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 health care 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, and 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); [$41,354,000,000] $165,000,000, which shall be in addition to funds previously appropriated under this heading that became available on October 1, 2012; and, in addition, $43,557,000,000, plus reimbursements, shall become available on October 1, [2012] 2013, and shall remain available until September 30, [2013] 2014: Provided, That, of the amount made available on October 1, 2013, under this heading, $1,400,000,000 shall remain available until September 30, 2015: 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. (Military Construction and Veterans Affairs, and Related Agencies Appropriations Act, 2012.)

Special and Trust Fund Receipts (in millions of dollars)

Program and Financing (in millions of dollars)

For 2014, the Budget is requesting $54.5 billion in advance appropriations for the three medical care appropriations: Medical Services, 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. Advance appropriations require a multi-year approach to budget planning whereby one year builds off the previous year. 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 example, estimated savings from management improvements to be achieved in 2012 will be carried forward into 2013 to reduce the appropriations needed . Without the carryover of these resources from 2012 , currently estimated at $500 million, VA would need a higher level of appropriations in 2013 .

For 2013, Medical Care appropriations are increased by $165 million over the enacted 2013 advance appropriations of $52.5 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, in 2012 and 2013 VA was able to reinvest funding in high priority medical programs.

With the resources requested for 2013 and 2014, VA will provide the highest quality health care services for veterans. VA estimates it will treat 6.3 million patients in 2013 and 6.4 million patients in 2014. Operation Enduring Freedom, Operation Iraqi Freedom and Operation New Dawn (OEF/OIF/OND) veterans are expected to reach 610,416 in 2013 (9.7 percent of the total) and 654,480 in 2014 (10.3 percent of the total).

Medical Services._For Medical Services, the Budget reflects the following appropriation funding: the 2012 enacted advance appropriations of $39.6 billion; the 2013 appropriation request of $41.5 billion; and the 2014 advance appropriations request of $43.6 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).

Medical Care Collections Fund (MCCF)._VA estimates collections of $3.0 billion in 2013 and nearly $3.1 billion in 2014, representing five percent of available 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.

Acute hospital care._Costs for 2013 are estimated to be $7,640 million for operating medical, neurological, surgical, contract and State home hospital beds.
Estimated operating levels are:

Rehabilitative care._Costs for 2013 are estimated to be $477 million for the provision of rehabilitative care, including spinal cord injury care.
Estimated operating levels are:

Psychiatric care._Costs for 2013 are estimated to be $5,186 million for the inpatient, residential, and outpatient care of veterans with problems related to mental illness, including alcohol and drug problems.
Estimated operating levels are:

Nursing home care._Costs for 2013 are estimated to be $4,269 million for the care of residents in VA community living centers, contract nursing homes, and State nursing homes.
Estimated operating levels are:

Noninstitutional extended care._Costs for 2013 are estimated to be $1,477 million for noninstitutional extended care programs such as adult day care; home based primary care, skilled nursing and rehabilitation care; and home health aids.
Estimated operating levels are:

Subacute care._Costs for 2013 are estimated to be $80 million for the treatment of veterans who require a level of care between acute and long-term care, as provided in VA hospital intermediate bed sections.
Estimated operating levels are:

State home domiciliary care._Costs for 2013 are estimated to be $57 million for the care of veterans in locations other than their own homes, such as domiciliary care programs.
Estimated operating levels are:

Outpatient care._Costs for 2013 are estimated to be $24,695 million for outpatient medical and dental care provided by staff, physicians, and dentists participating under a fee basis arrangement for certain eligible veterans.
Estimated operating levels are:

NUMBER OF MEDICAL VISITS AND DENTAL WORKLOADS

Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)._Costs for 2013 are estimated to be $1,291 million for private hospital and outpatient care for dependents and survivors of certain veterans.
Estimated operating levels are:

Provide high-quality health care._Use of clinical practice guidelines in treating patients results in improved health of veterans and reduced use of services. The prevention index spotlights and summarizes a variety of evidence-based measures for high-quality preventive health care. VHA's strategy to monitor satisfaction through patient surveys will identify areas of improvement in all medical services.

Access to medical care._VA's strategy is to improve access and timeliness of service by reducing waiting times in specialty and primary care clinics for new patient appointments in medical centers nationwide and by relying more extensively on non-institutional forms of long-term care. In 2012, VHA will begin measuring the four appointment performance measures using a 14-day standard, as noted in the chart below. VA strives to improve timely access to the delivery of primary and specialty care which is critical to providing high-quality care to veterans.

VA /DoD sharing._VA's strategy is to improve collaboration and exchange with the Department of Defense (DoD).

Revenue cycle improvement._VHA is seeking to improve its performance in the area of medical care collections. The revenue cycle improvement plan includes initiatives that will improve efficiency and accuracy.

Object Classification (in millions of dollars)

Employment Summary

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.); [$5,746,000,000] $6,033,000,000, plus reimbursements, shall become available on October 1, [2012] 2013, and shall remain available until September 30, [2013] 2014: Provided, That, of the amount available under this heading, $100,000,000 shall remain available until September 30, 2015. (Military Construction and Veterans Affairs, and Related Agencies Appropriations Act, 2012.)

Program and Financing (in millions of dollars)

For 2014, the Budget is requesting $6.0 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 appropriation funding: the 2012 enacted advance appropriations of $5.5 billion; the 2013 appropriations request of $5.7 billion; and the 2014 advance appropriations request of $6.0 billion. The 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 2013, 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, [$5,441,000,000] $4,872,000,000, plus reimbursements, shall become available on October 1, [2012] 2013, and shall remain available until September 30, [2013] 2014: Provided, That, of the amount made available under this heading, $250,000,000 shall remain available until September 30, 2015. (Military Construction and Veterans Affairs, and Related Agencies Appropriations Act, 2012.)

Program and Financing (in millions of dollars)

For 2014, the Budget is requesting advance appropriations of $4.9 billion for 2014 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 appropriation funding: the 2012 enacted advance appropriations of $5.4 billion; the 2013 appropriations request of $5.4 billion; and the 2014 advance appropriations request of $4.9 billion. 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 property disposition and acquisition. In 2014, VA is proposing to move Biomedical Engineering Services from Medical Facilities to Medical Services in order to properly align funding with the nature of the services provided.

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, [$581,000,000] $582,674,000, plus reimbursements, shall remain available until September 30, [2013] 2014. (Military Construction and Veterans Affairs, and Related Agencies Appropriations Act, 2012.)

Program and Financing (in millions of dollars)

For 2013, the total budgetary resources of $1.9 billion is comprised of $583 million in direct appropriations, $583 million in medical care support, and $710 million in Federal and private sector grants. The research program will support 3,526 full time equivalents through direct appropriation and a total of over 15,000 research staff through all funding sources.

This account is an intramural program that has had significant success developing research leading to clinical achievements that improve the health and quality of life for veterans and the Nation. VA is at the forefront of producing new transformational approaches and technologies for preventing, diagnosing, and treating disease. VA research transforms medicine by uniquely engaging veterans both as clinical patients and as research volunteers. Through technology, advancements, and information, research helps transform VA's health care into a leading example of medicine in the 21st Century.

High priority research programs in 2013 will provide Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF) and Operation New Dawn (OND) veterans and rural veterans with critical needs research activity. VA will focus on key areas affecting OEF/OIF/OND veterans including Homelessness/Access to Care and Rural Health, Personalized Medicine and Military Exposure-Related Illnesses. Homelessness is a top priority for VA, and research will focus on interventions, risk factors and health care usage patterns in an effort to eliminate homelessness. With regard to Access to Care, one of the critical missions of VA research is to identify system-wide gaps in care to veterans. This includes assessing specific barriers to care for vulnerable populations, including rural veterans. VA research has demonstrated an explicit focus on access as a component of validating the quality of care in all VA health care services, organizational structures, and mechanisms for delivering care. Current studies address new telemedicine and telehealth initiatives, community based outpatient clinics (CBOCs), collaborative care models, access for OEF/OIF/OND veterans, and access to specialized care such as VA rehabilitation services. The development, evaluation, and implementation of new telemedicine technologies represent an important focus of research to improve access to VA health care, particularly for rural veterans. Emphasis will also be placed on personalized medicine where using information on a patients' genetic make-up can lead to a more tailored, precise and effective level of care. The Million Veteran Program, with the goal of collecting one million genetic samples, will continue to be a significant undertaking in 2013 as VA investigates whether genetic influences in disease and/or responses to medications can be used to further advance personalized care with the ultimate goal to develop an evidence base for treatments that are optimized to each veteran's genetic makeup.

VA core research priorities in 2013 will include Mental Health, Gulf War Veterans' Illnesses and Exposures, Prosthetics, Traumatic Brain Injury , Spinal Cord Injury, Women Veterans, and a special initiative on Researching Pain.

VA scientists who partner with colleagues from other Federal agencies, academic medical centers, nonprofit organizations, and commercial entities nationwide further expand the reach and scope of VA research. Through VA's academic affiliations as well as collaborations with other Federal agencies, it is fully integrated with the larger biomedical research community.

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.

Performance Measure

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 and the Department of Defense 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. The 2013 Budget includes anticipated transfers of $247.4 million from VA and $139.5 million from DoD, totaling $386.9 million. VA will make transfers to the Fund from Medical Services, Medical Support and Compliance, Medical Facilities, and Information Technology. These funds will support the Captain James A. Lovell Federal Health Care Center (FHCC), which opened on December 20, 2010. The Fund will support 2,685 full time equivalents in 2013, comprised of 1,961 civilian and 724 uniformed military employees.

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 the Medical Services appropriation and the Joint Department of Defense-Department of Veterans Affairs Medical Facility Demonstration Fund (Joint Demonstration Fund) where they remain available until expended for the purposes of this account. In 2011, $2.8 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)

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, [$51,237,567,000] $61,741,232,000, to remain available until expended: Provided, That not to exceed [$32,187,000] $9,204,000 of the amount appropriated under this heading shall be reimbursed to "General operating expenses, Veterans Benefits Administration'', "Medical support and compliance'', 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 and Veterans Affairs, and Related Agencies Appropriations Act, 2012.)

Program and Financing (in millions of dollars)

WORKLOAD

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, 2013, is expected to be 1.9 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, 2013, is expected to be 1.9 percent.

AVERAGE NUMBER OF PENSION CASES AND PAYMENTS

Burial benefits provide for: (a) the payment of an allowance of $700 (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 $700 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 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

Legislation will be proposed to extend the Rounding-Down of the Compensation and Dependency and Indemnification Compensation (DIC) Cost of Living Adjustment, expand eligibility for Veterans Medallion for Headstones, and allow for Government Furnished Headstones.

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, [$12,108,488,000] and for the payment of benefits under the Veterans Retraining Assistance Program, $12,607,476,000, to remain available until expended: 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 and Veterans Affairs, and Related Agencies Appropriations Act, 2012.)

Program and Financing (in millions of dollars)

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

WORKLOAD - Vocational Rehabilitation and Employment

WORKLOAD - Education

This appropriation finances educational assistance allowances for certain service persons, veterans, and for eligible dependents of those: (a) veterans who died from service-connected causes or have a total and permanent rated service-connected disability; and (b) servicepersons who were captured or missing in action. In addition, certain disabled veterans are provided with vocational rehabilitation, specially adapted housing grants, and automobile grants with the associated approved adaptive equipment. Voluntary contributions by eligible servicepersons and matching contributions 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 expanded education benefits beginning on August 1, 2009. Based on length of active duty service and training rate, trainees may be entitled to benefits including: tuition and fees, housing allowance, books and supplies stipend, kickers, and Yellow Ribbon matching payments. Certain active duty members of the Armed Forces may transfer benefits to a spouse or children.

All volunteer force educational assistance (Montgomery GI Bill)._Public Law 98–525, enacted October 19, 1984, established two new educational programs: an assistance program for veterans who enter active duty during the period beginning July 1, 1985; and an assistance program for certain members of the Selected Reserve. Public Law 108–375 established a program to provide educational assistance to members of the reserve components called or ordered to active service in response to a war or national emergency declared by the President or the Congress, in recognition of the sacrifices that those members make in answering the call to duty. The Readjustment Benefit appropriation pays the basic benefit allowance for veterans, except for certain Post-Vietnam Era Veterans Education participants who transferred to the Montgomery GI Bill program. Supplementary educational assistance, Post-Vietnam Era Veterans Education converters, reservists, and the National Call to Service Program are financed by payments from Department of Defense.

Survivors and Dependants Educational Assistance (Chapter 35)._Benefits are provided to children and spouses of veterans who died of a service-connected disability or whose service-connected disability is rated permanent and total. In addition, dependents of servicepersons missing in action or interned by a hostile foreign government for more than 90 days are also eligible. The following table provides a comparison of trainees and costs for the Dependents Educational Assistance program.
The Veterans Retraining Assistance Program, established under Public Law 112–56, is a program that, beginning on July 1, 2012, will provide up to 12 months of retraining assistance to veterans at least 35 years of age but not more than 60 years of age, who are unemployed, received an honorable discharge and have no eligibility remaining for other education benefits. Veterans participating in this program would receive monthly payments equal to the three-year payment rate under the Montgomery GI Bill (MGIB) chapter 30 program.
The following table shows a caseload and cost comparison for these beneficiaries under existing legislation.

CASELOAD AND AVERAGE COST DATA

Vocational Rehabilitation and Employment (Chapter 31)._Servicemembers and veterans with service-connected disabilities receive the assistance necessary to help them prepare for, obtain, and maintain suitable employment. Comprehensive assessments may include interest and aptitude testing as well as specialized assessments such as functional capacity examinations. During the training phase of the program, eligible servicemembers and veterans are provided assistance for necessary training such as tuition, fees, books and supplies at colleges, technical schools and other training programs. A veteran enrolled in training receives a monthly subsistence allowance. Eligible veterans may also receive specialized or adaptive equipment to help them overcome a disability or enable them to compete with non-disabled individuals. At the completion of training, veterans are provided with employment and placement services, including supplies and equipment needed to enter employment, adaptive equipment and workplace accommodations, incentives to employers to reimburse them for hiring and training veterans with disabilities, and two final months of subsistence allowance.

CASELOAD AND AVERAGE COST DATA

Specially Adapted Housing Grants._Specially adapted housing grants, up to a maximum of $63,780, are provided to certain severely disabled veterans. In 2011, the maximum grant amount was $63,870 and is projected to increase, based on a cost of construction index, to $65,757 in 2013. Veterans who suffer service-connected blindness or who have lost the use of both upper extremities can receive up to $12,756 in 2011. The maximum grant amount is projected to increase to $13,151 in 2013.

Specially Adapted Housing Assistive Technology Grants._Under the Veterans Benefits Act of 2010, (Public Law 111–275), VA may provide grants of up to $200,000 per fiscal year to individuals or entities for the development of specially adapted housing assistive technologies and limits to $1 million the aggregate amount of such grants VA may award in any fiscal year.

Automobile Grants and Adaptive Equipment._Certain disabled veterans are provided with automobile grants with the associated approved adaptive equipment. An allowance is provided to certain service-disabled veterans and servicepersons toward the purchase price of an automobile. The maximum allowance was $11,000 in 2011, but will increase to $18,900 in 2012, under The Veterans Benefits Act of 2010, (Public Law 111–275) and will continue to increase based on the CPI-U. Adaptive equipment and the maintenance and replacement of such equipment is also provided.

CASELOAD AND AVERAGE COST DATA

Tuition Assistance._Public Law 106–398, enacted October 30, 2000, allows the military services to pay up to 100 percent of tuition and expenses charged by a school for service members. If a service department pays less than 100 percent, a service member eligible for the Montgomery GI Bill Active-duty (MGIB) or the Post 9–11 GI Bill (Chapter 33) can elect to receive VA benefits for all or a portion of the remaining expenses. Public Law 108–454 established a program that provides availability of education benefits for payment for national admissions exams and national exams for credit at institutions of higher education.

The National Exams._The benefit allows VA to reimburse for the fee charged for national tests for admission to institutions of higher learning and national tests providing an opportunity for course credit at institutions of 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 fees required for civilian occupational licensing and certification examinations needed to enter, maintain, or advance in employment in a vocation or profession, effective March 1, 2001.

National Call to Service._The 2003 National Defense Authorization Act directs the Department of Defense to offer an active duty enlistment option of 15 months plus training time to facilitate interest in National Service. Program participants will be given the opportunity to select one of the following incentives: a $5,000 enlistment bonus, repayment of student loans up to $18,000, or one of two education allowances.

Work-Study._Certain veterans, reservists, and dependents pursuing a program 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 is higher.

Payments to States._State approving agencies are reimbursed for the costs of inspecting, approving, and supervising programs of education and training offered by educational institutions and training establishments in which veterans, dependents, and reservists are enrolled or are about to enter.

Reporting Fees._Reporting fees are paid to education and training institutions to help defray the costs of certifying education enrollment for veterans enrolled in training during a calendar year.

Object Classification (in millions of dollars)

Program and Financing (in millions of dollars)

Legislation will be proposed to: extend Rounding-Down of Education COLA Through 2018; make permanent the Pilot Expansion of Certain Work-Study Activities; increase Cap on Contract Counseling; exclude temporary Residence Adaptations (TRA) Grants from the Three Specially Adapted Housing (SAH) Grants Limit; replace the SAH Program's Grant Limit; amend the Visual Impairment Standard For SAH Grants; restore Eligibility for Housing Adaptation; and provide SAH Grants to Veterans Living with Family.

For military and naval insurance, national service life insurance, servicemen's indemnities, service-disabled veterans insurance, and veterans mortgage life insurance as authorized by chapters 19 and 21, title 38, United States Code, [$100,252,000] $104,600,000, to remain available until expended. (Military Construction and Veterans Affairs, and Related Agencies Appropriations Act, 2012.)

Program and Financing (in millions of dollars)