[Appendix, Budget of the United States Government, Fiscal Year 1998]
[Page 889-899]
VETERANS HEALTH ADMINISTRATION
Federal Funds
General and special funds:
Medical Care
For necessary expenses for the maintenance and operation of
hospitals, nursing homes, and domiciliary facilities; for furnishing, as
authorized by law, inpatient and outpatient care and treatment to
beneficiaries of the Department of Veterans Affairs, including care and
treatment in facilities not under the jurisdiction of the Department;
and furnishing recreational facilities, supplies, and equipment;
funeral, burial, and other expenses incidental thereto for beneficiaries
receiving care in the Department; 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; oversight, engineering
and architectural activities not charged to project cost; 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; uniforms or allowances therefor, as authorized by
5 U.S.C. 5901-5902; aid to State homes as authorized by 38 U.S.C. 1741;
and not to exceed $8,000,000 to fund cost comparison studies as referred
to in 38 U.S.C. 8110(a)(5); [$17,008,447,000,] $16,958,846,000, plus
reimbursements: Provided, That [of the funds made available under this
heading, $700,000,000 is for the equipment and land and structures
object classifications only, which amount shall not become available for
obligation until August 1, 1997, and shall remain available until
September 30, 1998.] not to exceed 8.3 percent of amounts made available
herein shall remain available until September 30, 1999: Provided
further, That funds under this heading shall be available for medical
examinations required for benefits claims under title 38, United States
Code. (Departments of Veterans Affairs and Housing and Urban
Development, and Independent Agencies Appropriations Act, 1997.)
Note: In addition to resources requested here, $468 million in net
resources would be provided by an accompanying legislative proposal.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 36-0160-0-1-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
Operating expenses:
Provision of veterans health
care:
00.01 Acute hospital care......... 5,225 5,038 4,663
00.02 Rehabilitative care......... 377 375 343
00.03 Psychiatric care............ 1,535 1,558 1,428
00.04 Nursing home care........... 1,594 1,767 1,831
[[Page 890]]
00.05 Subacute care............... 544 495 453
00.06 Residential care............ 245 269 271
00.07 Outpatient care............. 5,184 5,939 6,426
00.08 Miscellaneous benefits and
services.................. 692 699 727
00.09 CHAMPVA....................... 91 92 92
--------- --------- ----------
00.91 Total operating expenses.... 15,487 16,232 16,234
Capital investment:
Provision of veterans health
care:
01.01 Acute hospital care......... 335 354 329
01.02 Rehabilitative care......... 21 22 21
01.03 Psychiatric care............ 59 62 58
01.04 Nursing home care........... 45 47 44
01.05 Subacute care............... 21 22 21
01.06 Residential care............ 14 15 14
01.07 Outpatient care............. 298 314 293
01.08 Miscellaneous benefits and
services.................. 26 27 26
01.09 CHAMPVA....................... 1
--------- --------- ----------
01.91 Total capital investment.... 820 863 806
--------- --------- ----------
01.92 Total direct program.......... 16,307 17,095 17,040
02.01 Reimbursable program.............. 66 75 146
--------- --------- ----------
10.00 Total obligations............... 16,373 17,170 17,186
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Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... 501 731 650
22.00 New budget authority (gross)...... 16,617 17,088 17,105
22.30 Unobligated balance expiring...... -14
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 17,104 17,819 17,755
23.95 New obligations................... -16,373 -17,170 -17,186
24.40 Unobligated balance available, end
of year: Uninvested balance..... 731 650 569
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New budget authority (gross), detail:
Current:
40.00 Appropriation................... 16,564 17,013 16,959
40.75 Reduction pursuant to P.L. 104-
134........................... -21
--------- --------- ----------
43.00 Appropriation (total)......... 16,543 17,013 16,959
Permanent:
Spending authority from
offsetting collections:
68.00 Offsetting collections (cash). 66 75 146
68.26 Offsetting collections
(unavailable balances)...... 8
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total)................... 74 75 146
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 16,617 17,088 17,105
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Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 2,179 2,394 2,460
73.10 New obligations................... 16,373 17,170 17,186
73.20 Total outlays (gross)............. -16,114 -17,103 -16,848
73.40 Adjustments in expired accounts... -44
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 2,394 2,460 2,798
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 14,131 14,526 14,192
86.93 Outlays from current balances..... 1,917 2,502 2,510
86.97 Outlays from new permanent
authority....................... 66 75 146
--------- --------- ----------
87.00 Total outlays (gross)........... 16,114 17,103 16,848
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -47 -53 -123
88.40 Non-Federal sources........... -19 -22 -23
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -66 -75 -146
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 16,551 17,013 16,959
90.00 Outlays........................... 16,048 17,028 16,702
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Summary of Budget Authority and Outlays
(in millions of dollars)
1996 actual 1997 est. 1998 est.
Enacted/requested:
Budget Authority.................. 16,551 17,013 16,959
Outlays........................... 16,048 17,028 16,702
Legislative proposal, not subject to
PAYGO:
Budget Authority.................. 591
Outlays........................... 591
------------------------------------
Total:
Budget Authority.................. 16,551 17,013 17,550
Outlays........................... 16,048 17,028 17,293
====================================
PERFORMANCE MEASURES
1994 actual 1995 actual 1996 actual 1997 1998
projected projected
Medical Care Summary:
Unique users (in millions).................... 2.811 2.890 2.937 2.937 3.072
Chronic disease index......................... N/A N/A 0.46 0.92 0.95
Prevention index.............................. N/A N/A 0.34 0.68 0.95
Percentage of inpatients receiving care in
accordance with externally set and accepted
standards................................... 98 96 96 97 98
Percentage of patients reporting their care as
very good or excellent:
Inpatient................................... N/A 60 65 70 75
Outpatient.................................. N/A 60 61 70 75
Percentage of networks improving performance
on two-thirds of customer service standards. N/A N/A 86 91 95
Bed-days of care per 1,000 unique users....... 3,523 3,183 2,525 2,275 2,025
Percentage of appropriate surgical and
invasive diagnostic procedures performed on
ambulatory basis............................ 35 39 52 58 65
Percentage of patients enrolled in primary
care........................................ 20 66 72 75 80
Percentage of medical care residents trained
in primary care............................. 34.0 37.5 38.5 41.0 43.5
The performance measures and workloads reported in this schedule
represent the total estimated workloads for fiscal years 1996-1998.
Fiscal year 1998 estimated performance measures and workload levels can
only be fully accomplished with: (1) approval of resources in this
schedule; (2) passage of proposed legislation referenced in the
following schedule; and (3) achieving receipts estimated. The short
narrative descriptions of net change by program sub-activity that
introduces these workload levels also include obligations and the
average employment estimates in total, the aggregate of both regular and
proposed legislation schedules.
Provision of Veterans Health Care--
Acute hospital care.--Costs for 1998 are estimated to decrease
by $194 million for operating medical, neurology, surgical, contract
and State home hospital beds, reflecting the shift to increased use
of ambulatory care.
Estimated operating levels are:
1996 actual 1997 est. 1998 est.
Patients treated.................. 621,495 575,334 560,377
Average daily census.............. 13,948 12,266 11,364
Average employment................ 67,902 61,175 57,364
Rehabilitative care.--A decrease of $18 million in 1998 is
estimated for providing rehabilitative care, including spinal cord
injury care.
Estimated operating levels are:
1996 actual 1997 est. 1998 est.
Patients treated.................. 18,625 18,021 17,537
Average daily census.............. 1,642 1,516 1,399
Average employment................ 5,724 5,344 4,998
Psychiatric care.--A decrease of $71 million is estimated in
1998 for the inpatient care of veterans with problems related to
mental illness, including alcohol and drug problems.
1996 actual I997 est. 1998 est.
Patients treated.................. 177,287 172,624 167,985
[[Page 891]]
Average daily census.............. 11,037 10,357 9,558
Average employment................ 25,162 23,944 22,474
Nursing home care.--In 1998, an increase of $116 million is
estimated for the care of residents in VA nursing homes, contract
nursing homes and State nursing homes.
Estimated operating levels are:
1996 actual 1997 est. 1998 est.
Patients treated.................. 82,390 86,091 87,446
Average daily census.............. 33,733 35,182 35,876
Average employment................ 19,567 20,494 20,806
Subacute care.--A decrease of $22 million is estimated in 1998
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.
1996 actual 1997 est. 1998 est.
Patients treated.................... 32,691 28,605 27,836
Average daily census................ 5,085 4,369 4,032
Average employment.................. 9,634 8,399 7,832
Residential care.--An increase of $12 million is estimated in
1998 for the care of veterans in locations other than their own
homes, such as residential rehabilitation and domiciliary care
programs.
1996 actual 1997 est. 1998 est.
Patients treated.................... 28,036 29,142 29,674
Average daily census................ 9,319 9,612 9,905
Average employment.................. 3,700 3,864 3,932
Outpatient care.--An increase of $758 million is estimated in
1998 for the cost of outpatient medical and dental care provided by
staff, physicians, and dentists participating under a fee basis
arrangement for certain eligible veterans.
NUMBER OF MEDICAL VISITS AND DENTAL WORKLOADS
1996 actual 1997 est. 1998 est.
Medical visits (in thousands):
Outpatient clinic visits.......... 28,360 29,209 31,504
Community based visits............ 935 935 935
Readjustment counseling........... 760 767 774
------------------------------------
Total....................... 30,055 30,911 33,213
====================================
Dental:
Staff:
Examinations.................. 234,968 235,000 235,000
Treatments.................... 152,373 150,000 150,000
------------------------------------
Total....................... 387,341 385,000 385,000
====================================
Fee: Cases completed............ 16,647 16,500 16,500
====================================
Average employment................ 56,906 59,653 63,911
====================================
Miscellaneous benefits and services.--This covers such items of
nondirect medical care and treatment as beneficiary travel, care of
the dead, operation of personnel quarters at medical facilities, and
the cost of furnishing supply, engineering, housekeeping, and other
administrative support services to other departments on a
nonreimbursable basis. An increase of $27 million is estimated for
1998.
1996 actual 1997 est. 1998 est.
Average employment................ 6,416 5,985 5,858
Civilian health and medical program of the Department of
Veterans Affairs (CHAMPVA).--No change is estimated in 1998 for
private hospital and outpatient care for dependents and survivors of
certain veterans.
1996 actual 1997 est. 1998 est.
Average daily hospital census..... 150 150 150
Outpatient (in thousands)......... 822,637 822,637 822,637
Average employment................ 142 142 142
Object Classification (in millions of dollars)
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Identification code 36-0160-0-1-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 6,506 6,689 6,548
11.3 Other than full-time permanent 863 717 704
11.5 Other personnel compensation.. 783 801 763
--------- --------- ----------
11.9 Total personnel compensation 8,152 8,207 8,015
12.1 Civilian personnel benefits..... 1,900 1,935 1,914
13.0 Benefits for former personnel... 11 148 15
Travel and transportation of
persons:
21.0 Employee travel............... 31 51 52
21.0 Beneficiary travel............ 108 118 123
21.0 Interagency motor pool
payments.................... 12 12 12
21.0 All other..................... 31 34 32
22.0 Transportation of things........ 25 30 30
23.1 Rental payments to GSA.......... 23 25 26
23.2 Rental payments to others....... 55 63 66
23.3 Communications, utilities, and
miscellaneous charges......... 430 464 465
24.0 Printing and reproduction....... 13 15 14
25.2 Other contractual services...... 1,221 1,363 1,528
Medical care:
25.6 Outpatient dental fees........ 12 13 14
25.6 Medical and nursing fees...... 275 289 303
25.6 Community nursing homes....... 338 325 364
25.6 Contract hospitalization...... 143 150 158
25.6 Civilian Health and Medical
Program of the Department of
Veterans Affairs............ 85 85 85
Supplies and materials:
26.0 Supplies and materials........ 2,317 2,608 2,673
26.0 Provisions.................... 92 95 94
31.0 Equipment....................... 632 567 545
32.0 Land and structures............. 187 256 258
Grants, subsidies, and
contributions:
41.0 Grants, subsidies, and
contributions............... 207 232 245
41.0 Grants to private
organizations............... 6 8 7
43.0 Interest and dividends.......... 1 2 2
--------- --------- ----------
99.0 Subtotal, direct obligations.. 16,307 17,095 17,040
99.0 Reimbursable obligations.......... 66 75 146
--------- --------- ----------
99.9 Total obligations............... 16,373 17,170 17,186
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Personnel Summary
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Identification code 36-0160-0-1-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Full-time equivalent employment. 194,364 188,143 177,987
1005 Full-time equivalent of overtime
and holiday hours............. 3,470 3,395 3,141
Reimbursable:
Total compensable workyears:
2001 Full-time equivalent employment. 789 857 1,666
2005 Full-time equivalent of overtime
and holiday hours............. 14 15 29
---------------------------------------------------------------------------
Note: An additional 7,664 FTE are funded through the legislative
proposal authorizing Medical Care to retain medical collections and user
fees.
Medical Care
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 36-0160-2-1-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
Reimbursements:
Operating expenses:
Provision of veterans health
care:
00.01 Acute hospital care......... 172
00.02 Rehabilitative care......... 13
00.03 Psychiatric care............ 55
00.04 Nursing home care........... 46
00.05 Subacute care............... 17
00.06 Residential care............ 9
00.07 Outpatient care............. 246
--------- --------- ----------
00.91 Total operating expenses.... 558
Capital investment:
Provision of veterans health
care:
01.01 Acute hospital care......... 14
01.02 Rehabilitative care......... 1
01.03 Psychiatric care............ 2
01.04 Nursing home care........... 2
01.05 Subacute care............... 1
01.06 Residential care............ 1
01.07 Outpatient care............. 12
--------- --------- ----------
01.91 Total capital investment.... 33
--------- --------- ----------
[[Page 892]]
01.92 Total reimbursement program... 591
--------- --------- ----------
10.00 Total obligations............... 591
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 591
23.95 New obligations................... -591
----------------------------------------------------------------------------
New budget authority (gross), detail:
40.00 Appropriation..................... 591
----------------------------------------------------------------------------
Change in unpaid obligations:
73.10 New obligations................... 591
73.20 Total outlays (gross)............. -591
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 591
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 591
90.00 Outlays........................... 591
---------------------------------------------------------------------------
The request in 1998 establishes a new course for veterans' health
care that emphasizes and supports an emerging dynamic, business-like
healthcare system that is innovative and cost effective, and will
improve the health and well being of veterans throughout the Nation. The
VA healthcare system will expand and improve with future budget
increases provided by the proposed retention of all medical collections
and user fees. The net total of these is an estimated $468 million in FY
1998 ($591 million less $123 million in administrative expenses).
The budget schedule includes a legislative proposal to retain
earnings from Medical Care Cost Recovery (MCCR) program third party and
user fee collections as reimbursements to Medical Care starting on
October 1, 1997. VA also plans to begin a demonstration program in 1998
to test the feasibility of ``Medicare subvention'', i.e.--billing
Medicare for healthcare provided to Medicare eligible Category C
veterans. By FY 2002, assuming that the Congress authorizes a Medicare
subvention demonstration and it is successful, and that Congress decides
to allow VA to expand it nationwide, the combination of the Medicare
reimbursements and allowing VA to retain medical collections and user
fees would support a 30 percent lower unit cost and 20 percent more
veterans served with 10 percent of the VA healthcare budget from non-
appropriated revenues. It would also give veterans more healthcare
provider choices.
The MCCR legislation proposed for FY 1998 repeals Section 1729(g) of
title 38, United States Code, and inserts language requiring all amounts
recovered or collected (third party, medical fees and other receipts)
for medical care and other services furnished to be deposited in the
Department of Veterans Affairs' Medical Care account and be available
until expended. At the same time, the existing Medical Care Cost
Recovery (MCCR) Fund is proposed for termination. These additional
expenditures within this discretionary account are being funded through
offsetting receipts as the result of the merger of the MCCR activities
with the Medical Care account.
This is one of several proposals in the budget to charge fees to
users directly availing themselves of, or subject to, a government
service, program, or activity, in order to cover the government's costs.
Legislation will be proposed to authorize the fees and, upon enactment
of the authorization, a budget amendment to the current appropriations
language will be proposed to make the fees available for expenditure.
Because the current requirements of the Budget Enforcement Act of 1990
make it difficult to fund discretionary programs with receipts that are
not authorized in appropriations acts, the Administration is proposing a
change in the requirements to facilitate the enactment of proposals such
as this one.
The additional expenditures described below include the
administrative costs of collecting receipts and user fees for the
medical services provided.
Provision of Veterans Health Care--
Acute hospital care--Medical collections and user fees provide
an estimated $186 million in 1998 for operating medical, neurology,
and surgical hospital beds.
1998 est.
Patients treated.................................. 15,835
Average daily census.............................. 315
Average employment................................ 2,390
Rehabilitative care.--Medical collections and user fees provide
an estimated $14 million in 1998 for rehabilitative care, including
spinal cord injury care.
1998 est.
Patients treated.................................. 513
Average daily census.............................. 41
Average employment................................ 208
Psychiatric care.--Medical collections and user fees provide an
estimated $57 million in 1998 for inpatient care of veterans with
problems related to mental illness, including alcohol and drug
problems.
1998 est.
Patients treated.................................. 4,911
Average daily census.............................. 279
Average employment................................ 938
Nursing home care.--Medical collections and user fees provide an
estimated $48 million in 1998 for the care of residents in VA
nursing homes.
1998 est.
Patients treated.................................. 1,128
Average daily census.............................. 409
Average employment................................ 839
Subacute care.--Medical collections and user fees provide an
estimated $18 million in 1998 for the treatment of veterans who
require a level of care between acute and long-term care, as
provided in VA hospital immediate bed sections.
1998 est.
Patients treated.................................. 814
Average daily census.............................. 118
Average employment................................ 327
Residential care.--Medical collections and user fees provide an
estimated $10 million in 1998 for the care of veterans in locations
other than their own homes, such as residential rehabilitation and
domiciliary care programs.
1998 est.
Patients treated.................................. 657
Average daily census.............................. 174
Average employment................................ 163
Outpatient care.--Medical collections and user fees provide an
estimated $258 million in 1998 for the cost of outpatient medical
care provided by VA staff and other health professionals
participating under a fee basis arrangement for certain eligible
veterans.
NUMBER OF MEDICAL VISITS
1998 est.
Medical visits (in thousands).....................
Staff............................................ 921
Fee.............................................. 27
--------------------
Total........................................... 948
Average employment................................ 2,799
Object Classification (in millions of dollars)
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Identification code 36-0160-2-1-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
99.0 Reimbursable obligations:
Subtotal, reimbursable
obligations..................... 591
--------- --------- ----------
99.9 Total obligations............... 591
---------------------------------------------------------------------------
[[Page 893]]
Personnel Summary
----------------------------------------------------------------------------
Identification code 36-0160-2-1-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Total compensable workyears:
2001 Full-time equivalent employment... 7,664
2005 Full-time equivalent of overtime
and holiday hours............... 73
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<F-dash>
Medical and Prosthetic Research
For necessary expenses in carrying out programs of medical and
prosthetic research and development as authorized by 38 U.S.C. chapter
73, to remain available until September 30, [1998, $262,000,000] 1999,
$234,374,000, plus reimbursements. (Departments of Veterans Affairs and
Housing and Urban Development, and Independent Agencies Appropriations
Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 36-0161-0-1-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
Operating expenses:
00.01 Medical research.............. 192 210 178
00.02 Rehabilitation research....... 23 24 22
00.03 Health services research...... 30 32 33
--------- --------- ----------
00.91 Total operating expenses.... 245 266 233
Capital investment:
01.01 Medical research.............. 8 7 5
01.02 Rehabilitation research....... 1 1 1
01.03 Health services research...... 2 2 1
--------- --------- ----------
01.91 Total capital investment.... 11 10 7
--------- --------- ----------
01.92 Total direct program.......... 256 276 240
02.01 Reimbursable program.............. 51 45 46
--------- --------- ----------
10.00 Total obligations............... 307 321 286
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... 20 20 6
22.00 New budget authority (gross)...... 308 307 280
22.30 Unobligated balance expiring...... -1
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 327 327 286
23.95 New obligations................... -307 -321 -286
24.40 Unobligated balance available, end
of year: Uninvested balance..... 20 6
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
40.00 Appropriation................... 257 262 234
Permanent:
68.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 51 45 46
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 308 307 280
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 52 79 94
73.10 New obligations................... 307 321 286
73.20 Total outlays (gross)............. -283 -305 -288
73.40 Adjustments in expired accounts... 2
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 79 94 93
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 178 192 172
86.93 Outlays from current balances..... 54 68 70
86.97 Outlays from new permanent
authority....................... 51 45 46
--------- --------- ----------
87.00 Total outlays (gross)........... 283 305 288
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -51 -45 -46
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 257 262 234
90.00 Outlays........................... 232 260 242
---------------------------------------------------------------------------
The Medical and Prosthetic Research account is comprised of the
following three programs:
Medical research.--This program is comprised of investigator-
initiated and special research. In addition to the broad spectrum of
biomedical research projects, priority is given to research Acquired
Immune Deficiency Syndrome and conditions that frequently occur among
veterans such as aging, alcoholism, schizophrenia, delayed stress
disorders and other mental illness, and spinal cord injury and tissue
regeneration. Cooperative studies include surgical treatment of angina
pectoris, adjunct treatment of diabetes, and relative potency and side-
effect liability of new and marketed sedatives.
Rehabilitation research.--This program is dedicated to the
development and application of science and technology to improve the
care of physically disabled veterans through prostheses for the amputee,
improved wheelchairs for the paralyzed, and better joint functions for
the arthritic. It also includes care for those with visual, hearing, and
speech disorders.
Health services research.--This program provides support for health
services projects at Department of Veterans Affairs medical centers for
improving the effectiveness and economy of delivery of health services
and improving the accessibility of services to veterans.
In support of the research activities of these three programs, VA
applies a variety of budgetary resources including appropriations from
the Medical Care account and reimbursements from the Department of
Defense, grants from the National Institutes of Health, private
proprietary sources, and voluntary agencies which provide additional
support for VA's researchers. The first table summarizes all budgetary
resources for the Medical and Prosthetic Research account. The second
table shows the total number of projects.
SUMMARY OF BUDGETARY RESOURCES
[In millions of dollars]
1996 actual 1997 est. 1998 est.
Medical and prosthetic research
appropriation....................... 257 262 234
Medical care appropriation.......... 335 328 325
Federal grants (NIH)................ 209 217 224
Other grants (voluntary agencies,
private proprietary)................ 106 110 113
DOD reimbursements.................. 16 20 *
------------------------------------
Total budgetary resources..... 923 937 896
====================================
*DoD reimbursements for FY 1998 are unknown.
PERFORMANCE MEASURES
1994 actual 1995 actual 1996 actual 1997 1998
projected projected
Research Summary:
Total number of projects funded................. 1,870 1,771 1,666 1,644 1,469
Total number of new projects funded............. 261 334 192 200 120
Number of cooperative studies................... 28 31 35 37 37
Number of VA-funded studies involving VA
patients or VA data bases....................... 972 854 786 786 786
Percentage of projects receiving total or
partial funding from extra-VA sources........... 58 58 57 59 64
Percentage of funds coming from extra-mural
sources......................................... 54 54 59 61 64
Object Classification (in millions of dollars)
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Identification code 36-0161-0-1-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 34 41 39
11.3 Other than full-time permanent 68 76 71
11.5 Other personnel compensation.. 4 4 4
--------- --------- ----------
11.9 Total personnel compensation 106 121 114
12.1 Civilian personnel benefits..... 27 28 24
21.0 Employee travel................. 2 2 2
23.3 Communications, utilities, and
miscellaneous charges......... 1 1 1
24.0 Printing and reproduction....... 1 1 1
25.5 Research and development
contracts..................... 73 80 69
26.0 Supplies and materials.......... 22 32 22
[[Page 894]]
31.0 Equipment....................... 11 11 7
41.0 Grants, subsidies, and
contributions................. 13
--------- --------- ----------
99.0 Subtotal, direct obligations.. 256 276 240
99.0 Reimbursable obligations.......... 51 45 46
--------- --------- ----------
99.9 Total obligations............... 307 321 286
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Personnel Summary
----------------------------------------------------------------------------
Identification code 36-0161-0-1-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Full-time equivalent employment. 2,595 2,833 2,522
1005 Full-time equivalent of overtime
and holiday hours............. 17 17 17
Reimbursable:
2001 Total compensable workyears: Full-
time equivalent employment...... 655 527 431
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<F-dash>
Medical Administration and Miscellaneous Operating Expenses
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
planning, design, project management, architectural, engineering, real
property acquisition and disposition, construction and renovation of any
facility under the jurisdiction or for the use of the Department of
Veterans Affairs, including site acquisition; engineering and
architectural activities not charged to project cost; and research and
development in building construction technology; [$61,207,000]
$60,160,000, plus reimbursements. (Departments of Veterans Affairs and
Housing and Urban Development, and Independent Agencies Appropriations
Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 36-0152-0-1-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Operating expenses: Integrated
health care system
administration.................. 63 61 60
--------- --------- ----------
10.00 Total obligations............... 63 61 60
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 63 61 60
23.95 New obligations................... -63 -61 -60
----------------------------------------------------------------------------
New budget authority (gross), detail:
40.00 Appropriation..................... 63 61 60
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 6 13 6
73.10 New obligations................... 63 61 60
73.20 Total outlays (gross)............. -57 -68 -60
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 13 6 6
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 53 56 55
86.93 Outlays from current balances..... 4 12 5
--------- --------- ----------
87.00 Total outlays (gross)........... 57 68 60
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 63 61 60
90.00 Outlays........................... 57 68 60
---------------------------------------------------------------------------
Supervision and administration of VA's comprehensive and integrated
healthcare system.--Central office staff elements provide executive
direction for all Department medical and construction programs through
program development, implementation, and the administration of policies,
plans, and objectives.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 36-0152-0-1-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Personnel compensation:
11.1 Full-time permanent............. 40 40 39
11.3 Other than full-time permanent.. 1 2 2
11.5 Other personnel compensation.... 2 2 2
--------- --------- ----------
11.9 Total personnel compensation.. 43 44 43
12.1 Civilian personnel benefits....... 6 7 6
13.0 Benefits for former personnel..... 1
21.0 Travel and transportation of
persons: employee travel........ 1 1
23.1 Rental payments to GSA............ 5 5 5
23.3 Communications, utilities, and
miscellaneous charges........... 1
25.2 Other services.................... 3 3 3
26.0 Supplies and materials............ 1 1 1
31.0 Equipment......................... 3 1
--------- --------- ----------
99.9 Total obligations............... 63 61 60
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 36-0152-0-1-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Total compensable workyears:
1001 Full-time equivalent employment... 635 610 565
1005 Full-time equivalent of overtime
and holiday hours............... 1 1 1
---------------------------------------------------------------------------
<F-dash>
Health Professional Scholarship Program
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 36-0163-0-1-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 10 4 4
73.20 Total outlays (gross)............. -6
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 4 4 4
----------------------------------------------------------------------------
Outlays (gross), detail:
86.93 Outlays from current balances..... 6
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... 6
---------------------------------------------------------------------------
Health professional scholarship.--To assist in the recruitment and
retention of staff, this program provided grants for tuition, stipend,
and other educational expenses for eligible students in programs leading
to a degree in nursing or other allied health disciplines.
No appropriation for this account was requested in FY 1997 and none
is requested for FY 1998.
<F-dash>
Medical Care Cost Recovery Fund
Unavailable Collections (in millions of dollars)
----------------------------------------------------------------------------
Identification code 36-5014-0-2-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Balance, start of year:
01.99 Balance, start of year............ 1,101 1,060 1,038
Receipts:
02.01 Medical cost recovery............. 93 97 176
02.02 Medical cost recovery, legislative
proposal, not subject to PAYGO.. 176
02.03 Medical cost recovery, legislative
proposal, subject to PAYGO...... -176
--------- --------- ----------
04.00 Total: Balances and collections... 1,194 1,157 1,214
Appropriation:
05.01 Medical care cost recovery fund... -126 -119 -123
05.03 Medical care cost recovery fund,
legislative proposal subject to
PAYGO........................... 123
[[Page 895]]
05.04 Medical care...................... -8
--------- --------- ----------
05.99 Subtotal appropriation............ -134 -119
07.99 Total balance, end of year........ 1,060 1,038 1,214
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 36-5014-0-2-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.09 Operating expenses................ 103 114 118
00.10 Capital investment................ 16 5 5
--------- --------- ----------
10.00 Total obligations............... 119 119 123
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... 6 14 13
22.00 New budget authority (gross)...... 126 119 123
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 132 133 136
23.95 New obligations................... -119 -119 -123
24.40 Unobligated balance available, end
of year: Uninvested balance..... 14 13 13
----------------------------------------------------------------------------
New budget authority (gross), detail:
60.25 Appropriation (special fund,
indefinite)..................... 126 119 123
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 14 23 23
73.10 New obligations................... 119 119 123
73.20 Total outlays (gross)............. -109 -119 -123
73.40 Adjustments in expired accounts... -1
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 23 23 24
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new permanent
authority....................... 109 119 123
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 126 119 123
90.00 Outlays........................... 109 119 123
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
1996 actual 1997 est. 1998 est.
Enacted/requested:
Budget Authority.................. 126 119 123
Outlays........................... 109 119 123
Legislative proposal, subject to
PAYGO:
Budget Authority.................. -123
Outlays........................... -123
------------------------------------
Total:
Budget Authority.................. 126 119
Outlays........................... 109 119
====================================
The Medical Care Cost Recovery (MCCR) Fund was established by the
Omnibus Budget Reconciliation Act of 1990, P.L. 100-508. This Fund
serves as a depository for all third-party insurance collections. A
portion of these monies will be utilized to provide for FTE and other
administrative costs associated with medical care cost recovery efforts.
After providing for the estimated cost of operations for the ensuing
year, remaining funds are transferred to the Department of Treasury
before January of the next year.
While the MCCR Fund reflects the program costs of both third-party
and copayment activities, the receipts only reflect third-party
recoveries. The table below presents the complete relationship between
the costs of MCCR activities and the total collections, regardless of
source, resulting from these activities.
In 1998, the Administration will propose legislation to permanently
extend current legal provisions due to expire in 1998. These provisions
provide for the collection of third party health insurance payments for
care provided by the VA for service-connected veterans with nonservice-
connected conditions, including copayments and income verification
provisions.
[In millions of dollars]
1996 actual 1997 est. 1998 est.
Program activity
Third-party recoveries.................. 495 471 523
Copayments and other collections........ 62 62 68
--------- --------- ----------
Total collections................. 557 533 591
Total program costs............... 119 120 123
Ratio of costs to collections........... 21.3% 22.4% 20.8%
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 36-5014-0-2-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Personnel compensation:
11.1 Full-time permanent............. 57 59 61
11.5 Other personnel compensation.... 15 16 16
--------- --------- ----------
11.9 Total personnel compensation.. 72 75 77
12.1 Civilian personnel benefits....... 16 17 17
21.0 Travel and transportation of
persons......................... 3 3 3
23.3 Communications, utilities, and
miscellaneous charges........... 4 5 5
25.2 Other services.................... 4 7 8
26.0 Supplies and materials............ 4 7 8
31.0 Equipment......................... 16 5 5
--------- --------- ----------
99.9 Total obligations............... 119 119 123
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 36-5014-0-2-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Total compensable workyears:
1005 Full-time equivalent of overtime
and holiday hours............... 46 46 46
1011 Exempt Full-time equivalent
employment...................... 2,269 2,295 2,295
---------------------------------------------------------------------------
<F-dash>
Medical Care Cost Recovery Fund
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 36-5014-4-2-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.09 Operating expenses................ -118
00.10 Capital investment................ -5
--------- --------- ----------
10.00 Total obligations............... -123
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... -123
23.95 New obligations................... 123
----------------------------------------------------------------------------
New budget authority (gross), detail:
60.25 Appropriation (special fund,
indefinite)..................... -123
----------------------------------------------------------------------------
Change in unpaid obligations:
73.10 New obligations................... -123
73.20 Total outlays (gross)............. 123
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new permanent
authority....................... -123
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. -123
90.00 Outlays........................... -123
---------------------------------------------------------------------------
Language is being proposed that would merge all medical related
collections with the Medical Care account. VA is expected to receive a
net increase of $468 million in funds to support the medical care of
veterans through this concept.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 36-5014-4-2-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Personnel compensation:
11.1 Full-time permanent............. -61
11.5 Other personnel compensation.... -16
--------- --------- ----------
11.9 Total personnel compensation.. -77
[[Page 896]]
12.1 Civilian personnel benefits....... -17
21.0 Travel and transportation of
persons......................... -3
23.3 Communications, utilities, and
miscellaneous charges........... -5
25.2 Other services.................... -8
26.0 Supplies and materials............ -8
31.0 Equipment......................... -5
--------- --------- ----------
99.9 Total obligations............... -123
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 36-5014-4-2-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Total compensable workyears:
1005 Full-time equivalent of overtime
and holiday hours............... -46
1011 Exempt Full-time equivalent
employment...................... -2,295
---------------------------------------------------------------------------
<F-dash>
Public enterprise funds:
Medical Facilities Revolving Fund
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 36-4138-0-3-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Operating expenses................ 1 1
00.02 Capital investment................ 1 1 1
--------- --------- ----------
10.00 Total obligations............... 1 2 2
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... 17 6 6
22.00 New budget authority (gross)...... 2 2 2
22.21 Unobligated balance transferred to
other accounts.................. -12
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 7 8 8
23.95 New obligations................... -1 -2 -2
24.40 Unobligated balance available, end
of year: Uninvested balance..... 6 6 5
----------------------------------------------------------------------------
New budget authority (gross), detail:
68.00 Spending authority from offsetting
collections (gross): Offsetting
collections (cash).............. 2 2 2
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 1
73.10 New obligations................... 1 2 2
73.20 Total outlays (gross)............. -1 -4 -4
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new permanent
authority....................... 1 2 2
86.98 Outlays from permanent balances... 2 2
--------- --------- ----------
87.00 Total outlays (gross)........... 1 4 4
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -2 -2 -2
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... -1 2 2
---------------------------------------------------------------------------
This account provides funds for the operating expenses of VA medical
facilities furnishing nursing home care to certain veterans in receipt
of pensions. Title 38 provides that a veteran with no spouse or child
will only receive $90 per month in pension beginning the third full
month following the month of admission to VA furnished nursing home
care. The difference between the $90 the veteran receives and the amount
otherwise authorized is transferred to this fund for spending expenses
at the facility furnishing the nursing care.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 36-4138-0-3-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
26.0 Supplies and materials............ 1 1
31.0 Equipment......................... 1 1 1
99.0 Subtotal, reimbursable obligations 1 2 2
--------- --------- ----------
99.9 Total obligations............... 1 2 2
---------------------------------------------------------------------------
<F-dash>
Canteen Service Revolving Fund
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 36-4014-0-3-705 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
Operating expenses:
00.01 Acquisitions.................... 117 131 132
00.02 Direct operations............... 78 87 86
--------- --------- ----------
00.91 Total operating expenses...... 195 218 218
01.01 Capital investment: Sales program:
Purchase of equipment and
leasehold....................... 7 7 7
--------- --------- ----------
10.00 Total obligations............... 202 225 225
----------------------------------------------------------------------------
Budgetary resources available for obligation:
Unobligated balance available, start of year:
21.90 Fund balance.................... -12 -14 -15
21.91 U.S. Securities: Par value...... 38 42 42
--------- --------- ----------
21.99 Total unobligated balance,
start of year............... 26 28 27
22.00 New budget authority (gross)...... 204 225 226
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 230 253 253
23.95 New obligations................... -202 -225 -225
Unobligated balance available, end of year:
24.90 Fund balance.................... -14 -15 -14
24.91 U.S. Securities: Par value...... 42 42 42
--------- --------- ----------
24.99 Total unobligated balance, end
of year....................... 28 27 28
----------------------------------------------------------------------------
New budget authority (gross), detail:
68.00 Spending authority from offsetting
collections (gross): Offsetting
collections (cash).............. 204 225 226
----------------------------------------------------------------------------
Change in unpaid obligations:
72.90 Unpaid obligations, start of year:
Obligated balance: Fund balance. 15 14 15
73.10 New obligations................... 202 225 225
73.20 Total outlays (gross)............. -204 -225 -226
74.90 Unpaid obligations, end of year:
Obligated balance: Fund balance. 14 15 15
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new permanent
authority....................... 202 225 226
86.98 Outlays from permanent balances... 2
--------- --------- ----------
87.00 Total outlays (gross)........... 204 225 226
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -2 -2 -1
88.40 Non-Federal sources........... -202 -223 -225
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -204 -225 -226
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... -2
---------------------------------------------------------------------------
The Veterans Canteen Service was established to furnish, at
reasonable prices, merchandise and services necessary to the comfort and
well-being of veterans in VA medical facilities.
Financing.--Operations will be financed from current revenues.
[[Page 897]]
Statement of Operations (in millions of dollars)
-----------------------------------------------------------------------------------------------
Identification code 36-4014-0-3-705 1995 actual 1996 actual 1997 est. 1998 est.
-----------------------------------------------------------------------------------------------
0101 Revenue........................... 209 209 225 225
0102 Expense........................... -206 -206 -221 -222
------------ -------------- ------------ -------------
0109 Net income or loss (-)............ 3 3 4 3
-----------------------------------------------------------------------------------------------
Balance Sheet (in millions of dollars)
-----------------------------------------------------------------------------------------------
Identification code 36-4014-0-3-705 1995 actual 1996 actual 1997 est. 1998 est.
-----------------------------------------------------------------------------------------------
ASSETS:
Federal assets:
1101 Fund balances with Treasury..... 3 2 4
Investments in US securities:
1102 Treasury securities, par...... 38 40 41 42
1106 Receivables, net.............. 2 1 2 2
1107 Advances and prepayments...... 2 2 2 1
1206 Non-Federal assets: Receivables,
net............................. 1
Other Federal assets:
1802 Inventories and related
properties.................... 27 24 25 26
1803 Property, plant and equipment,
net........................... 25 28 28 28
------------ -------------- ------------ -------------
1999 Total assets.................... 97 95 100 104
LIABILITIES:
Federal liabilities:
2101 Accounts payable................ 2 1
2104 Resources payable to Treasury... 1 1 2 2
Non-Federal liabilities:
2201 Accounts payable................ 10 9 8 9
2207 Other........................... 5 8 8 8
------------ -------------- ------------ -------------
2999 Total liabilities............... 18 18 19 19
NET POSITION:
3200 Invested capital.................. 44 42 47 46
3600 Other............................. 34 35 34 39
------------ -------------- ------------ -------------
3999 Total net position.............. 78 77 81 85
------------ -------------- ------------ -------------
4999 Total liabilities and net position 96 95 100 104
-----------------------------------------------------------------------------------------------
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 36-4014-0-3-705 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Personnel compensation:
11.1 Full-time permanent............. 40 41 40
11.3 Other than full-time permanent.. 14 18 18
--------- --------- ----------
11.9 Total personnel compensation.. 54 59 58
12.1 Civilian personnel benefits....... 15 18 18
21.0 Travel and transportation of
persons......................... 1 3 3
22.0 Transportation of things.......... 1 1
23.3 Communications, utilities, and
miscellaneous charges........... 1 1
24.0 Printing and reproduction......... 1 1
25.2 Other services.................... 3 6 6
26.0 Supplies and materials............ 123 128 129
31.0 Equipment......................... 6 8 8
99.0 Subtotal, reimbursable obligations 202 225 225
--------- --------- ----------
99.9 Total obligations............... 202 225 225
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 36-4014-0-3-705 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
2011 Total compensable workyears:
Exempt Full-time equivalent
employment...................... 3,065 3,200 3,200
---------------------------------------------------------------------------
<F-dash>
Special Therapeutic and Rehabilitation Activities Fund
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 36-4048-0-3-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
Reimbursable Program:
00.01 Contracts....................... 18 22 23
00.02 Education and training.......... 1 1 2
00.03 Operating expenses.............. 10 12 12
--------- --------- ----------
10.00 Total obligations............... 29 35 37
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.90 Unobligated balance available,
start of year: Fund balance..... 5 8 8
22.00 New budget authority (gross)...... 32 35 37
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 37 43 45
23.95 New obligations................... -29 -35 -37
24.90 Unobligated balance available, end
of year: Fund balance........... 8 8 8
----------------------------------------------------------------------------
New budget authority (gross), detail:
68.00 Spending authority from offsetting
collections (gross): Offsetting
collections (cash).............. 32 35 37
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 2 1 4
73.10 New obligations................... 29 35 37
73.20 Total outlays (gross)............. -29 -32 -33
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 1 4 8
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new permanent
authority....................... 29 32 33
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.40 Offsetting collections (cash)
from: Non-Federal sources..... -32 -35 -37
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... -3 -3 -3
---------------------------------------------------------------------------
This revolving fund, established pursuant to the Veterans Omnibus
Health Care Act of 1976, Public Law 94-581, provides a mechanism for the
furnishing of rehabilitative services to certain veteran beneficiaries
who are receiving medical care and treatment from the Department of
Veterans Affairs.
Funds to operate the various rehabilitative activities and provide
for the therapeutic work for remuneration for patients and members in VA
health care facilities are derived from contractual arrangements with
private industry or nonprofit entities. Public Law 102-54 authorizes VA
to contract with any Federal agency, including VA, and authorizes the
Fund to cover the training, education, and travel costs of employees
associated with the rehabilitative programs. This is a self-sustaining
fund, and therefore no appropriation is required to support these
activities.
Statement of Operations (in millions of dollars)
-----------------------------------------------------------------------------------------------
Identification code 36-4048-0-3-703 1995 actual 1996 actual 1997 est. 1998 est.
-----------------------------------------------------------------------------------------------
0101 Revenue........................... 27 32 35 37
0102 Expense........................... -23 -27 -35 -37
------------ -------------- ------------ -------------
0109 Net income or loss (-)............ 4 5
-----------------------------------------------------------------------------------------------
Balance Sheet (in millions of dollars)
-----------------------------------------------------------------------------------------------
Identification code 36-4048-0-3-703 1995 actual 1996 actual 1997 est. 1998 est.
-----------------------------------------------------------------------------------------------
ASSETS:
Federal assets:
1101 Fund balances with Treasury..... 7 10 13 16
Investments in US securities:
1106 Receivables, net.............. 2 1 1 1
1206 Non-Federal assets: Receivables,
net............................. 1 1 1 1
1803 Other Federal assets: Property,
plant and equipment, net........ 1 1 1
------------ -------------- ------------ -------------
1999 Total assets.................... 10 13 16 19
LIABILITIES:
2101 Federal liabilities: Accounts
payable......................... 1 1 4 7
------------ -------------- ------------ -------------
2999 Total liabilities............... 1 1 4 7
NET POSITION:
3200 Invested capital.................. 1
3300 Cumulative results of operations.. 8 11 11 11
------------ -------------- ------------ -------------
3999 Total net position.............. 8 12 11 11
------------ -------------- ------------ -------------
[[Page 898]]
4999 Total liabilities and net position 9 13 15 18
-----------------------------------------------------------------------------------------------
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 36-4048-0-3-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
25.2 Other services.................... 26 31 33
26.0 Supplies and materials............ 2 3 3
31.0 Equipment......................... 1 1 1
--------- --------- ----------
99.9 Total obligations............... 29 35 37
---------------------------------------------------------------------------
<F-dash>
Medical Center Research Organizations
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 36-4026-0-3-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Operating expenses................ 25 26 26
00.02 Capital investment................ 3 3 3
--------- --------- ----------
10.00 Total obligations............... 28 29 29
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.90 Unobligated balance available,
start of year: Fund balance..... 18 18 18
22.00 New budget authority (gross)...... 28 29 29
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 46 47 47
23.95 New obligations................... -28 -29 -29
24.90 Unobligated balance available, end
of year: Fund balance........... 18 18 18
----------------------------------------------------------------------------
New budget authority (gross), detail:
68.00 Spending authority from offsetting
collections (gross): Offsetting
collections (cash).............. 28 29 29
----------------------------------------------------------------------------
Change in unpaid obligations:
73.10 New obligations................... 28 29 29
73.20 Total outlays (gross)............. -28 -29 -29
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new permanent
authority....................... 28 29 29
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -1 -1 -1
88.40 Non-Federal sources........... -27 -28 -28
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -28 -29 -29
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................
---------------------------------------------------------------------------
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)
----------------------------------------------------------------------------
Identification code 36-4026-0-3-703 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
25.2 Other services.................... 17 18 18
26.0 Supplies and materials............ 8 8 8
31.0 Equipment......................... 3 3 3
--------- --------- ----------
99.9 Total obligations............... 28 29 29
---------------------------------------------------------------------------
<F-dash>
Trust Funds
[Transitional Housing Loan Program] General Post Fund, National Homes
(including transfer of funds)
For the cost of direct loans, $7,000, as authorized by Public Law
102-54, section 8, which shall be transferred from the ``General post
fund'': Provided, That such costs, including the cost of modifying such
loans, shall be as defined in section 502 of the Congressional Budget
Act of 1974, as amended: Provided further, That these funds are
available to subsidize gross obligations for the principal amount of
direct loans not to exceed $70,000.
In addition, for administrative expenses to carry out the direct
loan programs, $54,000, which shall be transferred from the ``General
post fund'', as authorized by Public Law 102-54, section 8. (Departments
of Veterans Affairs and Housing and Urban Development, and Independent
Agencies Appropriations Act, 1997.)
Unavailable Collections (in millions of dollars)
----------------------------------------------------------------------------
Identification code 36-8180-0-7-705 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Balance, start of year:
01.99 Balance, start of year............ 2 2 5
Receipts:
02.01 General post fund, national homes,
deposits........................ 24 28 29
02.02 General post fund, national homes,
interest on investments......... 3 3 3
--------- --------- ----------
02.99 Total receipts.................. 27 31 32
--------- --------- ----------
04.00 Total: Balances and collections... 29 33 37
Appropriation:
05.01 General post fund, national homes. -27 -28 -29
07.99 Total balance, end of year........ 2 5 8
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 36-8180-0-7-705 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Religious, recreational, and
entertainment activities........ 21 21 22
00.02 Research activities............... 3 3 4
00.03 Therapeutic residence maintenance. 1 1
00.04 Therapeutic residence purchase and
renovation...................... 1 1
--------- --------- ----------
10.00 Total obligations............... 25 26 27
----------------------------------------------------------------------------
Budgetary resources available for obligation:
Unobligated balance available, start of year:
21.40 Uninvested balance.............. -1 -3 -1
21.41 U.S. Securities: Par value...... 36 40 40
--------- --------- ----------
21.99 Total unobligated balance,
start of year............... 35 37 39
22.00 New budget authority (gross)...... 27 28 29
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 62 65 68
23.95 New obligations................... -25 -26 -27
Unobligated balance available, end of year:
24.40 Uninvested balance.............. -3 -1 -1
24.41 U.S. Securities: Par value...... 40 40 42
--------- --------- ----------
24.99 Total unobligated balance, end
of year....................... 37 39 41
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New budget authority (gross), detail:
60.27 Appropriation (trust fund,
indefinite)..................... 27 28 29
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Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 3 5 6
73.10 New obligations................... 25 26 27
73.20 Total outlays (gross)............. -24 -25 -25
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 5 6 7
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Outlays (gross), detail:
86.97 Outlays from new permanent
authority....................... 22 23 23
86.98 Outlays from permanent balances... 2 2 2
--------- --------- ----------
87.00 Total outlays (gross)........... 24 25 25
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Net budget authority and outlays:
89.00 Budget authority.................. 27 28 29
90.00 Outlays........................... 24 25 25
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[[Page 899]]
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. In addition, donations
from pharmaceutical companies, non-profit corporations, and individuals
to support VA medical research are deposited into this fund. (38 U.S.C.
chs. 83 and 85.)
Also under this heading are the activities of the Transitional
housing loan program. This program provides loans to nonprofit
organizations to assist them in leasing housing units exclusively for
use as a transitional group residence for veterans who are in (or who
have recently been in) a program for the treatment of substance abuse.
The amount of the loan cannot exceed $4,500 for any single residential
unit and each loan must be repaid within two years through monthly
installments. The total amount of loans outstanding at any time may not
exceed $100,000.
Object Classification (in millions of dollars)
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Identification code 36-8180-0-7-705 1996 actual 1997 est. 1998 est.
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21.0 Travel and transportation of
persons......................... 1 1 1
25.2 Other services.................... 11 12 12
26.0 Supplies and materials............ 6 6 6
31.0 Equipment......................... 4 4 4
32.0 Land and structures............... 3 3 4
--------- --------- ----------
99.9 Total obligations............... 25 26 27
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