recover actual costs but not toexceed [$48,431,000] $57,263,000 for the Office of Resolution Management,[$4,333,000] $6,000,000 for the Office of Employment Discrimination ComplaintAdjudication, [$17,700,000 for the Office of Accountability and WhistleblowerProtection], and [$3,230,000] $4,628,000 for the Office of Diversity and Inclusion:Provided, That payments may be made in advance for services to be furnished basedon estimated costs: Provided further, That amounts received shall be credited to the"General Administration" and "Information Technology Systems" accounts for useby the office that provided the service.

SEC. 211. No funds of the Department of Veterans Affairs shall be available forhospital care, nursing home care, or medical services provided to any person underchapter 17 of title 38, United States Code, for a non-service-connected disabilitydescribed in section 1729(a)(2) of such title, unless that person has disclosed to theSecretary of Veterans Affairs, in such form as the Secretary may require, current,accurate third-party reimbursement information for purposes of section 1729 of suchtitle: Provided, That the Secretary may recover, in the same manner as any otherdebt due the United States, the reasonable charges for such care or services fromany person who does not make such disclosure as required: Provided further, Thatany amounts so recovered for care or services provided in a prior fiscal year maybe obligated by the Secretary during the fiscal year in which amounts are received.

(INCLUDING TRANSFER OF FUNDS)SEC. 212. Notwithstanding any other provision of law, proceeds or revenues derived

from enhanced-use leasing activities (including disposal) may be deposited into the"Construction, Major Projects" and "Construction, Minor Projects" accounts and beused for construction (including site acquisition and disposition), alterations, andimprovements of any medical facility under the jurisdiction or for the use of theDepartment of Veterans Affairs. Such sums as realized are in addition to the amountprovided for in "Construction, Major Projects" and "Construction, Minor Projects".

SEC. 213. Amounts made available under "Medical Services" are available—(1) for furnishing recreational facilities, supplies, and equipment; and

1005DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATIVE PROVISIONS

(2) for funeral expenses, burial expenses, and other expenses incidental to fu-nerals and burials for beneficiaries receiving care in the Department.

(INCLUDING TRANSFER OF FUNDS)SEC. 214. Such sums as may be deposited [to] in the Medical Care Collections

Fund pursuant to section 1729A of title 38, United States Code, may be transferredto the "Medical Services" and "Medical Community Care" accounts to remainavailable until expended for the purposes of these accounts.

SEC. 215. The Secretary of Veterans Affairs may enter into agreements with Fed-erally Qualified Health Centers in the State of Alaska and Indian tribes and tribalorganizations which are party to the Alaska Native Health Compact with the IndianHealth Service, to provide healthcare, including behavioral health and dental care,to veterans in rural Alaska. The Secretary shall require participating veterans andfacilities to comply with all appropriate rules and regulations, as established by theSecretary. The term "rural Alaska" shall mean those lands which are not within theboundaries of the municipality of Anchorage or the Fairbanks North Star Borough.

(INCLUDING TRANSFER OF FUNDS)SEC. 216. Such sums as may be deposited to the Department of Veterans Affairs

Capital Asset Fund pursuant to section 8118 of title 38, United States Code, maybe transferred to the "Construction, Major Projects" and "Construction, Minor Pro-jects" accounts, to remain available until expended for the purposes of these accounts.

SEC. 217. Not later than 30 days after the end of each fiscal quarter, the Secretaryof Veterans Affairs shall submit to the Committees on Appropriations of both Housesof Congress a report on the financial status of the Department of Veterans Affairsfor the preceding quarter: Provided, That, at a minimum, the report shall includethe direction contained in the paragraph entitled "Quarterly reporting", under theheading "General Administration" in the joint explanatory statement accompanyingPublic Law 114–223.

(INCLUDING TRANSFER OF FUNDS)SEC. 218. Amounts made available under the "Medical Services", "Medical

Community Care", "Medical Support and Compliance", "Medical Facilities","General Operating Expenses, Veterans Benefits Administration", "Board of VeteransAppeals", "General Administration", and "National Cemetery Administration" ac-counts for fiscal year [2019] 2020 may be transferred to or from the "InformationTechnology Systems" account: Provided, That such transfers may not result in amore than 10 percent aggregate increase in the total amount made available by thisAct for the "Information Technology Systems" account: Provided further, That,before a transfer may take place, the Secretary of Veterans Affairs shall [requestfrom] submit notice thereofto the Committees on Appropriations of both Housesof Congress [the authority to make the transfer and an approval is issued].

(INCLUDING TRANSFER OF FUNDS)SEC. 219. Of the amounts appropriated to the Department of Veterans Affairs for

fiscal year [2019] 2020 for "Medical Services", "Medical Community Care","Medical Support and Compliance", "Medical Facilities", "Construction, MinorProjects", and "Information Technology Systems", up to [$301,578,000]$314,409,000, plus reimbursements, may be transferred to the Joint Department ofDefense—Department of Veterans Affairs Medical Facility Demonstration Fund,established by section 1704 of the National Defense Authorization Act for FiscalYear 2010 (Public Law 111–84; 123 Stat. [3571] 2571) and may be used for oper-ation of the facilities designated as combined Federal medical facilities as describedby section 706 of the Duncan Hunter National Defense Authorization Act for FiscalYear 2009 (Public Law 110–417; 122 Stat. 4500): Provided, That additional fundsmay be transferred from accounts designated in this section to the Joint Departmentof Defense—Department of Veterans Affairs Medical Facility Demonstration Fundupon written notification by the Secretary of Veterans Affairs to the Committees onAppropriations of both Houses of Congress: Provided further, That section 220 oftitle II of division [J] C of Public Law [115–141]115–244 is repealed.

(INCLUDING TRANSFER OF FUNDS)SEC. 220. Of the amounts appropriated to the Department of Veterans Affairs

which become available on October 1, [2019] 2020, for "Medical Services","Medical Community Care", "Medical Support and Compliance", and "MedicalFacilities", up to [$307,609,000] $322,931,000, plus reimbursements, may betransferred to the Joint Department of Defense—Department of Veterans AffairsMedical Facility Demonstration Fund, established by section 1704 of the NationalDefense Authorization Act for Fiscal Year 2010 (Public Law 111–84; 123 Stat.3571) and may be used for operation of the facilities designated as combined Federalmedical facilities as described by section 706 of the Duncan Hunter National DefenseAuthorization Act for Fiscal Year 2009 (Public Law 110–417; 122 Stat. 4500):Provided, That additional funds may be transferred from accounts designated in thissection to the Joint Department of Defense—Department of Veterans Affairs Med-ical Facility Demonstration Fund upon written notification by the Secretary of Vet-erans Affairs to the Committees on Appropriations of both Houses of Congress.

(INCLUDING TRANSFER OF FUNDS)SEC. 221. Such sums as may be deposited to the Medical Care Collections Fund

pursuant to section 1729A of title 38, United States Code, for healthcare providedat facilities designated as combined Federal medical facilities as described by section706 of the Duncan Hunter National Defense Authorization Act for Fiscal Year 2009(Public Law 110–417; 122 Stat. 4500) shall also be available: (1) for transfer to theJoint Department of Defense—Department of Veterans Affairs Medical FacilityDemonstration Fund, established by section 1704 of the National Defense Authoriz-ation Act for Fiscal Year 2010 (Public Law 111–84; 123 Stat. 3571); and (2) foroperations of the facilities designated as combined Federal medical facilities as de-scribed by section 706 of the Duncan Hunter National Defense Authorization Actfor Fiscal Year 2009 (Public Law 110–417; 122 Stat. 4500): Provided, That, not-withstanding section 1704(b)(3) of the National Defense Authorization Act forFiscal Year 2010 (Public Law 111–84; 123 Stat. 2573), amounts transferred to theJoint Department of Defense—Department of Veterans Affairs Medical FacilityDemonstration Fund shall remain available until expended.

(INCLUDING TRANSFER OF FUNDS)SEC. 222. Of the amounts available in this title for "Medical Services", "Medical

Community Care", "Medical Support and Compliance", and "Medical Facilities",a minimum of $15,000,000 shall be transferred to the DOD-VA Health Care SharingIncentive Fund, as authorized by section 8111(d) of title 38, United States Code, toremain available until expended, for any purpose authorized by section 8111 of title38, United States Code.[SEC. 223. None of the funds available to the Department of Veterans Affairs, in

this or any other Act, may be used to replace the current system by which the Veter-ans Integrated Service Networks select and contract for diabetes monitoring suppliesand equipment.][SEC. 224. The Secretary of Veterans Affairs shall notify the Committees on Ap-

propriations of both Houses of Congress of all bid savings in a major constructionproject that total at least $5,000,000, or 5 percent of the programmed amount of theproject, whichever is less: Provided, That such notification shall occur within 14days of a contract identifying the programmed amount: Provided further, That theSecretary shall notify the Committees on Appropriations of both Houses of Congress14 days prior to the obligation of such bid savings and shall describe the anticipateduse of such savings.][SEC. 225. None of the funds made available for "Construction, Major Projects"

may be used for a project in excess of the scope specified for that project in theoriginal justification data provided to the Congress as part of the request for appro-priations unless the Secretary of Veterans Affairs receives approval from the Com-mittees on Appropriations of both Houses of Congress.][SEC. 226. Not later than 30 days after the end of each fiscal quarter, the Secretary

of Veterans Affairs shall submit to the Committees on Appropriations of both Housesof Congress a quarterly report containing performance measures and data from eachVeterans Benefits Administration Regional Office: Provided, That, at a minimum,the report shall include the direction contained in the section entitled "Disabilityclaims backlog", under the heading "General Operating Expenses, Veterans BenefitsAdministration" in the joint explanatory statement accompanying Public Law114–223: Provided further, That the report shall also include information on thenumber of appeals pending at the Veterans Benefits Administration as well as theBoard of Veterans Appeals on a quarterly basis.][SEC. 227. The Secretary of Veterans Affairs shall provide written notification to

the Committees on Appropriations of both Houses of Congress 15 days prior to or-ganizational changes which result in the transfer of 25 or more full-time equivalentsfrom one organizational unit of the Department of Veterans Affairs to another.][SEC. 228. The Secretary of Veterans Affairs shall provide on a quarterly basis

to the Committees on Appropriations of both Houses of Congress notification ofany single national outreach and awareness marketing campaign in which obligationsexceed $2,000,000.]

(INCLUDING TRANSFER OF FUNDS)SEC. [229]223. The Secretary of Veterans Affairs, upon determination that such

action is necessary to address needs of the Veterans Health Administration, maytransfer to the "Medical Services" account any discretionary appropriations madeavailable for fiscal year [2019] 2020 in this title (except appropriations made tothe "General Operating Expenses, Veterans Benefits Administration" account) orany discretionary unobligated balances within the Department of Veterans Affairs,including those appropriated for fiscal year [2019] 2020, that were provided inadvance by appropriations Acts: Provided, That transfers shall be made only withthe approval of the Office of Management and Budget: Provided further, That thetransfer authority provided in this section is in addition to any other transfer authorityprovided by law: Provided further, That no amounts may be transferred from amountsthat were designated by Congress as an emergency requirement pursuant to a con-current resolution on the budget or the Balanced Budget and Emergency Deficit

THE BUDGET FOR FISCAL YEAR 20201006 ADMINISTRATIVE PROVISIONS—Continued

Control Act of 1985: Provided further, That such authority to transfer may not beused unless for higher priority items, based on emergent healthcare requirements,than those for which originally appropriated and in no case where the item for whichfunds are requested has been denied by Congress: Provided further, That, upon de-termination that all or part of the funds transferred from an appropriation are notnecessary, such amounts may be transferred back to that appropriation and shall beavailable for the same purposes as originally appropriated: Provided further, Thatbefore a transfer may take place, the Secretary of Veterans Affairs shall [requestfrom] submit notice thereof to the Committees on Appropriations of both Housesof Congress [the authority to make the transfer and receive approval of that request].

(INCLUDING TRANSFER OF FUNDS)SEC. [230]224. Amounts made available for the Department of Veterans Affairs

for fiscal year [2019] 2020, under the "Board of Veterans Appeals" and the "Gen-eral Operating Expenses, Veterans Benefits Administration" accounts may betransferred between such accounts: Provided, That before a transfer may take place,the Secretary of Veterans Affairs shall [request from] submit notice thereof to theCommittees on Appropriations of both Houses of Congress [the authority to makethe transfer and receive approval of that request].[SEC. 231. The Secretary of Veterans Affairs may not reprogram funds among

major construction projects or programs if such instance of reprogramming willexceed $7,000,000, unless such reprogramming is approved by the Committees onAppropriations of both Houses of Congress.][SEC. 232. (a) The Secretary of Veterans Affairs shall ensure that the toll-free

suicide hotline under section 1720F(h) of title 38, United States Code—(1) provides to individuals who contact the hotline immediate assistance from

a trained professional; and(2) adheres to all requirements of the American Association of Suicidology.

(b)(1) None of the funds made available by this Act may be used to enforce orotherwise carry out any Executive action that prohibits the Secretary of VeteransAffairs from appointing an individual to occupy a vacant civil service position, orestablishing a new civil service position, at the Department of Veterans Affairs withrespect to such a position relating to the hotline specified in subsection (a).

(2) In this subsection—(A) the term "civil service" has the meaning given such term in section 2101(1)

of title 5, United States Code; and(B) the term "Executive action" includes—

(i) any Executive order, presidential memorandum, or other action by thePresident; and

(ii) any agency policy, order, or other directive.(c)(1) The Secretary of Veterans Affairs shall conduct a study on the effectiveness

of the hotline specified in subsection (a) during the five-year period beginning onJanuary 1, 2016, based on an analysis of national suicide data and data collectedfrom such hotline.

(2) At a minimum, the study required by paragraph (1) shall—(A) determine the number of veterans who contact the hotline specified in sub-

section (a) and who receive follow up services from the hotline or mental healthservices from the Department of Veterans Affairs thereafter;

(B) determine the number of veterans who contact the hotline who are not referredto, or do not continue receiving, mental health care who commit suicide; and

(C) determine the number of veterans described in subparagraph (A) who commitor attempt suicide.][SEC. 233. None of the funds in this or any other Act may be used to close Depart-

ment of Veterans Affairs (VA) hospitals, domiciliaries, or clinics, conduct an envir-onmental assessment, or to diminish healthcare services at existing Veterans HealthAdministration medical facilities located in Veterans Integrated Service Network23 as part of a planned realignment of VA services until the Secretary provides tothe Committees on Appropriations of both Houses of Congress a report includingthe following elements:

(1) a national realignment strategy that includes a detailed description of re-alignment plans within each Veterans Integrated Services Network (VISN), in-cluding an updated Long Range Capital Plan to implement realignment require-ments;

(2) an explanation of the process by which those plans were developed andcoordinated within each VISN;

(3) a cost versus benefit analysis of each planned realignment, including thecost of replacing Veterans Health Administration services with contract care orother outsourced services;

(4) an analysis of how any such planned realignment of services will impactaccess to care for veterans living in rural or highly rural areas, including traveldistances and transportation costs to access a VA medical facility and availabilityof local specialty and primary care;

(5) an inventory of VA buildings with historic designation and the methodologyused to determine the buildings' condition and utilization;

(6) a description of how any realignment will be consistent with requirementsunder the National Historic Preservation Act; and

(7) consideration given for reuse of historic buildings within newly identifiedrealignment requirements: Provided, That, this provision shall not apply tocapital projects in VISN 23, or any other VISN, which have been authorized orapproved by Congress.]

[SEC. 234. Effective during the period beginning on October 1, 2018 and endingon January 1, 2024, none of the funds made available to the Secretary of VeteransAffairs by this or any other Act may be obligated or expended in contravention ofthe "Veterans Health Administration Clinical Preventive Services Guidance Statementon the Veterans Health Administration's Screening for Breast Cancer Guidance"published on May 10, 2017, as issued by the Veterans Health Administration NationalCenter for Health Promotion and Disease Prevention.]

SEC. [235]225. (a) Notwithstanding any other provision of law, the amounts ap-propriated or otherwise made available to the Department of Veterans Affairs forthe "Medical Services" account may be used to provide—

(1) fertility counseling and treatment using assisted reproductive technology toa covered veteran or the spouse of a covered veteran; or

(2) adoption reimbursement to a covered veteran.(b) In this section:

(1) The term "service-connected" has the meaning given such term in section101 of title 38, United States Code.

(2) The term "covered veteran" means a veteran, as such term is defined in section101 of title 38, United States Code, who has a service-connected disability thatresults in the inability of the veteran to procreate without the use of fertility treat-ment.

(3) The term "assisted reproductive technology" means benefits relating to repro-ductive assistance provided to a member of the Armed Forces who incurs a seriousinjury or illness on active duty pursuant to section 1074(c)(4)(A) of title 10, UnitedStates Code, as described in the memorandum on the subject of "Policy for AssistedReproductive Services for the Benefit of Seriously or Severely Ill/Injured (CategoryII or III) Active Duty Service Members" issued by the Assistant Secretary of De-fense for Health Affairs on April 3, 2012, and the guidance issued to implementsuch policy, including any limitations on the amount of such benefits available tosuch a member except that—

(A) the time periods regarding embryo cryopreservation and storage set forthin part III(G) and in part IV(H) of such memorandum shall not apply; and

(B) such term includes embryo cryopreservation and storage without limitationon the duration of such cryopreservation and storage.(4) The term "adoption reimbursement" means reimbursement for the adoption-

related expenses for an adoption that is finalized after the date of the enactmentof this Act under the same terms as apply under the adoption reimbursement pro-gram of the Department of Defense, as authorized in Department of Defense In-struction 1341.09, including the reimbursement limits and requirements set forthin such instruction.(c) Amounts made available for the purposes specified in subsection (a) of this

section are subject to the requirements for funds contained in section 508 of divisionH of the Consolidated Appropriations Act, 2018 (Public Law 115–141).

[(RESCISSION OF FUNDS)][SEC. 236. Of the funds made available for fiscal year 2019 under the heading

"Department of Veterans Affairs—Veterans Health Administration—Medical Supportand Compliance" in title II of division J of the Consolidated Appropriations Act,2018 (Public Law 115–141), $211,000,000 is hereby rescinded.][SEC. 237. None of the funds appropriated or otherwise made available by this

Act or any other Act for the Department of Veterans Affairs may be used in a mannerthat is inconsistent with: (1) section 842 of the Transportation, Treasury, Housingand Urban Development, the Judiciary, the District of Columbia, and IndependentAgencies Appropriations Act, 2006 (Public Law 109–115; 119 Stat. 2506); or (2)section 8110(a)(5) of title 38, United States Code.][SEC. 238. Section 842 of Public Law 109–115 shall not apply to conversion of

an activity or function of the Veterans Health Administration, Veterans BenefitsAdministration, or National Cemetery Administration to contractor performance bya business concern that is at least 51 percent owned by one or more Indian tribes asdefined in section 5304(e) of title 25, United States Code, or one or more NativeHawaiian Organizations as defined in section 637(a)(15) of title 15, United StatesCode.][SEC. 239. (a) Except as provided in subsection (b), the Secretary of Veterans

Affairs, in consultation with the Secretary of Defense and the Secretary of Labor,shall discontinue using Social Security account numbers to identify individuals inall information systems of the Department of Veterans Affairs as follows:

1007DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATIVE PROVISIONS—Continued

(1) For all veterans submitting to the Secretary of Veterans Affairs new claimsfor benefits under laws administered by the Secretary, not later than 5 years afterthe date of the enactment of this Act.

(2) For all individuals not described in paragraph (1), not later than 8 years afterthe date of the enactment of this Act.(b) The Secretary of Veterans Affairs may use a Social Security account number

to identify an individual in an information system of the Department of VeteransAffairs if and only if the use of such number is required to obtain information theSecretary requires from an information system that is not under the jurisdiction ofthe Secretary.][SEC. 240. For funds provided to the Department of Veterans Affairs for each of

fiscal year 2019 and 2020 for "Medical Services", section 239 of Division A ofPublic Law 114–223 shall apply.][SEC. 241. None of the funds appropriated in this or prior appropriations Acts or

otherwise made available to the Department of Veterans Affairs may be used totransfer any amounts from the Filipino Veterans Equity Compensation Fund to anyother account within the Department of Veterans Affairs.]

SEC. [242]226. Of the funds provided to the Department of Veterans Affairs foreach of fiscal year [2019] 2020 and fiscal year [2020] 2021 for "Medical Services",funds may be used in each year to carry out and expand the child care program au-thorized by section 205 of Public Law 111–163, notwithstanding subsection (e) ofsuch section.[SEC. 243. For funds provided to the Department of Veterans Affairs for each of

fiscal year 2019 and 2020, section of Division A of Public Law 114–223 shall apply.][SEC. 244. (a) The Secretary of Veterans Affairs may use amounts appropriated

or otherwise made available in this title to ensure that the ratio of veterans to full-time employment equivalents within any program of rehabilitation conducted underchapter 31 of title 38, United States Code, does not exceed 125 veterans to one full-time employment equivalent.

(b) Not later than 180 days after the date of the enactment of this Act, the Secretaryshall submit to Congress a report on the programs of rehabilitation conducted underchapter 31 of title 38, United States Code, including—

(1) an assessment of the veteran-to-staff ratio for each such program; and(2) recommendations for such action as the Secretary considers necessary to

reduce the veteran-to-staff ratio for each such program.][SEC. 245. None of the funds appropriated or otherwise made available in this

title may be used by the Secretary of Veterans Affairs to enter into an agreementrelated to resolving a dispute or claim with an individual that would restrict in anyway the individual from speaking to members of Congress or their staff on anytopic not otherwise prohibited from disclosure by Federal law or required by Exec-utive Order to be kept secret in the interest of national defense or the conduct offoreign affairs.][SEC. 246. For funds provided to the Department of Veterans Affairs for each of

fiscal year 2019 and 2020, section 258 of Division A of Public Law 114–223 shallapply.][SEC. 247. None of the funds appropriated or otherwise made available by this

Act may be used to conduct research using canines unless: the scientific objectivesof the study can only be met by research with canines; the study has been directlyapproved by the Secretary; and the study is consistent with the revised Departmentof Veterans Affairs canine research policy document released on December 18,2017: Provided, That not later than 180 days after enactment of this Act, the Secretaryshall submit to the Committees on Appropriations of both Houses of Congress adetailed report outlining under what circumstances canine research may be neededif there are no other alternatives, how often it was used during that time period, andwhat protocols are in place to determine both the safety and efficacy of the research.][SEC. 248. For an additional amount for the Department of Veterans Affairs,

$2,000,000,000 to remain available until expended, for infrastructure improvements,including new construction, and in addition to amounts otherwise made availablein this Act for such purpose, of which:

(1) $750,000,000 shall be available for seismic improvement projects andseismic program management activities, including projects that would otherwisebe funded by the Construction, Major Projects, the Construction, Minor Projects,Medical Facilities, or National Cemetery Administration accounts;

(2) $300,000,000 shall be for "Departmental Administration—Construction,Major Projects";

(3) $800,000,000 shall be for "Veterans Health Administration—Medical Fa-cilities" to be used for non-recurring maintenance; and

(4) $150,000,000 shall be for "Departmental Administration—Construction,Minor Projects":]

[Provided, That the additional amounts appropriated for the purposes of non-re-curring maintenance and minor construction may be used to carry out critical life-safety projects identified in the Department's annual facility condition assessments;

sustainment projects; modernization projects; infrastructure repair; renovations atexisting Veterans Health Administration medical centers and outpatient clinics; andprojects included in the Strategic Capital Investment Process plan: Provided further,That funds made available under this section for "Construction, Major Projects"shall be available for previously authorized and partially funded major constructionprojects: Provided further, That notwithstanding the requirements of section 8104(a)of title 38, United States Code, amounts made available under this heading forseismic improvement projects and seismic program management activities shall beavailable for the completion of both new and existing projects of the Department:Provided further, That the additional amounts appropriated under this section maynot be obligated or expended until the Secretary of Veterans Affairs submits to theCommittees on Appropriations of both Houses of Congress, and such Committeesapprove, a detailed expenditure plan, including project descriptions and costs, forany non-recurring maintenance, minor construction, major construction, or seismicimprovement project being funded with the additional amounts made available inthis administrative provision.][SEC. 249. (a) PROHIBITION ON USE OF FUNDS.—None of the funds appropriated

or otherwise made available by this Act may be used to deny an Inspector Generalfunded under this Act timely access to any records, documents, or other materialsavailable to the department or agency of the United States Government over whichsuch Inspector General has responsibilities under the Inspector General Act of 1978(5 U.S.C. App.), or to prevent or impede the access of such Inspector General tosuch records, documents, or other materials, under any provision of law, except aprovision of law that expressly refers to such Inspector General and expressly limitsthe right of access of such Inspector General.

(b) TIMELY ACCESS.—A department or agency covered by this section shallprovide its Inspector General access to all records, documents, and other materialsin a timely manner.

(c) COMPLIANCE.—Each Inspector General covered by this section shall ensurecompliance with statutory limitations on disclosure relevant to the informationprovided by the department or agency over which that Inspector General has respons-ibilities under the Inspector General Act of 1978 (5 U.S.C. App.).

(d) REPORT.—Each Inspector General covered by this section shall report to theCommittee on Appropriations of the Senate and the Committee on Appropriationsof the House of Representatives within 5 calendar days of any failure by any depart-ment or agency covered by this section to comply with this section.][SEC. 250. (a) PLAN REQUIRED.—Not later than 90 days after the date of the en-

actment of this Act, the Secretary of Veterans Affairs shall submit to the appropriatecommittees of Congress a plan to reduce the chances that clinical mistakes by em-ployees of the Department of Veterans Affairs will result in adverse events that re-quire institutional or clinical disclosures and to prevent any unnecessary hardshipfor patients and families impacted by such adverse events.

(b) ELEMENTS.—The plan required by subsection (a) shall include the following:(1) A description of a process for the timely identification of individuals impacted

by disclosures described in subsection (a) and the process for contacting thoseindividuals or their next of kin.

(2) A description of procedures for expediting any remedial or follow-up carerequired for those individuals.

(3) A detailed outline of proposed changes to the process of the Department forclinical quality checks and oversight.

(4) A communication plan to ensure all facilities of the Department are madeaware of any requirements updated pursuant to the plan.

(5) A timeline detailing the implementation of the plan.(6) An identification of the senior executive of the Department responsible for

ensuring compliance with the plan.(7) An identification of potential impacts of the plan on timely diagnoses for

patients.(8) An identification of the processes and procedures for employees of the De-

partment to make leadership at the facility and the Department aware of adverseevents that are concerning and that result in disclosures and to ensure that themedical impact on veterans of such disclosures is minimized.(c) APPROPRIATE COMMITTEES OF CONGRESS DEFINED.—In this section, the

term "appropriate committees of Congress" means—(1) the Committee on Veterans' Affairs and the Subcommittee on Military

Construction, Veterans Affairs, and Related Agencies of the Committee on Appro-priations of the Senate; and

(2) the Committee on Veterans' Affairs and the Subcommittee on MilitaryConstruction, Veterans Affairs, and Related Agencies of the Committee on Appro-priations of the House of Representatives.][SEC. 251. None of the funds made available in this Act may be used in a manner

that would increase wait times for veterans who seek care at medical facilities ofthe Department of Veterans Affairs.]

THE BUDGET FOR FISCAL YEAR 20201008 ADMINISTRATIVE PROVISIONS—Continued

[SEC. 252. None of the funds appropriated or otherwise made available by thisAct to the Veterans Health Administration may be used in fiscal year 2019 to convertany program which received specific purpose funds in fiscal year 2018 to a generalpurpose funded program unless the Secretary of Veterans Affairs submits writtennotification of any such proposal to the Committees on Appropriations of bothHouses of Congress at least thirty days prior to any such action and an approval isissued by the Committees.] (Military Construction, Veterans Affairs, and RelatedAgencies Appropriations Act, 2019.)

✦

GENERAL FUND RECEIPT ACCOUNTS(in millions of dollars)


Offsetting receipts from the public:

764General Fund Proprietary Interest Receipts, not Otherwise

Classified ...................................................................036–143500

101116134Contributions from Military Personnel, Veteran's

Educational Assistance Act of 1984 ...........................036–247300

.................3,4962,475Housing Downward Reestimates ....................................036–273330

111Native American Veteran Housing Loans, Negative

Subsidies ...................................................................036–275110

4752.................Housing Negative Subsidies ...........................................036–275510

515048All Other General Fund Proprietary Receipts Including

Budget Clearing Accounts ..........................................036–322000

6353,6712,662General Fund Offsetting receipts from the public .....................................

Intragovernmental payments:

531Undistributed Intragovernmental Payments and

Receivables from Cancelled Accounts ........................036–388500

531General Fund Intragovernmental payments ..............................................

✦

TITLE IV—GENERAL PROVISIONS

GENERAL PROVISIONS

SEC. 501. No part of any appropriation contained in this Act shall remain availablefor obligation beyond the current fiscal year unless expressly so provided herein.

SEC. 502. None of the funds made available in this Act may be used for any pro-gram, project, or activity, when it is made known to the Federal entity or official towhich the funds are made available that the program, project, or activity is not incompliance with any Federal law relating to risk assessment, the protection of privateproperty rights, or unfunded mandates.[SEC. 503. All departments and agencies funded under this Act are encouraged,

within the limits of the existing statutory authorities and funding, to expand theiruse of "E-Commerce" technologies and procedures in the conduct of their businesspractices and public service activities.]

SEC. [504]503. Unless stated otherwise, all reports and notifications required bythis Act shall be submitted to the Subcommittee on Military Construction and Vet-erans Affairs, and Related Agencies of the Committee on Appropriations of theHouse of Representatives and the Subcommittee on Military Construction and Vet-erans Affairs, and Related Agencies of the Committee on Appropriations of theSenate.

SEC. [505]504. None of the funds made available in this Act may be transferredto any department, agency, or instrumentality of the United States Government except

pursuant to a transfer made by, or transfer authority provided in, this or any otherappropriations Act.

SEC. [506]505. None of the funds made available in this Act may be used for aproject or program named for an individual serving as a Member, Delegate, orResident Commissioner of the United States House of Representatives.[SEC. 507. (a) Any agency receiving funds made available in this Act, shall, subject

to subsections (b) and (c), post on the public Web site of that agency any report re-quired to be submitted by the Congress in this or any other Act, upon the determin-ation by the head of the agency that it shall serve the national interest.

(b) Subsection (a) shall not apply to a report if—(1) the public posting of the report compromises national security; or(2) the report contains confidential or proprietary information.

(c) The head of the agency posting such report shall do so only after such reporthas been made available to the requesting Committee or Committees of Congressfor no less than 45 days.]

SEC. [508]506. (a) None of the funds made available in this Act may be used tomaintain or establish a computer network unless such network blocks the viewing,downloading, and exchanging of pornography.

(b) Nothing in subsection (a) shall limit the use of funds necessary for any Federal,State, tribal, or local law enforcement agency or any other entity carrying out crim-inal investigations, prosecution, or adjudication activities.

SEC. [509]507. None of the funds made available in this Act may be used by anagency of the executive branch to pay for first-class travel by an employee of theagency in contravention of sections 301–10.122 through 301–10.124 of title 41,Code of Federal Regulations.

SEC. [510]508. None of the funds made available in this Act may be used to ex-ecute a contract for goods or services, including construction services, where thecontractor has not complied with Executive Order No. 12989.[SEC. 511. None of the funds made available by this Act may be used by the De-

partment of Defense or the Department of Veterans Affairs to lease or purchase newlight duty vehicles for any executive fleet, or for an agency's fleet inventory, exceptin accordance with Presidential Memorandum—Federal Fleet Performance, datedMay 24, 2011.][SEC. 512. (a) IN GENERAL.—None of the funds appropriated or otherwise made

available to the Department of Defense in this Act may be used to construct, renovate,or expand any facility in the United States, its territories, or possessions to houseany individual detained at United States Naval Station, Guantanamo Bay, Cuba, forthe purposes of detention or imprisonment in the custody or under the control of theDepartment of Defense.

(b) The prohibition in subsection (a) shall not apply to any modification of facilitiesat United States Naval Station, Guantanamo Bay, Cuba.

(c) An individual described in this subsection is any individual who, as of June24, 2009, is located at United States Naval Station, Guantanamo Bay, Cuba, andwho—

(1) is not a citizen of the United States or a member of the Armed Forces of theUnited States; and

(2) is—(A) in the custody or under the effective control of the Department of Defense;

or(B) otherwise under detention at United States Naval Station, Guantanamo

Bay, Cuba.](Military Construction, Veterans Affairs, and Related Agencies Appropriations Act,2019.)

1009DEPARTMENT OF VETERANS AFFAIRS TITLE IV—GENERAL PROVISIONS

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