[Appendix]
[Detailed Budget Estimates by Agency]
[Department of Health and Human Services, except Social Security]
[From the U.S. Government Printing Office, www.gpo.gov]
THE BUDGET FOR FISCAL YEAR 1998
[[Page 491]]
DEPARTMENT OF HEALTH AND HUMAN SERVICES
FOOD AND DRUG ADMINISTRATION
Federal Funds
General and special funds:
Salaries and Expenses
For necessary expenses of the Food and Drug Administration,
including hire and purchase of passenger motor vehicles; for rental of
special purpose space in the District of Columbia or elsewhere; and for
miscellaneous and emergency expenses of enforcement activities,
authorized and approved by the Secretary and to be accounted for solely
on the Secretary's certificate, not to exceed $25,000; [$907,499,000, of
which not to exceed $87,528,000 in fees pursuant to section 736 of the
Federal Food, Drug, and Cosmetic Act may be credited to this
appropriation and remain available until expended: Provided, That fees
derived from applications received during fiscal year 1997 shall be
subject to the fiscal year 1997 limitation: Provided further, That none
of these funds shall be used to develop, establish, or operate any
program of user fees authorized by 31 U.S.C. 9701] $750,922,000.
[In addition, fees pursuant to section 354 of the Public Health
Service Act may be credited to this account, to remain available until
expended.]
In addition, fees pursuant to section 801 of the Federal Food, Drug,
and Cosmetic Act may be credited to this account, to remain available
until expended.
Buildings and Facilities
For plans, construction, repair, improvement, extension, alteration,
and purchase of fixed equipment or facilities of or used by the Food and
Drug Administration, where not otherwise provided, [$21,350,000]
$22,900,000, to remain available until expended (7 U.S.C. 2209b).
Rental Payments (FDA)
(including transfers of funds)
For payment of space rental and related costs pursuant to Public Law
92-313 for programs and activities of the Food and Drug Administration
which are included in this Act, $46,294,000: Provided, That in the event
the Food and Drug Administration should require modification of space
needs, a share of the salaries and expenses appropriation may be
transferred to this appropriation, or a share of this appropriation may
be transferred to the salaries and expenses appropriation, but such
transfers shall not exceed 5 percent of the funds made available for
rental payments (FDA) to or from this account. (Agriculture, Rural
Development, Food and Drug Administration, and Related Agencies
Appropriations Act, 1997.)
Unavailable Collections (in millions of dollars)
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Identification code 75-9911-0-1-554 1996 actual 1997 est. 1998 est.
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Balance, start of year:
01.99 Balance, start of year............
Receipts:
02.01 User fees, FDA, legislative
proposal........................ 237
Appropriation:
05.01 Salaries and expenses, legislative
proposal........................ -237
07.99 Total balance, end of year........
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Program and Financing (in millions of dollars)
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Identification code 75-9911-0-1-554 1996 actual 1997 est. 1998 est.
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Obligations by program activity:
Direct program:
00.01 Foods........................... 201 200 174
00.02 Drugs........................... 326 329 296
00.03 Devices and radiological
products...................... 144 147 107
00.04 National center for
toxicological research........ 31 31 31
00.05 Tobacco......................... 5 5 34
00.06 Other activities................ 90 86 86
00.07 Other rent and rent related
activities.................... 22 23 23
00.08 Rental payments................. 46 46 46
00.09 Buildings and facilities........ 25 40 23
--------- --------- ----------
00.91 Total direct program.......... 890 907 820
01.01 Reimbursable program.............. 109 114 13
--------- --------- ----------
10.00 Total obligations............... 999 1,021 833
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Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... 67 58 39
22.00 New budget authority (gross)...... 986 1,002 833
22.22 Unobligated balance transferred
from other accounts............. 4 1
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 1,057 1,061 872
23.95 New obligations................... -999 -1,021 -833
24.40 Unobligated balance available, end
of year: Uninvested balance..... 58 39 39
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New budget authority (gross), detail:
Current:
40.00 Appropriation................... 877 888 820
Permanent:
68.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 109 114 13
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 986 1,002 833
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Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 279 290 273
73.10 New obligations................... 999 1,021 833
73.20 Total outlays (gross)............. -975 -1,032 -865
73.40 Adjustments in expired accounts... -13 -6
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 290 273 241
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Outlays (gross), detail:
86.90 Outlays from new current authority 682 684 631
86.93 Outlays from current balances..... 184 234 221
86.97 Outlays from new permanent
authority....................... 109 114 13
86.98 Outlays from permanent balances...
--------- --------- ----------
87.00 Total outlays (gross)........... 975 1,032 865
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Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -14 -11 -11
88.40 Non-Federal sources........... -95 -103 -2
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -109 -114 -13
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Net budget authority and outlays:
89.00 Budget authority.................. 877 888 820
90.00 Outlays........................... 866 918 852
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[In millions of dollars]
1996 1997 1998
Distribution of budget authority by
account:
Salaries and expenses............. 818 820 751
Rental payments (FDA)............. 46 46 46
Buildings and facilities.......... 12 21 23
Distribution of outlays by account:
Salaries and expenses............. 788 852 785
Rental payments (FDA)............. 66 49 46
Buildings and facilities.......... 12 17 21
Summary of Budget Authority and Outlays
(in millions of dollars)
1996 actual 1997 est. 1998 est.
Enacted/requested:
Budget Authority.................. 877 888 820
Outlays........................... 866 918 852
Legislative proposal, subject to
PAYGO:
Budget Authority.................. 237
Outlays........................... 237
------------------------------------
[[Page 492]]
Total:
Budget Authority.................. 877 888 1,057
Outlays........................... 866 918 1,089
====================================
The Food and Drug Administration (FDA) administers laws concerning
misbranded and adulterated foods, drugs, human biologics, medical
devices, cosmetics, and human-made sources of radiation. The Budget
includes $750.9 million for Salaries and Expenses, which includes
funding for new food safety initiatives and tobacco regulation. In
addition, the Budget includes $244 million for user fees, an increase of
$136 million in user fees over FY 1997, which will be used to finance
FDA activities. Of the $244 million in user fees, $237 million consists
of reauthorized and new user fees, which are represented in the
legislative proposal schedule. The buildings and facilities
appropriation of $22.9 million provides funds for projects related to
the repair, construction, alteration, and improvement of all buildings
and facilities of FDA, while the rental payments appropriation of $46.3
million provides funds for payment of GSA space rental and related
costs.
Comparable Presentation of Budget Authority Under New User Fee Policy
(in millions of dollars)
1996 actual 1997 est. 1998 est.
Enacted/requested:
Budget Authority.................. 877 888 820
User Fees collected/requested:
Budget Authority.................. 103 108 244
Total:
Budget Authority.................. 980 996 1,064
As shown in the table above, the total resources (budget authority
plus user fees) available to FDA increase from $996 million in FY 1997
to $1.06 billion in FY 1998, a six percent increase.
Object Classification (in millions of dollars)
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Identification code 75-9911-0-1-554 1996 actual 1997 est. 1998 est.
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Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 405 423 379
11.3 Other than full-time permanent 28 30 27
11.5 Other personnel compensation.. 16 17 15
--------- --------- ----------
11.9 Total personnel compensation 449 470 421
12.1 Civilian personnel benefits..... 98 102 91
21.0 Travel and transportation of
persons....................... 17 16 12
22.0 Transportation of things........ 1 1 1
23.1 Rental payments to GSA.......... 42 42 42
23.2 Rental payments to others....... 6 6 4
23.3 Communications, utilities, and
miscellaneous charges......... 23 21 16
24.0 Printing and reproduction....... 3 3 2
25.1 Advisory and assistance services 10 7 5
25.2 Other services.................. 28 51 83
25.3 Purchases of goods and services
from Government accounts...... 49 35 25
25.4 Operation and maintenance of
facilities.................... 24 21 16
25.5 Research and development
contracts..................... 30 28 20
25.7 Operation and maintenance of
equipment..................... 34 25 17
26.0 Supplies and materials.......... 19 18 13
31.0 Equipment....................... 34 32 23
32.0 Land and structures............. 1 10 15
41.0 Grants, subsidies, and
contributions................. 20 18 13
42.0 Insurance claims and indemnities 2 1 1
--------- --------- ----------
99.0 Subtotal, direct obligations.. 890 907 820
99.0 Reimbursable obligations.......... 109 114 13
--------- --------- ----------
99.9 Total obligations............... 999 1,021 833
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Personnel Summary
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Identification code 75-9911-0-1-554 1996 actual 1997 est. 1998 est.
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Direct:
Total compensable workyears:
1001 Full-time equivalent employment. 8,459 8,475 7,353
1005 Full-time equivalent of overtime
and holiday hours............. 87 87 87
Reimbursable:
2001 Total compensable workyears: Full-
time equivalent employment...... 671 663 28
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Salaries and Expenses
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
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Identification code 75-9911-4-1-554 1996 actual 1997 est. 1998 est.
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Obligations by program activity:
Direct program:
00.01 Foods........................... 47
00.02 Drugs........................... 131
00.03 Devices and radiological
products...................... 59
--------- --------- ----------
10.00 Total obligations............... 237
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Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 237
23.95 New obligations................... -237
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New budget authority (gross), detail:
40.25 Appropriation (special fund,
indefinite)..................... 237
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Change in unpaid obligations:
73.10 New obligations................... 237
73.20 Total outlays (gross)............. -237
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 237
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 237
90.00 Outlays........................... 237
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This legislative proposal seeks $237 million in user fees to finance
FDA activities. These user fees build upon the successful implementation
of the Prescription Drug User Fee Act (PDUFA) of 1992, which authorized
the collection of fees paid by the pharmaceutical industry to expedite
FDA's review of human drug applications and the Mammography Quality
Standards Act (MQSA), which authorized the collection of fees for the
inspection of mammography facilities. The Budget includes continued
collection of PDUFA and MQSA fees, as well as fees for medical device
reviews, animal drug approvals, import inspections, food additive
petition reviews, generic/over-the-counter drug applications, and fees
for postmarket surveillance of products.
This is one of several proposals in the budget to charge fees to
users directly availing themselves of, or subject to, a government
service, program, or activity, in order to cover the government's costs.
Legislation will be proposed to authorize the fees and, upon enactment
of the authorization, a budget amendment to the current appropriations
language will be proposed to make the fees available for expenditure.
Because the current requirements of the Budget Enforcement Act of 1990
make it difficult to fund discretionary programs with receipts that are
not authorized in appropriations acts, the Administration is proposing a
change in the requirements to facilitate the enactment of proposals such
as this one.
Object Classification (in millions of dollars)
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Identification code 75-9911-4-1-554 1996 actual 1997 est. 1998 est.
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Personnel compensation:
11.1 Full-time permanent............. 128
[[Page 493]]
11.3 Other than full-time permanent.. 5
--------- --------- ----------
11.9 Total personnel compensation.. 133
12.1 Civilian personnel benefits....... 28
21.0 Travel and transportation of
persons......................... 4
23.1 Rental payments to GSA............ 1
23.3 Communications, utilities, and
miscellaneous charges........... 4
24.0 Printing and reproduction......... 1
25.1 Advisory and assistance services.. 3
25.2 Other services.................... 18
25.3 Purchases of goods and services
from Government accounts........ 7
25.4 Operation and maintenance of
facilities...................... 4
25.5 Research and development contracts 11
25.7 Operation and maintenance of
equipment....................... 9
26.0 Supplies and materials............ 4
31.0 Equipment......................... 10
--------- --------- ----------
99.9 Total obligations............... 237
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Personnel Summary
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Identification code 75-9911-4-1-554 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
1001 Total compensable workyears: Full-
time equivalent employment...... 1,757
---------------------------------------------------------------------------
Public enterprise funds:
Revolving Fund for Certification and Other Services
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4309-0-3-554 1996 actual 1997 est. 1998 est.
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Obligations by program activity:
00.01 Color additives................... 3 3 3
00.02 Insulin........................... 1 1 1
--------- --------- ----------
10.00 Total obligations............... 4 4 4
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Budgetary resources available for obligation:
21.90 Unobligated balance available,
start of year: Fund balance..... 3 4 4
22.00 New budget authority (gross)...... 5 5 5
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 8 9 9
23.95 New obligations................... -4 -4 -4
24.90 Unobligated balance available, end
of year: Fund balance........... 4 4 5
----------------------------------------------------------------------------
New budget authority (gross), detail:
68.00 Spending authority from offsetting
collections (gross): Offsetting
collections (cash).............. 5 5 5
----------------------------------------------------------------------------
Change in unpaid obligations:
72.90 Unpaid obligations, start of year:
Obligated balance: Fund balance. 1 1
73.10 New obligations................... 4 4 4
73.20 Total outlays (gross)............. -4 -5 -5
74.90 Unpaid obligations, end of year:
Obligated balance: Fund balance. 1
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new permanent
authority....................... 4 5 5
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.40 Offsetting collections (cash)
from: Non-Federal sources..... -5 -5 -5
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................
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FDA certifies batches of insulin and color additives for use in
foods, drugs, and cosmetics. It also lists color additives for use in
foods, drugs, medical devices, and cosmetics (21 U.S.C. 346a, 356, 357,
376). These services are financed wholly by fees paid by the industries
affected.
Object Classification (in millions of dollars)
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Identification code 75-4309-0-3-554 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
11.1 Personnel compensation: Full-time
permanent....................... 2 2 2
12.1 Civilian personnel benefits....... 1 1 1
23.1 Rental payments to GSA............ 1 1 1
99.0 Subtotal, reimbursable obligations 4 4 4
--------- --------- ----------
99.9 Total obligations............... 4 4 4
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Personnel Summary
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Identification code 75-4309-0-3-554 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
2001 Total compensable workyears: Full-
time equivalent employment...... 42 42 42
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HEALTH RESOURCES AND SERVICES ADMINISTRATION
Federal Funds
General and special funds:
Health Resources and Services
For carrying out titles II, III, VII, VIII, X, XII, XVI, XIX, and
XXVI of the Public Health Service Act, section 427(a) of the Federal
Coal Mine Health and Safety Act, title V of the Social Security Act, the
Health Care Quality Improvement Act of 1986, as amended, and the Native
Hawaiian Health Care Act of 1988, as amended, [$3,405,019,000]
$3,266,479,000, of which [$297,000] $225,000 shall remain available
until expended for interest subsidies on loan guarantees made prior to
fiscal year 1981 under part B of title VII of the Public Health Service
Act: Provided, That the Division of Federal Occupational Health may
utilize personal services contracting to employ professional management/
administrative and occupational health professionals: Provided further,
That of the funds made available under this heading, [$828,000] $500,000
shall be available until expended for facilities renovations at the
Gillis W. Long Hansen's Disease Center: Provided further, That in
addition to fees authorized by section 427(b) of the Health Care Quality
Improvement Act of 1986, fees shall be collected for the full disclosure
of information under the Act sufficient to recover the full costs of
operating the National Practitioner Data Bank, and shall remain
available until expended to carry out that Act: Provided further, That
no more than $5,000,000 is available for carrying out the provisions of
Public Law 104-73: [Provided further, That of the funds made available
under this heading, $198,452,000 shall be for the program under title X
of the Public Health Service Act to provide for voluntary family
planning projects: Provided further, That amounts provided to said
projects under such title shall not be expended for abortions, that all
pregnancy counseling shall be nondirective, and that such amounts shall
not be expended for any activity (including the publication or
distribution of literature) that in any way tends to promote public
support or opposition to any legislative proposal or candidate for
public office:] Provided further, That $167,000,000 shall be for State
AIDS Drug Assistance Programs authorized by section 2616 of the Public
Health Service Act [and shall be distributed to States as authorized by
section 2618(b)(2) of such Act]: Provided further, That notwithstanding
any other provision of law, funds made available under this heading may
be used to continue operating the Council on Graduate Medical Education
established by section 301 of Public law 102-408: Provided further,
That[, of the funds made available under this heading, not more than
$8,000,000 shall be made available and shall remain available until
expended for loan guarantees for loans made by non-Federal lenders for
the construction, renovation, and modernization of medical facilities
that are owned and operated by health centers funded under part A of
title XVI of the Public Health Service Act as amended, and, subject to
authorization, for loans made to health centers for the costs of
developing and operating managed care networks or plans, and that such
funds be available to subsidize guarantees of total loan principal in an
amount not to exceed $80,000,000: Provided further, That notwithstanding
section 502(a)(1) of the Social Security Act, not to exceed $103,609,000
is available for carrying out special projects of regional and national
significance pursuant to section 501(a)(2) of such Act] user fees to be
collected by the Secretary pursuant to 31 U.S.C. 9701 related to
[[Page 494]]
activities authorized by section 340B(a)(8) of the Public Health Service
Act shall be available to fund such activities and shall remain
available until expended. (Department of Health and Human Services
Appropriations Act, 1997.)
Program and Financing (in millions of dollars)
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Identification code 75-0350-0-1-550 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.01 Consolidated health centers..... 753 791 805
00.02 National Health Service Corps... 37 37 37
00.03 National Health Service Corps
recruitment................... 75 78 78
00.04 Hansen's disease center......... 17 17
00.05 Payment to Hawaii for the
treatment of Hansen's disease. 2 2
00.06 Buildings and facilities........ 1 1
00.07 Hansen's disease services
cluster....................... 17
00.08 Black lung clinics.............. 4 4 2
00.09 Alzheimer's demonstration grants 4 6
00.10 Nursing loan repayment.......... 2 2
00.11 Health professions curriculum
assistance.................... 257 290
00.12 Health professions clusters..... 130
00.13 Maternal and child health block
grant......................... 678 681 681
00.14 Healthy start................... 93 96 96
00.15 Emergency medical services for
children...................... 11 13 12
00.16 Organ transplantation........... 2 2 4
00.17 Bone marrow donor registry...... 15 15 15
00.18 Health care facilities.......... 18 13
00.19 Family planning................. 193 198 203
00.20 Program management.............. 112 113 111
00.21 Rural health policy development. 11 9 9
00.22 Rural health outreach........... 28 28 25
00.23 HIV............................. 757 996 1,036
00.24 Malpractice claims fund......... 1 1
00.25 LA emergency funds.............. 4
00.26 Abstinence education............ 50
00.27 Other HRSA programs............. 1 2
00.28 CHC loan guarantee program
account....................... 5 1
--------- --------- ----------
00.91 Total direct program.......... 3,075 3,400 3,313
01.01 Reimbursable obligations (cash)... 140 81 79
--------- --------- ----------
10.00 Total obligations............... 3,215 3,481 3,392
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... 22 29 27
22.00 New budget authority (gross)...... 3,218 3,479 3,392
22.22 Unobligated balance transferred
from other accounts............. 4
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 3,244 3,508 3,419
23.95 New obligations................... -3,215 -3,481 -3,392
24.40 Unobligated balance available, end
of year: Uninvested balance..... 29 27 28
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New budget authority (gross), detail:
Current:
40.00 Appropriation................... 3,077 3,405 3,266
Permanent:
60.00 Appropriation................... 50
68.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 141 74 76
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 3,218 3,479 3,392
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Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 3,053 2,299 2,454
73.10 New obligations................... 3,215 3,481 3,392
73.20 Total outlays (gross)............. -3,966 -3,326 -3,413
73.40 Adjustments in expired accounts... -3
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 2,299 2,454 2,431
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 1,271 1,362 1,306
86.93 Outlays from current balances..... 2,554 1,890 2,011
86.97 Outlays from new permanent
authority....................... 141 74 96
--------- --------- ----------
87.00 Total outlays (gross)........... 3,966 3,326 3,413
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -133 -68 -68
88.40 Non-Federal sources........... -8 -6 -8
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -141 -74 -76
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 3,077 3,405 3,316
90.00 Outlays........................... 3,825 3,252 3,337
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[Dollars in millions]
1996 1997 1998
Distribution of budget authority by
account:
Health resources and services..... 3,072 3,400 3,311
Health centers malpractice claims. 5 5 5
Distribution of outlays by account:
Health resources and services..... 3,820 3,247 3,332
Health centers malpractice claims. 5 5 5
Status of Direct Loans (in millions of dollars)
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Identification code 75-0350-0-1-550 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Cumulative balance of direct loans
outstanding:
1210 Outstanding, start of year........ 798 800 800
1231 Disbursements: Direct loan
disbursements................... 25 20
1251 Repayments: Repayments and
prepayments..................... -18 -18 -18
Write-offs for default:
1263 Direct loans.................... -1 -1 -1
1264 Other adjustments, net.......... -4 -1 -1
--------- --------- ----------
1290 Outstanding, end of year........ 800 800 780
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Status of Guaranteed Loans (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0350-0-1-550 1996 actual 1997 est. 1998 est.
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Position with respect to appropriations act
limitation on commitments:
2111 Limitation on guaranteed loans
made by private lenders......... 80
--------- --------- ----------
2150 Total guaranteed loan
commitments................... 80
----------------------------------------------------------------------------
Cumulative balance of guaranteed loans
outstanding:
2210 Outstanding, start of year........ 10 10 76
2231 Disbursements of new guaranteed
loans........................... 67 13
2251 Repayments and prepayments........ -1
--------- --------- ----------
2290 Outstanding, end of year........ 10 76 89
----------------------------------------------------------------------------
Memorandum:
2299 Guaranteed amount of guaranteed
loans outstanding, end of year.. 10 76 89
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Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in
millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0350-0-1-550 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Guaranteed loan levels supportable by subsidy
budget authority:
2150 Loan guarantee levels............. 23 5
2150 Loan guarantee levels............. 22 4
2150 Loan guarantee levels............. 22 4
--------- --------- ----------
2159 Total loan guarantee levels..... 67 13
Guaranteed loan subsidy (in percent):
2320 Subsidy rate...................... 5.41 5.41
2320 Subsidy rate...................... 13.26 13.26
2320 Subsidy rate...................... 4.35 4.35
--------- --------- ----------
2329 Weighted average subsidy rate... 7.67 7.67
Guaranteed loan subsidy budget authority:
2330 Subsidy budget authority.......... 2 1
2330 Subsidy budget authority.......... 1
2330 Subsidy budget authority.......... 2
--------- --------- ----------
2339 Total subsidy budget authority.. 5 1
Guaranteed loan subsidy outlays:
2340 Subsidy outlays................... 2 1
2340 Subsidy outlays................... 1
2340 Subsidy outlays................... 2
--------- --------- ----------
2349 Total subsidy outlays........... 5 1
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[[Page 495]]
Activities displayed here support categorical health resources and
services grants and the Medical Malpractice Claims Fund, which pays
malpractice claims filed against employees of federally-supported health
centers.
Object Classification (in millions of dollars)
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Identification code 75-0350-0-1-550 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 87 91 93
11.3 Other than full-time permanent 2 2 2
11.5 Other personnel compensation.. 4 3 3
--------- --------- ----------
11.9 Total personnel compensation 93 96 98
12.1 Civilian personnel benefits..... 22 22 23
13.0 Benefits for former personnel... 1 1
21.0 Travel and transportation of
persons....................... 2 2 2
23.1 Rental payments to GSA.......... 7 8 9
23.3 Communications, utilities, and
miscellaneous charges......... 4 4 4
24.0 Printing and reproduction....... 1 1 1
25.1 Advisory and assistance services 10 11 14
25.2 Other services.................. 39 37 36
25.3 Purchases of goods and services
from Government accounts...... 67 73 62
26.0 Supplies and materials.......... 2 2 2
31.0 Equipment....................... 2 3 3
41.0 Grants, subsidies, and
contributions................. 2,825 3,139 3,058
42.0 Insurance claims and indemnities 1 1
--------- --------- ----------
99.0 Subtotal, direct obligations.. 3,075 3,400 3,313
99.0 Reimbursable obligations.......... 140 81 79
--------- --------- ----------
99.9 Total obligations............... 3,215 3,481 3,392
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Personnel Summary
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Identification code 75-0350-0-1-550 1996 actual 1997 est. 1998 est.
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Direct:
Total compensable workyears:
1001 Full-time equivalent employment. 1,534 1,563 1,563
1005 Full-time equivalent of overtime
and holiday hours............. 10 10 10
1011 Exempt Full-time equivalent
employment.................... 145 137 137
Reimbursable:
2001 Total compensable workyears: Full-
time equivalent employment...... 304 170 170
Allocation account:
3001 Total compensable workyears: Full-
time equivalent employment...... 3 3 3
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Vaccine Injury Compensation
[For payment of claims resolved by the United States Court of
Federal Claims related to the administration of vaccines before October
1, 1988, $110,000,000, to remain available until expended.] (Department
of Health and Human Services Appropriations Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0320-0-1-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
10.00 Total obligations (object class
42.0)........................... 74 75 75
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... 69 106 141
22.00 New budget authority (gross)...... 110 110
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 179 216 141
23.95 New obligations................... -74 -75 -75
24.40 Unobligated balance available, end
of year: Uninvested balance..... 106 141 68
----------------------------------------------------------------------------
New budget authority (gross), detail:
40.05 Appropriation (indefinite)........ 110 110
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 2 7
73.10 New obligations................... 74 75 75
73.20 Total outlays (gross)............. -76 -68 -68
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 7 14
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 5
86.93 Outlays from current balances..... 71 68 68
--------- --------- ----------
87.00 Total outlays (gross)........... 76 68 68
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 110 110
90.00 Outlays........................... 76 68 68
---------------------------------------------------------------------------
The Vaccine Improvement Program was established pursuant to Public
Law 99-660 and Public Law 100-203, and serves as a source of funds to
pay claims for compensation for vaccine related injury or death. Payment
of claims associated with vaccine related injury or death occurring
before October 1, 1988 are financed from the General Fund and are
reflected in this account. Given sufficient carry-over funds from prior
years' appropriations to pay for the balance of the pre-1988 backlog of
claims yet to be adjudicated, no appropriation is requested in FY 1998
to cover payment of pre-1988 claims. Payment of claims associated with
vaccine related injury or death occurring after October 1, 1988 are
reflected in the Vaccine Improvement Trust Fund account.
Credit accounts:
Health Center Guaranteed Loan Financing Account
Status of Guaranteed Loans (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4442-0-3-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Position with respect to appropriations act
limitation on commitments:
2111 Limitation on guaranteed loans
made by private lenders......... 80
--------- --------- ----------
2150 Total guaranteed loan
commitments................... 80
----------------------------------------------------------------------------
Cumulative balance of guaranteed loans
outstanding:
2210 Outstanding, start of year........ 67
2231 Disbursements of new guaranteed
loans........................... 67 7
2261 Adjustments: Terminations for
default that result in loans
receivable...................... -1
--------- --------- ----------
2290 Outstanding, end of year........ 67 73
----------------------------------------------------------------------------
Memorandum:
2299 Guaranteed amount of guaranteed
loans outstanding, end of year.. 67 73
----------------------------------------------------------------------------
Addendum:
Cumulative balance of defaulted guaranteed
loans that result in loans receivable:
2310 Outstanding, start of year......
2331 Disbursements for guaranteed
loan claims................... 1
2351 Repayments of loans receivable..
--------- --------- ----------
2390 Outstanding, end of year...... 1
---------------------------------------------------------------------------
P.L. 104-299 and P.L. 104-208 authorize HRSA to guarantee up to $80
million in private loans to Health Centers for the costs of developing
and operating managed care networks or plans and for the construction,
renovation and modernization of medical facilities. Since this new
program will not begin to operate until late into FY 1997, HRSA will use
this $80 million loan guarantee limit over FY 1997 and FY 1998. As
required by the Federal Credit Reform Act of 1990, this Financing
Account records all cash flows to and from the Government resulting from
the Health Center Loan Guarantee Program. The Program Account for this
activity is displayed in the Health Resources and Services account (75-
0350) as a line in the Program and Financing Schedule.
[[Page 496]]
Balance Sheet (in millions of dollars)
-----------------------------------------------------------------------------------------------
Identification code 75-4442-0-3-551 1995 actual 1996 actual 1997 est. 1998 est.
-----------------------------------------------------------------------------------------------
ASSETS:
Investments in US securities:
1106 Federal assets: Receivables, net 80
Net value of assets related to
post-1991 acquired defaulted
guaranteed loans receivable:
1501 Defaulted guaranteed loans
receivable, gross............. 1
------------ -------------- ------------ -------------
1599 Net present value of assets
related to defaulted
guaranteed loans............ 1
------------ -------------- ------------ -------------
1999 Total assets.................... 80 1
LIABILITIES:
2204 Non-Federal liabilities:
Liabilities for loan guarantees. 80
------------ -------------- ------------ -------------
2999 Total liabilities............... 80
------------ -------------- ------------ -------------
4999 Total liabilities and net position 80
-----------------------------------------------------------------------------------------------
Health [Education Assistance Loans Program] Professions Graduate Student
Loan Insurance Program Account
For the cost of guaranteed loans, such sums as may be necessary to
carry out the purpose of the program, as authorized by title VII of the
Public Health Service Act, as amended: Provided, That such costs,
including the cost of modifying such loans, shall be as defined in
section 502 of the Congressional Budget Act of 1974: Provided further,
That these funds are available to subsidize gross obligations for the
total loan principal any part of which is to be guaranteed at not to
exceed [$140,000,000] $85,000,000. In addition, for administrative
expenses to carry out the guaranteed loan program, $2,688,000.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0340-0-1-552 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.02 Guaranteed loan subsidy........... 1
00.09 Administrative expenses subject to
limitation...................... 4 3 4
--------- --------- ----------
10.00 Total obligations............... 4 3 5
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 4 3 5
23.95 New obligations................... -4 -3 -5
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
40.00 Appropriation................... 3 3 3
Permanent:
60.05 Appropriation (indefinite)...... 1
62.00 Transferred from other accounts. 1 1
--------- --------- ----------
63.00 Appropriation (total)......... 1 2
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 4 3 5
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 1 2
73.10 New obligations................... 4 3 5
73.20 Total outlays (gross)............. -3 -5 -5
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 2
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 3 3 3
86.97 Outlays from new permanent
authority....................... 2
86.98 Outlays from permanent balances... 2
--------- --------- ----------
87.00 Total outlays (gross)........... 3 5 5
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 4 3 5
90.00 Outlays........................... 3 5 5
---------------------------------------------------------------------------
Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in
millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0340-0-1-552 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Guaranteed loan levels supportable by subsidy
budget authority:
2150 Loan guarantee levels............. 210 140 85
--------- --------- ----------
2159 Total loan guarantee levels..... 210 140 85
Guaranteed loan subsidy (in percent):
2320 Subsidy rate...................... 0.34 0.34 1.09
--------- --------- ----------
2329 Weighted average subsidy rate... 0.34 0.34 1.09
Guaranteed loan subsidy budget authority:
2330 Subsidy budget authority.......... 1 1
--------- --------- ----------
2339 Total subsidy budget authority.. 1 1
Guaranteed loan subsidy outlays:
2340 Subsidy outlays................... 1 1
--------- --------- ----------
2349 Total subsidy outlays........... 1 1
---------------------------------------------------------------------------
The Health Education Assistance Loan (HEAL) program guarantees loans
from private lenders to health professions students to help pay for the
costs of their training. As required by the Federal Credit Reform Act of
1990, this account records, for the HEAL program, the subsidy costs
associated with HEAL loan guarantees committed in 1992 and beyond
(including modifications of HEAL loan guarantees that resulted from
obligations or commitments in any year), as well as administrative
expenses of the program. The subsidy amounts are estimated on a present
value basis; the administrative expenses are estimated on a cash basis.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0340-0-1-552 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
11.1 Personnel compensation: Full-time
permanent....................... 2 2 2
25.2 Other services.................... 2 1 2
41.0 Grants, subsidies, and
contributions................... 1
--------- --------- ----------
99.9 Total obligations............... 4 3 5
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0340-0-1-552 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Total compensable workyears:
1001 Full-time equivalent employment... 20 20 20
1011 Exempt Full-time equivalent
employment...................... 6 6 6
---------------------------------------------------------------------------
Health Professions Graduate Student Loan Guaranteed Loan Financing
Account
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4304-0-3-552 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
10.00 Total obligations................. 6 7 11
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.90 Unobligated balance available,
start of year: Fund balance..... 202 226 250
22.00 New financing authority (gross)... 30 31 27
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 232 257 277
23.95 New obligations................... -6 -7 -11
24.90 Unobligated balance available, end
of year: Fund balance........... 226 250 268
----------------------------------------------------------------------------
New financing authority (gross), detail:
61.00 Transferred to other accounts..... -1 -1
68.00 Spending authority from offsetting
collections: Offsetting
collections (cash).............. 31 31 28
--------- --------- ----------
[[Page 497]]
70.00 Total new financing authority
(gross)....................... 30 31 27
----------------------------------------------------------------------------
Change in unpaid obligations:
73.10 New obligations................... 6 7 11
73.20 Total financing disbursements
(gross)......................... -6 -7 -11
87.00 Total financing disbursements
(gross)......................... 6 7 11
----------------------------------------------------------------------------
Offsets:
Against gross financing authority and
financing disbursements:
Offsetting collections (cash)
from:
88.00 Federal sources............... -1
88.25 Interest on uninvested funds.. -15 -20 -21
Non-Federal sources:
88.40 Premium income.............. -16 -10 -5
88.40 Recoveries of defaulted
loans..................... -1
88.40 Below threshold............. -1
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -31 -31 -28
----------------------------------------------------------------------------
Net financing authority and financing
disbursements:
89.00 Financing authority............... -1 -1
90.00 Financing disbursements........... -25 -24 -17
---------------------------------------------------------------------------
Status of Guaranteed Loans (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4304-0-3-552 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Position with respect to appropriations act
limitation on commitments:
2111 Limitation on guaranteed loans
made by private lenders......... 210 140 85
--------- --------- ----------
2150 Total guaranteed loan
commitments................... 210 140 85
----------------------------------------------------------------------------
Cumulative balance of guaranteed loans
outstanding:
2210 Outstanding, start of year........ 1,163 1,366 1,498
2231 Disbursements of new guaranteed
loans........................... 210 140 85
Adjustments:
2261 Terminations for default that
result in loans receivable.... -6 -7 -11
2263 Terminations for default that
result in claim payments...... -1 -1 -1
--------- --------- ----------
2290 Outstanding, end of year........ 1,366 1,498 1,571
----------------------------------------------------------------------------
Memorandum:
2299 Guaranteed amount of guaranteed
loans outstanding, end of year.. 1,366 1,498 1,571
----------------------------------------------------------------------------
Addendum:
Cumulative balance of defaulted guaranteed
loans that result in loans receivable:
2310 Outstanding, start of year...... 1 7 14
2331 Disbursements for guaranteed
loan claims................... 6 7 11
2351 Repayments of loans receivable.. -1
--------- --------- ----------
2390 Outstanding, end of year...... 7 14 24
---------------------------------------------------------------------------
As required by the Federal Credit Reform Act of 1990, this non-
budgetary account records all cash flows to and from the Government
resulting from Health Education Assistance Loan (HEAL) guarantees
committed in 1992 and beyond (including modifications of loan guarantees
that resulted from commitments in any year). The amounts in this account
are a means of financing and are not included in the budget totals.
Balance Sheet (in millions of dollars)
-----------------------------------------------------------------------------------------------
Identification code 75-4304-0-3-552 1995 actual 1996 actual 1997 est. 1998 est.
-----------------------------------------------------------------------------------------------
ASSETS:
Federal assets:
1101 Fund balances with Treasury..... 153 202 226 250
Investments in US securities:
1106 Receivables, net.............. 22 1
Non-Federal assets:
1201 Investments in non-Federal
securities, net............... 11 15 20 21
1206 Receivables, net................ 19 15 11 5
------------ -------------- ------------ -------------
1999 Total assets.................... 205 232 257 277
LIABILITIES:
2204 Non-Federal liabilities:
Liabilities for loan guarantees. 1,163 1,366 1,498 1,571
------------ -------------- ------------ -------------
2999 Total liabilities............... 1,163 1,366 1,498 1,571
NET POSITION:
3300 Cumulative results of operations.. -958 -1,134 -1,241 -1,294
------------ -------------- ------------ -------------
3999 Total net position.............. -958 -1,134 -1,241 -1,294
------------ -------------- ------------ -------------
4999 Total liabilities and net position 205 232 257 277
-----------------------------------------------------------------------------------------------
Health Professions Graduate Student Loan Insurance Fund Liquidating
Account
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4305-0-3-552 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Operating expenses: death and
disability...................... 5 7 8
00.02 Capital investment................ 38 55 39
00.03 Collection costs.................. 1 2 2
00.04 Consolidation transfers........... 6 1
--------- --------- ----------
10.00 Total obligations............... 44 70 50
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.90 Unobligated balance available,
start of year: Fund balance..... 24 12
22.00 New budget authority (gross)...... 33 58 51
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 57 70 51
23.95 New obligations................... -44 -70 -50
24.90 Unobligated balance available, end
of year: Fund balance........... 12
----------------------------------------------------------------------------
New budget authority (gross), detail:
60.05 Appropriation (indefinite)........ 13 38 30
68.00 Spending authority from offsetting
collections: Offsetting
collections (cash).............. 20 20 21
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 33 58 51
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 4 8
73.10 New obligations................... 44 70 50
73.20 Total outlays (gross)............. -40 -78 -51
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 8
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new permanent
authority....................... 13 58 51
86.98 Outlays from permanent balances... 27 20
--------- --------- ----------
87.00 Total outlays (gross)........... 40 78 51
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.40 Offsetting collections (cash)
from: Non-Federal sources..... -20 -20 -21
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 13 38 30
90.00 Outlays........................... 20 58 30
---------------------------------------------------------------------------
Status of Guaranteed Loans (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4305-0-3-552 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Cumulative balance of guaranteed loans
outstanding:
2210 Outstanding, start of year........ 1,620 1,549 1,454
2251 Repayments and prepayments........ -43 -48 -52
Adjustments:
2261 Terminations for default that
result in loans receivable.... -24 -35 -25
2263 Terminations for default that
result in claim payments...... -3 -4 -5
2264 Other adjustments, net.......... -1 -8 -3
--------- --------- ----------
2290 Outstanding, end of year........ 1,549 1,454 1,369
----------------------------------------------------------------------------
[[Page 498]]
Memorandum:
2299 Guaranteed amount of guaranteed
loans outstanding, end of year.. 1,549 1,454 1,368
----------------------------------------------------------------------------
Addendum:
Cumulative balance of defaulted guaranteed
loans that result in loans receivable:
2310 Outstanding, start of year...... 388 422 480
2331 Disbursements for guaranteed
loan claims................... 38 55 39
2351 Repayments of loans receivable.. -6 -6 -6
2361 Write-offs of loans receivable.. 9 9 9
2364 Other adjustments, net.......... -7
--------- --------- ----------
2390 Outstanding, end of year...... 422 480 522
---------------------------------------------------------------------------
\1\ Includes carryover commitments from prior years.
Note.--The adjustment to loans receivable represents interest, which
had not previously been reflected in cumulative outstanding balances.
As required by the Federal Credit Reform Act of 1990, this account
records, for the Health Education Assistance Loan program (HEAL), all
cash flows to and from the Government resulting from HEAL loan
guarantees committed prior to 1992. This account is shown on a cash
basis. All new activity in this program in 1992 and beyond (including
modifications of loan guarantees that resulted from obligations or
commitments in any year) is recorded in corresponding program and
financing accounts.
DATA ON LOANS
1996 actual 1997 est. 1998 est.
Dollar volume of loans insured ($ in
millions)........................... 209 140 85
Number of students.................. 18,422 12,727 7,727
Average value of loans.............. 11,324 11,000 11,000
Statement of Operations (in millions of dollars)
-----------------------------------------------------------------------------------------------
Identification code 75-4305-0-3-552 1995 actual 1996 actual 1997 est. 1998 est.
-----------------------------------------------------------------------------------------------
0101 Revenue........................... 87 80 82 50
0102 Expense........................... -36 -44 -70 -50
------------ -------------- ------------ -------------
0109 Net loss.......................... 51 36 12
-----------------------------------------------------------------------------------------------
Balance Sheet (in millions of dollars)
-----------------------------------------------------------------------------------------------
Identification code 75-4305-0-3-552 1995 actual 1996 actual 1997 est. 1998 est.
-----------------------------------------------------------------------------------------------
ASSETS:
1101 Federal assets: Fund balances with
Treasury........................ 20 12
Net value of assets related to
pre-1992 direct loans
receivable and acquired
defaulted guaranteed loans
receivable:
1701 Defaulted guaranteed loans,
gross......................... 388 422 480 522
1702 Interest receivable............. 5 6 6 6
1703 Allowance for estimated
uncollectible loans and
interest (-).................. -3 -7
1704 Defaulted guaranteed loans and
interest receivable, net...... 390 421 486 528
------------ -------------- ------------ -------------
1799 Value of assets related to
loan guarantees............. 390 421 486 528
1801 Other Federal assets: Cash and
other monetary assets........... 37 44 70 50
------------ -------------- ------------ -------------
1999 Total assets.................... 447 477 556 578
LIABILITIES:
2104 Federal liabilities: Resources
payable to Treasury............. 4 5 6 6
2201 Non-Federal liabilities: Accounts
payable......................... 33 38 55 39
------------ -------------- ------------ -------------
2999 Total liabilities............... 37 43 61 45
NET POSITION:
3300 Cumulative results of operations.. 410 434 495 533
------------ -------------- ------------ -------------
3999 Total net position.............. 410 434 495 533
------------ -------------- ------------ -------------
4999 Total liabilities and net position 447 477 556 578
-----------------------------------------------------------------------------------------------
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4305-0-3-552 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
25.2 Other services.................... 1 8 3
42.0 Insurance claims and indemnities.. 43 62 47
--------- --------- ----------
99.9 Total obligations............... 44 70 50
---------------------------------------------------------------------------
Health Loan Funds
Medical Facilities Guarantee and Loan Fund
federal interest subsidies for medical facilities
For carrying out subsections (d) and (e) of section 1602 of the
Public Health Service Act, [$7,000,000] $6,000,000, together with any
amounts received by the Secretary in connection with loans and loan
guarantees under title VI of the Public Health Service Act, to be
available without fiscal year limitation for the payment of interest
subsidies. During the fiscal year, no commitments for direct loans or
loan guarantees shall be made. (Department of Health and Human Services
Appropriations Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9931-0-3-550 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Operating expenses: Interest
subsidies, private.............. 8 8 8
01.01 Capital investment: Direct loans.. 1 1
--------- --------- ----------
10.00 Total obligations............... 8 9 9
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.90 Unobligated balance available,
start of year: Fund balance..... 55 58 52
22.00 New budget authority (gross)...... 16 15 15
22.60 Redemption of debt................ -5 -12 -12
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 66 61 55
23.95 New obligations................... -8 -9 -9
24.90 Unobligated balance available, end
of year: Fund balance........... 58 52 46
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
40.00 Appropriation................... 8 7 6
Permanent:
68.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 8 8 8
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 16 15 14
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 8 8 10
73.10 New obligations................... 8 9 9
73.20 Total outlays (gross)............. -7 -8 -6
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 8 10 13
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 7 7 6
86.93 Outlays from current balances..... 1
--------- --------- ----------
87.00 Total outlays (gross)........... 7 8 6
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
Non-Federal sources:
88.40 Interest repaid on loans not
sold...................... -1 -1 -1
88.40 Principal collections from
FFB....................... -5 -6 -6
88.40 Default collections,
principal................. -1
88.40 Interest collections from
FFB....................... -1 -1 -1
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -8 -8 -8
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 8 7 7
[[Page 499]]
90.00 Outlays........................... -1 -2
---------------------------------------------------------------------------
Status of Direct Loans (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9931-0-3-550 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Cumulative balance of direct loans
outstanding:
1210 Outstanding, start of year........ 45 34 23
1251 Repayments: Repayments and
prepayments..................... -7 -7 -5
1264 Write-offs for default: Other
adjustments, net................ -4 -4 -2
--------- --------- ----------
1290 Outstanding, end of year........ 34 23 16
---------------------------------------------------------------------------
Status of Guaranteed Loans (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9931-0-3-550 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Cumulative balance of guaranteed loans
outstanding:
2210 Outstanding, start of year........ 261 188 138
2251 Repayments and prepayments........ -73 -50 -40
--------- --------- ----------
2290 Outstanding, end of year........ 188 138 98
----------------------------------------------------------------------------
Memorandum:
2299 Guaranteed amount of guaranteed
loans outstanding, end of year.. 188 138 98
---------------------------------------------------------------------------
Title VII, part C of the Public Health Service Act established a
revolving fund from which health professions schools could borrow in
order to provide loans to their students.
Public Law 89-751, the Allied Health Professions Personnel Training
Act of 1966, amended the Public Health Service Act to authorize the
Federal Government to pay the difference between the interest paid by
students to the schools and the interest payable by the schools to the
Government National Mortgage Association (GNMA) and the Treasury.
Title VI and subsequently title XVI of the Public Health Service Act
established a loan and loan guarantee fund for medical facilities with a
maximum amount allowable for the Government's liability. Direct loans
were made available for public facilities and guaranteed loans for
private, nonprofit facilities. Funds under this authority were
established in the amount of $50 million for use in fulfilling
guarantees in event of default, $30 million as a revolving fund for
direct loans and an amount for interest subsidy payments on guaranteed
loans. Default and interest subsidy funds are replenished as necessary
through the annual appropriation process.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9931-0-3-550 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
33.0 Investments and loans............. 1 1
41.0 Grants, subsidies, and
contributions................... 7 7 7
43.0 Interest and dividends............ 1 1 1
--------- --------- ----------
99.9 Total obligations............... 8 9 9
---------------------------------------------------------------------------
Trust Funds
Vaccine Injury Compensation Program Trust Fund
For payments from the Vaccine Injury Compensation Program Trust
Fund, such sums as may be necessary for claims associated with vaccine-
related injury or death with respect to vaccines administered after
September 30, 1988, pursuant to subtitle 2 of title XXI of the Public
Health Service Act, to remain available until expended: Provided, That
for necessary administrative expenses, not to exceed $3,000,000 shall be
available from the Trust Fund to the Secretary of Health and Human
Services. (Department of Health and Human Services Appropriations Act,
1997.)
Unavailable Collections (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8175-0-7-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Balance, start of year:
01.99 Balance, start of year............ 912 1,047 1,179
Receipts:
02.01 Deposits.......................... 115 125 52
02.03 Interest income................... 58 66 74
--------- --------- ----------
02.99 Total receipts.................. 173 191 126
--------- --------- ----------
04.00 Total: Balances and collections... 1,085 1,238 1,305
Appropriation:
05.01 Vaccine injury compensation
program trust fund.............. -38 -59 -51
--------- --------- ----------
05.99 Subtotal appropriation............ -38 -59 -51
07.99 Total balance, end of year........ 1,047 1,179 1,254
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8175-0-7-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Compensation: Claims for post--FY
1989 injuries................... 30 50 42
Administrative expenses:
01.03 Claims processing (Claims Court) 2 2 2
01.04 Claims processing (Public Health
Service)...................... 3 3 3
01.05 Claims processing (Dept. of
Justice)...................... 3 4 4
--------- --------- ----------
01.91 Total, administrative expenses 8 9 9
--------- --------- ----------
10.00 Total obligations............... 38 59 51
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 38 59 51
23.95 New obligations................... -38 -59 -51
----------------------------------------------------------------------------
New budget authority (gross), detail:
40.26 Appropriation (trust fund,
definite)....................... 8 9 9
40.27 Appropriation (trust fund,
indefinite)..................... 30 50 42
--------- --------- ----------
43.00 Appropriation (total)........... 38 59 51
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 38 59 51
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 1 2
73.10 New obligations................... 38 59 51
73.20 Total outlays (gross)............. -37 -61 -51
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 2
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 36 59 51
86.93 Outlays from current balances..... 1 2
--------- --------- ----------
87.00 Total outlays (gross)........... 37 61 51
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 38 59 51
90.00 Outlays........................... 37 61 51
---------------------------------------------------------------------------
The Vaccine Improvement Program was established pursuant to Public
Law 99-660 and Public Law 100-203, and serves as a source of funds to
pay claims for compensation for vaccine related injury or death. This
account reflects payments for claims for vaccine related injury or death
occurring after October 1, 1988.
Current and projected vaccine excise tax receipts to the Vaccine
Injury Compensation Program Trust Fund far exceed current and projected
claims on the Trust Fund. The Budget proposes lowering revenue to the
Trust Fund by exempting Federal programs (which provide free vaccine to
low-income, uninsured and underinsured children) from payment of the
vaccine excise tax in FY 1998. Exempting these programs will result in
Federal savings in mandatory (HCFA Grants to States for Medicaid) and
discretionary (Centers for Disease Control and Prevention) programs
displayed in those accounts. The estimated reduction in receipts to the
Trust Fund is $73 million.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8175-0-7-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
25.2 Other services.................... 3 3 3
25.3 Purchases of goods and services
from Government accounts........ 5 6 6
[[Page 500]]
42.0 Insurance claims and indemnities.. 30 50 42
--------- --------- ----------
99.9 Total obligations............... 38 59 51
---------------------------------------------------------------------------
INDIAN HEALTH SERVICE
Federal Funds
General and special funds:
Indian Health Services
For expenses necessary to carry out the Act of August 5, 1954 (68
Stat. 674), the Indian Self-Determination Act, the Indian Health Care
Improvement Act, and titles II and III of the Public Health Service Act
with respect to the Indian Health Service, [$1,806,269,000],
$1,835,465,000 together with payments received during the fiscal year
pursuant to 42 U.S.C. 238(b) for services furnished by the Indian Health
Service: Provided, That funds made available to tribes and tribal
organizations through contracts, grant agreements, or any other
agreements or compacts authorized by the Indian Self-Determination and
Education Assistance Act of 1975 (25 U.S.C. 450), shall be deemed to be
obligated at the time of the grant or contract award and thereafter
shall remain available to the tribe or tribal organization without
fiscal year limitation: Provided further, That $12,000,000 shall remain
available until expended, for the Indian Catastrophic Health Emergency
Fund: Provided further, That [$356,325,000] $362,348,000 for contract
medical care shall remain available for obligation until September 30,
[1998] 1999: Provided further, That of the funds provided, not less than
[$11,706,000] $11,889,000 shall be used to carry out the loan repayment
program under section 108 of the Indian Health Care Improvement Act:
Provided further, That funds provided in this Act may be used for one-
year contracts and grants which are to be performed in two fiscal years,
so long as the total obligation is recorded in the year for which the
funds are appropriated: Provided further, That the amounts collected by
the Secretary of Health and Human Services under the authority of title
IV of the Indian Health Care Improvement Act shall remain available
until expended for the purpose of achieving compliance with the
applicable conditions and requirements of titles XVIII and XIX of the
Social Security Act (exclusive of planning, design, or construction of
new facilities): Provided further, That of the funds provided,
[$7,500,000] $12,000,000 shall remain available until expended, for the
Indian Self-Determination Fund, which shall be available for the
transitional costs of initial or expanded tribal contracts, compacts,
grants or cooperative agreements with the Indian Health Service under
the provisions of the Indian Self-Determination Act: Provided further,
That funding contained herein, and in any earlier appropriations Acts
for scholarship programs under the Indian Health Care Improvement Act
(25 U.S.C. 1613) shall remain available for obligation until September
30, [1998] 1999: Provided further, That amounts received by tribes and
tribal organizations under title IV of the Indian Health Care
Improvement Act shall be reported and accounted for and available to the
receiving tribes and tribal organizations until expended. (Department of
the Interior and Related Agencies Appropriations Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0390-0-1-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.01 Clinical services............... 1,412 1,451 1,468
00.02 Preventive health............... 78 81 82
00.03 Urban health.................... 24 25 26
00.04 Indian health professions....... 26 28 28
00.05 Tribal management............... 2 2 2
00.06 Direct operations............... 48 49 47
00.07 Self-governance................. 13 9 9
00.08 Contract support costs.......... 146 161 173
--------- --------- ----------
00.91 Total direct program.......... 1,749 1,806 1,835
04.01 Reimbursable program.............. 245 283 285
--------- --------- ----------
10.00 Total obligations............... 1,994 2,089 2,120
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... 60 76 76
22.00 New budget authority (gross)...... 2,012 2,089 2,120
22.30 Unobligated balance expiring...... -2
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 2,070 2,165 2,196
23.95 New obligations................... -1,994 -2,089 -2,120
24.40 Unobligated balance available, end
of year: Uninvested balance..... 76 76 76
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
40.00 Appropriation................... 1,745 1,806 1,835
Permanent:
68.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 267 283 285
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 2,012 2,089 2,120
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 602 565 540
73.10 New obligations................... 1,994 2,089 2,120
73.20 Total outlays (gross)............. -2,012 -2,114 -2,109
73.40 Adjustments in expired accounts... -19
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 565 540 551
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 1,287 1,319 1,340
86.93 Outlays from current balances..... 458 512 484
86.97 Outlays from new permanent
authority....................... 267 283 285
--------- --------- ----------
87.00 Total outlays (gross)........... 2,012 2,114 2,109
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -60 -64 -64
88.40 Non-Federal sources........... -207 -219 -221
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -267 -283 -285
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 1,745 1,806 1,835
90.00 Outlays........................... 1,746 1,831 1,824
---------------------------------------------------------------------------
The Indian Health Services account provides medical care, public
health services, and health professions training opportunities to
American Indians and Alaska Natives. An estimated $390,000,000 will be
administered by tribal governments under self-governance compacts in FY
1998.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0390-0-1-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 365 391 404
11.3 Other than full-time permanent 16 16 16
11.5 Other personnel compensation.. 26 27 28
--------- --------- ----------
11.9 Total personnel compensation 407 434 448
12.1 Civilian personnel benefits..... 117 122 125
13.0 Benefits for former personnel... 3 3 3
21.0 Travel and transportation of
persons....................... 27 28 28
22.0 Transportation of things........ 10 13 14
23.1 Rental payments to GSA.......... 10 10 10
23.3 Communications, utilities, and
miscellaneous charges......... 25 26 14
24.0 Printing and reproduction....... 1 1 1
25.1 Advisory and assistance services 1 1 1
25.2 Other services.................. 463 465 472
25.3 Purchases of goods and services
from Government accounts...... 2 1 2
25.4 Operation and maintenance of
facilities.................... 8 7 8
25.6 Medical care.................... 211 214 223
25.7 Operation and maintenance of
equipment..................... 7 7 8
25.8 Subsistence and support of
persons....................... 5 5 5
26.0 Supplies and materials.......... 97 99 100
31.0 Equipment....................... 18 18 18
[[Page 501]]
32.0 Land and structures............. 2
41.0 Grants, subsidies, and
contributions................. 335 352 355
--------- --------- ----------
99.0 Subtotal, direct obligations.. 1,749 1,806 1,835
99.0 Reimbursable obligations.......... 245 283 285
--------- --------- ----------
99.9 Total obligations............... 1,994 2,089 2,120
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0390-0-1-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Full-time equivalent employment. 10,331 10,345 10,345
1005 Full-time equivalent of overtime
and holiday hours............. 183 191 191
1011 Exempt Full-time equivalent
employment.................... 6 5 5
Reimbursable:
Total compensable workyears:
2001 Full-time equivalent employment. 2,517 2,517 2,517
2005 Full-time equivalent of overtime
and holiday hours............. 57 57 57
---------------------------------------------------------------------------
Indian Health Facilities
For construction, repair, maintenance, improvement, and equipment of
health and related auxiliary facilities, including quarters for
personnel; preparation of plans, specifications, and drawings;
acquisition of sites, purchase and erection of modular buildings, and
purchases of trailers; and for provision of domestic and community
sanitation facilities for Indians, as authorized by section 7 of the Act
of August 5, 1954 (42 U.S.C. 2004a), the Indian Self-Determination Act,
and the Indian Health Care Improvement Act, and for expenses necessary
to carry out such Acts and titles II and III of the Public Health
Service Act with respect to environmental health and facilities support
activities of the Indian Health Service, [$247,731,000] $247,635,000, to
remain available until expended: Provided, That notwithstanding any
other provision of law, funds appropriated for the planning, design,
construction or renovation of health facilities for the benefit of an
Indian tribe or tribes may be used to purchase land for sites to
construct, improve, or enlarge health or related facilities.
In addition, to become available on October 1 of the fiscal year
specified and remain available until expended: for construction of a
replacement of the health facility at Fort Defiance, Arizona, up to
$25,000,000 for fiscal year 1998, up to $25,000,000 for fiscal year
1999, and up to $28,000,000 for fiscal year 2000; for construction of a
replacement of the health facility at Keams Canyon, Arizona, up to
$13,900,000 for fiscal year 1998, up to $13,900,000 for fiscal year
1999, and up to $3,200,000 for fiscal year 2000. (Department of the
Interior and Related Agencies Appropriations Act, 1997.)
Unavailable Collections (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0391-0-1-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Balance, start of year:
01.99 Balance, start of year............
Receipts:
02.01 Rent and charges for quarters,
Indian Health Service, HRSA, HHS 4 5 5
Appropriation:
05.01 Indian health facilities.......... -4 -5 -5
07.99 Total balance, end of year........
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0391-0-1-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Construction...................... 110 112 129
01.01 Maintenance....................... 47 45 44
02.01 Facilities and environmental
health.......................... 93 100 105
05.01 Equipment......................... 15 16 13
--------- --------- ----------
10.00 Total obligations............... 265 273 291
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... 36 25 16
22.00 New budget authority (gross)...... 254 264 303
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 290 289 319
23.95 New obligations................... -265 -273 -291
24.40 Unobligated balance available, end
of year: Uninvested balance..... 25 16 28
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
40.00 Appropriation................... 239 248 287
Permanent:
60.25 Appropriation (special fund,
indefinite)................... 4 5 5
68.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 11 11 11
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 254 264 303
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 412 380 351
73.10 New obligations................... 265 273 291
73.20 Total outlays (gross)............. -297 -302 -283
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 380 351 360
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 65 62 72
86.93 Outlays from current balances..... 217 224 195
86.97 Outlays from new permanent
authority....................... 15 16 16
--------- --------- ----------
87.00 Total outlays (gross)........... 297 302 283
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.45 Offsetting collections (cash)
from: Offsetting governmental
collections................... -11 -11 -11
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 243 253 292
90.00 Outlays........................... 286 291 272
---------------------------------------------------------------------------
The Indian health facilities account supports construction, repair
and improvement, equipment, and environmental health and facilities
support for the Indian health services.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0391-0-1-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Personnel compensation:
11.1 Full-time permanent............. 45 45 45
11.3 Other than full-time permanent.. 6 6 6
11.5 Other personnel compensation.... 2 2 2
--------- --------- ----------
11.9 Total personnel compensation.. 53 53 53
12.1 Civilian personnel benefits....... 15 15 15
21.0 Travel and transportation of
persons......................... 4 5 4
22.0 Transportation of things.......... 4 4 4
23.3 Communications, utilities, and
miscellaneous charges........... 6 8 19
25.1 Advisory and assistance services.. 2 2 3
25.2 Other services.................... 41 37 56
25.4 Operation and maintenance of
facilities...................... 37 19 18
25.7 Operation and maintenance of
equipment....................... 10 3 3
25.8 Subsistence and support of persons 10 10 10
26.0 Supplies and materials............ 11 12 11
31.0 Equipment......................... 12 5 4
32.0 Land and structures............... 38 60 54
41.0 Grants, subsidies, and
contributions................... 22 28 27
43.0 Interest and dividends............ 12 10
--------- --------- ----------
99.9 Total obligations............... 265 273 291
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0391-0-1-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Total compensable workyears:
1001 Full-time equivalent employment... 1,454 1,454 1,454
1005 Full-time equivalent of overtime
and holiday hours............... 21 21 21
---------------------------------------------------------------------------
Administrative Provisions, Indian Health Service
Appropriations in this Act to the Indian Health Service shall be
available for services as authorized by 5 U.S.C. 3109 but at rates not
to exceed the per diem rate equivalent to the maximum rate payable for
senior-level positions under 5 U.S.C. 5376; hire of pas-
[[Page 502]]
senger motor vehicles and aircraft; purchase of medical equipment;
purchase of reprints; purchase, renovation and erection of modular
buildings and renovation of existing facilities; payments for telephone
service in private residences in the field, when authorized under
regulations approved by the Secretary; and for uniforms or allowances
therefore as authorized by 5 U.S.C. 5901-5902; and for expenses of
attendance at meetings which are concerned with the functions or
activities for which the appropriation is made or which will contribute
to improved conduct, supervision, or management of those functions or
activities: Provided, That in accordance with the provisions of the
Indian Health Care Improvement Act, non-Indian patients may be extended
health care at all tribally administered or Indian Health Service
facilities, subject to charges, and the proceeds along with funds
recovered under the Federal Medical Care Recovery Act (42 U.S.C. 2651-
53) shall be credited to the account of the facility providing the
service and shall be available without fiscal year limitation: Provided
further, That notwithstanding any other law or regulation, funds
transferred from the Department of Housing and Urban Development to the
Indian Health Service shall be administered under Public Law 86-121 (the
Indian Sanitation Facilities Act) and Public Law 93-638, as amended:
Provided further, That funds appropriated to the Indian Health Service
in this Act, except those used for administrative and program direction
purposes, shall not be subject to limitations directed at curtailing
Federal travel and transportation: Provided further, That
notwithstanding any other provision of law, funds previously or herein
made available to a tribe or tribal organization through a contract,
grant, or agreement authorized by title I or title III of the Indian
Self-Determination and Education Assistance Act of 1975 (25 U.S.C. 450),
may be deobligated and reobligated to a self-determination contract
under title I, or a self-governance agreement under title III of such
Act and thereafter shall remain available to the tribe or tribal
organization without fiscal year limitation: Provided further, That none
of the funds made available to the Indian Health Service in this Act
shall be used to implement the final rule published in the Federal
Register on September 16, 1987, by the Department of Health and Human
Services, relating to the eligibility for the health care services of
the Indian Health Service until the Indian Health Service has submitted
a budget request reflecting the increased costs associated with the
proposed final rule, and such request has been included in an
appropriations Act and enacted into law: Provided further, That funds
made available in this Act are to be apportioned to the Indian Health
Service as appropriated in this Act, and accounted for in the
appropriation structure set forth in this Act: Provided further, That
funds received from any source, including tribal contractors and
compactors for previously transferred functions which tribal contractors
and compactors no longer wish to retain, for services, goods, or
training and technical assistance, shall be retained by the Indian
Health Service and shall remain available until expended by the Indian
Health Service: Provided further, That reimbursements for training,
technical assistance, or services provided by the Indian Health Service
will contain total costs, including direct, administrative, and overhead
associated with the provision of goods, services, or technical
assistance: Provided further, That the appropriation structure for the
Indian Health Service may not be altered without advance [approval of]
notice submitted to the House and Senate Committees on Appropriations.
(Department of the Interior and Related Agencies Appropriations Act,
1997.)
CENTERS FOR DISEASE CONTROL AND PREVENTION
Federal Funds
General and special funds:
Disease Control, Research, and Training
To carry out titles II, III, VII, XI, XV, XVII, and XIX of the
Public Health Service Act, sections 101, 102, 103, 201, 202, 203, 301,
and 501 of the Federal Mine Safety and Health Act of 1977, and sections
20, 21 and 22 of the Occupational Safety and Health Act of 1970, title
IV of the Immigration and Nationality Act and section 501 of the Refugee
Education Assistance Act of 1980; including insurance of official motor
vehicles in foreign countries; and hire, maintenance, and operation of
aircraft, [$2,262,698,000] $2,252,900,000, of which [$30,553,000]
$23,007,000 shall remain available until expended for equipment and
construction and renovation of facilities, and of which $32,000,000
shall remain available until September 30, [1998] 1999 for mine safety
and health activities, and in addition, such sums as may be derived from
authorized user fees, which shall be credited to this account: Provided,
That in addition to amounts provided herein, up to [$48,400,000]
$70,063,000 shall be available from amounts available under section 241
of the Public Health Service Act, to carry out the National Center for
Health Statistics surveys: [Provided further, That none of the funds
made available for injury prevention and control at the Centers for
Disease Control and Prevention may be used to advocate or promote gun
control: Provided further, That the Director may redirect the total
amount made available under authority of Public Law 101-502, section 3,
dated November 3, 1990, to activities the Director may so designate:
Provided further, That the Congress is to be notified promptly of any
such transfer: Provided further, That the functions described in clause
(1) of the first proviso under the subheading ``mines and minerals''
under the heading ``Bureau of Mines'' in the text of title I of the
Department of the Interior and Related Agencies Appropriations Act,
1996, as enacted by section 101 (c) of the Omnibus Consolidated
Rescissions and Appropriations Act of 1996 (Public Law 104-134), are
hereby transferred to, and vested in, the Secretary of Health and Human
Services, subject to section 1531 of title 31, United States Code:
Provided further, That of the amount provided, $23,000,000 is designated
by Congress as an emergency requirement pursuant to section
251(b)(2)(D)(i) of the Balanced Budget and Emergency Deficit Control Act
of 1985, as amended.]
In addition, not to exceed $17,895,000 to carry out Title III of the
Public Health Service Act: Provided, That all purchases of vaccine with
grants from appropriations for fiscal year 1998 authorized by section
317(j) of the Public Health Act or section 1928 of the Social Security
Act shall be exempt from the payment of excise tax on vaccine.
In addition, [$41,000,000] $45,000,000, to be derived from the
Violent Crime Reduction Trust Fund, for carrying out [sections] section
40151 [and 40261] of Public Law 103-322. (Department of Health and Human
Services Appropriations Act, 1997.)
Unavailable Collections (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0943-0-1-999 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Balance, start of year:
01.99 Balance, start of year............
Receipts:
02.01 Cooperative Research and
Development Agreements, Centers
for Disease Control............. 1 1 1
Appropriation:
05.01 Disease control, research, and
training........................ -1 -1 -1
07.99 Total balance, end of year........
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0943-0-1-999 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.01 Preventive health block grant... 145 154 144
00.02 Prevention centers.............. 8 8 8
00.03 Sexually transmitted diseases... 105 106 111
00.04 Immunization.................... 468 468 429
00.05 Infectious diseases............. 181 207 232
00.06 Chronic and environmental
diseases...................... 348 388 421
00.07 Occupational safety and health.. 129 141 149
00.08 Mine safety and health.......... 32 32
00.09 Epidemic services............... 67 70 70
00.10 Health statistics............... 37 38 19
00.11 HIV............................. 585 617 637
00.12 Buildings and facilities........ 17 79 24
00.13 Program management.............. 3 3 3
00.14 Violent crime reduction programs 32 41 45
00.15 Office of the Director savings.. -8
--------- --------- ----------
00.91 Total direct program.......... 2,125 2,352 2,316
01.01 Reimbursable program.............. 134 134 134
--------- --------- ----------
10.00 Total obligations............... 2,259 2,486 2,450
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... 46 51
22.00 New budget authority (gross)...... 2,248 2,437 2,451
[[Page 503]]
22.10 Resources available from
recoveries of prior year
obligations..................... 18
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 2,312 2,488 2,451
23.95 New obligations................... -2,259 -2,486 -2,450
24.40 Unobligated balance available, end
of year: Uninvested balance..... 51
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
40.00 Appropriation................... 2,081 2,263 2,271
40.75 Reduction pursuant to P.L. 104-
208........................... -2
42.00 Transferred from other accounts. 32 41 45
--------- --------- ----------
43.00 Appropriation (total)......... 2,113 2,302 2,316
Permanent:
60.25 Appropriation (special fund,
indefinite)................... 1 1 1
68.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 134 134 134
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 2,248 2,437 2,451
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 2,124 2,061 2,223
73.10 New obligations................... 2,259 2,486 2,450
73.20 Total outlays (gross)............. -2,301 -2,324 -2,406
73.40 Adjustments in expired accounts... -4
73.45 Adjustments in unexpired accounts. -18
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 2,061 2,223 2,267
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 684 721 726
86.93 Outlays from current balances..... 1,482 1,468 1,545
86.97 Outlays from new permanent
authority....................... 134 134 134
86.98 Outlays from permanent balances... 1 1 1
--------- --------- ----------
87.00 Total outlays (gross)........... 2,301 2,324 2,406
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -134 -134 -134
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 2,114 2,303 2,317
90.00 Outlays........................... 2,167 2,190 2,272
---------------------------------------------------------------------------
[Dollars in millions]
1996 1997 1998
Distribution of budget authority by
account:
Disease control, research and
training........................ 2,075 2,263 2,271
Violent crime reduction programs.. 32 41 45
Distribution of outlays by account:
Disease control, research and
training........................ 2,163 2,233
Violent crime reduction programs.. 27 39
The Centers for Disease Control and Prevention (CDC) supports a
number of categorical programs including grants for immunizations,
control of sexually transmitted diseases, HIV prevention, and control of
other infectious and chronic diseases. CDC also supports the Preventive
Health Block Grant.
This display also includes amounts derived from the Violent Crime
Reduction Trust Fund.
Current and projected vaccine excise tax receipts to the Vaccine
Injury Compensation Program Trust Fund far exceed current and projected
claims on the Trust Fund. The Budget exempts Federal programs which
provide free vaccine to low-income, uninsured and underinsured children
from payment of vaccine excise tax for FY 1998, lowering the cost to the
Government of providing vaccine to these children. The savings to CDC's
discretionary immunization program and the funding provided above will
allow CDC to purchase as much vaccine in FY 1998 as in FY 1997. The $18
million in the savings resulting from the combined effects of the
exemption of the mandatory Vaccines for Children from the excise tax on
mandatory costs and tax receipts will offset some of the cost of CDC's
prevention activities. Funds carried-over by States from prior-year
appropriations permit additional immunization savings.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0943-0-1-999 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 223 255 258
11.3 Other than full-time permanent 10 10 10
11.5 Other personnel compensation.. 11 11 11
--------- --------- ----------
11.9 Total personnel compensation 244 276 279
12.1 Civilian personnel benefits..... 72 80 81
13.0 Benefits for former personnel... 2
21.0 Travel and transportation of
persons....................... 16 16 17
22.0 Transportation of things........ 3 4 4
23.1 Rental payments to GSA.......... 15 16 16
23.3 Communications, utilities, and
miscellaneous charges......... 19 20 20
24.0 Printing and reproduction....... 5 4 5
25.1 Advisory and assistance services 2 2 2
25.2 Other services.................. 71 76 72
25.5 Research and development
contracts..................... 179 232 225
25.7 Operation and maintenance of
equipment..................... 1 1
26.0 Supplies and materials.......... 145 167 162
31.0 Equipment....................... 40 96 75
32.0 Land and structures............. 3 31 18
41.0 Grants, subsidies, and
contributions................. 1,309 1,331 1,339
--------- --------- ----------
99.0 Subtotal, direct obligations.. 2,125 2,352 2,316
99.0 Reimbursable obligations.......... 134 134 134
--------- --------- ----------
99.9 Total obligations............... 2,259 2,486 2,450
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0943-0-1-999 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Full-time equivalent employment. 5,109 5,351 5,351
1005 Full-time equivalent of overtime
and holiday hours............. 29 29 29
1011 Exempt Full-time equivalent
employment.................... 48 45 45
Reimbursable:
Total compensable workyears:
2001 Full-time equivalent employment. 875 1,052 1,052
2005 Full-time equivalent of overtime
and holiday hours............. 2 2 2
---------------------------------------------------------------------------
Allocations Received From Other Accounts
Note.--Obligations incurred under allocations from other accounts
are included in the schedules of the parent appropriation as follows:
Environmental Protection Agency: ``Hazardous substance response
trust fund.''
NATIONAL INSTITUTES OF HEALTH
Federal Funds
General and special funds:
National Cancer Institute
For carrying out section 301 and title IV (except section 417B(d))
of the Public Health Service Act with respect to cancer,
[$2,382,532,000] $2,217,482,000. (Department of Health and Human
Services Appropriations Act, 1997.)
National Heart, Lung, and Blood Institute
For carrying out section 301 and title IV of the Public Health
Service Act with respect to cardiovascular, lung, and blood diseases,
and blood and blood products, [$1,433,001,000] $1,404,770,000.
(Department of Health and Human Services Appropriations Act, 1997.)
National Institute of Dental Research
For carrying out section 301 and title IV of the Public Health
Service Act with respect to dental disease, [$195,997,000] $190,081,000.
(Department of Health and Human Services Appropriations Act, 1997.)
National Institute of Diabetes and Digestive and Kidney Diseases
For carrying out section 301 and title IV of the Public Health
Service Act with respect to diabetes and digestive and kidney disease,
[$815,982,000] $821,164,000. (Department of Health and Human Services
Appropriations Act, 1997.)
[[Page 504]]
National Institute of Neurological Disorders and Stroke
For carrying out section 301 and title IV of the Public Health
Service Act with respect to neurological disorders and stroke,
[$726,746,000] $722,712,000. (Department of Health and Human Services
Appropriations Act, 1997.)
National Institute of Allergy and Infectious Diseases
For carrying out section 301 and title IV of the Public Health
Service Act with respect to allergy and infectious diseases,
[$1,257,234,000] $634,272,000. (Department of Health and Human Services
Appropriations Act, 1997.)
National Institute of General Medical Sciences
For carrying out section 301 and title IV of the Public Health
Service Act with respect to general medical sciences, [$998,470,000]
$992,032,000. (Department of Health and Human Services Appropriations
Act, 1997.)
National Institute of Child Health and Human Development
For carrying out section 301 and title IV of the Public Health
Service Act with respect to child health and human development,
[$631,703,000] $582,032,000. (Department of Health and Human Services
Appropriations Act, 1997.)
National Eye Institute
For carrying out section 301 and title IV of the Public Health
Service Act with respect to eye diseases and visual disorders,
[$332,735,000] $330,955,000. (Department of Health and Human Services
Appropriations Act, 1997.)
National Institute of Environmental Health Sciences
For carrying out sections 301 and 311 and title IV of the Public
Health Service Act with respect to environmental health sciences,
[$308,819,000] $313,583,000. (Department of Health and Human Services
Appropriations Act, 1997.)
National Institute on Aging
For carrying out section 301 and title IV of the Public Health
Service Act with respect to aging, [$486,047,000] $495,202,000.
(Department of Health and Human Services Appropriations Act, 1997.)
National Institute of Arthritis and Musculoskeletal and Skin Diseases
For carrying out section 301 and title IV of the Public Health
Service Act with respect to arthritis and musculoskeletal and skin
diseases, [$257,111,000] $258,932,000. (Department of Health and Human
Services Appropriations Act, 1997.)
National Institute on Deafness and Other Communication Disorders
For carrying out section 301 and title IV of the Public Health
Service Act with respect to deafness and other communication disorders,
[$188,422,000] $192,447,000. (Department of Health and Human Services
Appropriations Act, 1997.)
National Institute of Nursing Research
For carrying out section 301 and title IV of the Public Health
Service Act with respect to nursing research, [$59,743,000] $55,692,000.
(Department of Health and Human Services Appropriations Act, 1997.)
National Institute on Alcohol Abuse and Alcoholism
For carrying out section 301 and title IV of the Public Health
Service Act with respect to alcohol abuse and alcoholism, [$212,004,000]
$208,112,000. (Department of Health and Human Services Appropriations
Act, 1997.)
National Institute on Drug Abuse
For carrying out section 301 and title IV of the Public Health
Service Act with respect to drug abuse, [$489,375,000] $358,475,000.
(Department of Health and Human Services Appropriations Act, 1997.)
National Institute of Mental Health
For carrying out section 301 and title IV of the Public Health
Service Act with respect to mental health, [$701,585,000] $629,739,000.
(Department of Health and Human Services Appropriations Act, 1997.)
National Center for Research Resources
For carrying out section 301 and title IV of the Public Health
Service Act with respect to research resources and general research
support grants, [$415,145,000] $333,868,000: Provided, That none of
these funds shall be used to pay recipients of the general research
support grants program any amount for indirect expenses in connection
with such grants: Provided further, That [$20,000,000] $4,000,000 shall
be for extramural facilities construction grants. (Department of Health
and Human Services Appropriations Act, 1997.)
National [Center for] Human Genome Research Institute
For carrying out section 301 and title IV of the Public Health
Service Act with respect to human genome research, [$189,657,000]
$202,197,000. (Department of Health and Human Services Appropriations
Act, 1997.)
John E. Fogarty International Center
For carrying out the activities at the John E. Fogarty International
Center, [$26,586,000] $16,755,000. (Department of Health and Human
Services Appropriations Act, 1997.)
National Library of Medicine
For carrying out section 301 and title IV of the Public Health
Service Act with respect to health information communications,
[$151,103,000] $152,689,000, of which $4,000,000 shall be available
until expended for improvement of information systems: Provided, That in
fiscal year [1997] 1998, the Library may enter into personal services
contracts for the provision of services in facilities owned, operated,
or constructed under the jurisdiction of the National Institutes of
Health. (Department of Health and Human Services Appropriations Act,
1997.)
Office of the Director
(including transfer of funds)
For carrying out the responsibilities of the Office of the Director,
National Institutes of Health, [$287,206,000, of which $35,589,000 shall
be for the Office of AIDS Research] $234,247,000: Provided, That funding
shall be available for the purchase of not to exceed five passenger
motor vehicles for replacement only: Provided further, That the Director
may direct up to 1 percent of the total amount made available in this
Act to all National Institutes of Health appropriations to activities
the Director may so designate: Provided further, That no such
appropriation shall be increased or decreased by more than 1 percent by
any such transfers and that the Congress is promptly notified of the
transfer: Provided further, That NIH is authorized to collect
$15,000,000 in third party payments for the cost of clinical services
that are incurred in National Institutes of Health research facilities
in FY 1998 and that such payments shall be credited to the National
Institutes of Health Management Fund: Provided further, That all funds
credited to the NIH Management Fund shall remain available for one
fiscal year after the fiscal year in which they are deposited[: Provided
further, That up to $200,000 shall be available to carry out section 499
of the Public Health Service Act]. (Department of Health and Human
Services Appropriations Act, 1997.)
Office of AIDS Research
(including transfer of funds)
For carrying out part D of title XXIII of the Public Health Service
Act, $1,540,765,000: Provided, That the Director of the Office of AIDS
Research shall transfer from this appropriation the amounts necessary to
carry out subsection 2353(d) of the Act.
Buildings and Facilities
For the study of, construction of, and acquisition of equipment for,
facilities of or used by the National Institutes of Health, including
the acquisition of real property, [$200,000,000] $100,000,000, to remain
available until expended[, of which $90,000,000 shall be for the
clinical research center: Provided, That, notwithstanding any other
provision of law, a single contract or related contracts for the
development and construction of the clinical research center may be
employed which collectively include the full scope of the project:
Provided further, That the solicitation and contract shall contain the
clause ``availability of funds'' found at 48 CFR 52.232-18]. In
addition, to become available on October 1 of the fiscal year specified
and remain available until expended, for the clinical research center,
$90,000,000 for each of fiscal years 1998 and 1999, and $40,000,000
[[Page 505]]
for fiscal year 2000. (Department of Health and Human Services
Appropriations Act, 1997.)
Unavailable Collections (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9915-0-1-552 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Balance, start of year:
01.99 Balance, start of year............
Receipts:
02.01 Cooperative Research and
Development Agreements, NIH..... 7 12 15
Appropriation:
05.01 National Institutes of Health..... -7 -12 -15
07.99 Total balance, end of year........
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9915-0-1-552 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 National Cancer Institute......... 2,255 2,381 2,217
00.02 National Heart, Lung, and Blood
Institute....................... 1,351 1,433 1,405
00.03 National Institute of Dental
Research........................ 184 196 190
00.04 National Institute of Diabetes and
Digestive and Kidney Disease.... 768 816 821
00.05 National Institute of Neurological
Disorders and Stroke............ 684 726 723
00.06 National Institute of Allergy and
Infectious Diseases............. 1,171 1,257 634
00.07 National Institute of General
Medical Sciences................ 944 998 992
00.08 National Institute of Child Health
and Human Development........... 593 631 582
00.09 National Eye Institute............ 313 333 331
00.10 National Institute of
Environmental Health Sciences... 288 308 314
00.11 National Institute on Aging....... 454 486 495
00.12 National Institute of Arthritis
and Musculoskeletal and Skin
Disease......................... 243 257 259
00.13 National Institute on Deafness and
Other Communication Disorder.... 176 188 192
00.14 National Institute of Nursing
Research........................ 56 60 56
00.15 National Institute of Alcohol
Abuse and Alcoholism............ 199 212 208
00.16 National Institute on Drug Abuse.. 458 489 358
00.17 National Institute of Mental
Health.......................... 660 701 630
00.18 National Center for Research
Resources....................... 390 415 334
00.19 National Human Genome Research
Institute....................... 169 190 202
00.20 John E. Fogarty International
Center.......................... 25 27 17
00.21 National Library of Medicine...... 139 152 153
00.22 Office of the Director............ 260 287 234
00.23 Office of AIDS Research........... 1,541
00.24 Buildings and facilities.......... 101 387 190
00.25 Cooperative research and
development agreements.......... 6 24 15
00.26 Royalities........................ 13 20 20
--------- --------- ----------
00.91 Total direct program............ 11,900 12,974 13,113
01.01 Reimbursable program.............. 330 360 384
--------- --------- ----------
10.00 Total obligations............... 12,230 13,334 13,497
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... 164 221
22.00 New budget authority (gross)...... 12,285 13,113 13,497
22.30 Unobligated balance expiring...... 2
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 12,451 13,334 13,497
23.95 New obligations................... -12,230 -13,334 -13,497
24.40 Unobligated balance available, end
of year: Uninvested balance..... 221
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
40.00 Appropriation................... 11,928 12,747 13,078
40.75 Reduction pursuant to P.L. 104-
208........................... -6
--------- --------- ----------
43.00 Appropriation (total)......... 11,928 12,741 13,078
Permanent:
60.25 Appropriation (special fund,
indefinite)................... 7 12 15
Spending authority from
offsetting collections:
68.00 Offsetting collections (cash). 250 360 404
68.10 Change in orders on hand from
Federal sources............. 100
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total)................... 350 360 404
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 12,285 13,113 13,497
----------------------------------------------------------------------------
Change in unpaid obligations:
Unpaid obligations, start of year:
72.40 Obligated balance: Appropriation 7,647 9,247 10,063
72.95 Orders on hand from Federal
sources....................... 4,322 4,422 4,422
--------- --------- ----------
72.99 Total unpaid obligations,
start of year............... 11,969 13,669 14,485
73.10 New obligations................... 12,230 13,334 13,497
73.20 Total outlays (gross)............. -10,467 -12,518 -13,205
73.40 Adjustments in expired accounts... -63
Unpaid obligations, end of year:
74.40 Obligated balance: Appropriation 9,247 10,063 10,355
74.95 Orders on hand from Federal
sources....................... 4,422 4,422 4,422
--------- --------- ----------
74.99 Total unpaid obligations, end
of year..................... 13,669 14,485 14,777
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 4,489 4,935 5,067
86.93 Outlays from current balances..... 5,723 7,211 7,719
86.97 Outlays from new permanent
authority....................... 255 372 419
86.98 Outlays from permanent balances...
--------- --------- ----------
87.00 Total outlays (gross)........... 10,467 12,518 13,205
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -250 -360 -404
88.95 Change in orders on hand from
Federal sources................. -100
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 11,935 12,753 13,093
90.00 Outlays........................... 10,217 12,158 12,801
---------------------------------------------------------------------------
[Dollars in millions]
1996 1997 1998
Distribution of budget authority by
account:
National Cancer Institute......... 2,255 2,381 2,217
National Heart, Lung, and Blood
Institute....................... 1,351 1,432 1,405
National Institute of Dental
Research........................ 184 196 190
National Institute of Diabetes and
Digestive and Kidney Diseases... 769 816 821
National Institute of Neurological
Disorder and Stroke............. 684 726 723
National Institute of Allergy and
Infectious Diseases............. 1,171 1,257 634
National Institute of General
Medical Sciences................ 944 998 992
National Institute of Child Health
and Human Development........... 593 631 582
National Eye Institute............ 313 333 331
National Institute of
Environmental Health Sciences... 288 308 314
National Institute on Aging....... 454 486 495
National Institute of Arthritis
and Musculoskeletal and Skin
Diseases........................ 243 257 259
National Institute on Deafness and
Other Communication Disorders... 176 188 192
National Institute of Nursing
Research........................ 56 60 56
National Institute on Alcohol
Abuse and Alcoholism............ 199 212 208
National Institute on Drug Abuse.. 458 489 358
National Institute of Mental
Health.......................... 660 701 630
National Center for Research
Resources....................... 389 415 334
National Human Genome Research
Institute....................... 169 190 202
John E. Fogarty International
Center.......................... 25 27 17
National Library of Medicine...... 141 151 153
Office of the Director............ 260 287 234
Office of AIDS Research........... 1,541
Buildings and Facilities.......... 146 200 190
------------------------------------
Subtotal...................... 11,928 12,741 13,078
Cooperative Research and
Development Agreements.......... 7 12 15
------------------------------------
Total Budget Authority, NIH... 11,935 12,753 13,093
====================================
[Dollars in millions]
1996 1997 1998
Distribution of outlays by account:
National Cancer Institute......... 2,011 2,299 2,178
National Heart, Lung, and Blood
Institute....................... 1,214 1,387 1,391
National Institute of Dental
Research........................ 126 187 184
National Institute of Diabetes and
Digestive and Kidney Diseases... 794 790 811
National Institute of Neurological
Disorders and Stroke............ 501 693 709
National Institute of Allergy and
Infectious Diseases............. 893 1,185 608
National Institute of General
Medical Sciences................ 803 957 979
National Institute of Child Health
and Human Development........... 542 607 571
National Eye Institute............ 229 318 322
National Institute of
Environmental Health Sciences... 212 296 310
National Institute on Aging....... 359 461 484
National Institute of Arthritis
and Musculoskeletal and Skin
Diseases........................ 208 247 253
National Institute on Deafness and
Other Communication Disorders... 152 179 187
National Institute of Nursing
Research........................ 37 56 55
National Institute on Alcohol
Abuse and Alcoholism............ 222 204 203
[[Page 506]]
National Institute on Drug Abuse.. 407 461 339
National Institute of Mental
Health.......................... 617 669 608
National Center for Research
Resources....................... 289 400 344
National Human Genome Research
Institute....................... 145 176 191
John E. Fogarty International
Center.......................... 28 23 17
National Library of Medicine...... 117 145 152
Office of the Director............ 195 245 224
Office of AIDS Research........... 1,478
Buildings and Facilities.......... 118 161 188
------------------------------------
Subtotal Outlays.............. 10,212 12,146 12,786
Cooperative Research and
Development Agreements.......... 5 12 15
------------------------------------
Total Outlays, NIH............ 10,217 12,158 12,801
====================================
Note: The total amount for FY 1997 AIDS research was $1,501,720,000,
which was jointly determined by the Director of NIH and the Director of the
Office of AIDS Research pursuant to section 211 of P.L. 104-208.
$1,466,131,000 was made available to OAR. This amount is net of the
$35,589,000 in AIDS funds earmarked in P.L. 104-208 in the Office of the
Director account.
This program funds biomedical research and research training. These
accounts will continue to be appropriated separately, and are displayed
in a consolidated format to improve the readability of the presentation.
Detailed information is available through the Department of Health and
Human Services.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9915-0-1-552 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 457 476 496
11.3 Other than full-time permanent 96 106 108
11.5 Other personnel compensation.. 24 26 23
11.8 Special personal services
payments.................... 81 88 92
--------- --------- ----------
11.9 Total personnel compensation 658 696 719
12.1 Civilian personnel benefits..... 138 145 151
21.0 Travel and transportation of
persons....................... 18 19 19
22.0 Transportation of things........ 3 4 4
23.1 Rental payments to GSA.......... 4 5 5
23.2 Rental payments to others....... 7 6 6
23.3 Communications, utilities, and
miscellaneous charges......... 44 45 45
24.0 Printing and reproduction....... 14 12 12
25.1 Advisory and assistance services 19 21 27
25.2 Other services.................. 342 631 416
25.3 Purchases of goods and services
from Government accounts...... 857 764 764
25.4 Operation and maintenance of
facilities.................... 97 166 164
25.5 Research and development
contracts..................... 710 688 705
25.6 Medical care.................... 5 5 5
25.7 Operation and maintenance of
equipment..................... 34 33 33
25.8 Subsistence and support of
persons....................... 8 11
26.0 Supplies and materials.......... 120 124 123
31.0 Equipment....................... 105 102 98
41.0 Grants, subsidies, and
contributions................. 8,714 9,494 9,794
42.0 Insurance claims and indemnities 3 3 3
--------- --------- ----------
99.0 Subtotal, direct obligations.. 11,900 12,974 13,093
99.0 Reimbursable obligations.......... 330 360 404
--------- --------- ----------
99.9 Total obligations............... 12,230 13,334 13,497
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-9915-0-1-552 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Full-time equivalent employment. 15,050 15,047 15,088
1005 Full-time equivalent of overtime
and holiday hours............. 196 196 196
1011 Exempt Full-time equivalent
employment.................... 14 14
Reimbursable:
2001 Total compensable workyears: Full-
time equivalent employment...... 65 66 65
---------------------------------------------------------------------------
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
Federal Funds
General and special funds:
Substance Abuse and Mental Health Services
For carrying out [titles V and XIX of] the Public Health Service Act
with respect to substance abuse and mental health services, the
Protection and Advocacy for Mentally Ill Individuals Act of 1986,
[section 30401 of Public Law 103-322 and section 301 of the Public
Health Service Act with respect to program management, $2,134,743,000,
of which $5,000,000 shall be for grants to rural and Native American
projects and $12,800,000 shall be for activities authorized by section
30401 of Public Law 103-322] $2,155,943,000, of which $1,000,000,
together with unobligated balances for facilities renovation, shall be
available for sealing off and preserving the Federally-owned unoccupied
facilities at St. Elizabeths Hospital and shall remain available until
September 30, 1999. (Department of Health and Human Services
Appropriations Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1362-0-1-550 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Mental health and substance abuse
activities...................... 320 494 505
00.02 Mental health partnership......... 275 275 275
00.03 Substance abuse partnership....... 1,234 1,310 1,320
00.04 Substance abuse partnership--
temporary supplement (mandatory) 50 50
00.05 Program management................ 56 55 55
00.06 Building and facilities........... 1
--------- --------- ----------
00.91 Total direct program............ 1,885 2,184 2,206
01.01 Reimbursable program.............. 20 20 20
--------- --------- ----------
10.00 Total obligations............... 1,905 2,204 2,226
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... 2 2 2
22.00 New budget authority (gross)...... 1,905 2,204 2,226
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 1,907 2,206 2,228
23.95 New obligations................... -1,905 -2,204 -2,226
24.40 Unobligated balance available, end
of year: Uninvested balance..... 2 2 2
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
40.00 Appropriation................... 1,883 2,134 2,156
42.00 Transferred from other accounts. 2
--------- --------- ----------
43.00 Appropriation (total)......... 1,885 2,134 2,156
Permanent:
65.00 Advance appropriation (definite) 50 50
68.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 20 20 20
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 1,905 2,204 2,226
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 1,250 1,048 1,327
73.10 New obligations................... 1,905 2,204 2,226
73.20 Total outlays (gross)............. -2,104 -1,925 -2,109
73.40 Adjustments in expired accounts... -3
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 1,048 1,327 1,444
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 905 1,067 1,078
86.93 Outlays from current balances..... 1,179 813 986
86.97 Outlays from new permanent
authority....................... 20 45 45
--------- --------- ----------
87.00 Total outlays (gross)........... 2,104 1,925 2,109
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -20 -20 -20
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 1,885 2,184 2,206
[[Page 507]]
90.00 Outlays........................... 2,083 1,905 2,089
---------------------------------------------------------------------------
This program provides Federal support for treatment and prevention
in the areas of alcoholism, drug abuse, and mental health.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1362-0-1-550 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 31 32 32
11.3 Other than full-time permanent 1 1 1
11.5 Other personnel compensation.. 1 1 1
--------- --------- ----------
11.9 Total personnel compensation 33 34 34
12.1 Civilian personnel benefits..... 7 7 7
21.0 Travel and transportation of
persons....................... 1 1 1
23.1 Rental payments to GSA.......... 3 3 3
23.3 Communications, utilities, and
miscellaneous charges......... 2 1 1
24.0 Printing and reproduction....... 2 2 1
25.1 Advisory and assistance services 33 38 70
25.2 Other services.................. 64 102 125
25.3 Purchases of goods and services
from Government accounts...... 14 13 11
31.0 Equipment....................... 1 1 1
41.0 Grants, subsidies, and
contributions................. 1,723 1,980 1,950
42.0 Insurance claims and indemnities 2 2 2
--------- --------- ----------
99.0 Subtotal, direct obligations.. 1,885 2,184 2,206
99.0 Reimbursable obligations.......... 20 20 20
--------- --------- ----------
99.9 Total obligations............... 1,905 2,204 2,226
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-1362-0-1-550 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Full-time equivalent employment. 590 590 590
1005 Full-time equivalent of overtime
and holiday hours............. 2 2 2
Reimbursable:
Total compensable workyears:
2001 Full-time equivalent employment. 2 2 2
2011 Exempt Full-time equivalent
employment.................... 64 61 61
---------------------------------------------------------------------------
AGENCY FOR HEALTH CARE POLICY AND RESEARCH
Federal Funds
General and special funds:
Health Care Policy and Research
For carrying out titles III and IX of the Public Health Service Act,
and part A of title XI of the Social Security Act, [$96,175,000]
$87,000,000; in addition, amounts received from Freedom of Information
Act fees, reimbursable and interagency agreements, and the sale of data
tapes shall be credited to this appropriation and shall remain available
until expended: Provided, That the amount made available pursuant to
section 926(b) of the Public Health Service Act shall not exceed
[$47,412,000] $62,000,000. (Department of Health and Human Services
Appropriations Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1700-0-1-552 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
01.01 Research on health care systems
cost and access............... 7 36 17
01.02 Health insurance and expenditure
surveys....................... 10 10
01.03 Research on health care outcomes
and quality................... 56 48 58
01.04 Program support................. 2 2 2
--------- --------- ----------
01.91 Total direct program.......... 65 96 87
04.01 Reimbursable program.............. 69 57 71
--------- --------- ----------
10.00 Total obligations............... 134 153 158
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 134 153 158
23.95 New obligations................... -134 -153 -158
24.40 Unobligated balance available, end
of year: Uninvested balance..... 1
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
40.00 Appropriation................... 65 96 87
Permanent:
68.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 69 57 71
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 134 153 158
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 159 142 143
73.10 New obligations................... 134 153 158
73.20 Total outlays (gross)............. -150 -152 -159
73.40 Adjustments in expired accounts... -1
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 142 143 142
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority -25 16 15
86.93 Outlays from current balances..... 106 79 73
86.97 Outlays from new permanent
authority....................... 69 57 71
--------- --------- ----------
87.00 Total outlays (gross)........... 150 152 159
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -69 -57 -71
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 65 96 87
90.00 Outlays........................... 81 95 88
---------------------------------------------------------------------------
This activity supports research and information dissemination on
health care services and technology, medical effectiveness, and patient
outcomes.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1700-0-1-552 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 6 12 13
11.3 Other than full-time permanent 1 1 2
11.5 Other personnel compensation.. 1
--------- --------- ----------
11.9 Total personnel compensation 7 14 15
12.1 Civilian personnel benefits..... 1 4 4
23.1 Rental payments to GSA.......... 1 3 3
23.3 Communications, utilities, and
miscellaneous charges......... 1 1 1
24.0 Printing and reproduction....... 1 2 2
25.2 Other services.................. 2 4 4
25.3 Purchases of goods and services
from Government accounts...... 1 2 2
25.5 Research and development
contracts..................... 11 11 30
31.0 Equipment....................... 1 1
41.0 Grants, subsidies, and
contributions................. 40 54 25
--------- --------- ----------
99.0 Subtotal, direct obligations.. 65 96 87
99.0 Reimbursable obligations.......... 69 57 71
--------- --------- ----------
99.9 Total obligations............... 134 153 158
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-1700-0-1-552 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Full-time equivalent employment. 104 197 197
1005 Full-time equivalent of overtime
and holiday hours............. 1 1 1
Reimbursable:
2001 Total compensable workyears: Full-
time equivalent employment...... 148 55 55
---------------------------------------------------------------------------
[[Page 508]]
HEALTH CARE FINANCING ADMINISTRATION
Federal Funds
General and special funds:
Grants to States for Medicaid
For carrying out, except as otherwise provided, titles XI and XIX of
the Social Security Act, [$75,056,618,000] $71,530,429,000, to remain
available until expended.
For making, after May 31, [1997] 1998, payments to States under
title XIX of the Social Security Act for the last quarter of fiscal year
[1997] 1998 for unanticipated costs, incurred for the current fiscal
year, such sums as may be necessary.
For making payments to States under title XIX of the Social Security
Act for the first quarter of fiscal year [1998, $27,988,993,000] 1999,
$27,800,689,000, to remain available until expended.
Payment under title XIX may be made for any quarter with respect to
a State plan or plan amendment in effect during such quarter, if
submitted in or prior to such quarter and approved in that or any
subsequent quarter. (Department of Health and Human Services
Appropriations Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0512-0-1-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Medicaid vendor payments.......... 88,642 93,346 99,144
00.02 State and local administration.... 3,881 4,634 4,875
00.03 Vaccine purchases................. 204 523 365
--------- --------- ----------
10.00 Total obligations (object class
41.0)......................... 92,728 98,503 104,384
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... 12,740 2,155 4,864
22.00 New budget authority (gross)...... 82,142 101,212 99,519
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 94,882 103,367 104,384
23.95 New obligations................... -92,728 -98,503 -104,384
24.40 Unobligated balance available, end
of year: Uninvested balance..... 2,155 4,864
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
40.00 Appropriation................... 55,094 75,057 71,530
Permanent:
65.00 Advance appropriation (definite) 27,048 26,155 27,989
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 82,142 101,212 99,519
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 4,606 5,344 5,344
73.10 New obligations................... 92,728 98,503 104,384
73.20 Total outlays (gross)............. -91,990 -98,503 -104,384
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 5,344 5,344 5,344
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 47,596 64,849 66,187
86.93 Outlays from current balances..... 17,346 7,499 10,208
86.97 Outlays from new permanent
authority....................... 27,048 26,155 27,989
--------- --------- ----------
87.00 Total outlays (gross)........... 91,990 98,503 104,384
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 82,142 101,212 99,519
90.00 Outlays........................... 91,990 98,503 104,384
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
1996 actual 1997 est. 1998 est.
Enacted/requested:
Budget Authority.................. 82,142 101,212 99,519
Outlays........................... 91,990 98,503 104,384
Legislative proposal, subject to
PAYGO:
Budget Authority.................. 1,456
Outlays........................... 39 1,417
------------------------------------
Total:
Budget Authority.................. 82,142 101,212 100,975
Outlays........................... 91,990 98,542 105,801
====================================
Medicaid assists States in providing medical care to their low-
income population by granting Federal matching payments under title XIX
of the Social Security Act to States with approved plans.
Current and projected vaccine excise tax receipts to the Vaccine
Injury Compensation Program Trust Fund far exceed current and projected
claims to the Trust Fund. The Budget proposes lowering revenue to the
Trust Fund by exempting Federal programs (which provide free vaccine to
low-income, uninsured, and underinsured children) from payment of the
vaccine excise tax in FY 1998. Exempting these programs will result in
Federal savings to the Grants to States for Medicaid account.
Grants to States for Medicaid
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0512-4-1-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
10.00 Total obligations (object class
41.0)........................... 39 1,417
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... -39
22.00 New budget authority (gross)...... 1,456
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 1,417
23.95 New obligations................... -39 -1,417
24.40 Unobligated balance available, end
of year: Uninvested balance..... -39
----------------------------------------------------------------------------
New budget authority (gross), detail:
40.00 Appropriation..................... 1,456
----------------------------------------------------------------------------
Change in unpaid obligations:
73.10 New obligations................... 39 1,417
73.20 Total outlays (gross)............. -39 -1,417
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 39 1,456
86.93 Outlays from current balances..... -39
--------- --------- ----------
87.00 Total outlays (gross)........... 39 1,417
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 1,456
90.00 Outlays........................... 39 1,417
---------------------------------------------------------------------------
This schedule reflects the effects of Medicaid, Medicare, welfare,
children's health, and other mandatory proposals included in the Budget
on the Grants to States for Medicaid account.
Payments to Health Care Trust Funds
For payment to the Federal Hospital Insurance and the Federal
Supplementary Medical Insurance Trust Funds, as provided under sections
217(g) and 1844 of the Social Security Act, sections 103(c) and 111(d)
of the Social Security Amendments of 1965, section 278(d) of Public Law
97-248, and for administrative expenses incurred pursuant to section
201(g) of the Social Security Act, [$60,079,000,000] $63,581,000,000.
(Department of Health and Human Services Appropriations Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0580-0-1-571 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Supplementary medical insurance
(SMI)........................... 61,702 59,354 63,416
00.02 Hospital insurance for uninsured
(HI)............................ 358 405 -52
00.03 Federal uninsured payment (HI).... 61 76 86
00.04 Program management (HI)........... 145 142 131
[[Page 509]]
00.06 Federal payments from taxation of
OASDI benefits (HI)............. 4,069 4,163 4,351
00.07 SECA tax credits (HI)............. -10
00.08 Fraud and abuse control, FBI...... 47 56
00.10 Fraud and abuse control, criminal
fines........................... 15 15
00.11 Fraud and abuse control, civil
monetary penalties.............. 218 237
--------- --------- ----------
10.00 Total obligations............... 66,325 64,420 68,240
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 67,372 64,522 68,240
22.30 Unobligated balance expiring...... -1,047 -102
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 66,325 64,420 68,240
23.95 New obligations................... -66,325 -64,420 -68,240
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
40.00 Appropriation................... 63,313 60,079 63,581
Permanent:
60.05 Appropriation (indefinite)...... 4,059 4,443 4,659
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 67,372 64,522 68,240
----------------------------------------------------------------------------
Change in unpaid obligations:
73.10 New obligations................... 66,325 64,420 68,240
73.20 Total outlays (gross)............. -66,325 -64,420 -68,240
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 62,266 59,977 63,581
86.97 Outlays from new permanent
authority....................... 4,059 4,443 4,659
--------- --------- ----------
87.00 Total outlays (gross)........... 66,325 64,420 68,240
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 67,372 64,522 68,240
90.00 Outlays........................... 66,325 64,420 68,240
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
1996 actual 1997 est. 1998 est.
Enacted/requested:
Budget Authority.................. 67,372 64,522 68,240
Outlays........................... 66,325 64,420 68,240
Legislative proposal, not subject to
PAYGO:
Budget Authority.................. 14,668
Outlays........................... 14,668
------------------------------------
Total:
Budget Authority.................. 67,372 64,522 82,908
Outlays........................... 66,325 64,420 82,908
====================================
Payments are made (1) to the Federal Supplementary Medical Insurance
Trust Fund; and (2) to the Federal Hospital Insurance Trust Fund for
individuals aged 65 and over who meet certain transitional insured
status requirements, and for civil service employees and annuitants who
worked before 1983 and who were employed during January 1983. Beginning
in 1992, amounts are included for non-Medicare activities of HCFA
Program Management.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0580-0-1-571 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
41.0 Grants, subsidies, and
contributions................... 65,761 63,797 68,075
42.0 Insurance claims and indemnities.. 419 481 34
92.0 Undistributed..................... 145 142 131
--------- --------- ----------
99.9 Total obligations............... 66,325 64,420 68,240
---------------------------------------------------------------------------
Payments to Health Care Trust Funds
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0580-2-1-571 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
10.00 Total obligations (object class
41.0)........................... 14,668
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 14,668
23.95 New obligations................... -14,668
----------------------------------------------------------------------------
New budget authority (gross), detail:
40.00 Appropriation..................... 14,668
----------------------------------------------------------------------------
Change in unpaid obligations:
73.10 New obligations................... 14,668
73.20 Total outlays (gross)............. -14,668
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 14,668
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 14,668
90.00 Outlays........................... 14,668
---------------------------------------------------------------------------
This schedule reflects the effects of the Medicare reform proposals
contained in the Administration's balanced budget proposal on the
Payments to Health Care Trust Funds account.
Program Management
For carrying out, except as otherwise provided, titles XI, XVIII,
and XIX of the Social Security Act, title XIII of the Public Health
Service Act, and the Clinical Laboratory Improvement Amendments of 1988,
not to exceed [$1,735,125,000] $1,774,500,000, to be transferred from
the Federal Hospital Insurance and the Federal Supplementary Medical
Insurance Trust Funds, as authorized by section 201(g) of the Social
Security Act; together with all funds collected in accordance with
section 353 of the Public Health Service Act, the latter funds to remain
available until expended, together with such sums as may be collected
from authorized user fees and the sale of data, which shall remain
available until expended: Provided, That all funds derived in accordance
with 31 U.S.C. 9701 from organizations established under title XIII of
the Public Health Service Act are to be credited to and available for
carrying out the purposes of this appropriation. (Department of Health
and Human Services Appropriations Act, 1997.)
Unavailable Collections (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0511-0-1-550 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Balance, start of year:
01.99 Balance, start of year............
Receipts:
02.01 Survey and certification fees,
HCFA, legislative proposal...... 10
Appropriation:
05.01 Program management, legislative
proposal........................ -10
07.99 Total balance, end of year........
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0511-0-1-550 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.01 Research, demonstrations, and
evaluation projects........... 53 44 45
00.02 Medicare contractors............ 1,555 1,207 1,223
00.04 State certification............. 145 158 148
00.05 Administrative costs............ 325 325 359
--------- --------- ----------
00.91 Total direct program............ 2,078 1,734 1,775
Reimbursable program:
08.01 CLIA............................ 29 43 43
08.02 Other reimbursements............ 4 2 2
--------- --------- ----------
08.91 Total reimbursable program...... 33 45 45
--------- --------- ----------
10.00 Total obligations............... 2,111 1,779 1,820
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... 15 17 17
22.00 New budget authority (gross)...... 2,159 1,779 1,820
22.30 Unobligated balance expiring...... -46
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 2,128 1,796 1,837
[[Page 510]]
23.95 New obligations................... -2,111 -1,779 -1,820
24.40 Unobligated balance available, end
of year: Uninvested balance..... 17 17 17
----------------------------------------------------------------------------
New budget authority (gross), detail:
68.00 Spending authority from offsetting
collections (gross): Offsetting
collections (cash).............. 2,159 1,779 1,820
2,159 1,779 1,820
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 445 452 452
73.10 New obligations................... 2,111 1,779 1,820
73.20 Total outlays (gross)............. -2,116 -1,779 -1,820
73.40 Adjustments in expired accounts... 12
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 452 452 452
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new permanent
authority....................... 2,116 1,779 1,820
86.98 Outlays from permanent balances...
--------- --------- ----------
87.00 Total outlays (gross)........... 2,116 1,779 1,820
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -2,124 -1,734 -1,775
88.40 Non-Federal sources........... -35 -45 -45
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -2,159 -1,779 -1,820
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... -43
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
1996 actual 1997 est. 1998 est.
Enacted/requested:
Budget Authority..................
Outlays........................... -43
Legislative proposal, subject to
PAYGO:
Budget Authority.................. 2,610
Outlays........................... 2,523
------------------------------------
Total:
Budget Authority.................. 2,610
Outlays........................... -43 2,523
====================================
Program management activities include funding for research, Medicare
contractors, survey and certification, CLIA, and administrative costs.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0511-0-1-550 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Personnel compensation:
11.1 Full-time permanent............. 216 228 239
11.3 Other than full-time permanent.. 5 5 5
11.5 Other personnel compensation.... 1 2 2
--------- --------- ----------
11.9 Total personnel compensation.. 222 235 246
12.1 Civilian personnel benefits....... 38 41 47
21.0 Travel and transportation of
persons......................... 5 3 5
23.1 Rental payments to GSA............ 16 23 31
23.3 Communications, utilities, and
miscellaneous charges........... 7 4 8
24.0 Printing and reproduction......... 5 3 6
25.1 Advisory and assistance services.. 34 27 29
25.2 Other services.................... 274 225 213
25.6 Medical care...................... 1,466 1,205 1,221
26.0 Supplies and materials............ 3 1 1
31.0 Equipment......................... 13 6
41.0 Grants, subsidies, and
contributions................... 28 12 6
99.5 Below reporting threshold......... 1
--------- --------- ----------
99.9 Total obligations............... 2,111 1,779 1,820
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0511-0-1-550 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Total compensable workyears:
1001 Full-time equivalent employment... 4,081 4,085 4,085
1005 Full-time equivalent of overtime
and holiday hours............... 9 9 9
---------------------------------------------------------------------------
Program Management
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0511-4-1-550 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Healthy working families grants... 1,738
00.02 Grants for health insurance
cooperatives.................... 25
00.03 Healthy kids State partnership
grants.......................... 750
00.04 Survey and certification user fee. 10
--------- --------- ----------
10.00 Total obligations............... 2,523
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance.........................
22.00 New budget authority (gross)...... 2,610
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 2,610
23.95 New obligations................... -2,523
24.40 Unobligated balance available, end
of year: Uninvested balance..... 87
----------------------------------------------------------------------------
New budget authority (gross), detail:
60.00 Appropriation..................... 2,600
60.25 Appropriation (special fund,
indefinite)..................... 10
--------- --------- ----------
63.00 Appropriation (total)........... 2,610
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 2,610
----------------------------------------------------------------------------
Change in unpaid obligations:
73.10 New obligations................... 2,523
73.20 Total outlays (gross)............. -2,523
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new permanent
authority....................... 2,523
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 2,610
90.00 Outlays........................... 2,523
---------------------------------------------------------------------------
This schedule reflects the effects on the Program Management account
of the Administration's proposals to: (1) create a four year
demonstration called ``Healthy Working Families'' to finance health
insurance for the temporarily unemployed, (2) create a State grant
program to foster the development of purchasing cooperatives, (3) create
a State grant demonstration program called ``Healthy Kids'' to support
State efforts to expand insurance options for uninsured children, and
(4) require States to collect and retain fees from providers to cover
the cost of initial surveys required for participation in the Medicare
program.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0511-4-1-550 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
25.2 Other services.................... 10
41.0 Grants, subsidies, and
contributions................... 2,513
--------- --------- ----------
99.9 Total obligations............... 2,523
---------------------------------------------------------------------------
Health Maintenance Organization Loan and Loan Guarantee Fund
For carrying out subsections (d) and (e) of section 1308 of the
Public Health Service Act, any amounts received by the Secretary
[[Page 511]]
in connection with loans and loan guarantees under title XIII of the
Public Health Service Act, to be available without fiscal year
limitation for the payment of outstanding obligations. During fiscal
year [1997] 1998, no commitments for direct loans or loan guarantees
shall be made. (Department of Health and Human Services Appropriations
Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4420-0-3-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.05 Interest payments to FFB.......... 1 1
--------- --------- ----------
10.00 Total obligations (object class
43.0)......................... 1 1
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.90 Unobligated balance available,
start of year: Fund balance..... 11 11 10
22.00 New budget authority (gross)...... 4 2 2
22.60 Redemption of debt................ -3 -2 -2
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 12 11 10
23.95 New obligations................... -1 -1
24.90 Unobligated balance available, end
of year: Fund balance........... 11 10 10
----------------------------------------------------------------------------
New budget authority (gross), detail:
68.00 Spending authority from offsetting
collections (gross): Offsetting
collections (cash).............. 4 2 2
----------------------------------------------------------------------------
Change in unpaid obligations:
73.10 New obligations................... 1 1
73.20 Total outlays (gross)............. -1 -1 -1
----------------------------------------------------------------------------
Outlays (gross), detail:
86.93 Outlays from current balances..... 1 1 1
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
Non-Federal sources:
88.40 Interest.................... -1
88.40 Other....................... -3 -2 -2
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -4 -2 -2
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... -3 -1 -1
---------------------------------------------------------------------------
Trust Funds
Federal Hospital Insurance Trust Fund
Unavailable Collections (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8005-0-7-571 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Balance, start of year:
01.99 Balance, start of year............ 114,830 106,229 96,363
Receipts:
02.01 Transfers from general fund (FICA
taxes).......................... 97,866 102,064 105,744
02.02 Receipts from Railroad Retirement
Board........................... 362 366 367
02.03 Transfers from general fund (SECA
taxes).......................... 6,752 6,750 8,056
02.04 Federal employer contributions
(FICA).......................... 1,787 1,805 1,943
02.05 Postal service employer
contributions (FICA)............ 522 595 618
02.06 Refunds........................... 17
02.07 Interest received by trust funds.. 10,350 9,914 8,855
02.08 Other proprietary receipts from
the public...................... 1
02.09 Interest received by trust funds,
legislative proposal............ 302
02.10 Taxation on OASDI benefits........ 4,069 4,163 4,351
02.11 Premiums collected for uninsured
individuals not otherwise
eligible, legislative proposal.. -180
02.12 Interest payments by Railroad
Retirement Board................ 39 35 35
02.13 Payments from the general fund
(uninsured and program
management)..................... 554 623 165
02.14 Payments for military service
credits......................... 73 70 64
02.15 Premiums collected for uninsured
individuals not otherwise
eligible........................ 1,107 1,265 1,385
02.16 Payment from the general fund..... 47 56
02.17 Criminal fines, transfers from the
general fund.................... 15 15
02.18 Civil monetary penalties,
transfers from the general fund. 218 237
02.20 Civil penalties and damages....... 50 50
--------- --------- ----------
02.99 Total receipts.................. 123,499 127,980 132,063
--------- --------- ----------
04.00 Total: Balances and collections... 238,329 234,209 228,426
Appropriation:
05.01 Federal hospital insurance trust
fund............................ -132,100 -137,259 -148,484
05.02 Health care fraud and abuse
control account................. -591 -676
05.04 Federal hospital insurance trust
fund, legislative proposal
subject to PAYGO................ 19,410
--------- --------- ----------
05.99 Subtotal appropriation............ -132,100 -137,850 -129,750
06.20 Reduction pursuant to Public Law
104-208......................... 4
07.99 Total balance, end of year........ 106,229 96,363 98,676
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8005-0-7-571 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Benefit payments, HI.............. 128,003 136,021 147,171
00.02 Administration, HI................ 1,172 1,123 1,218
00.03 Peer review organizations, HI..... 521 80 63
00.04 Research, HI...................... 38 31 31
00.05 Quinquennial adjustment for
military service credits........ 2,366
--------- --------- ----------
10.00 Total obligations............... 132,100 137,255 148,484
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 132,100 137,255 148,484
23.95 New obligations................... -132,100 -137,255 -148,484
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
40.26 Appropriation (trust fund,
definite)..................... 1,169 1,114 1,209
Permanent:
60.27 Appropriation (trust fund,
indefinite)................... 122,330 126,866 130,732
60.28 Appropriation (unavailable
balances)..................... 8,601 9,279 16,543
60.75 Reduction pursuant to P.L. 104-
208........................... -4
--------- --------- ----------
63.00 Appropriation (total)......... 130,931 136,141 147,274
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 132,100 137,255 148,484
----------------------------------------------------------------------------
Change in unpaid obligations:
72.41 Unpaid obligations, start of year:
Obligated balance: U.S.
Securities: Par value........... 14,691 19,107 18,890
73.10 New obligations................... 132,100 137,255 148,484
73.20 Total outlays (gross)............. -127,683 -137,471 -148,686
74.41 Unpaid obligations, end of year:
Obligated balance: U.S.
Securities: Par value........... 19,107 18,890 18,688
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 1,098 1,045 1,140
86.93 Outlays from current balances..... 130 148 113
86.97 Outlays from new permanent
authority....................... 111,894 117,319 128,656
86.98 Outlays from permanent balances... 14,561 18,959 18,777
--------- --------- ----------
87.00 Total outlays (gross)........... 127,683 137,471 148,686
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 132,100 137,255 148,484
90.00 Outlays........................... 127,683 137,471 148,686
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
1996 actual 1997 est. 1998 est.
Enacted/requested:
Budget Authority.................. 132,100 137,255 148,483
Outlays........................... 127,683 137,471 148,686
Legislative proposal, subject to
PAYGO:
Budget Authority.................. -19,410
Outlays........................... -19,410
------------------------------------
Total:
Budget Authority.................. 132,100 137,255 129,073
Outlays........................... 127,683 137,471 129,276
====================================
The Hospital Insurance (HI) program funds the costs of hospital and
related care for individuals age 65 or older and for eligible disabled
people.
The status of the trust fund is as follows:
[[Page 512]]
Status of Funds (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8005-0-7-571 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Unexpended balance, start of year:
0100 Treasury balance.................. -344 -467 1
0101 U.S. Securities: Par value........ 129,864 125,803 115,253
--------- --------- ----------
0199 Total balance, start of year.... 129,520 125,336 115,254
Cash income during the year:
Governmental receipts:
0200 FHI Trust Fund, Transfers from
general fund (FICA taxes)..... 97,865 102,064 105,744
0201 FHI Trust Fund, Transfers from
general fund (SECA taxes)..... 6,752 6,750 8,056
0202 Refunds......................... 17
0205 FHI Trust Fund, Receipts from
Railroad Retirement Board..... 362 366 367
0206 HCFAC: Civil Penalties and
Damages....................... 50 50
Proprietary receipts:
0221 FHI Trust Fund, Premiums
collected for uninsured
individuals not otherwise
eligible...................... 1,107 1,265 1,385
0222 FHI Trust Fund, Premiums
collected for uninsured
individuals not otherwise
eligible, proposed legislation -180
0223 Other proprietary receipts...... 1
Intragovernmental transactions:
0240 FHI Trust Fund, Federal employer
contributions (FICA).......... 1,787 1,805 1,943
0241 FHI Trust Fund, Postal service
employer contributions (FICA). 522 595 618
0242 FHI Trust Fund, Federal payment
for transitional coverage for
uninsured Federal employees... 61 76 86
0243 FHI Trust Fund, Federal payment
for transitional coverage for
the uninsured................. 358 405 -52
0244 FHI Trust Fund, Federal payment
for SECA tax credits.......... -10
0245 FHI Trust Fund, General Fund
transfer, Program management
(HI).......................... 145 142 131
0246 FHI Trust Fund, Federal payments
for OASDI taxes............... 4,069 4,163 4,351
0248 FHI Trust fund, Interest payment
from Railroad Retirement Board 39 35 35
0249 FHI Trust Fund, Interest on
investments................... 10,350 9,914 8,855
0250 FHI Trust Fund, Interest on
investments................... 302
0251 FHI Trust Fund, Transfer from
Department of Defense for
military service credits...... 73 70 64
0252 HCFAC: FBI...................... 47 56
0253 HCFAC: Criminal Fines........... 15 15
0254 HCFAC: Civil Monetary Penalties. 218 237
0297 Income under present law.......... 123,499 127,980 131,941
0298 Income under proposed legislation. 122
--------- --------- ----------
0299 Total cash income............... 123,499 127,980 132,063
Cash outgo during year:
0500 Benefit payments.................. -123,908 -136,022 -147,171
0501 Benefit payments (proposed
legislation).................... 19,410
0502 Administration.................... -1,178 -1,139 -1,215
0504 Peer review organizations......... -181 -257 -262
0505 Research.......................... -50 -54 -38
0506 HCFAC............................. -591 -676
0507 Quinquennial Adjustment for
Military Service Credits........ -2,366
0597 Outgo under present law (-)....... -127,683 -138,062 -149,362
0598 Outgo under proposed legislation
(-)............................. 19,410
--------- --------- ----------
0599 Total cash outgo (-).............. -127,683 -138,062 -129,952
Unexpended balance, end of year:
0700 Uninvested balance................ -467 1 1
0701 U.S. Securities: Par value........ 125,803 115,253 117,364
--------- --------- ----------
0799 Total balance, end of year...... 125,336 115,254 117,365
---------------------------------------------------------------------------
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8005-0-7-571 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
25.3 Purchases of goods and services
from Government accounts........ 673 603 618
Grants, subsidies, and contributions:
41.0 Payment for health insurance
experiments and demonstration
projects...................... 38 31 31
41.0 Payment for peer review
organization (PRO) activities. 521 80 63
42.0 Insurance claims and indemnities.. 128,003 136,021 147,171
Undistributed:
92.0 Quinquennial Adjustment for
Military Service Credits...... 2,366
92.0 Reimbursement for administrative
expenses for other than SSA
LAE........................... 41 40 40
93.0 Administrative expenses: Portion
of limitation on salaries and
expenses: Social Security
Administration.................. 458 481 560
99.5 Below reporting threshold......... -1 1
--------- --------- ----------
99.9 Total obligations............... 132,100 137,255 148,484
---------------------------------------------------------------------------
The estimate of administrative expenses borne by each of the
financing sources, including the Hospital Insurance (HI) and
Supplemental Medical Insurance (SMI) trust funds for Medicare-related
activities performed by the Social Security Administration (SSA), has
been made by SSA based on the current cost allocation methodology.
Pursuant to section 201(g) of the Social Security Act, a final
accounting of actual payments is made after the close of each fiscal
year. In the Conference Committee Report for Public Law 103-296, The
Social Security Independence and Program Improvements Act of 1994, the
conferees requested that the Secretary of Health and Human Services and
the Commissioner of Social Security make a joint examination of the most
appropriate cost allocation methodology and report their joint findings
to the Congress within 36 months of enactment. The Secretary and the
Commissioner are in the process of designing and carrying out this study
and preparing the required report to Congress.
Federal Hospital Insurance Trust Fund
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8005-4-7-571 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Benefit payments, HI.............. -19,410
--------- --------- ----------
10.00 Total obligations (object class
42.0)......................... -19,410
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... -19,410
23.95 New obligations................... 19,410
----------------------------------------------------------------------------
New budget authority (gross), detail:
60.28 Appropriation (unavailable
balances)....................... -19,410
----------------------------------------------------------------------------
Change in unpaid obligations:
73.10 New obligations................... -19,410
73.20 Total outlays (gross)............. 19,410
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new permanent
authority....................... -19,410
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. -19,410
90.00 Outlays........................... -19,410
---------------------------------------------------------------------------
This schedule reflects the effects of the Medicare reform proposals
contained in the Administration's balanced budget proposal on the
Hospital Insurance Trust Fund.
Health Care Fraud and Abuse Control Account
(federal hospital insurance trust fund)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8393-0-7-571 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Medicare integrity program........ 440 500
00.02 FBI fraud and abuse control....... 47 56
00.03 Other fraud and abuse control..... 104 120
--------- --------- ----------
10.00 Total obligations............... 591 676
----------------------------------------------------------------------------
[[Page 513]]
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 591 676
23.95 New obligations................... -591 -676
----------------------------------------------------------------------------
New budget authority (gross), detail:
60.26 Appropriation (trust fund,
definite)....................... 591 676
----------------------------------------------------------------------------
Change in unpaid obligations:
73.10 New obligations................... 591 676
73.20 Total outlays (gross)............. -591 -676
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new permanent
authority....................... 591 676
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 591 676
90.00 Outlays........................... 591 676
---------------------------------------------------------------------------
The Health Care Fraud and Abuse Control (HCFAC) Account was
established by Sec. 201 of Public Law 104-191, the Health Insurance
Portability and Accountability Act of 1996. P.L. 104-191 established the
HCFAC Account within the Federal Hospital Insurance Trust Fund and
appropriated funds, to be available without further appropriation, from
the Trust Fund to the HCFAC Account for specified health care fraud and
abuse control activities of the Department of Health and Human Services
(HHS), the Department of Justice, and other agencies.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8393-0-7-571 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Direct obligations:
25.6 Medical care (HCFA)............. 440 500
92.0 Undistributed (FBI)............. 47 56
--------- --------- ----------
99.0 Subtotal, direct obligations.. 487 556
Allocation Account:
Personnel compensation:
Full-time permanent:
11.1 Full-time permanent (OIG)... 43 50
11.1 Full-time permanent (DoJ)... 7 9
11.1 Full-time permanent (OGC)... 1 1
--------- --------- ----------
11.9 Total personnel compensation 51 60
Civilian personnel benefits:
12.1 Civilian personnel benefits
(OIG)....................... 9 10
12.1 Civilian personnel benefits
(DoJ)....................... 2 3
Travel and transportation of
persons:
21.0 Travel and transportation of
persons (OIG)............... 3 3
21.0 Travel and transportation of
persons (DoJ)............... 1 1
21.0 Travel and transportation of
persons (OGC)............... 1 1
Rental payments to GSA:
23.1 Rental payments to GSA (OIG).. 4 5
23.1 Rental payments to GSA (DoJ).. 1 1
Communications, utilities, and
miscellaneous charges:
23.3 Communications, utilities, and
miscellaneous charges (OIG). 1 1
23.3 Communications, utilities, and
miscellaneous charges (DoJ). 1 1
Advisory and assistance
services:
25.1 Advisory and assistance
services (OIG).............. 1 1
25.1 Advisory and assistance
services (HCFA)............. 2 2
Other services:
25.2 Other services (OIG).......... 1 2
25.2 Other services (DoJ).......... 9 10
25.2 Other services (AoA).......... 1 1
25.2 Other services (Adverse Action
Data Bank).................. 2 2
25.2 Other services (Other non-HHS,
non-DoJ).................... 3 4
25.3 Purchases of goods and services
from Government accounts (OIG) 6 7
Supplies and materials:
26.0 Supplies and materials (OIG).. 1 1
26.0 Supplies and materials (DoJ).. 1 1
Equipment:
31.0 Equipment (OIG)............... 1 1
31.0 Equipment (DoJ)............... 2 2
--------- --------- ----------
99.0 Subtotal, allocation account.. 104 120
--------- --------- ----------
99.9 Total obligations............... 591 676
---------------------------------------------------------------------------
This schedule reflects estimated distribution of the Allocation
Account. Actual FY 1998 distribution will be determined by the Secretary
of HHS and the Attorney General.
1996 actual 1997 est. 1998 est.
Department of Justice (DOJ)......... 24 28
Office of the Inspector General, HHS 70 81
Health Care Financing Administration 2 2
Office of General Counsel, HHS...... 2 2
Administration on Aging............. 1 1
Other HHS........................... 2 2
Other non-HHS/DOJ................... 3 4
------------------------------------
Total........................... 104 120
====================================
Federal Supplementary Medical Insurance Trust Fund
Unavailable Collections (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8004-0-7-571 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Balance, start of year:
01.99 Balance, start of year............ 8,848 21,963 25,369
Receipts:
02.01 Federal contributions............. 61,702 59,354 63,416
02.02 Interest received by trust fund... 1,388 1,440 1,424
02.03 Other proprietary receipts from
the public...................... 4
02.05 Premiums collected for the aged... 16,858 16,779 18,060
02.06 Premiums collected for the
disabled........................ 2,073 2,249 2,538
02.07 Federal contributions, proposed
legislation..................... 14,668
02.09 Premiums collected for the aged,
proposed legislation............ -30
02.10 Premiums collected for the
disabled, proposed legislation.. -1
--------- --------- ----------
02.99 Total receipts.................. 82,025 79,822 100,075
--------- --------- ----------
04.00 Total: Balances and collections... 90,873 101,785 125,444
Appropriation:
05.01 Federal supplementary medical
insurance trust fund............ -68,910 -76,416 -84,010
05.03 Federal supplementary medical
insurance trust fund, proposed
legislation..................... -14,889
--------- --------- ----------
05.99 Subtotal appropriation............ -68,910 -76,416 -98,899
07.99 Total balance, end of year........ 21,963 25,369 26,545
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8004-0-7-571 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Benefit payments, SMI............. 67,107 74,923 82,456
00.02 Administration, SMI............... 1,759 1,476 1,537
00.03 Peer review organizations, SMI.... 27 4 3
00.04 Research, SMI..................... 17 13 14
--------- --------- ----------
10.00 Total obligations............... 68,910 76,416 84,010
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 68,910 76,416 84,010
23.95 New obligations................... -68,910 -76,416 -84,010
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
40.26 Appropriation (trust fund,
definite)..................... 1,770 1,484 1,546
Permanent:
60.27 Appropriation (trust fund,
indefinite)................... 80,255 78,338 83,892
60.28 Appropriation (unavailable
balances)..................... -13,115 -3,406 -1,428
--------- --------- ----------
63.00 Appropriation (total)......... 67,139 74,931 82,463
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 68,910 76,416 84,010
----------------------------------------------------------------------------
Change in unpaid obligations:
72.41 Unpaid obligations, start of year:
Obligated balance: U.S.
Securities: Par value........... 5,027 4,991 4,919
73.10 New obligations................... 68,910 76,416 84,010
73.20 Total outlays (gross)............. -68,946 -76,487 -84,015
74.41 Unpaid obligations, end of year:
Obligated balance: U.S.
Securities: Par value........... 4,991 4,919 4,914
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 1,647 1,361 1,420
86.93 Outlays from current balances..... 123 189 124
86.97 Outlays from new permanent
authority....................... 62,272 70,135 77,676
[[Page 514]]
86.98 Outlays from permanent balances... 4,904 4,802 4,795
--------- --------- ----------
87.00 Total outlays (gross)........... 68,946 76,487 84,015
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 68,910 76,416 84,010
90.00 Outlays........................... 68,946 76,487 84,015
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
1996 actual 1997 est. 1998 est.
Enacted/requested:
Budget Authority.................. 68,909 76,415 84,009
Outlays........................... 68,946 76,487 84,015
Legislative proposal, subject to
PAYGO:
Budget Authority.................. 14,889
Outlays........................... 14,889
------------------------------------
Total:
Budget Authority.................. 68,909 76,415 98,898
Outlays........................... 68,946 76,487 98,904
====================================
The Supplementary Medical Insurance (SMI) program is a voluntary
program which affords protection against the costs of physician and
certain other medical services. The program also covers treatment of
end-stage renal disease for eligible enrollees. SMI costs are financed
by premium payments from enrollees and contributions from the general
revenues.
The status of the trust fund is as follows:
Status of Funds (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8004-0-7-571 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Unexpended balance, start of year:
0100 Treasury balance.................. 361 -222 1
0101 U.S. Securities: Par value........ 13,513 27,175 30,287
--------- --------- ----------
0199 Total balance, start of year.... 13,874 26,953 30,288
Cash income during the year:
Proprietary receipts:
0221 Premiums collected for the aged,
FSMI Fund..................... 16,858 16,779 18,060
0222 Premiums collected for the aged,
FSMI Fund, proposed
legislation................... -30
Proprietary receipts:
0223 Premiums collected for the
disabled, FSMI Fund......... 2,073 2,249 2,538
0223 Premiums collected for the
disabled, FSMI Fund,
proposed legislation........ -1
0224 Proprietary receipts............ 4
Intragovernmental transactions:
0240 Federal contributions, FSMI Fund 61,702 59,354 63,416
0241 Federal contributions, FSMI
Fund, proposed legislation.... 14,668
0242 Interest received by trust fund,
FSMI Fund..................... 1,388 1,440 1,424
0297 Income under present law.......... 82,025 79,822 85,438
0298 Income under proposed legislation. 14,637
--------- --------- ----------
0299 Total cash income............... 82,025 79,822 100,075
Cash outgo during year:
Cash outgo during the year (-):
0501 Benefit payments & ESRD......... -67,167 -74,924 -82,457
0501 Benefit payments, proposed
legislation................... -14,889
0502 Administration.................... -1,747 -1,526 -1,527
0504 Peer review organizations......... -10 -14 -14
0505 Research.......................... -23 -24 -17
0597 Outgo under present law (-)....... -68,946 -76,487 -84,015
0598 Outgo under proposed legislation
(-)............................. -14,889
--------- --------- ----------
0599 Total cash outgo (-).............. -68,946 -76,487 -98,904
Unexpended balance, end of year:
0700 Treasury balance.................. -222 1 1
0701 U.S. Securities: Par value........ 27,175 30,287 31,458
--------- --------- ----------
0799 Total balance, end of year...... 26,953 30,288 31,459
---------------------------------------------------------------------------
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8004-0-7-571 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
25.3 Purchases of goods and services
from Government accounts........ 1,405 1,110 1,133
Grants, subsidies, and contributions:
41.0 Payment for peer review
organization (PRO) activity... 27 4 3
41.0 Payment for health insurance
experiments and demonstration
projects...................... 17 13 14
42.0 Insurance claims and indemnities.. 67,107 74,923 82,456
93.0 Administrative expenses: Portion
of limitation on salaries and
expenses: Social Security
Administration.................. 354 365 404
--------- --------- ----------
99.9 Total obligations............... 68,910 76,416 84,010
---------------------------------------------------------------------------
The estimate of administrative expenses borne by each of the
financing sources, including the Hospital Insurance (HI) and
Supplemental Medical Insurance (SMI) trust funds for Medicare-related
activities performed by the Social Security Administration (SSA), has
been made by SSA based on the current cost allocation methodology.
Pursuant to section 201(g) of the Social Security Act, a final
accounting of actual payments is made after the close of each fiscal
year. In the Conference Committee Report for Public Law 103-296, The
Social Security Independence and Program Improvements Act of 1994, the
conferees requested that the Secretary of Health and Human Services and
the Commissioner of Social Security make a joint examination of the most
appropriate cost allocation methodology and report their joint findings
to the Congress within 36 months of enactment. The Secretary and the
Commissioner are in the process of designing and carrying out this study
and preparing the required report to Congress.
Federal Supplementary Medical Insurance Trust Fund
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8004-4-7-571 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Benefit payments, SMI............. 14,889
--------- --------- ----------
10.00 Total obligations (object class
42.0)......................... 14,889
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 14,889
23.95 New obligations................... -14,889
----------------------------------------------------------------------------
New budget authority (gross), detail:
60.27 Appropriation (trust fund,
indefinite)..................... 14,889
14,889
----------------------------------------------------------------------------
Change in unpaid obligations:
73.10 New obligations................... 14,889
73.20 Total outlays (gross)............. -14,889
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new permanent
authority....................... 14,889
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 14,889
90.00 Outlays........................... 14,889
---------------------------------------------------------------------------
This schedule reflects the effects of the Medicare reform proposals
contained in the Administration's balanced budget proposal on the
Supplementary Medical Insurance Trust Fund.
Allocations Received From Other Accounts
Note.--Obligations incurred under allocations from other accounts
are included in the schedules of the parent appropriation as follows:
Health Care Financing Administration: ``Health Care Fraud and Abuse
Control Account.''
[[Page 515]]
ADMINISTRATION FOR CHILDREN AND FAMILIES
Federal Funds
General and special funds:
Temporary Assistance for Needy Families
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1552-0-1-609 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 State family assistance grant..... 111 13,535 16,489
00.02 Territories--family assistance
grants.......................... 78 78
00.03 Matching grants to territories.... 11 11
00.05 Supplemental grants for population
increases....................... 87
00.07 Tribal work programs.............. 8 8
--------- --------- ----------
00.91 Subtotal........................ 111 13,632 16,673
Loan program:
01.01 Loan fund disbursements......... 26 121
01.02 Loan fund repayments............ -38
--------- --------- ----------
01.91 Total loan program.............. 26 83
--------- --------- ----------
10.00 Total obligations (object class
41.0)......................... 111 13,658 16,756
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 111 13,658 16,756
23.95 New obligations................... -111 -13,658 -16,756
----------------------------------------------------------------------------
New budget authority (gross), detail:
60.05 Appropriation (indefinite)........ 111 13,658 16,756
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 111 1,369
73.10 New obligations................... 111 13,658 16,756
73.20 Total outlays (gross)............. -12,365 -16,586
73.40 Adjustments in expired accounts... -35
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 111 1,369 1,539
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new permanent
authority....................... 12,295 15,422
86.98 Outlays from permanent balances... 70 1,164
--------- --------- ----------
87.00 Total outlays (gross)........... 12,365 16,586
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 111 13,658 16,756
90.00 Outlays........................... 12,365 16,586
---------------------------------------------------------------------------
This account provides funding for activities established by the
Personal Responsibility and Work Opportunity Reconciliation Act of 1996
(P.L. 104-193). The Temporary Assistance for Needy Families block grant
provides funding to States for aid to poor families with children.
This account also includes Federal loans for State welfare programs,
established by section 406 of the Social Security Act as amended.
Administrative expenses for this activity are estimated to be $300,000
in fiscal year 1998 and are funded through ACF Federal administration in
the Children and Families Services Programs account.
Contingency Fund
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1522-0-1-609 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
10.00 Total obligations (object class
41.0)........................... 45 80
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 45 80
23.95 New obligations................... -45 -80
----------------------------------------------------------------------------
New budget authority (gross), detail:
60.00 Appropriation..................... 45 80
----------------------------------------------------------------------------
Change in unpaid obligations:
72.90 Unpaid obligations, start of year:
Obligated balance: Fund balance. 22
73.10 New obligations................... 45 80
73.20 Total outlays (gross)............. -23 -96
74.90 Unpaid obligations, end of year:
Obligated balance: Fund balance. 22 6
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new permanent
authority....................... 23 74
86.98 Outlays from permanent balances... 22
--------- --------- ----------
87.00 Total outlays (gross)........... 23 96
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 45 80
90.00 Outlays........................... 23 96
---------------------------------------------------------------------------
The Contingency Fund for State Welfare Programs supplements the
Temporary Assistance for Needy Families block grant by providing
matching amounts to States that reach certain unemployment or Food Stamp
caseload thresholds and maintain 100 percent of historical State
spending on block-granted programs.
Family Support Payments to States
[For making payments of such sums as necessary to each State for
carrying out the program of Aid to Families with Dependent Children
under title IV-A of the Social Security Act in fiscal year 1997 before
the effective date of the program of Temporary Assistance to Needy
Families (TANF) with respect to such State: Provided, That the sum of
the amounts available to a State with respect to expenditures under such
title IV-A in fiscal year 1997 under this appropriation and under such
title IV-A as amended by the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996 shall not exceed the limitations
under section 116(b) of such Act.]
[For making payments to States for carrying out title IV-A (other
than section 402(g)(6)) of the Social Security Act in calendar quarters
prior to October 1, 1996, such sums as may be necessary.]
[For making payments to States or other non-Federal entities under
titles I, IV-D, X, XI, XIV, and XVI of the Social Security Act and the
Act of July 5, 1960 (24 U.S.C. ch. 9), $2,158,000,000 to remain
available until expended.]
[For making, after May 31 of the current fiscal year, payments to
States or other non-Federal entities under titles I, IV-D, X, XI, XIV,
and XVI of the Social Security Act, for the last three months of the
current year for unanticipated costs, incurred for the current fiscal
year, such sums as may be necessary.]
[For making payments to States or other non-Federal entities under
titles I, IV-D, X, XI, XIV, and XVI of the Social Security Act and the
Act of July 5, 1960 (24 U.S.C. ch. 9) for the first quarter of fiscal
year 1998, $607,000,000 to remain available until expended.] (Department
of Health and Human Services Appropriations Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1501-0-1-609 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
Aid to families with dependent children (AFDC)
payments:
Benefit payments:
00.01 Properly issued payments...... 10,420 2,054 28
00.02 Erroneously issued payments... 665
00.03 Collection of excess State
errors...................... -15
--------- --------- ----------
00.91 Subtotal, benefit payments...... 11,085 2,054 13
01.02 Payments to territories........... 27 27 27
01.03 Emergency assistance.............. 1,546 743 233
01.04 Repatriation...................... 1 1
01.05 AFDC day care..................... 761 26 13
01.06 Transitional day care............. 303 11 5
01.07 At-risk day care.................. 291
01.08 State welfare administrative costs 1,531 235 8
--------- --------- ----------
01.91 Subtotal, other payments........ 4,459 1,043 287
--------- --------- ----------
[[Page 516]]
02.00 Subtotal, AFDC.................. 15,544 3,097 300
Child support enforcement (CSE):
02.01 Gross Federal share of
collections................... -1,263
02.02 Federal incentive payments to
States........................ 406 437 437
02.03 State child support
administrative costs.......... 1,984 2,335 2,386
02.04 Access and Visitation Grants.... 10 10
--------- --------- ----------
02.91 Subtotal, CSE................. 1,127 2,782 2,833
--------- --------- ----------
10.00 Total obligations (object class
41.0)......................... 16,671 5,879 3,133
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... 105 1,343 3,089
22.00 New budget authority (gross)...... 18,014 7,625 1,044
22.30 Unobligated balance expiring...... -105
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 18,014 8,968 4,133
23.95 New obligations................... -16,671 -5,879 -3,133
24.40 Unobligated balance available, end
of year: Uninvested balance..... 1,343 3,089 1,000
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
40.00 Appropriation................... 13,614 2,158
Permanent:
65.00 Advance appropriation (definite) 4,400 4,800 607
68.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 667 437
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 18,014 7,625 1,044
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 1,690 1,691 475
73.10 New obligations................... 16,671 5,879 3,133
73.20 Total outlays (gross)............. -16,670 -7,093 -3,461
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 1,691 475 147
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 10,592 1,158
86.93 Outlays from current balances..... 1,678 2,754 519
86.97 Outlays from new permanent
authority....................... 4,400 3,181 1,044
86.98 Outlays from permanent balances... 1,898
--------- --------- ----------
87.00 Total outlays (gross)........... 16,670 7,093 3,461
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.40 Offsetting collections (cash)
from: Non-Federal sources..... -667 -437
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 18,014 6,958 607
90.00 Outlays........................... 16,670 6,426 3,024
---------------------------------------------------------------------------
States have transitioned to the new Temporary Assistance for Needy
Families program more quickly than anticipated. As a result, unobligated
balances remain in this account which are sufficient to cover expected
State needs for child support enforcement activities through the first
quarter of fiscal year 1999. It is anticipated that this account will
return to its traditional appropriations cycle after then.
P.L. 104-193 modified the treatment of child support collections,
making it a combination of offsetting collections and receipts rather
than a reduction in obligations to States. The text table below shows
the traditional display of child support enforcement costs:
Net Costs of Child Support Enforcement
(In millions of dollars)
1996 1997 1998
Gross Federal share of collections.. -1,263 -1,506 -1,469
Federal incentive payments to States 406 437 437
State child support administrative
costs............................... 1,984 2,335 2,386
Access and visitation grants........ 10 10
------------------------------------
Subtotal........................ 1,126 1,276 1,364
Low Income Home Energy Assistance
For making payments under title XXVI of the Omnibus Budget
Reconciliation Act of 1981, [$1,000,000,000.] $300,000,000: Provided,
That these funds are hereby designated by Congress to be emergency
requirements pursuant to section 251(b)(2)(D) of the Balanced Budget and
Emergency Deficit Control Act of 1985: Provided further, That these
funds shall be made available only after submission to Congress of a
formal budget request by the President that includes designation of the
entire amount of the request as an emergency requirement as defined in
the Balanced Budget and Emergency Deficit Control Act.
For making payments under title XXVI of [the Omnibus Budget
Reconciliation] such Act [of 1981], $1,000,000,000, to be available for
obligation in the period October 1, [1997] 1998 through September 30,
[1998] 1999. (Department of Health and Human Services Appropriations
Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1502-0-1-609 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
10.00 Total obligations (object class
41.0)........................... 1,080 1,005 1,000
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 1,080 1,005 1,000
23.95 New obligations................... -1,080 -1,005 -1,000
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
40.00 Appropriation................... 180 1,415 300
40.79 Contingent appropriation not
available..................... -415 -300
--------- --------- ----------
43.00 Appropriation (total)......... 180 1,000
Permanent:
65.00 Advance appropriation (definite) 900 5 1,000
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 1,080 1,005 1,000
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 346 358 267
73.10 New obligations................... 1,080 1,005 1,000
73.20 Total outlays (gross)............. -1,067 -1,097 -996
73.40 Adjustments in expired accounts... -1
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 358 267 271
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 135 750
86.93 Outlays from current balances..... 230
86.97 Outlays from new permanent
authority....................... 627 5 750
86.98 Outlays from permanent balances... 305 342 16
--------- --------- ----------
87.00 Total outlays (gross)........... 1,067 1,097 996
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 1,080 1,005 1,000
90.00 Outlays........................... 1,067 1,097 996
---------------------------------------------------------------------------
This program makes grants to States and Indian tribes to aid low-
income households with high energy costs through payments to eligible
households, energy suppliers, and weatherization providers.
Refugee and Entrant Assistance
For making payments for refugee and entrant assistance activities
authorized by title IV of the Immigration and Nationality Act and
section 501 of the Refugee Education Assistance Act of 1980 (Public Law
96-422), [$412,076,000] $392,332,000: Provided, That funds appropriated
pursuant to section 414(a) of the Immigration and Nationality Act under
Public Law [103-333] 104-134 for fiscal year [1995]
[[Page 517]]
1996 shall be available for the costs of assistance provided and other
activities conducted in [such year and in] fiscal years [1996 and 1997]
1997 and 1998. (Department of Health and Human Services Appropriations
Act, 1997.)
[Refugee Resettlement Assistance]
[For necessary expenses for the targeted assistance program
authorized by title IV of the Immigration and Nationality Act and
section 501 of the Refugee Education Assistance Act of 1980 and
administered by the Office of Refugee Resettlement of the Department of
Health and Human Services, in addition to amounts otherwise available
for such purposes, $5,000,000]. (Foreign Operations, Export Financing,
and Related Appropriations Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1503-0-1-609 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
10.00 Total obligations................. 408 427 396
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... 2 2 2
22.00 New budget authority (gross)...... 413 427 396
22.30 Unobligated balance expiring...... -5
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 410 429 398
23.95 New obligations................... -408 -427 -396
24.40 Unobligated balance available, end
of year: Uninvested balance..... 2 2 2
----------------------------------------------------------------------------
New budget authority (gross), detail:
40.00 Appropriation..................... 407 417 392
41.00 Transferred to other accounts..... -4
--------- --------- ----------
43.00 Appropriation (total)........... 403 417 392
50.00 Reappropriation................... 10 10 4
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 413 427 396
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 297 337 335
73.10 New obligations................... 408 427 396
73.20 Total outlays (gross)............. -361 -429 -405
73.40 Adjustments in expired accounts... -7
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 337 335 326
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 171 205 190
86.93 Outlays from current balances..... 190 224 215
--------- --------- ----------
87.00 Total outlays (gross)........... 361 429 405
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 413 427 396
90.00 Outlays........................... 361 427 404
---------------------------------------------------------------------------
States are subsidized for administering the refugee assistance
program.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1503-0-1-609 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
25.1 Advisory and assistance services.. 2 2 2
25.3 Purchases of goods and services
from Government accounts........ 4
25.6 Medical care...................... 3
41.0 Grants, subsidies, and
contributions................... 399 425 394
--------- --------- ----------
99.9 Total obligations............... 408 427 396
---------------------------------------------------------------------------
Family Preservation and Support
For carrying out Section 430 of the Social Security Act,
[$240,000,000] $255,000,000. (Department of Health and Human Services
Appropriations Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1512-0-1-506 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Grants to States and Tribes....... 209 224 239
00.02 Training and technical assistance. 6 6 6
00.03 State court assessment activities. 10 10 10
--------- --------- ----------
10.00 Total obligations............... 225 240 255
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 225 240 255
23.95 New obligations................... -225 -240 -255
----------------------------------------------------------------------------
New budget authority (gross), detail:
40.00 Appropriation..................... 225 240 255
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 171 270 324
73.10 New obligations................... 225 240 255
73.20 Total outlays (gross)............. -126 -186 -227
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 270 324 352
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 18 19 20
86.93 Outlays from current balances..... 108 167 207
--------- --------- ----------
87.00 Total outlays (gross)........... 126 186 227
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 225 240 255
90.00 Outlays........................... 126 186 227
---------------------------------------------------------------------------
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1512-0-1-506 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
25.1 Advisory and assistance services.. 6 6 6
41.0 Grants, subsidies, and
contributions................... 219 234 249
--------- --------- ----------
99.9 Total obligations............... 225 240 255
---------------------------------------------------------------------------
[Job Opportunities and Basic Skills]
[For carrying out aid to families with dependent children work
programs, as authorized by part F of title IV of the Social Security
Act, $1,000,000,000.] (Department of Health and Human Services
Appropriations Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1509-0-1-504 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
10.00 Total obligations (object class
41.0)........................... 879 169
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 1,000 1,000
22.30 Unobligated balance expiring...... -121 -831
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 879 169
23.95 New obligations................... -879 -169
----------------------------------------------------------------------------
New budget authority (gross), detail:
40.00 Appropriation..................... 1,000 1,000
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 314 254 99
73.10 New obligations................... 879 169
73.20 Total outlays (gross)............. -931 -324 -89
73.40 Adjustments in expired accounts... -7
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 254 99 10
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 695 133
86.93 Outlays from current balances..... 236 191 89
--------- --------- ----------
[[Page 518]]
87.00 Total outlays (gross)........... 931 324 89
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 1,000 1,000
90.00 Outlays........................... 931 324 89
---------------------------------------------------------------------------
This activity is replaced by Temporary Assistance for Needy
Families.
State Legalization Impact-Assistance Grants
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1508-0-1-506 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 2
73.20 Total outlays (gross)............. 2 -2
73.40 Adjustments in expired accounts... 1
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 2
----------------------------------------------------------------------------
Outlays (gross), detail:
86.93 Outlays from current balances..... 2
86.98 Outlays from permanent balances... -2
--------- --------- ----------
87.00 Total outlays (gross)........... -2 2
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... -2 2
---------------------------------------------------------------------------
Child Care Entitlement to States
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1550-0-1-609 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Mandatory child care.............. 1,238 1,240
00.02 Matching child care............... 717 896
00.03 Training and technical assistance. 5 5
--------- --------- ----------
10.00 Total obligations (object class
41.0)......................... 1,960 2,141
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 1,967 2,175
22.30 Unobligated balance expiring...... -7 -34
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 1,960 2,141
23.95 New obligations................... -1,960 -2,141
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
50.00 Reappropriation................. 108
Permanent:
60.00 Appropriation................... 1,967 2,067
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 1,967 2,175
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 368
73.10 New obligations................... 1,960 2,141
73.20 Total outlays (gross)............. -1,592 -1,922
73.40 Adjustments in expired accounts... -108
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 368 479
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new permanent
authority....................... 1,592 1,666
86.98 Outlays from permanent balances... 256
--------- --------- ----------
87.00 Total outlays (gross)........... 1,592 1,922
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 1,967 2,175
90.00 Outlays........................... 1,592 1,922
---------------------------------------------------------------------------
This account provides child care funding for welfare recipients and
low-income working families established by the Personal Responsibility
and Work Opportunity Reconciliation Act of 1996 (P.L. 104-193).
Child Care and Development Block Grant
[(including transfer of funds)]
For carrying out sections 658A through 658R of the Omnibus Budget
Reconciliation Act of 1981 (The Child Care and Development Block Grant
Act of 1990), [$956,120,000, of which $937,000,000 shall become
available on October 1, 1997 and shall remain available through
September 30, 1998] in addition to amounts already appropriated for
fiscal year 1998, $63,000,000; and to become available on October 1,
1998 and remain available until September 30, 1999, $1,000,000,000:
Provided, That of funds appropriated for each of fiscal years 1998 and
1999, $19,120,000 shall [become] be available [for obligation on October
1, 1996] for child care resource and referral and school-aged child care
activities[, of which $6,120,000 shall be derived from an amount that
shall be transferred from the amount appropriated under section 452(j)
of the Social Security Act (42 U.S.C. 652(j)) for fiscal year 1996 and
remaining available for expenditure]. (Department of Health and Human
Services Appropriations Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1515-0-1-609 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Block grant payments to States.... 932 19 997
00.02 Advisory and assistance services.. 3 3
--------- --------- ----------
10.00 Total obligations............... 935 19 1,000
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 935 19 1,000
23.95 New obligations................... -935 -19 -1,000
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
40.00 Appropriation................... 935 13 63
42.00 Transferred from other accounts. 6
--------- --------- ----------
43.00 Appropriation (total)......... 935 19 63
Permanent:
65.00 Advance appropriation (definite) 937
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 935 19 1,000
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 1,415 1,413 473
73.10 New obligations................... 935 19 1,000
73.20 Total outlays (gross)............. -933 -959 -998
73.40 Adjustments in expired accounts... -4
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 1,413 473 475
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 13 42
86.93 Outlays from current balances..... 933 946 328
86.97 Outlays from new permanent
authority....................... 628
--------- --------- ----------
87.00 Total outlays (gross)........... 933 959 998
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 935 19 1,000
90.00 Outlays........................... 933 959 998
---------------------------------------------------------------------------
This appropriation helps low-income families pay for child care and
related services.
[[Page 519]]
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1515-0-1-609 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
25.1 Advisory and assistance services.. 2 3
41.0 Grants, subsidies, and
contributions................... 932 19 997
99.5 Below reporting threshold......... 1
--------- --------- ----------
99.9 Total obligations............... 935 19 1,000
---------------------------------------------------------------------------
Social Services Block Grant
For making grants to States pursuant to section 2002 of the Social
Security Act, [$2,500,000,000: Provided, That notwithstanding section
2003(c) of such Act, as amended, the amount specified for allocation
under such section for fiscal year 1997 shall be $2,500,000,000]
$2,380,000,000. (Department of Health and Human Services Appropriations
Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1534-0-1-506 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Block grant....................... 2,381 2,500 2,380
00.02 Empowerment zone.................. 360
--------- --------- ----------
10.00 Total obligations (object class
41.0)......................... 2,741 2,500 2,380
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... 360
22.00 New budget authority (gross)...... 2,381 2,500 2,380
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 2,741 2,500 2,380
23.95 New obligations................... -2,741 -2,500 -2,380
----------------------------------------------------------------------------
New budget authority (gross), detail:
40.00 Appropriation..................... 2,381 2,500 2,380
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 962 1,217 1,023
73.10 New obligations................... 2,741 2,500 2,380
73.20 Total outlays (gross)............. -2,484 -2,694 -2,621
73.40 Adjustments in expired accounts... -2
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 1,217 1,023 782
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 2,203 2,250 2,142
86.93 Outlays from current balances..... 281 261 249
86.98 Outlays from permanent balances... 183 230
--------- --------- ----------
87.00 Total outlays (gross)........... 2,484 2,694 2,621
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 2,381 2,500 2,380
90.00 Outlays........................... 2,484 2,694 2,621
---------------------------------------------------------------------------
Social services block grant.--The proposed level will support grants
to States for social services to: (1) prevent, reduce, or eliminate
dependency; (2) prevent neglect, abuse, or exploitation of children and
adults; (3) prevent or reduce inappropriate institutional care; (4)
secure admission or referral for institutional care when other forms of
care are not appropriate; and (5) provide services to individuals in
institutions.
Children and Families Services Programs
[(including rescissions)]
For carrying out, except as otherwise provided, the Runaway and
Homeless Youth Act, the Developmental Disabilities Assistance and Bill
of Rights Act, the Head Start Act, the Child Abuse Prevention and
Treatment Act, [the Temporary Child Care for Children with Disabilities
and Crisis Nurseries Act of 1986,] Adoption Initiative activities under
title IV-E and IV-B of the Social Security Act, section 429A, part B of
title IV of the Social Security Act, section 413 of the Social Security
Act, [the Family Violence Prevention and Services Act,] the Native
American Programs Act of 1974, title II of Public Law 95-266 (adoption
opportunities), the Abandoned Infants Assistance Act of 1988, and part
B(1) of title IV of the Social Security Act; for making payments under
the Community Services Block Grant Act; and for necessary administrative
expenses to carry out said Acts and titles I, IV, X, XI, XIV, XVI, and
XX of the Social Security Act, the Act of July 5, 1960 (24 U.S.C. ch.
9), the Omnibus Budget Reconciliation Act of 1981, title IV of the
Immigration and Nationality Act, section 501 of the Refugee Education
Assistance Act of 1980, and section 126 and titles IV and V of Public
Law 100-485, [$5,363,569,000], $5,498,900,000 of which [$536,432,000]
$414,720,000 shall be for making payments under the Community Services
Block Grant Act[: Provided, That to the extent Community Services Block
Grant funds are distributed as grant funds by a State to an eligible
entity as provided under the Act, and have not been expended by such
entity, they shall remain with such entity for carryover into the next
fiscal year for expenditure by such entity consistent with program
purposes: Provided further, That of the amount appropriated for fiscal
year 1997 under section 672(a) of the Community Services Block Grant
Act, the Secretary shall use up to one percent of the funds available to
correct allocation errors that occurred in fiscal year 1995 and fiscal
year 1996 to ensure that the minimum allotment to each State for each of
fiscal years 1995 and 1996 would be $2,222,460: Provided further, That
no more than one-half of one percent of the funds available under
section 672(a) shall be used for the purposes of section 674(a) of the
Community Services Block Grant Act].
[In addition, $20,000,000, to be derived from the Violent Crime
Reduction Trust Fund, for carrying out sections 40155, 40211 and 40241
of Public Law 103-322.]
[Funds appropriated for fiscal year 1996 and fiscal year 1997 under
section 429A(e), part B of title IV of the Social Security Act shall be
reduced by $6,000,000 in each such year.]
[Funds appropriated for fiscal year 1997 under section 413(h)(1) of
the Social Security Act shall be reduced by $15,000,000.] (Department of
Health and Human Services Appropriations Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1536-0-1-506 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Head Start........................ 3,569 3,981 4,305
Social services programs:
Children, youth, and families:
01.03 Runaway and homeless youth.... 44 44 44
01.04 Runaway youth transitional
living...................... 15 15 15
01.07 Child abuse state grants...... 21 21 21
01.08 Child abuse discretionary
grants...................... 14 14 14
01.09 Community based resource
centers..................... 23 33 33
01.11 Abandoned infants assistance.. 12 12 12
01.13 Temporary child care and
crisis nurseries............ 10
01.14 Child welfare services........ 277 292 292
01.15 Child welfare training........ 2 4 4
01.17 Adoption opportunities........ 11 13 13
01.18 Adoption Initiative........... 21
01.19 Family violence grants........ 33 62
01.20 Social services and income
maintenance research........ 44 18
Developmental disabilities:
01.23 State grants.................. 65 65 65
01.24 Protection and advocacy....... 27 27 27
01.25 Special projects.............. 5 5 5
01.26 University affiliated projects.. 17 17 17
01.27 Native american programs........ 35 35 35
--------- --------- ----------
01.91 Subtotal social services
programs.................... 611 703 636
02.01 ACF Federal administration........ 150 143 143
--------- --------- ----------
02.93 Total direct program............ 4,330 4,827 5,084
Community services programs:
03.01 Community services block grants. 390 490 415
03.03 Community food and nutrition.... 4 4
03.04 Community services discretionary 41 43
--------- --------- ----------
03.91 Subtotal, community services.... 435 537 415
04.01 Reimbursable program.............. 7 11 11
--------- --------- ----------
10.00 Total obligations............... 4,772 5,375 5,510
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... 13 7 7
[[Page 520]]
22.00 New budget authority (gross)...... 4,768 5,375 5,510
22.30 Unobligated balance expiring...... -2
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 4,779 5,382 5,517
23.95 New obligations................... -4,772 -5,375 -5,510
24.40 Unobligated balance available, end
of year: Uninvested balance..... 7 7 7
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
40.00 Appropriation................... 4,766 5,364 5,499
Permanent:
Spending authority from
offsetting collections:
68.00 Offsetting collections (cash). 1 11 11
68.10 Change in orders on hand from
Federal sources............. 1
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total)................... 2 11 11
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 4,768 5,375 5,510
----------------------------------------------------------------------------
Change in unpaid obligations:
Unpaid obligations, start of year:
72.40 Obligated balance: Appropriation 3,308 3,225 3,523
72.95 Orders on hand from Federal
sources....................... 1 1
--------- --------- ----------
72.99 Total unpaid obligations,
start of year............... 3,308 3,226 3,524
73.10 New obligations................... 4,772 5,375 5,510
73.20 Total outlays (gross)............. -4,752 -5,078 -5,403
73.40 Adjustments in expired accounts... -103
Unpaid obligations, end of year:
74.40 Obligated balance: Appropriation 3,225 3,523 3,630
74.95 Orders on hand from Federal
sources....................... 1 1 1
--------- --------- ----------
74.99 Total unpaid obligations, end
of year..................... 3,226 3,524 3,631
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 2,073 2,335 2,392
86.93 Outlays from current balances..... 2,678 2,732 3,000
86.97 Outlays from new permanent
authority....................... 1 11 11
--------- --------- ----------
87.00 Total outlays (gross)........... 4,752 5,078 5,403
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -1 -11 -11
88.95 Change in orders on hand from
Federal sources................. -1
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 4,766 5,364 5,499
90.00 Outlays........................... 4,750 5,067 5,392
---------------------------------------------------------------------------
Head Start.--The proposed level is consistent with the President's
goal to serve 1 million children by 2002, and will enable Head Start
projects to continue comprehensive early childhood development services.
Social Services.--The proposed level will continue to support State,
local, and private efforts to provide developmental and other services
for children and youth, grants to improve support networks for persons
with developmental disabilities, and economic development assistance to
Native American populations.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1536-0-1-506 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 96 93 93
11.3 Other than full-time permanent 1 1 1
--------- --------- ----------
11.9 Total personnel compensation 97 94 94
12.1 Civilian personnel benefits..... 17 16 17
21.0 Travel and transportation of
persons....................... 3 3 1
23.1 Rental payments to GSA.......... 13 12 12
23.3 Communications, utilities, and
miscellaneous charges......... 2 2 2
24.0 Printing and reproduction....... 1 2 1
25.1 Advisory and assistance services 69 77 85
25.2 Other services.................. 2 2 2
25.3 Purchases of goods and services
from Government accounts...... 12 13 13
25.7 Operation and maintenance of
equipment..................... 4 3 3
26.0 Supplies and materials.......... 1
31.0 Equipment....................... 2 1 1
41.0 Grants, subsidies, and
contributions................. 4,543 5,139 5,268
--------- --------- ----------
99.0 Subtotal, direct obligations.. 4,766 5,364 5,499
99.0 Reimbursable obligations.......... 6 11 11
--------- --------- ----------
99.9 Total obligations............... 4,772 5,375 5,510
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-1536-0-1-506 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Total compensable workyears:
1001 Full-time equivalent employment... 1,732 1,669 1,627
1005 Full-time equivalent of overtime
and holiday hours............... 2 2 2
---------------------------------------------------------------------------
Violent Crime Reduction Programs
For activities authorized by sections 30401, 40155, 40211, and 40241
of Public Law 103-322, $99,000,000, to remain available until expended,
which shall be derived from the Violent Crime Reduction Trust Fund, of
which $12,800,000 shall be for the Community Schools Youth Services and
Supervision Grant Program; $70,000,000 for Family Violence (including
grants for Battered Women's Shelters); $15,000,000 for Education and
Prevention Grants to Reduce Sexual Abuse of Runaway, Homeless, and
Street Youth; and $1,200,000 for the National Domestic Violence Hotline.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8605-0-1-754 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Family violence/battered women's
shelters and domestic violence
hotline......................... 15 12 71
00.02 Education and prevention grants to
reduce sexual abuse of runaway,
homeless and street youth....... 6 8 15
00.03 Community schools program......... 13
--------- --------- ----------
10.00 Total obligations............... 21 20 99
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 21 20 99
23.95 New obligations................... -21 -20 -99
----------------------------------------------------------------------------
New budget authority (gross), detail:
42.00 Transferred from other accounts... 21 20 99
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 11 21 24
73.10 New obligations................... 21 20 99
73.20 Total outlays (gross)............. -11 -17 -35
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 21 24 88
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 4 4 20
86.93 Outlays from current balances..... 7 13 15
--------- --------- ----------
87.00 Total outlays (gross)........... 11 17 35
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 21 20 99
90.00 Outlays........................... 11 17 35
---------------------------------------------------------------------------
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8605-0-1-754 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
25.1 Advisory and assistance services.. 1 4
41.0 Grants, subsidies, and
contributions................... 21 19 95
--------- --------- ----------
[[Page 521]]
99.9 Total obligations............... 21 20 99
---------------------------------------------------------------------------
Children's Research and Technical Assistance
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1553-0-1-609 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Training and technical assistance. 19 15
00.02 Federal parent locator service.... 24 25 30
00.03 Child welfare study............... 6
00.04 Welfare research.................. 15
--------- --------- ----------
10.00 Total obligations (object class
41.0)......................... 24 44 66
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... 12
22.00 New budget authority (gross)...... 37 32 66
22.30 Unobligated balance expiring...... -1
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 36 44 66
23.95 New obligations................... -24 -44 -66
24.40 Unobligated balance available, end
of year: Uninvested balance..... 12
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
41.00 Transferred to other accounts... -6
Permanent:
60.00 Appropriation................... 37 38 66
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 37 32 66
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 24 27
73.10 New obligations................... 24 44 66
73.20 Total outlays (gross)............. -41 -59
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 24 27 34
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new permanent
authority....................... 29 35
86.98 Outlays from permanent balances... 12 24
--------- --------- ----------
87.00 Total outlays (gross)........... 41 59
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 37 32 66
90.00 Outlays........................... 41 59
---------------------------------------------------------------------------
This provides funding for research and technical assistance
activities established in P.L. 104-193. Amounts for child welfare study
and welfare research are in addition to research amounts in the Children
and Families Services Program account.
Payments to States for Foster Care and Adoption Assistance
For making payments to States or other non-Federal entities, under
title IV-E of the Social Security Act, [$4,445,031,000] $3,200,000,000
of which $200,000,000 shall be placed in reserve for use only in such
amounts and in such times as may become necessary to make payments to
States.
For making payments to States or other non-Federal entities, under
title IV-E of the Social Security Act, for the first quarter of fiscal
year [1998, $1,111,000,000] 1999, $1,157,500,000. (Department of Health
and Human Services Appropriations Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1545-0-1-506 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Foster care....................... 3,148 3,319 3,340
00.02 Independent living................ 70 70 70
00.03 Adoption assistance............... 486 568 701
--------- --------- ----------
10.00 Total obligations (object class
41.0)......................... 3,704 3,957 4,111
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 4,322 4,445 4,311
22.30 Unobligated balance expiring...... -618 -488 -200
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 3,704 3,957 4,111
23.95 New obligations................... -3,704 -3,957 -4,111
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
40.00 Appropriation................... 4,322 4,445 3,200
Permanent:
65.00 Advance appropriation (definite) 1,111
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 4,322 4,445 4,311
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 919 870 1,038
73.10 New obligations................... 3,704 3,957 4,111
73.20 Total outlays (gross)............. -3,691 -3,789 -4,071
73.40 Adjustments in expired accounts... -62
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 870 1,038 1,078
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 2,993 3,117 2,408
86.93 Outlays from current balances..... 698 672 796
86.97 Outlays from new permanent
authority....................... 867
--------- --------- ----------
87.00 Total outlays (gross)........... 3,691 3,789 4,071
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 4,322 4,445 4,311
90.00 Outlays........................... 3,691 3,789 4,071
---------------------------------------------------------------------------
Foster care.--The proposed level will support eligible low-income
children who must be placed outside the home. An average of 300,000
children per month will be served in 1998.
Adoption assistance.--The proposed funding level will support
subsidies for families adopting eligible low-income children with
special needs. An average of 153,000 children per month will be served
in 1998.
The budget includes funding for the adoption initiative that seeks
to double by 2002 the number of children adopted or permanently placed
from the foster care system each year. Incentive payments to States
increasing adoptions would begin in 1999. Discretionary resources to
support the initiative are included in the Children and Families
Services Programs account.
ADMINISTRATION ON AGING
Federal Funds
General and special funds:
Aging Services Programs
For carrying out, to the extent not otherwise provided, the Older
Americans Act of 1965, as amended, [$830,168,000] $838,168,000:
Provided, That notwithstanding section 308(b)(1) of such Act, the
amounts available to each State for administration of the State plan
under title III of such Act shall be reduced not more than 5 percent
below the amount that was available to such State for such purpose for
fiscal year 1995: Provided further, That in considering grant
applications for nutrition services for elder Indian recipients, the
Assistant Secretary shall provide maximum flexibility to applicants who
seek to take into account subsistence, local customs and other
characteristics that are appropriate to the unique cultural, regional
and geographic needs of the American Indian, Alaskan and Hawaiian native
communities to be served. (Department of Health and Human Services
Appropriations Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0142-0-1-506 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
01.01 Supportive services and centers... 301 301 292
[[Page 522]]
01.02 Preventive health................. 15 15 15
01.03 Grants for protection of
vulnerable older Americans...... 9
01.05 Congregate meals.................. 365 365 360
01.06 Home-delivered meals.............. 105 105 110
01.07 In-home services.................. 9 9 9
01.08 Grants to Indian tribes........... 16 16 16
01.09 Research, training and
discretionary projects.......... 3 4 4
01.10 Federal administration............ 15 15 15
01.13 Alzheimer's Initiative............ 8
01.15 DOL transfer for senior community
service employment program...... 440
--------- --------- ----------
10.00 Total obligations............... 829 830 1,278
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 829 830 1,278
23.95 New obligations................... -829 -830 -1,278
----------------------------------------------------------------------------
New budget authority (gross), detail:
40.00 Appropriation..................... 829 830 838
42.00 Transferred from other accounts... 440
--------- --------- ----------
43.00 Appropriation (total)........... 829 830 1,278
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 829 830 1,278
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 215 223 201
73.10 New obligations................... 829 830 1,278
73.20 Total outlays (gross)............. -818 -851 -914
73.40 Adjustments in expired accounts... -3
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 223 201 564
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 647 645 732
86.93 Outlays from current balances..... 171 206 182
--------- --------- ----------
87.00 Total outlays (gross)........... 818 851 914
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 829 830 1,278
90.00 Outlays........................... 818 851 914
---------------------------------------------------------------------------
Administration on Aging.--The proposed level will continue to
provide supportive and nutrition services, research, training and
demonstration projects for the elderly.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0142-0-1-506 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
11.1 Personnel compensation: Full-time
permanent....................... 9 9 9
12.1 Civilian personnel benefits....... 2 2 2
23.1 Rental payments to GSA............ 2 1 1
25.2 Other services.................... 2 2 2
41.0 Grants, subsidies, and
contributions................... 814 816 1,264
--------- --------- ----------
99.9 Total obligations............... 829 830 1,278
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0142-0-1-506 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Total compensable workyears:
1001 Full-time equivalent employment... 149 150 150
1005 Full-time equivalent of overtime
and holiday hours............... 1 1 1
---------------------------------------------------------------------------
Allocations Received From Other Accounts
Note.--Obligations incurred under allocations from other accounts
are included in the schedules of the parent appropriation as follows:
Health Care Financing Administration: ``Health Care Fraud and Abuse
Control Account.''
DEPARTMENTAL MANAGEMENT
Federal Funds
General and special funds:
General Departmental Management
For necessary expenses, not otherwise provided, for general
departmental management, including hire of six sedans, and for carrying
out titles III, XVII, and XX of the Public Health Service Act, and
research studies under section 1110 of the Social Security Act,
[$174,523,000] $166,326,000, together with $5,851,000, to be transferred
and expended as authorized by section 201(g)(1) of the Social Security
Act from the Hospital Insurance Trust Fund and the Supplemental Medical
Insurance Trust Fund[: Provided, That of the funds made available under
this heading for carrying out title XVII of the Public Health Service
Act, $11,500,000 shall be available until expended for extramural
construction: Provided further, That notwithstanding section 2010 (b)
and (c) under title XX of the Public Health Service Act, as amended, of
the funds made available under this heading, $10,879,000 shall be for
activities specified under section 2003(b)(2) of title XX of the Public
Health Service Act, as amended, and of which $9,011,000 shall be for
prevention grants under section 510(b)(2) of title V of the Social
Security Act, as amended: Provided further, That of the amount provided,
$5,775,000 is designated by Congress as an emergency requirement
pursuant to section 251(b)(2)(D)(i) of the Balanced Budget and Emergency
Deficit Control Act of 1985, as amended]. (Department of Health and
Human Services Appropriations Act, 1997.)
Office of Consumer Affairs
For necessary expenses of the Office of Consumer Affairs, including
services authorized by 5 U.S.C. 3109[, but at rates for individuals not
to exceed the per diem rate equivalent to the rate for GS-18,
$1,500,000] $1,800,000: Provided, That the Office may accept and deposit
to this account, during fiscal year 1998, gifts for the purpose of
defraying its costs of printing, publishing, and distributing consumer
information and educational materials; not to exceed $1,110,000 of total
gift fund balances are available for those purposes, in addition to any
amounts appropriated herein; and any balance shall remain available for
such purposes to the extent provided in subsequent appropriations Acts:
Provided further, That none of the funds provided under this heading may
be made available for any other activities within the Department of
Health and Human Services. (Omnibus Consolidated Appropriations Act,
1997.)
Office for Civil Rights
For expenses necessary for the Office for Civil Rights,
[$16,216,000] $17,216,000, together with not to exceed $3,314,000, to be
transferred and expended as authorized by section 201(g)(1) of the
Social Security Act from the Hospital Insurance Trust Fund and the
Supplemental Medical Insurance Trust Fund. (Department of Health and
Human Services Appropriations Act, 1997.)
[Policy Research]
[For carrying out, to the extent not otherwise provided, research
studies under section 1110 of the Social Security Act and section 301(l)
of Public Law 104-191, $18,500,000: Provided, That $9,500,000, to remain
available until September 30, 1998, shall be for carrying out section
301(l) of Public Law 104-191]. (Department of Health and Human Services
Appropriations Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9912-0-1-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct activities:
00.01 General Departmental Management. 139 180 172
00.02 U.S.Office of Consumer Affairs.. 2 2 2
00.03 Office for Civil Rights......... 20 19 21
00.04 Policy Research................. 9 19
00.05 Emergency Supplement............ 25
--------- --------- ----------
00.91 Total direct activities....... 195 220 195
01.01 Reimbursable activities........... 61 67 67
--------- --------- ----------
10.00 Total obligations............... 256 287 262
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... 16 26 26
[[Page 523]]
22.00 New budget authority (gross)...... 267 287 262
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 283 313 288
23.95 New obligations................... -256 -287 -262
24.40 Unobligated balance available, end
of year: Uninvested balance..... 26 26 26
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
40.00 Appropriation................... 188 210 185
42.00 Transferred from other accounts. 2
--------- --------- ----------
43.00 Appropriation (total)......... 190 210 185
Permanent:
68.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 77 77 77
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 267 287 262
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 108 153 139
73.10 New obligations................... 256 287 262
73.20 Total outlays (gross)............. -223 -300 -270
73.40 Adjustments in expired accounts... 12
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 153 139 131
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 101 106 100
86.93 Outlays from current balances..... 45 117 93
86.97 Outlays from new permanent
authority....................... 77 77 77
--------- --------- ----------
87.00 Total outlays (gross)........... 223 300 270
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -77 -77 -77
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 190 210 185
90.00 Outlays........................... 145 223 193
---------------------------------------------------------------------------
[Dollars in millions]
1996 actual 1997 est. 1998 est.
Distribution of budget authority by
account:
General departmental management... 140 174 166
Office of Consumer Affairs........ 2 2 2
Office for Civil Rights........... 16 16 17
Policy research................... 9 19
Distribution of outlays by account:
General departmental management... 106 153 175
Office of Consumer Affairs........ 3 2 2
Office for Civil Rights........... 15 17 17
Policy research................... 15 12
Emergency supplemental............ 6 40
Departmental Management (DM) is a consolidated display of accounts
that fund activities which provide leadership, policy, legal, and
administrative guidance to HHS components; carry out the Department's
civil rights and nondiscrimination enforcement programs; present
consumer needs and viewpoints in the Federal government; and support
research to develop policy initiatives and improve existing HHS
programs. DM also includes the activities of the Office of Public Health
and Science, including adolescent family life, disease prevention and
health promotion, physical fitness and sports, minority health, research
integrity, women's health, and emergency preparedness. These accounts
will continue to be appropriated separately, and are being displayed in
a consolidated format to improve the readability of the presentation.
Detailed information will continue to be available through the
Department of Health and Human Services.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9912-0-1-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 76 82 83
11.3 Other than full-time permanent 3 3 3
11.5 Other personnel compensation.. 1 1 1
--------- --------- ----------
11.9 Total personnel compensation 80 86 87
12.1 Civilian personnel benefits..... 12 16 17
21.0 Travel and transportation of
persons....................... 2 1 1
23.1 Rental payments to GSA.......... 13 13 12
23.3 Communications, utilities, and
miscellaneous charges......... 3 4 4
24.0 Printing and reproduction....... 1 2 1
25.1 Advisory and assistance services 1
25.2 Other services.................. 9 18 9
25.3 Purchases of goods and services
from Government accounts...... 24 25 23
25.5 Research and development
contracts..................... 5 6 6
25.6 Medical care.................... 2
25.7 Operation and maintenance of
equipment..................... 5 5
26.0 Supplies and materials.......... 4 1 2
31.0 Equipment....................... 3 2 3
41.0 Grants, subsidies, and
contributions................. 31 41 30
--------- --------- ----------
99.0 Subtotal, direct obligations.. 195 220 195
99.0 Reimbursable obligations.......... 61 67 67
--------- --------- ----------
99.9 Total obligations............... 256 287 262
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-9912-0-1-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Full-time equivalent employment. 1,326 1,352 1,331
1005 Full-time equivalent of overtime
and holiday hours............. 8 8 8
Reimbursable:
2001 Total compensable workyears: Full-
time equivalent employment...... 118 83 83
---------------------------------------------------------------------------
Allocations Received From Other Accounts
Note.--Obligations incurred under allocations from other accounts
are included in the schedules of the parent appropriation as follows:
Health Care Financing Administration: ``Health Care Fraud and Abuse
Control Account.''
PROGRAM SUPPORT CENTER
General and special funds:
Retirement Pay and Medical Benefits for Commissioned Officers
For retirement pay and medical benefits of Public Health Service
Commissioned Officers as authorized by law, and for payments under the
Retired Serviceman's Family Protection Plan and Survivor Benefit Plan
and for medical care of dependents and retired personnel under the
Dependents' Medical Care Act (10 U.S.C. ch. 55), and for payments
pursuant to section 229(b) of the Social Security Act (42 U.S.C.
429(b)), such amounts as may be required during the current fiscal year.
(Department of Health and Human Services Appropriations Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0379-0-1-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Retirement payments............... 119 139 149
00.02 Survivors' benefits............... 9 11 12
00.03 Medical care...................... 24 26 28
00.04 Military service credits.......... 3 3 2
--------- --------- ----------
10.00 Total obligations............... 155 179 191
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 167 179 191
22.30 Unobligated balance expiring...... -12
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 155 179 193
23.95 New obligations................... -155 -179 -191
----------------------------------------------------------------------------
New budget authority (gross), detail:
40.05 Appropriation (indefinite)........ 167 179 191
----------------------------------------------------------------------------
[[Page 524]]
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 14 8 7
73.10 New obligations................... 155 179 191
73.20 Total outlays (gross)............. -170 -180 -190
73.40 Adjustments in expired accounts... 9
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 8 7 8
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 148 172 183
86.93 Outlays from current balances..... 22 8 7
--------- --------- ----------
87.00 Total outlays (gross)........... 170 180 190
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 167 179 191
90.00 Outlays........................... 170 180 190
---------------------------------------------------------------------------
This activity funds annuities of retired Public Health Service (PHS)
commissioned officers and survivors of retirees, and medical care to
active duty PHS commissioned officers, retirees, and dependents of
members and retirees of the PHS Commissioned Corps.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0379-0-1-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
13.0 Benefits for former personnel..... 128 150 161
25.2 Other services.................... 24 26 28
25.3 Purchases of goods and services
from Government accounts........ 3 3 2
--------- --------- ----------
99.9 Total obligations............... 155 179 191
---------------------------------------------------------------------------
Health Activities Funds
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9913-0-1-550 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 12 11 10
73.20 Total outlays (gross)............. -1 -1 -1
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 11 10 9
----------------------------------------------------------------------------
Outlays (gross), detail:
86.93 Outlays from current balances..... 1 1 1
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... 1 1 1
---------------------------------------------------------------------------
This display shows activities in support of St. Elizabeths Hospital
and scientific activities overseas that were supported by foreign
currencies by the United States abroad.
Intragovernmental funds:
HHS Service and Supply Fund
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9941-0-4-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Program support center............ 218 238 237
00.02 Federal employee occupational
health.......................... 95 104
00.03 OS activities..................... 7 6 7
--------- --------- ----------
10.00 Total obligations............... 225 339 348
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.90 Unobligated balance available,
start of year: Fund balance..... 30 32 32
22.00 New budget authority (gross)...... 221 339 348
22.10 Resources available from
recoveries of prior year
obligations..................... 6
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 257 371 380
23.95 New obligations................... -225 -339 -348
24.90 Unobligated balance available, end
of year: Fund balance........... 32 32 32
----------------------------------------------------------------------------
New budget authority (gross), detail:
Spending authority from offsetting
collections:
68.00 Offsetting collections (cash)... 179 339 348
68.10 Change in orders on hand from
Federal sources............... 42
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total)..................... 221 339 348
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 221 339 348
----------------------------------------------------------------------------
Change in unpaid obligations:
Unpaid obligations, start of year:
72.90 Obligated balance: Fund balance. 10 -9
72.95 Orders on hand from Federal
sources....................... 107 149 149
--------- --------- ----------
72.99 Total unpaid obligations,
start of year............... 117 140 149
73.10 New obligations................... 225 339 348
73.20 Total outlays (gross)............. -196 -330 -348
73.45 Adjustments in unexpired accounts. -6
Unpaid obligations, end of year:
74.90 Obligated balance: Fund balance. -9
74.95 Orders on hand from Federal
sources....................... 149 149 149
--------- --------- ----------
74.99 Total unpaid obligations, end
of year..................... 140 149 149
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new permanent
authority....................... 178 339 348
86.98 Outlays from permanent balances... 18 -9
--------- --------- ----------
87.00 Total outlays (gross)........... 196 330 348
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -179 -339 -348
88.95 Change in orders on hand from
Federal sources................. -42
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... 18 -9
---------------------------------------------------------------------------
The HHS Service and Supply Fund (SSF) provides common centralized
services to HHS components. The Program Support Center (PSC) line
includes activities funded through the SSF and the OS Working Capital
Fund (WCF) in FY 1996. The WCF terminated in FY 1997 and the PSC and OS
activities are funded solely through the SSF. The OS activities line
includes the Fund Manager, Departmental Contracts Information System,
Audit Resolution, OS Graphics, and the Regional Health Administrators.
For FY 1996, Federal Employee Occupational Health funds operated through
the Health Resources and Services Administration general fund account,
but are funded through the SSF beginning in FY 1997.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9941-0-4-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Personnel compensation:
11.1 Full-time permanent............. 58 66 67
11.3 Other than full-time permanent.. 3 2 2
11.5 Other personnel compensation.... 1 2 2
--------- --------- ----------
11.9 Total personnel compensation.. 62 70 71
12.1 Civilian personnel benefits....... 12 14 14
21.0 Travel and transportation of
persons......................... 1 3 3
[[Page 525]]
22.0 Transportation of things.......... 2 2 2
23.1 Rental payments to GSA............ 12 12 10
23.3 Communications, utilities, and
miscellaneous charges........... 11 15 16
24.0 Printing and reproduction......... 1 1 1
25.1 Advisory and assistance services.. 1 1
25.2 Other services.................... 63 140 144
25.3 Purchases of goods and services
from Government accounts........ 28 29 27
26.0 Supplies and materials............ 28 47 53
31.0 Equipment......................... 5 5 6
99.0 Subtotal, reimbursable obligations 225 339 348
--------- --------- ----------
99.9 Total obligations............... 225 339 348
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-9941-0-4-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Total compensable workyears:
2001 Full-time equivalent employment... 1,236 1,319 1,279
2005 Full-time equivalent of overtime
and holiday hours............... 15 22 22
---------------------------------------------------------------------------
Miscellaneous Trust Funds
Unavailable Collections (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9971-0-7-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Balance, start of year:
01.99 Balance, start of year............
Receipts:
02.01 Contributions, Indian health
facilities, Health Services
Administration.................. 31 31 31
02.02 Gifts and contributions,
Miscellaneous trust funds....... 13 13 13
02.03 Interest, Miscellaneous trust
funds........................... 1 1 1
--------- --------- ----------
02.99 Total receipts.................. 45 45 45
Appropriation:
05.01 Miscellaneous trust funds......... -45 -45 -45
07.99 Total balance, end of year........
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9971-0-7-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.02 Gifts............................. 22 14 14
00.03 Contributions, Indian health
facilities...................... 32 31 31
--------- --------- ----------
10.00 Total obligations............... 54 45 45
----------------------------------------------------------------------------
Budgetary resources available for obligation:
Unobligated balance available, start of year:
21.40 Uninvested balance.............. 20 25 25
U.S. Securities:
21.41 Par value..................... 23 9 9
21.42 Unrealized discounts.......... -1
--------- --------- ----------
21.99 Total unobligated balance,
start of year............... 42 34 34
22.00 New budget authority (gross)...... 45 45 45
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 87 79 79
23.95 New obligations................... -54 -45 -45
Unobligated balance available, end of year:
24.40 Uninvested balance.............. 25 25 25
24.41 U.S. Securities: Par value...... 9 9 9
--------- --------- ----------
24.99 Total unobligated balance, end
of year....................... 34 34 34
----------------------------------------------------------------------------
New budget authority (gross), detail:
60.27 Appropriation (trust fund,
indefinite)..................... 45 45 45
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 95 96 90
73.10 New obligations................... 54 45 45
73.20 Total outlays (gross)............. -53 -51 -48
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 96 90 87
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new permanent
authority....................... 15 12 12
86.98 Outlays from permanent balances... 38 39 36
--------- --------- ----------
87.00 Total outlays (gross)........... 53 51 48
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 45 45 45
90.00 Outlays........................... 53 51 48
---------------------------------------------------------------------------
[Dollars in millions]
1996 1997 1998
Distribution of budget authority by
account:
Gifts............................. 14 14 14
Contributions, Indian health
facilities...................... 31 31 31
Distribution of outlays by account:
Gifts............................. 24 23 22
Contributions, Indian health
facilities...................... 29 28 26
Gifts to the Public Health Service are for the benefit of patients
and for research. Contributions are made for the construction,
improvement, extension, and provision of sanitation facilities.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9971-0-7-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Personnel compensation:
11.3 Other than full-time permanent.. 3 3 3
11.5 Other personnel compensation.... 1 1 1
11.8 Special personal services
payments...................... 1 1 1
--------- --------- ----------
11.9 Total personnel compensation.. 5 5 5
12.1 Civilian personnel benefits....... 1 1 1
21.0 Travel and transportation of
persons......................... 1 1 1
22.0 Transportation of things.......... 1 1 1
25.2 Other services.................... 2 2 2
25.3 Purchases of goods and services
from Government accounts........ 2 1 1
25.5 Research and development contracts 11 7 7
25.7 Operation and maintenance of
equipment....................... 5 3 3
26.0 Supplies and materials............ 3 3 3
31.0 Equipment......................... 1 1 1
32.0 Land and structures............... 19 19 19
41.0 Grants, subsidies, and
contributions................... 3 1 1
--------- --------- ----------
99.9 Total obligations............... 54 45 45
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-9971-0-7-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Total compensable workyears:
1001 Full-time equivalent employment... 100 100 100
1005 Full-time equivalent of overtime
and holiday hours............... 20 20 20
---------------------------------------------------------------------------
OFFICE OF THE INSPECTOR GENERAL
General and special funds:
Office of Inspector General
For expenses necessary for the Office of Inspector General in
carrying out the provisions of the Inspector General Act of 1978, as
amended, [$32,999,000, together with any funds, to remain available
until expended, that represent the equitable share from the forfeiture
of property in investigations in which the Office of Inspector General
participated, and which are transferred to the Office of Inspector
General by the Department of Justice, the Department of the Treasury, or
the United States Postal Service] $31,921,000. (Department of Health and
Human Services Appropriations Act, 1997.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0128-0-1-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Direct program.................... 79 33 32
01.01 Reimbursable program.............. 10 13 12
--------- --------- ----------
10.00 Total obligations............... 89 46 44
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance available,
start of year: Uninvested
balance......................... 1 1 1
[[Page 526]]
22.00 New budget authority (gross)...... 89 46 44
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 90 47 45
23.95 New obligations................... -89 -46 -44
24.40 Unobligated balance available, end
of year: Uninvested balance..... 1 1 1
----------------------------------------------------------------------------
New budget authority (gross), detail:
Current:
40.00 Appropriation................... 58 33 32
Permanent:
68.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 31 13 12
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 89 46 44
----------------------------------------------------------------------------
Change in unpaid obligations:
72.40 Unpaid obligations, start of year:
Obligated balance: Appropriation 9 5
73.10 New obligations................... 89 46 44
73.20 Total outlays (gross)............. -80 -50 -45
74.40 Unpaid obligations, end of year:
Obligated balance: Appropriation 9 5 4
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new current authority 52 30 29
86.93 Outlays from current balances..... -3 7 4
86.97 Outlays from new permanent
authority....................... 31 13 12
--------- --------- ----------
87.00 Total outlays (gross)........... 80 50 45
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -31 -13 -12
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 58 33 32
90.00 Outlays........................... 49 37 33
---------------------------------------------------------------------------
The Office of Inspector General identifies and recommends actions to
correct fraud, waste, and abuse in HHS administered and assisted
programs and operations through audits and investigations.
In addition to the discretionary resources appropriated to the
Office of the Inspector General (IG), the Health Insurance Portability
and Accountability Act of 1996 makes available mandatory funding for use
by the IG to combat Medicare fraud and abuse through a coordinated
Health Care Fraud and Abuse Control (HCFAC) Program with the Department
of Justice. The following table shows total funding resources for the
IG:
1966 actual 1997 est. 1998 est.
Budget Authority:
Discretionary Appropriations.......... 58 33 32
Medicare Trust Fund Transfers......... 21 0 0
Mandatory (HCFAC Account)............. 0 70 81
--------- --------- ----------
Total............................. 79 103 113
Outlays:
Discretionary Appropriations.......... 49 37 33
Medicare Trust Fund Transfers......... 21 0 0
Mandatory (HCFAC Account)............. 0 70 81
--------- --------- ----------
Total............................. 70 107 114
This schedule reflects estimated distribution of mandatory funds
from the HCFAC Account in FY 1998. Actual FY 1998 distribution will be
determined by the Secretary of HHS and the Attorney General.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0128-0-1-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 48 21 21
11.5 Other personnel compensation.. 1
--------- --------- ----------
11.9 Total personnel compensation 49 21 21
12.1 Civilian personnel benefits..... 10 4 4
21.0 Travel and transportation of
persons....................... 2 1 1
23.1 Rental payments to GSA.......... 5 2 2
23.3 Communications, utilities, and
miscellaneous charges......... 1 1 1
25.1 Advisory and assistance services 1
25.2 Other services.................. 1 1
25.3 Purchases of goods and services
from Government accounts...... 7 3 3
26.0 Supplies and materials.......... 1
31.0 Equipment....................... 2
--------- --------- ----------
99.0 Subtotal, direct obligations.. 79 33 32
99.0 Reimbursable obligations.......... 10 13 12
--------- --------- ----------
99.9 Total obligations............... 89 46 44
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0128-0-1-551 1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Full-time equivalent employment. 839 348 330
1005 Full-time equivalent of overtime
and holiday hours............. 5 2 2
Reimbursable:
2001 Total compensable workyears: Full-
time equivalent employment...... 87 33 32
Allocation account:
3001 Total compensable workyears: Full-
time equivalent employment...... 610 691
---------------------------------------------------------------------------
Allocations Received From Other Accounts
Note.--Obligations incurred under allocations from other accounts
are included in the schedules of the parent appropriations as follows:
Health Care Financing Administration: ``Health Care Fraud and Abuse
Control Account.''
Note for Entire HHS Chapter.--The personnel summaries for all HHS
accounts reflect current estimates and add to the HHS totals shown in
the Federal Employment in the Executive Branch table of the Budget.
Within the HHS totals, account-by-account estimates may be subject to
change as staffing plans are implemented. The HHS FTE totals reflect
compliance with section 416 of the Social Security Act, as amended by
Public Law 104-193, the Personal Responsibility and Work Opportunity Act
of 1996, which requires a reduction of FTE consistent with the
replacement of Aid to Families with Dependent Children and Job
Opportunities and Basic Skills training program with Temporary
Assistance for Needy Families.
GENERAL FUND RECEIPT ACCOUNTS
(in millions of dollars)
----------------------------------------------------------------------------
1996 actual 1997 est. 1998 est.
----------------------------------------------------------------------------
Offsetting receipts from the public:
75-310700 Federal share of child
support collections................. 839 1,032
--------- --------- ----------
General Fund Offsetting receipts from
the public............................. 839 1,032
----------------------------------------------------------------------------
Intragovernmental payments:
20-310530 Quinquennial adjustment for
military service credits, Federal
hospital insurance.................. 2,366
--------- --------- ----------
General Fund Intragovernmental payments. 2,366
---------------------------------------------------------------------------
[[Page 527]]
GENERAL PROVISIONS
Sec. 201. Funds appropriated in this title shall be available for
not to exceed $37,000 for official reception and representation expenses
when specifically approved by the Secretary.
Sec. 202. The Secretary shall make available through assignment not
more than 60 employees of the Public Health Service to assist in child
survival activities and to work in AIDS programs through and with funds
provided by the Agency for International Development, the United Nations
International Children's Emergency Fund or the World Health
Organization.
Sec. 203. None of the funds appropriated under this Act may be used
to implement section 399L(b) of the Public Health Service Act or section
1503 of the National Institutes of Health Revitalization Act of 1993,
Public Law 103-43.
[Sec. 204. None of the funds made available by this Act may be used
to withhold payment to any State under the Child Abuse Prevention and
Treatment Act by reason of a determination that the State is not in
compliance with section 1340.2(d)(2)(ii) of title 45 of the Code of
Federal Regulations. This provision expires upon the date of enactment
of the reauthorization of the Child Abuse Prevention and Treatment Act.]
Sec. [205] 204. None of the funds appropriated in this Act for the
National Institutes of Health and the Substance Abuse and Mental Health
Services Administration shall be used to pay the salary of an
individual, through a grant or other extramural mechanism, at a rate in
excess of $125,000 per year.
[Sec. 206. None of the funds appropriated in this Act may be
expended pursuant to section 241 of the Public Health Service Act,
except for funds specifically provided for in this Act, or for other
taps and assessments made by any office located in the Department of
Health and Human Services, prior to the Secretary's preparation and
submission of a report to the Committee on Appropriations of the Senate
and of the House detailing the planned uses of such funds.]
[(transfer of funds)]
[Sec. 207. Of the funds appropriated or otherwise made available for
the Department of Health and Human Services, General Departmental
Management, for fiscal year 1997, the Secretary of Health and Human
Services shall transfer to the Office of the Inspector General such sums
as may be necessary for any expenses with respect to the provision of
security protection for the Secretary of Health and Human Services.]
[Sec. 208. None of the funds appropriated in this Act may be
obligated or expended for the Federal Council on Aging under the Older
Americans Act or the Advisory Board on Child Abuse and Neglect under the
Child Abuse Prevention and Treatment Act.]
[(transfer of funds)]
[Sec. 209. Not to exceed 1 percent of any discretionary funds
(pursuant to the Balanced Budget and Emergency Deficit Control Act, as
amended) which are appropriated for the current fiscal year for the
Department of Health and Human Services in this Act may be transferred
between appropriations, but no such appropriation shall be increased by
more than 3 percent by any such transfer: Provided, That the
Appropriations Committees of both House of Congress are notified at
least fifteen days in advance of any transfer.]
(transfer of funds)
Sec. [210] 205. The Director of the National Institutes of Health,
jointly with the Director of the Office of AIDS Research, may transfer
up to 3 percent among institutes, centers, and divisions from the total
amounts identified by these two Directors as funding for research
pertaining to the human immunodeficiency virus: Provided, That the
Congress is promptly notified of the transfer.
[(transfer of funds)]
[Sec. 211. Of the amounts made available in this Act for the
National Institutes of Health, the amount for research related to the
human immunodeficiency virus, as jointly determined by the Director of
NIH and the Director of the Office of AIDS Research, shall be made
available to the ``Office of AIDS Research'' account. The Director of
the Office of AIDS Research shall transfer from such account amounts
necessary to carry out section 2353(d)(3) of the Public Health Service
Act.]
[Sec. 212. Not later than January 1, 1997, the Administrator of the
Health Care Financing Administration, with the advice and technical
assistance of the Agency for Health Care Policy and Research, shall
transmit to the appropriate committees of the Congress a report
including--
(1) a review of all available studies and research data on the
treatment of end-stage emphysema and chronic obstructive pulmonary
disease by both unilateral and bilateral lung volume reduction
surgery, involving both invasive and noninvasive surgery and
supplemental surgical methods, including laser applications; and
(2) a recommendation, based on such review, as to the
appropriateness of Medicare coverage of such procedures and the
conditions, if necessary, that facilities and physicians should be
required to meet, to ensure the efficacy of such procedures, as more
detailed clinical studies are conducted.]
[Sec. 213. Section 304(a)(1) of the Family Violence Prevention and
Services Act (42 U.S.C. 10403(a)(1)) is amended by striking ``$200,000''
and inserting ``$400,000''.]
[Sec. 214. The new clinical research center at the National
Institutes of Health is hereby named the Mark O. Hatfield Clinical
Research Center.]
[Sec. 215. Section 345 of Public Law 104-193 is amended by replacing
``section 457(a)'' wherever it appears with ``a plan approved under this
part''. Amounts available under such section shall be calculated as
though such section were effective October 1, 1995.] (Department of
Health and Human Services Appropriations Act, 1997.)