DEPARTMENT OF VETERANS AFFAIRS

Federal Funds

For necessary expenses for furnishing, as authorized by law, inpatient and outpatient care and treatment to beneficiaries of the Department of Veterans Affairs and veterans described in section 1705(a) of title 38, United States Code, including care and treatment in facilities not under the jurisdiction of the Department, and including medical supplies and equipment, bioengineering services, food services, and salaries and expenses of healthcare employees hired under title 38, United States Code, aid to State homes as authorized by section 1741 of title 38, United States Code, assistance and support services for caregivers as authorized by section 1720G of title 38, United States Code, loan repayments authorized by section 604 of the Caregivers and Veterans Omnibus Health Services Act of 2010 (Public Law 111–163; 124 Stat. 1174; 38 U.S.C. 7681 note), and hospital care and medical services authorized by section 1787 of title 38, United States Code; [$2,369,158,000] $1,078,993,000, which shall be in addition to funds previously appropriated under this heading that became available on October 1, [2015] 2016; and, in addition, [$51,673,000,000] $44,886,554,000, plus reimbursements, shall become available on October 1, [2016] 2017, and shall remain available until September 30, [2017] 2018: Provided, That, of the amount made available on October 1, [2016] 2017, under this heading, $1,400,000,000 shall remain available until September 30, [2018] 2019: Provided further, That, notwithstanding any other provision of law, the Secretary of Veterans Affairs shall establish a priority for the provision of medical treatment for veterans who have service-connected disabilities, lower income, or have special needs: Provided further, That, notwithstanding any other provision of law, the Secretary of Veterans Affairs shall give priority funding for the provision of basic medical benefits to veterans in enrollment priority groups 1 through 6: Provided further, That, notwithstanding any other provision of law, the Secretary of Veterans Affairs may authorize the dispensing of prescription drugs from Veterans Health Administration facilities to enrolled veterans with privately written prescriptions based on requirements established by the Secretary: Provided further, That the implementation of the program described in the previous proviso shall incur no additional cost to the Department of Veterans Affairs [: Provided further, That, of the amount made available on October 1, 2016, under this heading, not less than $1,500,000,000 shall be available for Hepatitis C Virus (HCV) clinical treatments, including clinical treatments with modern medications that have significantly higher cure rates than older medications, are easier to prescribe, and have fewer and milder side effects: Provided further, That the Secretary of Veterans Affairs shall ensure that sufficient amounts appropriated under this heading for medical supplies and equipment are available for the acquisition of gender appropriate prosthetics]. (Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2016.)

Special and Trust Fund Receipts (in millions of dollars)

Program and Financing (in millions of dollars)

For 2018, the Budget requests $66.4 billion in advance appropriations for the four medical care appropriations: Medical Services, Medical Community Care, Medical Support and Compliance, and Medical Facilities. This request for advance appropriations fulfills the Administration's commitment to provide reliable and timely resources to support the delivery of accessible and high-quality medical services for veterans. This funding enables timely and predictable funding for VA's medical care to prevent our Nation's veterans from being adversely affected by budget delays, and provides opportunities to more effectively use resources in a constrained fiscal environment.

For 2017, Medical Care appropriations are increased by $1.7 billion over the 2017 advance appropriations request of $63.3 billion. Each year, VA updates its budget estimates to incorporate the most recent data on health care utilization rates, actual program experience, and other factors, such as economic trends in unemployment and inflation. As a result of these updates, the adjusted budget estimates more accurately reflect the projected medical demands of veterans enrolled in the VA health care system.

The Veterans Access, Choice, and Accountability Act of 2014 ("Veterans Choice Act"), Public Law 113–146 provided $5 billion in mandatory funding to increase veterans' access to health care by hiring more physicians and staff and improving VA's physical infrastructure. It also provided $10 billion in mandatory funding through 2017 to establish a temporary program ("Veterans Choice Program") improving veterans' access to health care by allowing eligible veterans who meet certain wait-time or distance standards to use eligible health care providers outside the VA system.

With the resources requested for 2017 and 2018, VA will provide the highest quality health care services for veterans. VA estimates it will treat 7.0 million patients in 2017 and 7.1 million patients in 2018. Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND) veterans are expected to reach 922,664 in 2017 (13.2 percent of the total) and 995,196 in 2018 (14.0 percent of the total).

Medical Care Collections Fund (MCCF).—VA estimates collections of nearly $3.6 billion in 2017 and over $3.6 billion in 2018, representing over five percent of available Medical Care resources in both years. VA has the authority to collect inpatient and outpatient co-payments, medication co-payments, and nursing home co-payments; authority for certain income verification; authority to recover third-party insurance payments from veterans for nonservice-connected conditions; and authority to collect revenue from enhanced use leases. These collections also include those collected from the Compensated Work Therapy Program, Compensation and Living Expenses Program, and the Parking Program.

Medical Services.—For Medical Services, the Budget reflects the following discretionary appropriation funding: the 2016 enacted advance appropriation of $47.6 billion, augmented with $2.4 billion (as provided in Public Law 114–113); the 2017 enacted advance appropriation of $51.7 billion, together with an additional $1.1 billion as requested in this Budget; and the 2018 advance appropriation request of $44.9 billion. This appropriation provides for a comprehensive, integrated health care delivery system that addresses the needs of eligible veterans and beneficiaries in VA medical centers, outpatient clinic facilities, contract hospitals, State homes, and outpatient programs on a fee basis. Hospital and outpatient care is also provided by the private sector for certain dependents and survivors of veterans under the Civilian Health and Medical Programs for the Department of Veterans Affairs (CHAMPVA). In addition to this funding, the Budget reflects mandatory funding provided in section 801 of the Veterans Choice Act (Public Law 113–146): $1.7 billion remains in 2016.

Estimated obligations and workload for six categories of health care services are shown below: outpatient care, inpatient care, mental health care, long term services and supports, prosthetics care, and dental care. In addition, estimated obligations and workload are also shown for four programs: CHAMPVA and other dependent programs, readjustment counseling, Caregivers, and non-VA care. In each of the six categories of health care services, the obligations and workload shown reflect only the provision of care by VA providers; obligations and workload for all types of non-VA care are displayed separately in the section on non-VA care. Finally, the obligations for each of the six categories of health care services do not include the funding provided by section 801 of the Veterans Choice Act, but the estimated workload levels do include the additional workload associated with this funding.

Outpatient care.—Obligations in the Medical Services account for 2017 are estimated to be $26,028 million for this health service category, which includes funding for ambulatory care in VA hospital-based and community-based clinics.

Estimated operating levels are:

Inpatient care.—Obligations in the Medical Services account for 2017 are estimated to be $6,953 million, which includes funding for inpatient care in VA medical centers.

Estimated operating levels are:

Mental health care.—Obligations in the Medical Services account for 2017 are estimated to be $5,852 million for the inpatient, residential, and outpatient care of veterans with conditions related to mental illness, including alcohol and drug problems. Mental health services and operations ensure the availability of a range of services, from treatment of a variety of common mental health conditions in primary care to more intensive interventions in specialty mental health programs for more severe and persisting mental health conditions. Specialty services such as evidence-based psychotherapies, intensive outpatient programs, residential rehabilitation treatment, and inpatient care are available to meet the range of veterans' needs.

Estimated operating levels are:

Long term services and supports.—Obligations in the Medical Services account for 2017 are estimated to be $3,166 million for the care of veteran residents in VA-operated long-term care programs. VA offers a spectrum of geriatric and extended care services to veterans enrolled in its health care system. The spectrum of long-term care services includes non-institutional and institutional services. All VA medical centers provide home- and community-based long-term care programs. The patient-focused approach supports veterans who wish to live safely at home in their own communities for as long as possible. In addition, veterans receive institutional long-term care through one of four venues: VA Community Living Centers (CLCs); Community Nursing Homes; State Veterans Nursing Homes; and State Veterans Home Domiciliaries. The operating levels for institutional care below represent only VA CLCs.

Estimated operating levels are:

Prosthetics care.—Obligations in the Medical Services account for 2017 are estimated to be $3,646 million for veterans. Prosthetic and Sensory Aids Service is an integrated delivery system designed to provide medically prescribed prosthetic and sensory aids, medical devices, assistive aids, repairs and services to eligible disabled veterans to maximize the independence and enhance their quality of life. This includes, but is not limited to, artificial limbs, hearing aids, and home oxygen; items that improve accessibility such as ramps and vehicle modifications, wheelchairs and mobility aids; and devices surgically placed in the veteran, such as stents.

Dental care.—Obligations in the Medical Services account for 2017 are estimated to be $1,089 million for the treatment of veterans who require dental care. Dental care services are provided to eligible veterans with a "medical condition negatively impacted by poor dentition." These patients may include poorly controlled diabetic patients, patients with head or neck cancer, organ transplant patients, and others. Veterans with a 100 percent service-connected disability are eligible for comprehensive dental care as needed. In addition, homeless veterans enrolled in certain residential treatment programs are also eligible for dental treatment.

Estimated operating levels are:

Rehabilitation.—Obligations in the Medical Services account for 2017 are estimated to be $655 million for the provision of rehabilitative care, including Blind Rehabilitation and Spinal Cord Injury programs. These services include inpatient and outpatient blind and vision rehabilitation programs, adjustment to blindness counseling, patient and family education, and assistive technology. The mission of Spinal Cord Injury and Disorders (SCI/D) Services is to promote the health, independence, quality of life and productivity 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 and family education.

Estimated operating levels are:

Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) Programs.—Obligations in the Medical Services account for 2017 are estimated to be $300 million (excludes care in the community portion found under the new Medical Community Care appropriation) for pharmacy and medical service personnel dealing with CHAMPVA matters.

Readjustment Counseling.—Obligations in the Medical Services account for 2017 are estimated to be $243 million. This program provides readjustment counseling services at VA Vet Centers. Vet Centers are community-based counseling centers that provide a wide range of social and psychological services to include: professional readjustment counseling to veterans who have served in a combat zone, military sexual trauma counseling, bereavement counseling for families who experience an active duty death, substance abuse assessments and referral, medical referral, VBA benefits explanation and referral, and employment counseling. Services are also extended to the family members of eligible veterans for issues related to military service and the readjustment of those veterans.

Estimated operating levels are:

Caregivers (Title I) Programs.—Obligations in the Medical Services account for 2017 are estimated to be $700 million. The Caregivers and Veterans Omnibus Health Services Act of 2010, Public Law 111–163, authorized VA to provide assistance and support services for Caregivers of eligible veterans. This program provides a wide range of services for primary caregivers to include: a monthly personal caregiver stipend, respite care, access to mental health services, beneficiary travel, and health care benefits through the existing CHAMPVA Program.

Estimated operating levels are:

Public Law 113–146, Veterans Choice Act, Section 801.—On August 7, 2014, President Obama signed into law the Veterans Access, Choice, and Accountability Act of 2014 (Public Law 113–146) ("Veterans Choice Act"). The 2017 Budget supports implementation of the Veterans Choice Act and the Administration's goal of providing timely, high-quality health care for our Nation's veterans. The Veterans Choice Act provided $5 billion in mandatory funding in Section 801 to increase veterans' access to health care by hiring more physicians and staff and improving the VA's physical infrastructure. Obligations in the Medical Services account for 2017 are estimated to be $822 million for Section 301/302, hiring medical staff, and supplies and materials.

Estimated funding levels are:

Object Classification (in millions of dollars)

Employment Summary

For necessary expenses for furnishing health care to individuals pursuant to chapter 17 of title 38, United States Code, at non-Department facilities, $7,246,181,000, plus reimbursements, to be derived from amounts appropriated in title II of division J of Public Law 114–113 under the headings "Medical Services", "Medical Support and Compliance", or "Medical Facilities" which became available on October 1, 2016; and, in addition, $9,409,118,000 shall become available on October 1, 2017, and shall remain available until September 30, 2018: Provided, That, of the amount made available on October 1, 2017, $1,500,000,000 shall remain available until September 30, 2019.

Program and Financing (in millions of dollars)

For 2018, the Budget requests $9.4 billion in advance appropriations for Medical Community Care. This request for advance appropriations fulfills the Administration's commitment to provide reliable and timely resources to support the delivery of accessible and high-quality medical services for veterans.

The Medical Community Care appropriation provides for the furnishing of Hospital Care and Medical Services to eligible veterans through agreements with certain eligible entities that have an agreement to provide such care and services for VA. Medical Community Care will be the source of funding for care that VA provides to veterans through community providers.

Estimated operating levels are:

Object Classification (in millions of dollars)

For necessary expenses in the administration of the medical, hospital, nursing home, domiciliary, construction, supply, and research activities, as authorized by law; administrative expenses in support of capital policy activities; and administrative and legal expenses of the Department for collecting and recovering amounts owed the Department as authorized under chapter 17 of title 38, United States Code, and the Federal Medical Care Recovery Act (42 U.S.C. 2651 et seq.), [$6,524,000,000] $6,654,480,000, plus reimbursements, shall become available on October 1, [2016] 2017, and shall remain available until September 30, [2017] 2018: Provided, That, of the amount made available on October 1, [2016] 2017, under this heading, $100,000,000 shall remain available until September 30, [2018] 2019. (Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2016.)

Program and Financing (in millions of dollars)

For 2018, the Budget requests $6.7 billion in advance appropriations for Medical Support and Compliance. This request for advance appropriations fulfills the Administration's commitment to provide reliable and timely resources to support the delivery of accessible and high-quality medical services for veterans.

For Medical Support and Compliance, the Budget reflects the following discretionary appropriation funding from 2016 through 2018: the 2016 enacted advance appropriation of $6.1 billion, the 2017 enacted advance appropriation of $6.5 billion, and the 2018 advance appropriation request of $6.7 billion. In addition to this funding, the Budget reflects mandatory funding provided in section 801 of the Veterans Access, Choice, and Accountability Act of 2014 (Public Law 113–146): $27 million remains available in 2016.

Medical Support and Compliance appropriation finances the expenses of management, security, and administration of the VA health care system through the operation of VA medical centers, other facilities, Veterans Integrated Service Network offices and facility director offices, chief of staff operations, quality of care oversight, legal services, billing and coding activities, procurement, financial management, and human resource management.

Object Classification (in millions of dollars)

Employment Summary

Program and Financing (in millions of dollars)

The purpose of the Department of Defense-Veterans Affairs Health Care Sharing Incentive Fund, often referred to as the Joint Incentive Fund (JIF), is to enable the Departments to carry out a program to identify and provide incentives to implement creative sharing initiatives at the facility, intra-regional and nationwide levels. The JIF promotes collaboration and new approaches to problem solving to enable the Departments to improve the coordination of health care services. The Departments have established the fund and developed processes and criteria to solicit and select projects. Section 721 of the 2003 National Defense Authorization Act, Public Law 107–314, established the fund and requires VA and Department of Defense to establish a joint incentive program. In 2017, each Secretary shall contribute a minimum of $15 million to the fund after the appropriation is enacted.

Object Classification (in millions of dollars)

Employment Summary

For necessary expenses for the maintenance and operation of hospitals, nursing homes, domiciliary facilities, and other necessary facilities of the Veterans Health Administration; for administrative expenses in support of planning, design, project management, real property acquisition and disposition, construction, and renovation of 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 under the jurisdiction of the Department, not otherwise provided for, either by contract or by the hire of temporary employees and purchase of materials; for leases of facilities; and for laundry services; [$105,132,000] $649,000,000, which shall be in addition to funds previously appropriated under this heading that became available on October 1, [2015] 2016; and, in addition, [$5,074,000,000] $5,434,880,000, plus reimbursements, shall become available on October 1, [2016] 2017, and shall remain available until September 30, [2017] 2018: Provided, That, of the amount made available on October 1, [2016] 2017, under this heading, $250,000,000 shall remain available until September 30, [2018] 2019. (Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2016.)

Program and Financing (in millions of dollars)

For 2018, the Budget requests advance appropriations of $5.4 billion for Medical Facilities. This request for advance appropriations fulfills the Administration's commitment to provide reliable and timely resources to support the delivery of accessible and high-quality medical services for veterans.

For Medical Facilities, the Budget reflects the following discretionary appropriation funding from 2016 through 2018: the 2016 enacted advance appropriation of $4.9 billion, together with an additional $105 million (as directed in Public Law 114–113); the 2017 enacted advance appropriation request of $5.1 billion, together with an additional $649 million as requested in this Budget; and the 2018 advance appropriation request of $5.4 billion. In addition to this funding, the Budget reflects mandatory funding provided in section 801 of the Veterans Access, Choice, and Accountability Act of 2014 (Public Law 113–146): $1.2 billion remains available in 2016.

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

Object Classification (in millions of dollars)

Employment Summary

For necessary expenses in carrying out programs of medical and prosthetic research and development as authorized by chapter 73 of title 38, United States Code, [$630,735,000] $663,366,000, plus reimbursements, shall remain available until September 30, [2017] 2018 [: Provided, That the Secretary of Veterans Affairs shall ensure that sufficient amounts appropriated under this heading are available for gender appropriate prosthetic research and toxic exposure research]. (Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2016.)

Program and Financing (in millions of dollars)

For 2017, the total budgetary resources of $1.9 billion is comprised of $663 million in direct appropriations, $564 million in medical care support such as physicians' pay, utilities and other overhead, $500 million in Federal grants, and $185 million in other non-federal resources. The research program will support 3,521 full time equivalents through direct appropriation.

This account is an intramural program that has had outstanding success performing research that has led to critical clinical achievements that improve the health and quality of life for veterans and the Nation. VA research transforms medicine by engaging veterans as research volunteers and utilizing the results of that research in clinical care. Through technology, advancements, innovations, and information, research helps transform VA's health care into a leading example of medicine in the twenty-first century.

In 2017, VA's research priorities focus on ensuring world-class care for veterans throughout their lives, emphasizing personalized precision medicine approaches to improve clinical outcomes, and developing a Learning Health Care System. Health services research will continue to advance implementation of improved treatments in the VA health care system and optimize systems approaches to care delivery. VA will advance engineering research and development to improve the lives of disabled veterans by personalizing prosthetic systems that replace lost limbs or activate remaining nerves and muscles.

Building on the Million Veteran Program (MVP) to advance the President's Precision Medicine initiative (PMI) is a major goal for VA Research in 2017 and 2018. MVP, a groundbreaking genomic research program, seeks to collect genetic samples and general health information from one million veterans. This program will use genetic analysis to show how to improve treatments by understanding individual patients, thus improving care for veterans and the Nation. MVP has enrolled more than 438,000 veterans. An initial genetic analysis is ongoing; some data are now available to investigators who are beginning studies on postraumatic stress disorder, schizophrenia, bipolar disorder, and Gulf War Illness. VA research is committed to ensuring the success of the PMI, and in FY 2017 will reprioritize program spending to provide additional support to this initiative.

Research to benefit Gulf War veterans remains a priority. Over the past several years, the number of projects funded and the level of funding have increased each year. As directed by Senate Report 111–40, the VA research program ensures that no less than $15 million is available for Gulf War research each year; the actual amount spent on such research depends on the quantity and quality of research proposals. VA has worked to develop Gulf War researchers to ensure that research proposals of high scientific merit are submitted. Funding increased from $9.7 million in 2014, to $10.5 million in 2015, $12.5 million in 2016, with a 2017 estimate of $15 million.

VA is expanding research efforts to improve women veterans' health, by studying how VA provides for women veterans' general and gender-specific health care needs, and understanding military experiences of women veterans as well as later health risk factors.

VA works closely with other federal agencies to assure effective use of scarce taxpayer resources in executing its research mission. We conduct joint programmatic reviews with the Department of Defense (DoD) and National Institutes of Health to ensure that our research efforts are well coordinated and Under the President's National Research action Plan (NRAP), VA and DoD created research consortia for traumatic brain injury and posttraumatic stress disorder, investing $107 million over five years. High level coordination has become routine for all three agencies, benefit veterans and the American public.

Veterans' health issues are addressed comprehensively in the following four program divisions and the medical care research support required for these programs:

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

Clinical science.—Administers investigations (i.e., human subject research such as drug, surgical, single subject, pilot, and multi-center cooperative studies as well as feasibility trials) aimed at instituting new, more effective clinical care.

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

Rehabilitation.—Develops novel approaches to restoring veterans with traumatic amputation, central nervous system injuries, loss of sight and/or hearing, or other physical and cognitive impairments to full and productive lives.

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

SUMMARY OF PROGRAM RESOURCES [in millions of dollars]

Object Classification (in millions of dollars)

Employment Summary

Program and Financing (in millions of dollars)

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 Defense Authorization Act for Fiscal Year 2010. This funding will support the continuing operations of the Captain James A. Lovell Federal Health Care Center (FHCC), which opened on December 20, 2010. In 2016 and 2017, VA expects to transfer funds from the Medical Services, Medical Support and Compliance, Medical Facilities, and Information Technology Systems accounts, while DOD expects to transfer funds from the Defense Health Program account.

Object Classification (in millions of dollars)

Employment Summary

Program and Financing (in millions of dollars)

VA has the authority to collect co-payments, which are deposited into the Medical Care Collections Fund (MCCF) receipt account. As allowed by the provisions of the appropriations Act, these receipts are transferred to Medical Services, Medical Community Care, and the Joint Department of Defense-Department of Veterans Affairs Medical Facility Demonstration Fund (Joint Demonstration Fund) appropriations where they remain available until expended for the purposes of this account. In 2015, nearly $3.5 billion was collected in the MCCF receipt account and transferred to the Medical Services appropriation and Joint Demonstration Fund to provide health care to our veterans. These collections consist of co-payments from veterans for inpatient, outpatient, and nursing home care, and prescribed medications; third-party insurance payments from veterans for nonservice-connected conditions; and collections from enhanced-use leases, the Compensated Work Therapy Program, Compensation and Living Expensed Program, and the Parking Program.

Program and Financing (in millions of dollars)

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

Financing.— Operations will be financed from current revenues.

Object Classification (in millions of dollars)

Employment Summary

Program and Financing (in millions of dollars)

These nonprofit corporations provide a flexible funding mechanism for the conduct of approved research at Department of Veterans Affairs medical centers. These organizations will derive funds to operate various research activities from Federal and non-Federal sources. No appropriation is required to support these activities.

Object Classification (in millions of dollars)

Program and Financing (in millions of dollars)

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

Estimated operating levels are:

Object Classification (in millions of dollars)

Employment Summary

Trust Funds

Special and Trust Fund Receipts (in millions of dollars)

Program and Financing (in millions of dollars)

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

Object Classification (in millions of dollars)

Federal Funds

For the payment of compensation benefits to or on behalf of veterans and a pilot program 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 on behalf of veterans as authorized by chapters 15, 51, 53, 55, and 61 of title 38, United States 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 under the 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, and 2106, and chapters 23, 51, 53, 55, and 61 of title 38, United States Code, [$162,948,673,000] $90,119,449,000, to remain available until expended [, of which $86,083,128,000 shall] and to become available on October 1, [2016] 2017: Provided, That not to exceed [$15,562,000 of the amount made available for fiscal year 2016 and $16,021,000] $17,224,000 of the amount made available for fiscal year [2017] 2018 under this heading shall be reimbursed to "General Operating Expenses, Veterans Benefits Administration", and "Information Technology Systems" for necessary expenses in implementing the provisions of chapters 51, 53, and 55 of title 38, United States Code, the funding source for which is specifically provided as the "Compensation and Pensions" appropriation: Provided further, That such sums as may be earned on an actual qualifying patient basis, shall be reimbursed to "Medical Care Collections Fund" to augment the funding of individual medical facilities for nursing home care provided to pensioners as authorized. (Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2016.)

Program and Financing (in millions of dollars)

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

WORKLOAD

For 2018, the Budget requests $90,119,449,000 in advance appropriations for Compensation and Pensions. This request satisfies the requirement created by the Consolidated and Further Continuing Appropriations Act, 2015 (Public Law 113–235) and prevents our Nation's veterans from being adversely 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 aggravated during active military service. Dependency and Indemnity Compensation is paid to survivors of servicepersons or veterans whose death occurred while on active duty or as a result of service-connected disabilities. Compensation and vocational rehabilitation is provided to the children of Vietnam veterans who were born with certain birth defects. The Secretary may pay a clothing allowance to each veteran who uses a prescribed medication for a service-connected skin condition or wears a prosthetic or orthopedic appliance (including a wheelchair) which, in the judgment of the Secretary, tends to damage or tear the clothing of such veteran.

Miscellaneous benefits provided for are:

(a) payments for claims made pursuant to the provision of the World War Adjusted Compensation Act of 1924, as amended;

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

(c) payments authorized by the Equal Access to Justice Act.

The appropriation also provides for a program to allow VA to perform income matches for certain compensation recipients.

In accordance with Public Law 97–377, the Reinstated Entitlement Program for Survivors (REPS) program restores Social Security benefits to certain surviving spouses or children of veterans who died of service-connected causes.

Legislation is proposed to provide a cost-of-living adjustment comparable to the annual social security increase to recipients of disability compensation, dependency and indemnity compensation, and clothing allowances. The increase, effective with payments made on January 1, 2017, is expected to be 0.8 percent.

AVERAGE NUMBER OF COMPENSATION CASES AND PAYMENTS

Pension benefits may be paid to veterans or their survivors. A veteran's entitlement is based on active duty service of a specific length (normally 90 days or more) during a designated war period, disabilities considered permanent and total, and countable income below established levels. There is 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 annual social security increase is provided for those pensioners in the improved program and to parents receiving dependency and indemnity compensation. The increase, effective with payments made on January 1, 2017, is expected to be 0.8 percent.

AVERAGE NUMBER OF PENSION CASES AND PAYMENTS

Burial benefits in FY 2016 provide for: (a) the payment of an allowance of $747 (plus transportation charges where death occurs under VA care) to reimburse, in part, the burial and funeral expense of an eligible deceased veteran; (b) the payment of $747 for a plot allowance where an eligible veteran is not buried in a national cemetery or other cemetery under the jurisdiction of the United States; (c) the payment of a burial allowance of up to $2,000 when a veteran dies as a result of a service-connected disability; (d) furnishing a flag to drape the casket of each deceased veteran entitled thereto; (e) furnishing a headstone or marker for the grave of a veteran and, in certain cases, eligible dependents; and (f) authority to provide outer burial receptacles in the National Cemetery Administration.

NUMBER OF BURIAL BENEFITS

Program and Financing (in millions of dollars)

For the payment of readjustment and rehabilitation benefits to or on behalf of veterans as authorized by chapters 21, 30, 31, 33, 34, 35, 36, 39, 41, 51, 53, 55, and 61 of title 38, United States Code, [$30,654,185,000] $13,708,648,000, to remain available until expended [, of which $16,340,828,000 shall] and to become available on October 1, [2016] 2017: Provided, That expenses for rehabilitation program services and assistance which the Secretary is authorized to provide under subsection (a) of section 3104 of title 38, United States Code, other than under paragraphs (1), (2), (5), and (11) of that subsection, shall be charged to this account. (Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2016.)

Program and Financing (in millions of dollars)

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