As part of the Friends of VA Medical Care and Health Research (FOVA) executive committee, NAVREF joined voices with others in the coalition to endorse testimony submitted to the the Senate Committee on Appropriations, Subcommittee on Military Construction, Veterans Affairs, and Related Agencies asking for the VA Medical and Prosthetic Research Program funding approval of $713 million for FY18. FOVA additionally requested funding to address critical research laboratory and related deficiencies of $50 million for up to five major construction projects in VA research facilities, and $175 million for nonrecurring maintenance and minor construction (separate from funding for medical facilities). The full text is below.
Testimony of the
Friends of VA Medical Care and Health Research (FOVA)
Fiscal Year 2018 Appropriations for the U.S. Department of Veterans Affairs Medical and Prosthetic Research Program
submitted to the
Senate Committee on Appropriations
Subcommittee on Military Construction, Veterans Affairs, and Related Agencies
Chairman Jerry Moran, Ranking Member Brian Schatz, and Members of the Subcommittee—
The Friends of VA Medical Care and Health Research (FOVA) respectfully urges the Subcommittee to approve funding for the Medical and Prosthetic Research Program within the U.S. Department of Veterans Affairs (VA) at $713 million in fiscal year (FY) 2018. In addition, FOVA requests funding to address critical research laboratory and related deficiencies of $50 million for up to five major construction projects in VA research facilities, and $175 million for nonrecurring maintenance and minor construction (separate from funding for medical facilities).
FOVA is a diverse coalition representing national academic, medical, and scientific societies; voluntary health and patient advocacy groups; and veterans service organizations. FOVA was founded almost 25 years ago, to ensure that America's veterans receive high-quality health care. We believe an important connection exists among VA health care, VA’s academic affiliates, and the VA Research and Development program. This relationship supports advanced practice and effective, safe care for veterans, helps veterans recover from war, disease and illness, and pays even more dividends to the nation, including promoting better health for all.
The Administration and Congress should provide at least $713 million for the VA Medical and Prosthetic Research program for FY 2018 to support current research on chronic conditions of aging veterans and for emerging research on conditions prevalent among younger Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans.
The VA Research program is uniquely positioned to advance genomic medicine through the Million Veteran Program (MVP), an effort that seeks to collect genetic samples and general health information from 1 million veterans over the next five years. When completed, the MVP will constitute one of the largest genetic repositories in existence, offering tremendous potential to study the health of veterans. To date, more than 550,000 veterans have enrolled in MVP. While the FOVAs recommend $65 million to support this transformative and innovative program, this program should not impede other critical VA research priorities.
The Administration and Congress should provide funding for up to five major construction projects in VA research facilities in the amount of at least $50 million and appropriate $175 million in nonrecurring maintenance and for minor construction projects to address deficiencies identified in the independent VA research facilities review provided to Congress.
The Administration and Congress should preserve the integrity of the VA research program as an exclusively intramural program, firmly grounded in scientific peer review, and should oppose designated funding for specific areas of research outside of the VA national management of the entire VA research portfolio.
Background and Justification
The VA Medical and Prosthetic Research and Development program is widely acknowledged as a success on many levels, all directly leading to improved care for veterans and an elevated standard of care for all Americans:
• Advancing Patient Care - VA Research has made critical contributions to advance standards of care for veterans in areas ranging from tuberculosis in the 1940s to immunoassay in the 1950s to today’s ongoing projects dealing with Alzheimer’s disease, developing and perfecting the DEKA advanced prosthetic arm and other inventions to help the recovery of veterans grievously injured in war, studies in genomics and in chronic pain, cardiology, diabetes, and improved treatments for PTSD and other mental health challenges. These studies and their findings ultimately aid the health of all American.
• Recruitment and Retention - VA Research is a completely intramural program that recruits clinicians to care for veterans while conducting biomedical research. More than 70 percent of these clinicians are VA-funded researchers. VA also awards over 500 career development grants each year designed to help retain its best and brightest researchers for long and productive careers in VA health care.
• High-Quality Research - VA researchers are well published (between 8,000 and 10,000 refereed articles annually) and boast three Nobel laureates and seven awardees of the Lasker Award (the “American Nobel Prize”); this level of success translates effectively from the bench to the veteran’s bedside.
• Investing Taxpayers’ Dollars Wisely - Through a nationwide array of synergistic relationships with other federal agencies, academic affiliates, nonprofit organizations, and for-profit industries, the program leverages its modest annual appropriation into a nearly $2 billion overall research enterprise.
Despite numerous successes in research and innovation, since FY 2010 appropriated funding for VA research and development has lagged biomedical research inflation, resulting in stagnant VA purchasing power. As estimated by the Department of Commerce Bureau of Economic Analysis and the National Institutes of Health (NIH), to maintain VA research at current service levels, the VA Medical and Prosthetic Research appropriation would require $19 million in FY 2018 (a 2.8 percent increase over the FY 2017 level). Should availability of research awards decline as a function of budgetary policy, VA risks terminating ongoing research projects and losing these clinician researchers who are integral to providing direct care for our nation’s veterans. Numerous meritorious proposals for new VA research cannot be awarded without a significant infusion of additional funding for this vital program.
The FOVAs believe an additional $19 million in FY 2018, beyond uncontrollable inflation, is necessary for expanding research on conditions prevalent among O IF/O EF/OND veterans as well as continuing inquiries in chronic conditions of aging veterans from previous wartime periods. Additional funding will also help VA support emerging areas that remain critically underfunded, including:
• post-deployment mental health concerns such as PTSD, depression, anxiety, and suicide;
• the gender-specific health care needs of the VA growing population of women veterans;
• engineering and technology to improve the lives of veterans with prosthetic systems that replace lost limbs or activate paralyzed nerves, muscles, and limbs;
• studies dedicated to understanding chronic multi-symptom illnesses among Gulf War veterans and the long-term health effects of potentially hazardous substances to which they may have been exposed; and
• innovative health services strategies, such as telehealth and self-directed care, relatively new concepts that lead to accessible, high-quality, cost-effective care for all veterans, as VA works to address chronic patient backlogs and reduce waiting times.
State-of-the-art research also requires an investment in state-of-the-art technology, equipment, and facilities. For decades, VA construction and maintenance appropriations have failed to provide the resources VA needs to replace, maintain, or upgrade its aging research facilities. The impact of this funding shortage was observed in a congressionally mandated report that found a clear need for research infrastructure improvements system wide. Nearly 40 percent of the deficiencies found were designated “Priority 1: Immediate needs, including corrective action to return components to normal service or operation; stop accelerated deterioration; replace items that are at or beyond their useful life; and/or correct life safety hazards.”
Contact: FOVA Executive Committee - http://www.friendsofva.org/committee.htm