Promoting Partnerships To Improve Veterans’ Health

Advocacy & Government Relations

NAVREF is an active participant in advocacy efforts to secure robust support for VA research and development.  This entails lobbying for an increase in the annual appropriation of VA medical and prosthetic research account, which is separate from VA health care appropriation.  Also, when warranted, NAVREF works with House and Senate Veterans Affairs Committees to highlight pertinent research and education issues.  Finally, these committees also are critical to the statute that authorizes NPCs.

NAVREF coordinates its funding advocacy efforts with the Friends of VA Medical Care and Health Research (FOVA), a coalition of more than 80 medical specialty, patient advocacy, scientific and academic organizations committed to high quality care for veterans. 


NAVREF Core Advocacy Aspects

NAVREF believes it is time to update our enabling legislation to clarify areas of confusion and/or misinterpretation. We believe these changes will improve the ability of VA-affiliated nonprofit corporations (NPCs) to satisfy Congressional intent to support VA research and education activities and bring greater benefit to Veterans.

Flexible Funding Mechanism – a key aspect of the original legislation is the opening sentence, “The Secretary may authorize the establishment at any Department medical center of a nonprofit corporation to provide a flexible funding mechanism for the conduct of approved research and education at the medical center.” One significant component of this flexibility is the ability of NPCs to accept non-VA appropriated funding under authority of a Memorandum of Agreement (MOA). The statute should be updated to specify that transferring funds from VA to NPC by MOA has the force of a contract in the eyes of the Economy Act for purposes of obligating funds.

Independence – the statute states that an NPC is not “…owned or controlled by the United States” or “an agency or instrumentality of the United States.” However, the VA and other entities frequently question the authority of NPCs to operate independently. For example, the NIH Grants Policy Statement permits academic affiliates the authority to pay principal investigators up to a 60-hour work week, but specifically denies this authority to the NPCs because of a perception of “inter-dependence.” Furthermore, the authority of the Secretary of Veterans Affairs to establish or disestablish a NPC is often cited by VA personnel when imposing controls that limit the flexibility of NPCs. The statute should be updated to specify that while NPCs are clearly related to VA medical centers and designed to support research and education activities at VA medical centers, they remain independent and autonomous nonprofit corporations.

  • 8 Mar 2024 2:30 PM | Elizabeth Stout (Administrator)

    The Senate voted 63-35 to advance a $460 billion spending package, preventing a potential government shutdown. The package covers six spending bills, securing funding for military construction, water development, and key departments like Veterans Affairs, Agriculture, and Justice.

    As the bills approach President Biden's desk, attention turns to passing the remaining appropriations bills, highlighting the Senate's dedication to timely fiscal decisions by the March 22 deadline.

  • 5 Mar 2024 10:50 AM | Elizabeth Stout (Administrator)

    In the recent release of the first FY 2024 appropriations package, VA medical and prosthetics research funding reached $943 million, an increase of $27 million from FY 2023. While this marks a positive step in supporting crucial research areas like traumatic brain injury and precision oncology, it falls short of the FOVA coalition's request for $980 million. Despite this setback, the FOVA coalition, chaired by NAVREF, remains steadfast in its commitment to advocate for increased appropriations for VA research programs. The additional funding for toxic exposures research emphasizes the government's recognition of health challenges faced by veterans, depicting the ongoing need for sustained advocacy to ensure robust support for vital research initiatives.

  • 29 Feb 2024 4:20 PM | Elizabeth Stout (Administrator)

    Today, the House of Representatives overwhelmingly approved a short-term spending bill, paving the way for the finalization of fiscal 2024 appropriations. The measure is now poised for consideration in the Senate. Senate Majority Leader Charles E. Schumer (D-NY) has indicated that the Senate could pass the bill as early as later today.

    The approved short-term spending bill sets the stage for the first tranche of spending bills, which are scheduled for a House vote next Wednesday. This initial set includes critical measures such as Agriculture, Commerce-Justice-Science, Energy-Water, Interior-Environment, Military Construction-VA, and Transportation-HUD.

    To avert a potential partial government shutdown, lawmakers have set a deadline of March 22 for the consideration of the second batch of bills. This subsequent package encompasses the Defense, Financial Services, Legislative Branch, Homeland Security, Labor-HHS-Education, and State-Foreign Operations measures.

    Amidst these developments, it is noteworthy that House VA Committee Ranking Member Rep. Takano has recently corresponded to Secretary McDonough addressing concerns related to the Section 208 issue. As this matter unfolds, NAVREF remains committed to keeping you informed on the latest developments.

  • 22 Feb 2024 9:30 AM | Elizabeth Stout (Administrator)

    Today, the Friends of VA Research (FOVA) Executive Committee (of which NAVREF is the Chair) submitted a letter to the HVAC and SVAC leadership calling for a one-year delay in VA’s implementation regarding a new interpretation of 18 USC Section 208.

    We are deeply concerned that this new interpretation will create additional disincentives and barriers for our nation’s leading scientists and experts to pursue research activities at the VA, further shutting out our nation’s Veterans from clinical trial opportunities that can save lives.

    Read our letter here.

  • 16 Feb 2024 2:30 PM | Elizabeth Stout (Administrator)

    On February 15, 2024, the Subcommittee on Technology Modernization conducted an Oversight Hearing titled “Electronic Health Record Modernization Deep Dive: Can the Oracle Pharmacy Software Be Made Safe and Effective?” The hearing shed light on significant challenges faced by the Department of Veterans Affairs (VA) in implementing the Oracle Electronic Health Record (EHR) system. The issues discussed included increased Pharmacy Staffing needs, errors in medication information, and concerns regarding patient safety:

    • David Case, Deputy Inspector General for VA's OIG, informed lawmakers that an upcoming report revealed potential risks in the VA's pharmacy software. Patients at both new and legacy EHR sites may be prescribed contraindicated medications, and legacy providers may make clinical decisions based on inaccurate data. Approximately 250,000 veterans with medication orders or allergies documented in the new EHR as of September 2023 are at risk if they visit legacy EHR sites.
    • The primary issue highlighted in the upcoming report, as stated by David Case, is the inaccurate sharing of prescription information between the new Oracle EHR system and the VA's existing VistA system. This discrepancy poses a critical challenge as VistA is still in use at all but five of the VA's 171 medical centers.
    • Neil Evans, acting program executive director of VA’s Office of Electronic Health Records Modernization, expressed the department's commitment to achieving success in transitioning to a "single-instance, enterprise-wide electronic health record" interoperable with DOD's new EHR system. Despite challenges, he highlighted the joint deployment with DOD at the Captain James A. Lovell Federal Health Care Center scheduled for early March. This deployment is significant as it marks the final federal EHR deployment at a DOD site and the first VA deployment at a larger and more complex VA health care facility.
    • The Oracle EHR system's adoption has led to a surge in Pharmacy Staffing needs within the VA. The five hospitals using the system have increased their staffing by 20%, and Evans’ office anticipates that the large, more complex hospital in North Chicago will require as much as 60% more pharmacy staff with the new system.
  • 18 Jan 2024 5:00 PM | Elizabeth Stout (Administrator)

    On Thursday, the Senate approved a two-step stopgap measure to extend government funding into March. The Senate's midday vote resulted in a 77-18 majority, followed by a 314-108 approval in the House during the afternoon. This latest continuing resolution extends the funding deadline for various departments, including Agriculture, Transportation, Housing and Urban Development, Energy, and the Food and Drug Administration, to March 1. Additionally, it moves the funding deadline for other government agencies, such as Defense, Labor, and Education, from Feb. 2 to March 8.

  • 17 Jan 2024 10:30 AM | Elizabeth Stout (Administrator)

    Washington, D.C – The Friends of VA Medical Care and Health Research (FOVA), a coalition representing over 80 national academic, medical, and scientific societies, is calling on Congress for support in securing a $980 million allocation for the Department of Veterans Affairs' Medical and Prosthetic Research Program in FY24.

    In a recently submitted letter, FOVA commends Congress for its commitment to advancing the health and well-being of our nation's veterans through robust funding for VA research. The coalition specifically highlights the proposed $938 million allocation for the program in FY 2024, acknowledging its potential to address the evolving challenges faced by veterans.

    However, FOVA is looking toward the future, urging Congress to direct at least $980 million for the VA research program. This proposed increase of $64 million (7%) over the FY 2023 funding level reflects FOVA's dedication to sustaining the trajectory of growth and possibility for the VA research program.

    In addition to funding for research, FOVA emphasizes the need for continued investment in physical and information technology infrastructure. Allocating at least $100 million for major and minor construction, along with at least $22 million for the Office of Information and Technology, will ensure that the VA research program operates at its full potential.

    FOVA extends its gratitude to Congress for its continued commitment to the health and well-being of our veterans. The coalition looks forward to ongoing collaboration and support to make a lasting impact on the lives of those who have served our nation.


    For media inquiries please contact:

    Elizabeth Stout

    estout@navref.org


    About FOVA:

    The Friends of VA Medical Care and Health Research (FOVA) is a coalition comprised of more than 80 national academic, medical, and scientific societies, voluntary health and patient advocacy groups, as well as veteran-focused associations. FOVA is dedicated to advocating for robust funding and support for the Department of Veterans Affairs' Medical and Prosthetic Research Program.

  • 17 Jan 2024 10:00 AM | Elizabeth Stout (Administrator)

    The Senate voted on Tuesday night (1/16) in favor of the initial procedural step crucial to avoiding a partial government shutdown by the week's end.

    With a vote of 68-13, the chamber agreed to conclude discussions on the motion to proceed to the shell legislative framework for the stopgap spending measure. This measure is slated to extend until March 1 for four of the twelve annual appropriations bills and until March 8 for the remaining eight.

    Leadership in both chambers supports the stopgap measure, aiming to provide appropriators with additional time for negotiating the final fiscal 2024 appropriations bills. This comes in the wake of the $1.66 trillion topline agreement announced earlier this month by Speaker Mike Johnson, R-La., and Senate Majority Leader Charles E. Schumer, D-N.Y. Without the stopgap extension, budget authority for agencies covered by the Agriculture, Energy-Water, Military Construction-VA, and Transportation-HUD bills would expire after Friday, Jan. 19, as per current law.

    Currently, appropriators are engaged in negotiations on how the topline, encompassing $886.3 billion for defense and $772.7 billion for nondefense, will be allocated across the 12 annual appropriations bills. Senate Appropriations Chair Patty Murray, D-Wash., and House Appropriations Chairwoman Kay Granger, R-Texas, are actively involved in negotiating subcommittee allocations, a process originally expected to conclude last week.

  • 16 Jan 2024 1:00 PM | Elizabeth Stout (Administrator)

    The recently released short-term patch aims to sustain current spending rates for federal agencies through March 1 and March 8, maintaining the bifurcated deadline structure seen in the previous stopgap law.

    Under the existing interim funding measure, budget authority for federal agencies covered by Agriculture, Energy-Water, Military Construction-VA, and Transportation-HUD would otherwise expire after Friday, Jan. 19. The second deadline, pertaining to agencies funded by the remaining eight fiscal 2024 appropriations bills, is set for Feb. 2.

    Senate Majority Leader Charles E. Schumer, D-N.Y., has announced the commencement of the process to consider the new stopgap bill on Tuesday. A Senate vote, scheduled today for 5:30 p.m., aims to conclude the debate on the motion to proceed to the shell legislative vehicle for the continuing resolution. 

    Speaker Mike Johnson, R-La., initially reluctant towards short-term CRs, is facing pushback from conservatives regarding the $1.66 trillion topline spending deal with Schumer. Some conservatives argue for a longer CR, hoping that potential automatic funding cuts by April 30 could serve as leverage to reduce spending and secure policy concessions. Despite differing views, this ongoing situation underscores the complexities and negotiations surrounding federal funding.

    Please stay tuned for further updates, and feel free to reach out if you have any questions or concerns.

  • 10 Jan 2024 11:45 AM | Elizabeth Stout (Administrator)

    As we approach critical deadlines for federal budget negotiations, we want to provide you with a concise update on the latest developments on Capitol Hill:

    Stopgap Spending Bill Necessity: Lawmakers from both sides of the aisle have acknowledged the imperative need for a short-term stopgap spending bill. This temporary measure is deemed necessary to afford appropriators the time required to finalize fiscal year 2024 funding measures after a recent topline deal.

    Subcommittee Allocations Negotiations: Negotiations are currently underway between Senate Appropriations Chair Patty Murray (D-WA)  and House Appropriations Chairwoman Kay Granger (R-TX) regarding joint subcommittee allocations. The goal is to have these allocations finalized by Friday, January 12. Without these crucial numbers, the completion of the bills' drafting remains unattainable.

    Impending January 19 Deadline: As we approach the January 19 deadline, there is a growing urgency to pass funding for various agencies. Failure to pass either the full-year bills or a stopgap measure by this date would result in a partial lapse in funding for agencies such as Agriculture, Energy-Water, Military Construction-VA, and Transportation-HUD.

    Potential Lapse in Funding and Critical Functions: In the absence of a funding solution, there is a risk of a partial lapse in funding, affecting certain agency functions. However, critical functions, such as veterans' health care (due to advance funding) and public safety measures like air traffic control, are expected to continue.

    Speaker's Commitment and Potential CR: Speaker Mike Johnson has stated that the continuing resolution (CR) introduced in November would be the last short-term stopgap measure. Despite this commitment, the complexity of finalizing full-year appropriations may necessitate another short-term stopgap measure, potentially until March 1.


ADVOCACY THROUGH PARTNERSHIP.

Together with the Friends of VA Medical Care and Research, NAVREF works with a network of organizations to deliver our message to Congress.


FOVA activities including:

  • Developing recommendations for VA research funding
  • Monitoring the federal budget/appropriations process
  • Meeting with key House and Senate committee members and their staffs
  • Organizing congressional briefings
  •  Maintaining a roster of organizations that endorse FOVA’s funding recommendations
  • Recommending report language on topics of importance to VA research
  • Testifying before the appropriations subcommittees
  • Sending letters to members of Congress at key times during the budget/appropriations cycle

For up-to-date information on the funding needs of VA research and raising awareness of the VA research program, please go to the FOVA website: http://www.friendsofva.org.





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