Promoting research partnerships to improve veterans’ health

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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 Advocacy Agenda

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 a 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.

The VA Office of Research and Development contracted for a study of this issue that is scheduled for completion in September 2018.  While we hope the outcome of this study will be a more uniform approach to NPC administration of federal awards, we encourage Congress to closely monitor this issue.

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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  • 30 Jun 2017 9:37 AM | Hawk Tran (Administrator)

    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)

    on

    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


  • 8 Jun 2017 1:30 PM | Hawk Tran (Administrator)

    On Thursday, June 8th, NAVREF testified before members of Congress and sent a clear message to the House VA Committee's Oversight and Investigations Subcommittee that our relationship to VA was not only valuable, but highly beneficial to the continued success of the VA research program. NAVREF would like to appreciate the strong support from our members, especially our colleagues that took time from their busy schedules to join us in Washington, D.C. 

    Their presence showed Congress that we were united in our message, and it also represented our strength to the CRADO who joined our delegation for lunch. The hearing was another step forward to improved collaboration and communication with VACO, ORD, and all stakeholders who join us in our vision to provide veterans with the finest healthcare in the nation.

    Read the written testimony here

  • 16 May 2017 9:16 AM | Hawk Tran (Administrator)

    The Friends of VA Medical Care and Health Research (FOVA) held a Spring Capitol Hill Briefing on May 16th to present ongoing research and technologies to Congressional Staffers in two sessions. The event was moderated by Rick Starrs, NAVREF CEO, with remarks given by the CRADO, Dr. Rachel Ramoni and Dr. Patricia Dorn from ORD.

    Dr. Leigh Hochberg from the VA RR&D Center for Neurorestoration and Neurotechnology in Providence presented research into neural pathways between the brain and computers to communicate with writing programs as well as robotic limbs. He emphasized that with current Wi-Fi technologies, we may be close to neural implants that communicate with computer systems. Dr. Dustin Tyler from the VA RR&D Center for Advanced Platform Technology in Cleveland presented research into peripheral nerve interfaces for prosthetics that can deliver the sense of feeling and was joined by vet Keith. Dr. Goldish from the Minneapolis VA Health Care System Extended Care and Rehabilitation Service Line brought vet John along to help demonstrate the progress made with a mobile manual standing wheelchair and the need for further advancements, such as lighter materials. Dr. Ann Spungen from the VA RR&D Center for the Medical Consequences of Spinal Cord Injury at James J. Peters VAMC in Bronx, NY was joined by vet Luke and biomechanical engineer Pierre to demonstrate how an exoskeleton uses natural tilt to assist person with SCI in walking.

    Presenters expressed the need for VA support to continue their research as well as how much more these technologies can do to help veterans in the future. Staff members from the offices for Representatives Banks (R-IN), Coffman (R-CO), Grisham (D-NM), Lawson (D-FL), Palmer (R-6-AL), Veasey (D-TX), and Walorski (R-IN) attended the briefing sessions. Audience members also included members from Vietnam Veterans of America, ORD, OCLA, RR&D, AAMC, APA, IAVA, Academy Health, NAEVR, NAMI, SVAC, and the Senate Committee of Veterans Affairs.

    NAVREF is an executive member of the Friends of VA coalition.


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