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The Department of Veterans Affairs is proposing regulations to implement legislation authorizing VA to conduct a new, two-year grant program to fund eligible veterans services organizations (VSOs) to upgrade their community facilities, through construction or repair, to serve as complementary and integrative health self-care well-being (CIH W-B) centers to promote and expand CIH W-B programs. These regulations would specify grant eligibility criteria, the number of grants available, their maximum amount, constraints on the allocation and use of the funds, and other requirements necessary to implement this pilot grant program. These amendments are in accordance with the President’s priorities by advancing equity and support to underserved, vulnerable and marginalized communities.

Statement of Need:

The Consolidated Appropriations Act, 2018 (the Act). Pub. L. 115-141, 132 Stat. 825 (2018). Section 252 of the Act authorized VA to carry out a two-year pilot program of grants to nonprofit veterans services organizations (VSOs) recognized by the Secretary in accordance with section 5902 of title 38, United States Code (U.S.C.) in accordance with section 5902 of title 38, United States Code (U.S.C.) to upgrade, through construction or repair, VSO community facilities to serve as health and wellness centers to promote and expand complementary and integrative wellness programs.

Summary of the Legal Basis:

• On March 23, 2018, the President signed into law the Consolidated Appropriations Act, 2018 (the Act), Public Law (Pub. L.) 115-141, 132 Stat. 825 (2018). Section 252 of the Act authorized VA to carry out a two-year pilot program of grants to nonprofit veterans services organizations (VSOs) recognized by the Secretary in accordance with section 5902 of title 38, United States Code (U.S.C.) to upgrade, through construction or repair, VSO community facilities to serve as health and wellness centers to promote and expand complementary and integrative wellness programs. Section 252 of the Act is codified at 38 U.S.C. 1701 note. The Act provided limitations in administering this pilot grant program, including that no single grant may exceed $500,000 total, no more than 20 grants may be provided, the grant may not be used to purchase real estate or carry out repairs of facilities leased by the VSO or to construct facilities on property leased by the VSO, and that the grant funds must be used to construct or repair facilities located in at least 10 different geographic locations and are either in economically depressed areas or areas designated as highly rural that are not in close proximity to a VA medical center. 38 U.S.C. 1701 note. In this rulemaking, we propose to establish and implement this two-year program in part 64 of title 38, Code of Federal Regulations (CFR).

Alternatives:

The legislation defines that the Program shall be a 2-year pilot which will not exceed $5 million funding per fiscal year, for a total of $10 million for the duration. While a number of parts of the proposed rule are required by the statutory authority, we did have discretion in how we defined the complementary and integrative wellness programs that would be covered by this grant program. That term wasn’t defined in the law and we have decided to allow grants to upgrade facilities to promote, expand, and provide complementary and integrative health self-care well-being services which is consistent with established VA policy and practice. We could have defined it broader that that to include what we consider CIH treatment services, however, that could lead to issues of the safety and well-being of the veteran and would circumvent VHA’s community care program if we were to do so.

Anticipated Costs and Benefits:

VA has determined that there are transfers of $5 million in FY 2023 and $10 million over the 2-year window ending in FY 2024 based off the limits set forth in the legislation. Additionally, there are PRA costs, which are indicated below. This pilot program will have no costs beyond FY 2024.

Risks:

The risks would be non-compliance with statutory authority and/or not being able to provide benefits pursuant to our statutory authority.