This analysis was prepared by Crossroads Strategies, LLC on behalf of AACOM.

OME Priorities in House MilCon-VA Bill- H.R 8580

On May 23, the House Appropriations Committee passed the Fiscal Year 2025 (FY25) funding bill for Military Construction, Veterans Affairs, and Related Agencies by a vote of 34 to 25. 

The legislation appropriates a total of $379 billion - $148 billion in discretionary and $231 billion in mandatory spending. Of this, $337.4 billion is allocated towards the Department of Veterans Affairs, which is $75.5 million above the FY25 Budget Request and $30.2 billion above the FY24 enacted level. The bill fully funds the Biden Administration’s FY25 budget request for veterans’ medical care at $112.6 billion.

On June 5, the full House passed the appropriations bill by a vote of 209 – 197 without significant additions to the Committee mark. 25 Members chose to not vote on passage.

• Nonaddictive Opioid Alternatives — The Committee remains concerned about the continued use of opioids in the veteran population. The Committee requests that the Department to provide a report to the Committee no later than 60 days after enactment of this act on veterans’ access to non-opioid pain relief medications. The report should include: (1) steps the Department will take to ensure that coverage, cost-sharing, and access are not an impediment to veterans receiving these medications; (2) what actions need to be taken to ensure Tricare beneficiaries have access to prescriptions for nonaddictive opioid alternatives for both acute and chronic pain; and (3) how the Department will support continued and expanded education to providers on nonaddictive opioid alternatives.
• Expanding Recruitment — Recognizing the challenge VA has in recruitment and retention of clinicians and to help VA continue to train its workforce to improve service to veterans, the Committee urges VA to explore potential options to enhance recruitment and retention, such as expanding benefits to relocate to underserved VA medical facilities and expanding reimbursement to clinicians for Continuing Professional Education, regardless of individual specialty or board certification.
• Expedited Hiring Authority — The Committee strongly encourages the Department to focus hiring efforts on converting clinical trainees to full VA employment immediately upon completion of their residencies by utilizing expedited hiring authority granted by Title 38.
• VA/HHS Collaboration on Health Workforce Shortages — The Committee encourages VA to work with the Department of Health and Human Services (HHS) to explore ways the agencies can work together, such as by creating a taskforce, to increase the availability of providers, including in the behavioral health workforce among physicians specializing in cancer, spinal cord, and neuropsychiatric conditions. This collaboration is urged to examine VA’s recruitment challenges, review programs that could enhance recruitment and retention, and to think creatively on how other Federal agencies like HHS can identify and address provider shortages. VA also is encouraged to consult with the Department of Defense to explore recruiting those who have left military service.
• Medication Optimization for Veterans — The Committee commends VA’s work to implement a National Pharmacogenomics Program to ensure all eligible veterans have access to appropriate, evidence-based pharmacogenomic testing, and that VA has a robust and highly trained healthcare professional workforce to help veterans who have undergone pharmacogenomic testing.
• Cancer Screening at Veterans Affairs Medical Centers — The Department is encouraged to ensure its healthcare providers screen for the numerous types of cancers that veterans experience.
• Pain — The Committee recognizes the balance between supporting access to care for veterans with pain and the veteran’s risk of developing dependency for prescription pain medication. The Committee supports the implementation of a process improvement initiative that will reduce the risk of tolerance, dependence, misuse, addiction, and diversion of prescription pain medication by establishing more precise and effective prescribing guidelines to ensure veterans receive appropriate care and provides up to $5,000,000 for this purpose. The Committee expects VA to deploy an innovative clinical decision support tool to evaluate and interpret the acute and chronic pain management needs for military veterans, their dependents, and/or employees of VA. The Committee supports the use of a novel care model that is available to those receiving treatment through traditional VHA hospitals/clinics and those utilizing Care in the Community. Such model should enable better value, a better standard of care, and seek to significantly reduce VA spending on pharmacy and behavioral health services. The Committee requests the Department to provide a report within 180 days on its plans for the model and how it intends to phase in its use across VHA over the next several years.
• Academic Collaborations at Community Based Outpatient Clinics (CBOC) — The Committee encourages the VA to expand academic collaborations with CBOCs, as they provide valuable patient care and access to services that can be strengthened by collaboration with educational institutions. Through clinical traineeships and research fellowships, emerging health professionals can gain a better understanding of veterans’ specific healthcare needs, improve patient outcomes, advance specialized research, and increase the talented workforce pipeline. VA is encouraged to consider including public academic medical centers in CBOC collaborations.
• Mental Health Screenings — The Committee provides $16,380,187,000 for mental health programs. Of the total, $3,161,426,000 is for suicide prevention and treatment programs, including $582,554,000 for suicide prevention outreach and $306,683,000 for the Veterans Crisis Line.
• Whole Family Care Partnerships — The Committee is particularly interested in partnerships related to mental health, including the mental health of veterans’ families, and provides up to $2,500,000 to increase outreach to this in-need underserved population.
• Medical and Prosthetic Research - The bill appropriates $923.5 million for Medical and Prosthetic Research, $55.5 million above the requested level but $19.4 million below the FY24 enacted level.