DEPARTMENT OF VETERANS AFFAIRS

The 2011 Budget provides the resources to help achieve the President's vision of transforming VA into a 21st Century organization that is veteran-centric, results-driven, and forward-looking. This Budget provides $60,321 million in gross discretionary funding for veterans health, benefits, and other services, including $56,966 million in net discretionary budget authority and $3,355 million in anticipated medical collections.

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, food services, and salaries and expenses of health care employees hired under title 38, United States Code, and aid to State homes as authorized by section 1741 of title 38, United States Code; [$71,843,500,000] $39,649,985,000, plus reimbursements, [of which $37,136,000,000] shall become available on October 1, [2010] 2011, and shall remain available until September 30, [2011] 2012: Provided, That, of the amount made available under this heading [for fiscal year 2010, not to exceed $1,015,000,000] $1,600,000,000 shall remain available until September 30, [2011] 2013: Provided further, That, notwithstanding any other provision of law, the Secretary of Veterans Affairs shall establish a priority for the provision of medical treatment for veterans who have service-connected disabilities, lower income, or have special needs: Provided further, That, notwithstanding any other provision of law, the Secretary of Veterans Affairs shall give priority funding for the provision of basic medical benefits to veterans in enrollment priority groups 1 through 6: Provided further, That, notwithstanding any other provision of law, the Secretary of Veterans Affairs may authorize the dispensing of prescription drugs from Veterans Health Administration facilities to enrolled veterans with privately written prescriptions based on requirements established by the Secretary: Provided further, That the implementation of the program described in the previous proviso shall incur no additional cost to the Department of Veterans Affairs[: Provided further, That for the Department of Defense/Department of Veterans Affairs Health Care Sharing Incentive Fund, as authorized by section 8111(d) of title 38, United States Code, a minimum of $15,000,000 shall remain available until expended for any purpose authorized by section 8111 of title 38, United States Code]. (Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2010.)

Special and Trust Fund Receipts (in millions of dollars)

Program and Financing (in millions of dollars)

For 2012, the Budget is requesting $50.6 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.

With the resources already appropriated for 2011, VA will further expand health care eligibility to non-disabled veterans earning modest incomes. This expansion will bring nearly 550,000 eligible veterans into the VA health care system by 2013. The 2011 appropriated level provides the resources needed to achieve this expansion while maintaining high quality and timely care for lower-income and service-disabled veterans who currently rely on VA medical care.

The Department of Defense (DOD) and VA will combine their resources in 2011 to operate the first totally integrated Federal health care facility in the country— the Captain James A. Lovell Federal Health Care Center located in North Chicago, Illinois. This facility will care for all eligible VA and DOD beneficiaries. Each department will contribute funding to the Joint DOD-VA Medical Facility Demonstration Fund established by section 1704 of Public Law 111-84, the "National Defense Authorization Act for Fiscal Year 2010". Funding appropriated for Medical Services, Medical Support and Compliance, Medical Facilities, as well as the funding requested in 2011 for the Information Technology Systems account will be transferred to the Joint DOD-VA Medical Facility Demonstration Fund.

Medical services.—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). For 2012, the Budget requests $39.6 billion for Medical Services.

Medical Care Collections Fund (MCCF).—For 2012, VA estimates collections of nearly $3.7 billion, representing 8 percent of available resources. 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.

Provision of veterans' health care

Acute hospital care.—Costs for 2011 are estimated to be $7,601 million for operating medical, neurological, surgical, contract and State home hospital beds.
Estimated operating levels are:

Rehabilitative care.—Costs for 2011 are estimated to be $536 million for the provision of rehabilitative care, including spinal cord injury care.
Estimated operating levels are:

Psychiatric care.—Costs for 2011 are estimated to be $3,717 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 2011 are estimated to be $4,019 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 2011 are estimated to be $1,273 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 2011 are estimated to be $76 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 2011 are estimated to be $60 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 2011 are estimated to be $22,324 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 2011 are estimated to be $1,114 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.

VA DOD sharing.—VA's strategy is to improve collaboration and exchange with 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.); [$10,237,000,000] $5,535,000,000, plus reimbursements, [of which $5,307,000,000] shall become available on October 1, [2010] 2011, and shall remain available until September 30, [2011] 2012: Provided, That, of the amount made available under this heading [for fiscal year 2010, not to exceed $145,000,000] $250,000,000 shall remain available until September 30, [2011] 2013.

Program and Financing (in millions of dollars)

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.

For 2012, the Budget is requesting $5.5 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.

Object Classification (in millions of dollars)

Employment Summary

Program and Financing (in millions of dollars)

The purpose of 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 more effectively service veterans. 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 (DOD) to establish a joint incentive program. In 2011, 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, and 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, [$10,599,000,000] $5,426,000,000, plus reimbursements, [of which $5,740,000,000] shall become available on October 1, [2010] 2011, and shall remain available until September 30, [2011] 2012: Provided, That, of the amount made available under this heading [for fiscal year 2010, not to exceed $145,000,000] $350,000,000 shall remain available until September 30, [2011: Provided further, That, of the amount available for fiscal year 2010, $130,000,000 for non-recurring maintenance shall be allocated in a manner not subject to the Veterans Equitable Resource Allocation] 2013. (Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2010.)

Program and Financing (in millions of dollars)

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.

For 2012, the Budget is requesting advance appropriations of $5.4 billion for 2012 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.

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] $590,000,000, plus reimbursements, shall remain available until September 30, [2011] 2012. (Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2010.)

Program and Financing (in millions of dollars)

For 2011, the total budgetary resources of $1.9 billion are comprised of $590 million in direct appropriations, $590 million in medical care support, and $710 million in Federal and private sector grants. The research program will support 3,345 FTE through direct appropriation and a total of over 15,000 research staff through all funding sources. High priority Research programs in 2011 will provide Operation Enduring Freedom and Operation Iraqi Freedom Veterans and Rural Veterans with critical needs research activity.

This account is an intramural program and VA R&D has had significant success developing research leading to clinical achievements that improve the health and quality of life for veterans and the Nation. This success enables VA to be 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. 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 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.

VA will also focus on Genomic & Personalized Medicine where using information on a patients' genetic make-up can lead to a more tailored, precise and effective level of care. VA expects to continue investigating whether genetic influences in disease and/or responses to medications can be used to further advance personalized care.

VA core priorities will include Mental Health, Women Veterans, Regenerative Medicine, Comparative Effectiveness Research, and Diabetes.

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 Science & Technology (FS&T) 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)

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 where they remain available until expended for the purposes of this account. In 2009, $2.8 billion was collected in the MCCF receipt account and transferred to the Medical Services appropriation 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, [$47,396,106,000] $53,492,234,000, to remain available until expended: Provided, That not to exceed [$29,283,000] $30,423,000 of the amount appropriated under this heading shall be reimbursed to "General operating expenses'', "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, 2010.)

Program and Financing (in millions of dollars)

Summary of Budget Authority and Outlays (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, 2011, is expected to be 0.0 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, 2011, is expected to be 0.0 percent.

AVERAGE NUMBER OF PENSION CASES AND PAYMENTS

Burial benefits provide for: (a) the payment of an allowance of $300 (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 $300 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

Program and Financing (in millions of dollars)

For the payment of readjustment and rehabilitation benefits to or on behalf of veterans as authorized by chapters 21, 30, 31, 33, 34, 35, 36, 39, 51, 53, 55, and 61 of title 38, United States Code, [$9,232,369,000] $10,440,245,000, 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, 2010.)

Program and Financing (in millions of dollars)

WORKLOAD

WORKLOAD

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.
The following table shows a caseload and cost comparison for these beneficiaries under existing legislation.

CASELOAD AND AVERAGE COST DATA

Dependents' education and training.—This program provides benefits 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.

NUMBER OF TRAINEES AND COST

Special Assistance to Disabled Veterans.—Service-disabled veterans requiring vocational rehabilitation receive assistance to cover the costs of subsistence, tuition, books, supplies, and equipment. In addition to monetary benefits, individuals may also receive rehabilitation evaluation, planning, and delivery services designed to move the veteran into a suitable job.

Automobile Grants and Adaptive Equipment.—Certain disabled veterans are provided with automobile grants with the associated approved adaptive equipment. An allowance, up to a maximum of $11,000, is provided to certain service-disabled veterans and servicepersons toward the purchase price of an automobile. Adaptive equipment and the maintenance and replacement of such equipment is also provided.

Specially Adapted Housing Grants.—Specially adapted housing grants, up to a maximum of $63,780, are provided to certain severely disabled veterans. Veterans who suffer service-connected blindness or who have lost the use of both upper extremities can receive up to $12,756.

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 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.

CASELOAD AND AVERAGE COST DATA

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)

For military and naval insurance, national service life insurance, servicemen's indemnities, service-disabled veterans insurance, and veterans mortgage life insurance as authorized by title 38, United States Code, chapters 19 and 21, [$49,288,000] $62,589,000, to remain available until expended. (Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2010.)

Program and Financing (in millions of dollars)

WORKLOAD

Note.—Department of Veterans Affairs insurance policy loans are not an extension of Federal credit. Credit schedules previously shown for this account have been discontinued.
The insurance business line administers six life insurance programs, including two trust funds, two public enterprise funds, a trust revolving fund, and Veterans' Mortgage Life Insurance (VMLI), and supervises four additional programs for the benefit of servicepersons, veterans, and their beneficiaries through contracts with a commercial company. All programs are operated on a commercial basis, to the extent possible, consistent with all applicable statutes. The insurance appropriation is the supplemental funding mechanism for the following Government life insurance activities: National Service Life Insurance (NSLI); Service-Disabled Veterans Insurance Fund (S-DVI); and Veterans' Mortgage Life Insurance.

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

Payment to Service-Disabled Veterans Insurance Fund.—Payments are made to the S-DVI fund to supplement the premiums and other receipts of the fund in amounts necessary to pay claims on insurance policies issued to veterans with service-connected disabilities.

Veterans' Mortgage Life Insurance.—Payments are made to mortgage holders under this program, which provides mortgage protection life insurance to veterans who have received a grant for specially adapted housing due to severe disabilities. The general decline in the number of policies and the amount of insurance in force is expected to continue in 2011 as indicated in the following table.

POLICIES AND INSURANCE IN FORCE

Object Classification (in millions of dollars)

Program and Financing (in millions of dollars)