Congress Approves Funding for FY 2023, Eliminates Annual Renewal of VA Clothing Allowance
By PVA National Staff
Congress approved H.R. 2617, the Consolidated Appropriations Act, 2023, in the final days of the 117th Congress, providing funding for the government for the remainder of the fiscal year (FY). Other sections in the massive $1.7 trillion spending bill direct changes with various veterans’ benefits and education programs, including one of PVA’s top legislative goals for 2023.
First, the law provides over $300 billion in funding for the VA, including $134.7 in discretionary funding which is a $22.5 billion increase over FY 22. Some specific funding amounts are as follows:
- $118.7 billion for Veterans Medical Care to meet veterans’ comprehensive health care needs, including:
- $13.9 billion for mental health care to provide treatment and support for the two million veterans receiving mental health services
- $840.5 million for women’s health, to help VA deliver gender-specific health care services, as well as retrofit its facilities to create a more welcoming environment
- $498 million for suicide prevention outreach
- $183.3 million for substance use disorder programs
- $663 million for opioid abuse prevention
- $3.9 billion for administering benefits, including disability compensation and burial benefits, to more than six million veterans and their survivors, including:
- $430 million for the National Cemetery Administration
- $285 million for the Board of Veterans’ Appeals
- $50 million for grants to State and Tribal cemeteries
- $5 billion to the Cost of War Toxic Exposure Fund to ensure that the PACT Act continues to be implemented at VA and that the 3.5 million newly eligible veterans and others can get the care and benefits they have earned
- $5.8 billion for strengthening VA information technology systems
The Consolidated Appropriations Act also contains the Joseph Maxwell Cleland and Robert Joseph Dole Memorial Veterans Benefits and Health Care Improvement Act—a large omnibus package of veterans related provisions that PVA has been tracking for more than a year now. Some of the provisions in this section:
- Make all World War II veterans eligible for VA health care, regardless of service connection or income level.
- Codify VA’s current regulation of how to measure wait times for community care eligibility. Wait times will be measured from the date the veteran requests the appointment, unless a later date is agreed to by the veteran and their VA provider, to the first next available appointment date.
- Require VA to develop a plan by October 1, 2023, to create a method for veterans to have access to expected community care wait times and expected VA wait times.
- Ensure community care providers can meet VA access standards.
- Direct VA to create a pilot program to allow veterans to schedule their own community care appointments with community care providers. The program would be implemented in at least two Veterans Integrated Services Networks (VISNs). The pilot program is approved for an 18-month duration, with conditions for extension if successful, and must begin within a year of the law’s enactment.
- Establish a deadline of 180 days for the filing of claims for payment of veterans’ non-service connected emergency treatment. Veterans may not be held liable for payment if a claim was submitted after 180 days due to administrative effort by either the individual or entity, or VA.
- Direct a Government Accountability Office (GAO) report on the rural and highly rural transportation programs, including services provided, effectiveness of the program, staffing assessment, and program assets.
- Prevent VA from imposing or collecting copayments for a veteran’s first three mental health care outpatient visits each calendar year, beginning 180 days after the law’s enactment.
- Call for a review of data that is publicly available on the Access to Care VA website and for VA to consult with veterans service organizations, veterans, and caregivers of veterans to gather insights about potential modifications that could help improve users’ understanding and use of the data.
- Require VA to determine whether a previously identified service-connected injury or ailment served as a principal or contributing factor for veterans who died from COVID-19 when survivors file for Dependency and Indemnity Compensation.
- Authorize VA to extend the time limitation for use of VA education benefit programs whenever schools must close due to emergency and other situations.
- Direct GAO to conduct a study on waste, fraud, and abuse of the VA Beneficiary Travel program.
- Create a five-year, five-site pilot program whereby the VA Beneficiary Travel program will provide mileage reimbursement in advance of confirmed medical appointments for low-income veterans. This program is intended to provide support to veterans for whom the cost of gas to and from health care appointments can mean forgoing necessary medical care. Another five-year pilot will provide veterans with financial support for transportation to and from Vet Center appointments.
- Requires VA to develop a strategy for the long-term care of veterans, identifying current and future needs based on demographic data and availability of services. This strategy would be required to consider the needs of an increasingly diverse aging veteran population – including women veterans, veterans with traumatic brain injury, veterans with memory loss, and other groups with unique needs. The bill requires VA to report its finding to Congress by mid-December 2023.
Multiple provisions will improve access to mental health care, ensure patient safely, and improve VA’s project management, planning, and prioritization functions over its information technology programs.
Two provisions stand out among the rest because they directly correlate with PVA legislative goals. The first allows VA over the next five years to pay for up to 900 veterans to receive care in a Medical Foster Home (MFH). For more than two decades, VA has been allowed to refer veterans to an MFH home but until now they have not been allowed to pay for it. We believe this change, albeit temporary, would help veterans and the VA alike by giving greater access to non-institutional long-term care and reducing costs for long-term care, allowing more veterans to receive needed assistance.
The one provision most likely to impact PVA members makes the VA clothing allowance automatic until the VA determines the veteran is no longer eligible to receive the benefit or declines to receive it. The way the program was being administered placed an unnecessary burden on the veteran, as well as VA who must process each of these claims. We have been working with Congress for over a year to get this changed. We thank Senators Catherine Cortez Masto (D-NV) and John Boozman (R-AR) and Representatives Mike Levin (D-CA) and Barry Moore (R-AL) for championing this issue which led to making this important change.
The Consolidated Appropriations Act also included several initiatives long sought by the disability community. The Medicaid Money Follows the Person program was extended through September 30, 2027 and funded at $450 million a year. This program seeks to provide long-term services and supports to Medicaid beneficiaries in the community rather than in an institution. The agreement also extended through that date important spousal impoverishment protections under the Medicaid home and community-based services (HCBS) program.
Provisions in the ABLE Age Adjustment Act were also included in the omnibus. The ABLE Act, which was passed several years ago, allows individuals with disabilities to place earnings, income, and other assets in an ABLE account in order to preserve their access to certain federal means tested benefits such as Medicaid. This measure changes ABLE eligibility requirement to include individuals whose disability began before age 46 (up from age 26 in current law). These changes will become effective in 2025.
With regard to agencies beyond VA, the omnibus funds the Administration on Community Living at $2.5 billion, an increase of $220 million above the FY 2022 enacted level. This amount includes:
- $1.1 billion for Senior Nutrition programs, an increase of $100 million above the FY 2022 enacted level
- $410 million for HCBS, an increase of $11 million above the FY 2022 enacted level
Within the appropriations for the Departments of Transportation and Housing and Urban Development (HUD) were the following:
- Assistance for low-income and disabled veterans – The agreement directs HUD to combine the $1,000,000 provided for the veterans housing rehabilitation and modification pilot program with available carryover balances from FY 2023. The agreement encourages HUD to increase awareness about this program and the funding opportunities among veterans, veterans service organizations, and eligible entities, and to maximize the number of awards in the next notice of funding availability.
- ADA accessibility at Amtrak stations – The agreement directs Amtrak to submit an updated report to the House and Senate Committees on Appropriations no later than July 28, 2023, detailing the ADA stations program plan and timeline to make the remaining 292 stations ADA compliant and accessible.
The budget agreement acknowledges the Department of Labor’s (DOL) efforts to incentivize states to reduce barriers to entry into licensed occupations and increase license portability to facilitate mobility of workers in such occupations, with an emphasis on transitioning service members, veterans, and military spouses. It also urges the DOL Employment and Training Administration, in collaboration with the Department of Health and Human Services, to support the expansion of the skilled care workforce to provide HCBS to older adults and people with disabilities.
The Office of Disability Employment Policy received a modest increase of $2.5 million to a level of $43 million for FY 2023. DOL’s Homeless Veterans Reintegration Program, was funded at $65.5 million for an increase of $5 million above the FY 2022 enacted level. The Jobs for Veterans State Grants (JVSG) program received $185 million. JVSG supports disabled veterans’ outreach program specialists working at the local level through American Job Centers. Other DOL programs targeted at veterans and transitioning service members were funded at the following levels: $34.3 million for the Transition Assistance Program and $3.4 million for the National Veterans’ Employment and Training Services Institute.
The Social Security Administration (SSA) received a much-needed increase of $785 million with directions from the Appropriations Committee to undertake “a multi-year sustained effort” to address the backlogs in disability claims processing and long waits for people to speak with someone at the call centers. Unfortunately, efforts to include improvements to the Supplemental Security Income (SSI) program, including increasing asset limits, did not make it into the final package. The agreement also encourages SSA to expand outreach to potential beneficiaries, prioritizing underserved communities and individuals most likely to need support and urges SSA to ensure its policies and procedures for closing field offices and resident stations include at least 120 days advance notice to the public, SSA employees, Congress, and other stakeholders.
In report language, Congress expressed support for agency efforts to improve administrative processes that reduce overpayments, including in the Ticket to Work program, which can create significant challenges as beneficiaries attempt to return to work. In addition, SSA is asked to detail in its FY 2024 budget request its efforts in implementing an Occupational Information System and Medical-Vocational Guidelines to move away from the outdated Dictionary of Occupational Titles.