[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]


[[Page 425]]


                 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 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; 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; [$1,103,140,000] $1,255,384,000, of which not to 
exceed [$132,273,000] $145,434,000 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 1999 shall be 
subject to the fiscal year 1999 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: Provided further, 
That of the total amount appropriated: (1) $231,580,000 shall be for the 
Center for Food Safety and Applied Nutrition and related field 
activities in the Office of Regulatory Affairs, of which, and 
notwithstanding section 409(h)(5)(A) of the Federal Food, Drug, and 
Cosmetic Act (21 U.S.C. 301 et seq.), an amount of $500,000 shall be 
made available for the development of systems, regulations, and pilot 
programs, if any, that would be required to permit full implementation, 
consistent with section 409(h)(5) of that Act, in fiscal year 2000 of 
the food contact substance notification program under section 409(h) of 
such Act; (2) $291,981,000 shall be for the Center for Drug Evaluation 
and Research and related field activities in the Office of Regulatory 
Affairs; (3) $125,095,000 shall be for the Center for Biologics 
Evaluation and Research and for related field activities in the Office 
of Regulatory Affairs; (4) $41,973,000 shall be for the Center for 
Veterinary Medicine and for related field activities in the Office of 
Regulatory Affairs; (5) $145,736,000 shall be for the Center for Devices 
and Radiological Health and for related field activities in the Office 
of Regulatory Affairs; (6) $31,579,000 shall be for the National Center 
for Toxicological Research; (7) $34,000,000 shall be for the Office of 
Tobacco; (8) $25,855,000 shall be for Rent and Related activities, other 
than the amounts paid to the General Services Administration; (9) 
$88,294,000 shall be for payments to the General Services Administration 
for rent and related costs; and (10) $87,047,000 shall be for other 
activities, including the Office of the Commissioner, the Office of 
Policy, the Office of External Affairs, the Office of Operations, the 
Office of Management and Systems, and central services for these 
offices: Provided further, That funds may be transferred from one 
specified activity to another with the prior approval of the Committee 
on Appropriations of both Houses of Congress]  no more than $100,180,000 
shall be for payments to the General Services Administration for rent 
and related costs: Provided further, That effective October 1, 1999, (1) 
the functions and authorities related to fish or fishery products under 
such Act, including inspections and other activities authorized under 
section 203(h) of that Act, are transferred from the Secretary of 
Commerce to the Secretary of Health and Human Services (hereafter 
``HHS'') acting through the Commissioner for Food and Drugs; (2) the 
Secretary of Commerce shall transfer to the Secretary of HHS (A) all 
personnel of the Seafood Inspection Division of the National Oceanic and 
Atmospheric Administration of the Department of Commerce and such other 
employees of the Department of Commerce as may be designated by the 
Secretary of Commerce, with the concurrence of the Secretary of HHS, all 
of whom shall become personnel of a voluntary seafood inspection unit 
within the Food and Drug Administration; and (B) all assets and 
liabilities of the Department of Commerce or its components pertaining 
to the activities specified in clause (1), which shall become assets and 
liabilities of such seafood inspection unit, including facilities, 
contracts, property, records, accounts payable and receivable, and 
unexpended and unobligated balances of funds; (3) all rules, 
regulations, administrative directives, grants, contracts, and other 
determinations and agreements in effect on such date with respect to (or 
to the extent they apply to) the functions and authorities specified in 
clause (1) shall remain in effect until modified, terminated, suspended, 
set aside, or repealed by the Secretary of HHS or the Commissioner of 
Food and Drugs; (4) the Secretary of HHS is authorized to promulgate, 
without need for comment, a final rule transferring to or duplicating in 
title 21 of the Code of Federal Regulations (as appropriate) regulations 
of the Secretary of Commerce necessary to carry out the functions 
specified in clause (1); (5) activities of such seafood inspection unit 
to carry out provisions of the Agricultural Marketing Act shall be 
funded exclusively from fees charged for, and other amounts specifically 
appropriated for, such activities, and fees collected and amounts 
appropriated for such activities shall not be used for any other 
purpose; and (6) for purposes of any reduction in the personnel 
complement of the Food and Drug Administration or of such unit on or 
before September 30, 2004, such unit will be deemed a distinct 
competitive area within the Food and Drug Administration, under 5 CFR 
351.402: Provided further, That of the total amount appropriated, 
$3,000,000 shall be available until expended for the costs of 
transferring functions related to fish and fishery products (including 
costs of relocation, personnel training, and public information), and 
shall be deposited, together with fees derived from performance of such 
functions, into a separate account.
    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, [$11,350,000] 
$31,750,000, to remain available until expended (7 U.S.C. 2209b). 
(Agriculture, Rural Development, Food and Drug Administration, and 
Related Agencies Appropriations Act, 1999, as included in Public Law 
105-277, section 101(a).)

              Unavailable Collections (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9911-0-1-554      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Balance, start of year:
01.99 Balance, start of year............
    Receipts:
02.01 Cooperative research and 
        development agreements..........           1           1           1
    Appropriation:
05.01 Salaries and expenses.............          -1          -1          -1
07.99 Total balance, end of year........
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9911-0-1-554      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   Foods...........................         206         232         266
00.02   Drugs...........................         337         337         373
00.03   Devices and radiological 
          products......................         144         146         164
00.04   National center for 
          toxicological research........          32          32          34
00.05   Tobacco.........................          34          34          68
00.06   Other activities................          79          81          81
00.07   Other rent and rent related 
          activities....................          26          26          26
00.08   Rental payments.................          46          83          95
00.09   Buildings and facilities........          28          20          32
00.10   CRADAs..........................           1           1           1
00.11   Seafood inspection program--
          transfer......................                                   3
09.01 Reimbursable program..............         130         164         192
                                           ---------   ---------  ----------

[[Page 426]]


10.00   Total new obligations...........       1,063       1,156       1,335
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          68         100          92
22.00 New budget authority (gross)......       1,092       1,147       1,335
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................           3
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       1,163       1,247       1,427
23.95 Total new obligations.............      -1,063      -1,156      -1,335
24.40 Unobligated balance available, end 
        of year.........................         100          92          92
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

40.00   Appropriation...................         925         982       1,142
      Permanent:

60.25   Appropriation (special fund, 
          indefinite)...................           1           1           1
        Spending authority from 
            offsetting collections:
68.00     Offsetting collections (cash).         163         161         189
68.10     From Federal sources: Change 
            in receivables and unpaid, 
            unfilled orders.............           3           3           3
                                           ---------   ---------  ----------
68.90       Spending authority from 
              offsetting collections 
              (total)...................         166         164         192
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       1,092       1,147       1,335
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         276         330         340
73.10 Total new obligations.............       1,063       1,156       1,335
73.20 Total outlays (gross).............      -1,001      -1,143      -1,301
73.45 Adjustments in unexpired accounts.          -3
      Unpaid obligations, end of year:

74.40   Obligated balance, end of year..         330         340         371
74.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............           3           3           3
                                           ---------   ---------  ----------
74.99     Total unpaid obligations, end 
            of year.....................         333         343         374
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority         668         751         862
86.93 Outlays from current balances.....         170         227         246
86.97 Outlays from new permanent 
        authority.......................         163         164         192
86.98 Outlays from permanent balances...           1           1           1
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       1,001       1,143       1,301
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.40   Offsetting collections (cash) 
          from: Non-Federal sources.....        -163        -161        -189
88.95 From Federal sources: Change in 
        receivables and unpaid, unfilled 
        orders..........................          -3          -3          -3
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         926         983       1,143
90.00 Outlays...........................         838         982       1,112
---------------------------------------------------------------------------

                        [In millions of dollars]

                                        1998         1999        2000
Distribution of budget authority by 
    account:
  Salaries and expenses.............         859         889       1,016
  Rental payments (FDA).............          46          83          95
  Buildings and facilities..........          21          11          32
Distribution of outlays by account:
  Salaries and expenses.............         777         873         998
  Rental payments (FDA).............          48          87          95
  Buildings and facilities..........          13          22          19

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1998 actual  1999 est.   2000 est.
Enacted/requested:
  Budget Authority..................         926         983       1,143
  Outlays...........................         839         982       1,112
Legislative proposal, not subject to 
    PAYGO:
  Budget Authority..................
  Outlays...........................
                                    ------------------------------------
Total:
  Budget Authority..................         926         983       1,143
  Outlays...........................         839         982       1,112
                                    ====================================

    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 
provides a $190.2 million (+17 percent) increase over the FY 1999 
enacted program level. The Budget includes $1,109.9 million for Salaries 
and Expenses, which includes funding for the food safety initiative and 
tobacco regulation, as well as new initiatives for injury reporting and 
product safety assurance in order to help meet FDA responsibilities 
under the FDA Modernization Act of 1997. Of the Salaries and Expenses 
amount, $94.5 million will be used for payments to the General Services 
Administration for rent and rent related costs (an additional $5.6 
million will be derived from fees). The Budget reflects the transfer of 
the Seafood Inspection Division of the National Oceanic and Atmospheric 
Administration of the Department of Commerce to the FDA, which will be 
financed with $12.7 million in currently authorized fees. In addition, 
the Budget includes $183.2 million for user fees, an increase of $30.7 
million in user fees over FY 1999, which will be used to finance FDA 
activities. Of the $183.2 million in user fees, $17 million consists of 
new user fees related to the review of direct and indirect food additive 
petitions and for the review of medical device applications, which are 
represented in the legislative proposal schedule. The buildings and 
facilities appropriation of $31.7 million provides funds for projects 
related to the repair, construction, alteration, and improvement of all 
buildings and facilities of FDA. 

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9911-0-1-554      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........         425         451         497
11.3      Other than full-time permanent          26          27          29
11.5      Other personnel compensation..          15          16          17
                                           ---------   ---------  ----------
11.9        Total personnel compensation         466         494         543
12.1    Civilian personnel benefits.....         105         112         123
21.0    Travel and transportation of 
          persons.......................          16          16          20
22.0    Transportation of things........           3           3           3
23.1    Rental payments to GSA..........          46          83          95
23.2    Rental payments to others.......           5           5           7
23.3    Communications, utilities, and 
          miscellaneous charges.........          21          20          25
24.0    Printing and reproduction.......           4           4           5
25.1    Advisory and assistance services          16          15          19
25.2    Other services..................          63          63          79
25.3    Purchases of goods and services 
          from Government accounts......          39          38          47
25.4    Operation and maintenance of 
          facilities....................          23          23          28
25.5    Research and development 
          contracts.....................          10          10          12
25.7    Operation and maintenance of 
          equipment.....................          21          21          25
26.0    Supplies and materials..........          15          15          19
31.0    Equipment.......................          29          29          35
32.0    Land and structures.............          27          18          30
41.0    Grants, subsidies, and 
          contributions.................          22          21          26
42.0    Insurance claims and indemnities           2           2           2
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..         933         992       1,143
99.0  Reimbursable obligations..........         130         164         192
                                           ---------   ---------  ----------
99.9    Total new obligations...........       1,063       1,156       1,335
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-9911-0-1-554      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: Full-
        time equivalent employment......       8,083       8,090       8,479

[[Page 427]]

    Reimbursable:
2001  Total compensable workyears: Full-
        time equivalent employment......         788         819       1,049
---------------------------------------------------------------------------

                                     

                                

                          Salaries and Expenses

              (Legislative proposal, not subject to PAYGO)

    Contingent upon the enactment of authorizing legislation, up to 
$17,000,000 derived from fees assessed for activities related to the 
review of direct and indirect food additive petitions and the review of 
medical device applications may be collected and credited to this 
appropriation, to remain available until expended for those activities.

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9911-2-1-554      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
09.01 Additive user fees................                                  17
                                           ---------   ---------  ----------
10.00   Total new obligations...........                                  17
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                  17
23.95 Total new obligations.............                                 -17
----------------------------------------------------------------------------

    New budget authority (gross), detail:
68.00 Spending authority from offsetting 
        collections (gross): Offsetting 
        collections (cash)..............                                  17
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                  17
73.20 Total outlays (gross).............                                 -17
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................                                  17
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.40   Offsetting collections (cash) 
          from: Non-Federal sources.....                                 -17
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................
---------------------------------------------------------------------------

    The Budget includes $183.2 million in user fees, of which $17 
million are new user fees to finance FDA activities as reflected in the 
legislative proposal schedule. Additional appropriations language is 
being proposed contingent upon the enactment of authorizing legislation. 
The authorizing legislation will be proposed to authorize the collection 
and spending of the fees subject to appropriation action.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9911-2-1-554      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
99.0  Reimbursable obligations: 
        Subtotal, reimbursable 
        obligations.....................                                  17
                                           ---------   ---------  ----------
99.9    Total new obligations...........                                  17
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-9911-2-1-554      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: Full-
        time equivalent employment......
    Reimbursable:
2001  Total compensable workyears: Full-
        time equivalent employment......                                  89
---------------------------------------------------------------------------

Public enterprise funds:

           Revolving Fund for Certification and Other Services

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4309-0-3-554      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations.............           4           4           4
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................           4           5           5
22.00 New budget authority (gross)......           4           4           4
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......           9           9           9
23.95 Total new obligations.............          -4          -4          -4
24.40 Unobligated balance available, end 
        of year.........................           5           5           5
----------------------------------------------------------------------------

    New budget authority (gross), detail:
68.00 Spending authority from offsetting 
        collections (gross): Offsetting 
        collections (cash)..............           4           4           4
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year           2           2           2
73.10 Total new obligations.............           4           4           4
73.20 Total outlays (gross).............          -3          -4          -4
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..           2           2           2
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................           3           4           4
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.40   Offsetting collections (cash) 
          from: Non-Federal sources.....          -4          -4          -4
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................          -1
---------------------------------------------------------------------------

    FDA certifies 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)

----------------------------------------------------------------------------
Identification code 75-4309-0-3-554      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
11.1  Personnel compensation: Full-time 
        permanent.......................           2           2           2
23.1  Rental payments to GSA............           1           1           1
26.0  Supplies and materials............           1           1           1
                                           ---------   ---------  ----------
99.9    Total new obligations...........           4           4           4
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-4309-0-3-554      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
2001  Total compensable workyears: Full-
        time equivalent employment......          33          35          36
---------------------------------------------------------------------------

                                


 
              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, XIX, and XXVI of 
the Public Health Service Act, section 427(a) of the Federal Coal Mine 
Health and Safety Act, title V and section 1820 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, 
[$4,108,040,000] $4,101,083,000, of which $150,000

[[Page 428]]

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, [and of which $65,345,000 shall be 
available for the construction and renovation of health care and other 
facilities,] and of which $25,000,000 from general revenues, 
notwithstanding section 1820(j) of the Social Security Act, shall be 
available for carrying out the Medicare rural hospital flexibility 
grants program under section 1820 of such 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, $250,000 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, 
[$215,000,000] $239,952,000 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 [$461,000,000] $496,000,000 shall be for State 
AIDS Drug Assistance Programs authorized by section 2616 of the Public 
Health Service 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, 
notwithstanding section 502(a)(1) of the Social Security Act, not to 
exceed $107,434,000 is available for carrying out special projects of 
regional and national significance pursuant to section 501(a)(2) of such 
Act: Provided further, That of the amount provided, $2,000,000 shall be 
for support of the Center for Sustainable Health Outreach at the 
University of Southern Mississippi in affiliation with Harrison 
Institute at Georgetown University for the establishment of 
demonstration programs that create model health access programs, health-
related jobs and sustainability of community-based providers of health 
services in rural and urban communities; and $1,250,000 shall be for the 
American Federation for Negro Affairs Education and Research Fund:] 
Provided further, That fees collected for the full disclosure of 
information under the ``Health Care Fraud and Abuse Data Collection 
Program,'' authorized by section 221 of the Health Insurance Portability 
and Accountability Act of 1996, shall be sufficient to recover the full 
costs of operating the Program, and shall remain available to carry out 
that Act until expended. (Department of Health and Human Services 
Appropriations Act, 1999, as included in Public Law 105-277, section 
101(f).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0350-0-1-550      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   Health centers..................         816         920         940
00.02   National Health Service Corps...          37          37          37
00.03   National Health Service Corps 
          recruitment...................          78          78          78
00.04   Hansen's disease center.........          17          22          17
00.05   Payment to Hawaii for the 
          treatment of Hansen's disease.           2           2           2
00.06   Buildings and facilities........           3
00.07   Black lung clinics..............           5           5           5
00.08   State Alzheimer's demonstration 
          grants........................           6
00.09   Nursing loan repayment..........           2           2           2
00.10   Health professions..............         289         302         212
00.11   Maternal and child health block 
          grant.........................         681         700         695
00.12   Emergency medical services for 
          children......................          13          15
00.13   Healthy start...................          96         105         105
00.14   HIV/AIDS........................       1,150       1,411       1,511
00.15   Organ transplantation...........           3          10          10
00.16   Health care facilities..........          28          65
00.17   Bone marrow donor registry......          15          18          18
00.18   Rural health policy development.          12          12           6
00.19   Rural health outreach grants....          32          39          32
00.20   Program management..............         114         119         122
00.21   Family planning.................         203         215         240
00.22   Abstinence education............          50          50          50
00.23   Health centers tort claims fund.           2           2           5
00.24   Rural health flexibility grants.                      25          25
00.25   Telehealth......................                                  13
00.27   Critical care programs..........                                  23
00.28   Universal newborn hearing.......                                   4
00.29   Health centers loan guarantee 
          program account...............                       4           4
09.01 Reimbursable program..............          75          92          93
                                           ---------   ---------  ----------
10.00   Total new obligations...........       3,729       4,250       4,249
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          39          47          46
22.00 New budget authority (gross)......       3,736       4,249       4,246
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       3,775       4,296       4,292
23.95 Total new obligations.............      -3,729      -4,250      -4,249
23.98 Unobligated balance expiring......          -1
24.40 Unobligated balance available, end 
        of year.........................          47          46          43
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

40.00   Appropriation...................       3,618       4,108       4,101
41.00   Transferred to other accounts...          -7
                                           ---------   ---------  ----------
43.00     Appropriation (total).........       3,611       4,108       4,101
      Permanent:

60.00   Appropriation...................          50          50          50
68.00   Spending authority from 
          offsetting collections: 
          Offsetting collections (cash).          75          91          95
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       3,736       4,249       4,246
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year       2,397       2,726       3,064
73.10 Total new obligations.............       3,729       4,250       4,249
73.20 Total outlays (gross).............      -3,382      -3,912      -4,184
73.40 Adjustments in expired accounts...         -18
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..       2,726       3,064       3,129
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority       1,397       1,565       1,554
86.93 Outlays from current balances.....       1,891       2,213       2,487
86.97 Outlays from new permanent 
        authority.......................          94         110         114
86.98 Outlays from permanent balances...                      24          29
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       3,382       3,912       4,184
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............         -63         -79         -79
88.40     Non-Federal sources...........         -12         -12         -16
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........         -75         -91         -95
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       3,661       4,158       4,151
90.00 Outlays...........................       3,307       3,821       4,089
---------------------------------------------------------------------------

                          [Dollars in millions]

                                        1998         1999        2000
Distribution of budget authority by 
    account:
  Health resources and services.....       3,656       4,153       4,186
  Health centers malpractice claims.           5           5           5
Distribution of outlays by account:
  Health resources and services.....       3,305       3,819       4,111
  Health centers malpractice claims.           2           2           2

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1998 actual  1999 est.   2000 est.
Enacted/requested:
  Budget Authority..................       3,661       4,158       4,151
  Outlays...........................       3,307       3,821       4,089
Legislative proposal, not subject to 
    PAYGO:
  Budget Authority..................                                  40
  Outlays...........................                                  15
                                    ------------------------------------

[[Page 429]]


Total:
  Budget Authority..................       3,661       4,158       4,191
  Outlays...........................       3,307       3,821       4,104
                                    ====================================

Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in 
                            millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0350-0-1-550      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Guaranteed loan levels supportable by subsidy 
                budget authority:
2150  Health Centers: Facilities 
        Renovation Loan guarantee levels                      54          34
2150  Health Centers: Managed Care 
        Network Development Loan 
        guarantee levels................                      20           7
2150  Health Centers: Managed Care Plan 
        Loan guarantee levels...........           9          26          10
                                           ---------   ---------  ----------
2159    Total loan guarantee levels.....           9         100          51
    Guaranteed loan subsidy (in percent):
2320  Facilities Loan Subsidy rate......        2.21        2.26        0.71
2320  Managed Care Network Development 
        Loan Subsidy rate...............        8.40        8.59        8.19
2320  Managed Care Plan Loan Subsidy 
        rate............................        5.03        5.11        4.16
                                           ---------   ---------  ----------
2329    Weighted average subsidy rate...        5.11        5.32        2.41
    Guaranteed loan subsidy budget authority:
2330  Facilities Loan Subsidy budget 
        authority.......................                       1           1
2330  Managed Care Network Development 
        Loan Subsidy budget authority...                       2           2
2330  Managed Care Plan Loan Subsidy 
        budget authority................                       1           1
                                           ---------   ---------  ----------
2339    Total subsidy budget authority..                       4           4
    Guaranteed loan subsidy outlays:
2340  Facilities Loan Subsidy outlays...                       1           1
2340  Managed Care Network Development 
        Loan Subsidy outlays............                       2           2
2340  Managed Care Plan Loan Subsidy 
        outlays.........................                       1           1
                                           ---------   ---------  ----------
2349    Total subsidy outlays...........                       4           4
---------------------------------------------------------------------------

    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)

----------------------------------------------------------------------------
Identification code 75-0350-0-1-550      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........          90         101         105
11.3      Other than full-time permanent           2           2           2
11.5      Other personnel compensation..           5           5           5
                                           ---------   ---------  ----------
11.9        Total personnel compensation          97         108         112
12.1    Civilian personnel benefits.....          24          25          26
13.0    Benefits for former personnel...                       1           1
21.0    Travel and transportation of 
          persons.......................           3           3           3
22.0    Transportation of things........           1           1           1
23.1    Rental payments to GSA..........           9           8           9
23.3    Communications, utilities, and 
          miscellaneous charges.........           4           4           5
24.0    Printing and reproduction.......           2           1           1
25.1    Advisory and assistance services          34          33          33
25.2    Other services..................          51          48          49
25.3    Purchases of goods and services 
          from Government accounts......          39          34          34
25.4    Operation and maintenance of 
          facilities....................           2           1           1
25.6    Medical care....................                       1           1
25.7    Operation and maintenance of 
          equipment.....................           3           1           1
25.8    Subsistence and support of 
          persons.......................                       2           2
26.0    Supplies and materials..........           3           2           2
31.0    Equipment.......................           4           1           1
41.0    Grants, subsidies, and 
          contributions.................       3,376       3,882       3,869
42.0    Insurance claims and indemnities           2           2           5
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..       3,654       4,158       4,156
99.0  Reimbursable obligations..........          75          92          93
                                           ---------   ---------  ----------
99.9    Total new obligations...........       3,729       4,250       4,249
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0350-0-1-550      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Direct:
      Total compensable workyears:

1001    Full-time equivalent employment.       1,543       1,578       1,705
1011    Exempt Full-time equivalent 
          employment....................         101         146
    Reimbursable:
2001  Total compensable workyears: Full-
        time equivalent employment......         198         211         221
    Allocation account:
3001  Total compensable workyears: Full-
        time equivalent employment......           1           1           1
---------------------------------------------------------------------------

                                

                      Health Resources and Services

              (Legislative proposal, not subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0350-2-1-550      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   Pediatric GME service delivery..                                  40
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................                                  40
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                  40
23.95 Total new obligations.............                                 -40
----------------------------------------------------------------------------

    New budget authority (gross), detail:
40.00 Appropriation.....................                                  40
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                  40
73.20 Total outlays (gross).............                                 -15
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..                                  25
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority                                  15
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                  40
90.00 Outlays...........................                                  15
---------------------------------------------------------------------------

    The Children's Hospitals Graduate Medical Education grant program is 
designed to provide temporary financial assistance for graduate medical 
education at free-standing children's hospitals. By providing grants to 
such hospitals to help pay for a portion of their direct medical 
education costs, this new program will improve the financial viability 
of these hospitals, allowing them to focus on expanded services and 
improved patient care.

                                

                       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, $100,000,000, to remain available until expended.] (Department 
of Health and Human Services Appropriations Act, 1999, as included in 
Public Law 105-277, Section 101(f).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0320-0-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations (object 
        class 42.0).....................          84          79          73
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................         145          61          82
22.00 New budget authority (gross)......                     100
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         145         161          82
23.95 Total new obligations.............         -84         -79         -73

[[Page 430]]

24.40 Unobligated balance available, end 
        of year.........................          61          82           9
----------------------------------------------------------------------------

    New budget authority (gross), detail:
40.00 Appropriation.....................                     100
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year           3           2           2
73.10 Total new obligations.............          84          79          73
73.20 Total outlays (gross).............         -85         -79         -73
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..           2           2           2
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority                      16
86.93 Outlays from current balances.....          85          63          73
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........          85          79          73
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                     100
90.00 Outlays...........................          85          79          73
---------------------------------------------------------------------------

    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 2000 
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

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4442-0-3-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................                       1           6
22.00 New financing authority (gross)...                       5           5
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......                       6          11
24.40 Unobligated balance available, end 
        of year.........................           1           6          11
----------------------------------------------------------------------------

    New financing authority (gross), detail:
68.00 Spending authority from offsetting 
        collections (gross): (Federal 
        Sources: from program account)..                       5           5
----------------------------------------------------------------------------

    Offsets:
      Against gross financing authority and 
          financing disbursements:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............                      -4          -4
88.40     Premium Income................                      -1          -1
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........                      -5          -5
----------------------------------------------------------------------------

    Net financing authority and financing 
        disbursements:
89.00 Financing authority...............
90.00 Financing disbursements...........          -1          -5          -5
---------------------------------------------------------------------------

             Status of Guaranteed Loans (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4442-0-3-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Position with respect to appropriations act 
                limitation on commitments:
2111  Limitation on guaranteed loans 
        made by private lenders.........         160         151          51
2113  Uncommitted limitation carried 
        forward.........................        -151         -51
                                           ---------   ---------  ----------
2150    Total guaranteed loan 
          commitments...................           9         100          51
----------------------------------------------------------------------------

    Cumulative balance of guaranteed loans 
                outstanding:
2210  Outstanding, start of year........                       9          82
2231  Disbursements of new guaranteed 
        loans...........................           9          73          48
2261  Adjustments: Terminations for 
        default that result in loans 
        receivable......................
                                           ---------   ---------  ----------
2290    Outstanding, end of year........           9          82         130
----------------------------------------------------------------------------

    Memorandum:
2299  Guaranteed amount of guaranteed 
        loans outstanding, end of year..           9          82         130
----------------------------------------------------------------------------

    Addendum:
      Cumulative balance of defaulted guaranteed 
          loans that result in loans receivable:

2310    Outstanding, start of year......
2331    Disbursements for guaranteed 
          loan claims...................
2351    Repayments of loans receivable..
                                           ---------   ---------  ----------
2390      Outstanding, end of year......
---------------------------------------------------------------------------

    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 program 
has only used $9 million of its available $160 million in loan guarantee 
authority, HRSA will use the remaining existing loan guarantee limit 
over FY 1999 and FY 2000. 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.

                             Balance Sheet (in millions of dollars)

-----------------------------------------------------------------------------------------------
Identification code   75-4442-0-3-551    1997 actual    1998 actual     1999 est.      2000 est.
-----------------------------------------------------------------------------------------------
    ASSETS:
      Investments in US securities:

1106    Federal assets: Receivables, net                          9           109            160
                                        ------------ --------------  ------------  -------------
1999    Total assets....................                          9           109            160
    LIABILITIES:
2204  Non-Federal liabilities: 
        Liabilities for loan guarantees.                          9           109            160
                                        ------------ --------------  ------------  -------------
2999    Total liabilities...............                          9           109            160
                                        ------------ --------------  ------------  -------------
4999  Total liabilities and net position                          9           109            160
-----------------------------------------------------------------------------------------------

                                

            Health Education Assistance Loans Program Account

    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. For administrative expenses to carry out the guaranteed loan 
program, including section 709 of the Public Health Service Act, 
$3,688,000. (Department of Health and Human Services Appropriations Act, 
1999, as included in Public Law 105-277, section 101(f).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0340-0-1-552      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.02 Guaranteed loan subsidy...........           1

[[Page 431]]

00.09 Administrative expenses subject to 
        limitation......................           4           4           4
                                           ---------   ---------  ----------
10.00   Total new obligations...........           5           4           4
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......           5           4           4
23.95 Total new obligations.............          -5          -4          -4
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

40.00   Appropriation...................           4           4           4
      Permanent:

68.00   Spending authority from 
          offsetting collections: 
          Offsetting collections (cash).           1
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................           5           4           4
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year           1           2
73.10 Total new obligations.............           5           4           4
73.20 Total outlays (gross).............          -5          -5          -4
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..           2
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority           3           4           4
86.93 Outlays from current balances.....           1           1
86.97 Outlays from new permanent 
        authority.......................           1
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........           5           5           4
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........          -1
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................           4           4           4
90.00 Outlays...........................           3           5           4
---------------------------------------------------------------------------

Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in 
                            millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0340-0-1-552      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Guaranteed loan levels supportable by subsidy 
                budget authority:
2150  Loan guarantee levels.............          85
                                           ---------   ---------  ----------
2159    Total loan guarantee levels.....          85
    Guaranteed loan subsidy (in percent):
2320  Subsidy rate......................        1.09        0.00        0.00
                                           ---------   ---------  ----------
2329    Weighted average subsidy rate...        1.09        0.00        0.00
    Guaranteed loan subsidy budget authority:
2330  Subsidy budget authority..........           1
                                           ---------   ---------  ----------
2339    Total subsidy budget authority..           1
    Guaranteed loan subsidy outlays:
2340  Subsidy outlays...................           1
                                           ---------   ---------  ----------
2349    Total subsidy outlays...........           1
----------------------------------------------------------------------------

    Administrative expense data:
3510  Budget authority..................           4           4           4
3590  Outlays from new authority........           2           4           4
---------------------------------------------------------------------------

    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      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
11.1  Personnel compensation: Full-time 
        permanent.......................           2           2           2
25.3  Purchases of goods and services 
        from Government accounts........           1           1           1
41.0  Grants, subsidies, and 
        contributions...................           1
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..           4           3           3
99.5  Below reporting threshold.........           1           1           1
                                           ---------   ---------  ----------
99.9    Total new obligations...........           5           4           4
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0340-0-1-552      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Total compensable workyears:
1001  Full-time equivalent employment...          21          20          25
1011  Exempt Full-time equivalent 
        employment......................           7           7
---------------------------------------------------------------------------

                                

           Health Education Assistance Loans Financing Account

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4304-0-3-552      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Death and disability claims.......           3           1           1
00.02 Default claims....................          13          15          21
                                           ---------   ---------  ----------
10.00   Total new obligations...........          16          16          22
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................         247         259         268
22.00 New financing authority (gross)...          28          26          28
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         275         285         296
23.95 Total new obligations.............         -16         -16         -22
24.40 Unobligated balance available, end 
        of year.........................         259         268         274
----------------------------------------------------------------------------

    New financing authority (gross), detail:
68.00 Spending authority from offsetting 
        collections (gross): Offsetting 
        collections (cash)..............          28          26          28
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............          16          16          22
73.20 Total financing disbursements 
        (gross).........................         -16         -16         -22
87.00 Total financing disbursements 
        (gross).........................          16          16          22
----------------------------------------------------------------------------

    Offsets:
      Against gross financing authority and 
          financing disbursements:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............          -1
88.25     Interest on uninvested funds..         -22         -25         -26
          Non-Federal sources:
88.40       Premium income..............          -5
88.40       Recoveries of defaulted 
              loans.....................                      -1          -2
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........         -28         -26         -28
----------------------------------------------------------------------------

    Net financing authority and financing 
        disbursements:
89.00 Financing authority...............
90.00 Financing disbursements...........         -11         -10          -6
---------------------------------------------------------------------------

             Status of Guaranteed Loans (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4304-0-3-552      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Position with respect to appropriations act 
                limitation on commitments:
2111  Limitation on guaranteed loans 
        made by private lenders.........          85
                                           ---------   ---------  ----------
2150    Total guaranteed loan 
          commitments...................          85
----------------------------------------------------------------------------

    Cumulative balance of guaranteed loans 
                outstanding:
2210  Outstanding, start of year........       1,494       1,562       1,546
2231  Disbursements of new guaranteed 
        loans...........................          85
      Adjustments:

2261    Terminations for default that 
          result in loans receivable....         -14         -15         -20
2263    Terminations for default that 
          result in claim payments......          -3          -1          -1
                                           ---------   ---------  ----------
2290    Outstanding, end of year........       1,562       1,546       1,525
----------------------------------------------------------------------------

[[Page 432]]


    Memorandum:
2299  Guaranteed amount of guaranteed 
        loans outstanding, end of year..       1,562       1,546       1,525
----------------------------------------------------------------------------

    Addendum:
      Cumulative balance of defaulted guaranteed 
          loans that result in loans receivable:

2310    Outstanding, start of year......          18          32          45
2331    Disbursements for guaranteed 
          loan claims...................          14          15          20
2351    Repayments of loans receivable..                      -2          -2
                                           ---------   ---------  ----------
2390      Outstanding, end of year......          32          45          63
---------------------------------------------------------------------------

    This account records all cash flows to and from the Government 
resulting from (HEAL) loan guarantees committed between 1992 and 1998. 

                             Balance Sheet (in millions of dollars)

-----------------------------------------------------------------------------------------------
Identification code   75-4304-0-3-552    1997 actual    1998 actual     1999 est.      2000 est.
-----------------------------------------------------------------------------------------------
    ASSETS:
      Federal assets:

1101    Fund balances with Treasury.....         226            247           259            268
        Investments in US securities:
1106      Receivables, net..............                          1
      Non-Federal assets:

1201    Investments in non-Federal 
          securities, net...............          19             22            25             26
1206    Receivables, net................          14              5             1              2
                                        ------------ --------------  ------------  -------------
1999    Total assets....................         259            275           285            296
    LIABILITIES:
2204  Non-Federal liabilities: 
        Liabilities for loan guarantees.       1,494          1,562         1,546          1,525
                                        ------------ --------------  ------------  -------------
2999    Total liabilities...............       1,494          1,562         1,546          1,525
    NET POSITION:
3300  Cumulative results of operations..      -1,235         -1,287        -1,261         -1,229
                                        ------------ --------------  ------------  -------------
3999    Total net position..............      -1,235         -1,287        -1,261         -1,229
                                        ------------ --------------  ------------  -------------
4999  Total liabilities and net position         259            275           285            296
-----------------------------------------------------------------------------------------------

                                

          Health Education Assistance Loans Liquidating Account

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4305-0-3-552      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Death and disability claims.......           4           9          10
00.02 Defaulted loans...................          29          40          34
00.03 Debt collection...................           5           8           8
                                           ---------   ---------  ----------
10.00   Total new obligations...........          38          57          52
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................           5
22.00 New budget authority (gross)......          33          57          52
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......          38          57          52
23.95 Total new obligations.............         -38         -57         -52
----------------------------------------------------------------------------

    New budget authority (gross), detail:
60.05 Appropriation (indefinite)........          30          37          32
      Spending authority from offsetting 
          collections:

68.00   Offsetting collections (cash)...          21          20          20
68.27   Capital transfer to general fund         -18
                                           ---------   ---------  ----------
68.90     Spending authority from 
            offsetting collections 
            (total).....................           3          20          20
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................          33          57          52
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year           6           5
73.10 Total new obligations.............          38          57          52
73.20 Total outlays (gross).............         -39         -62         -52
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..           5
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................          33          57          52
86.98 Outlays from permanent balances...           6           5
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........          39          62          52
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.40   Offsetting collections (cash) 
          from: Non-Federal sources.....         -21         -20         -20
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................          12          37          32
90.00 Outlays...........................          18          42          32
---------------------------------------------------------------------------

             Status of Guaranteed Loans (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4305-0-3-552      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Cumulative balance of guaranteed loans 
                outstanding:
2210  Outstanding, start of year........       1,478       1,412       1,321
2251  Repayments and prepayments........         -52         -58         -69
      Adjustments:

2261    Terminations for default that 
          result in loans receivable....         -12         -28         -21
2263    Terminations for default that 
          result in claim payments......          -2          -5          -6
                                           ---------   ---------  ----------
2290    Outstanding, end of year........       1,412       1,321       1,225
----------------------------------------------------------------------------

    Memorandum:
2299  Guaranteed amount of guaranteed 
        loans outstanding, end of year..       1,412       1,321       1,225
----------------------------------------------------------------------------

    Addendum:
      Cumulative balance of defaulted guaranteed 
          loans that result in loans receivable:

2310    Outstanding, start of year......         470         494         500
2331    Disbursements for guaranteed 
          loan claims...................          29          40          34
2351    Repayments of loans receivable..         -14         -14         -14
2361    Write-offs of loans receivable..         -20         -20         -20
2364    Other adjustments, net..........          29
                                           ---------   ---------  ----------
2390      Outstanding, end of year......         494         500         500
---------------------------------------------------------------------------

    Note.--Includes carryover commitments from prior years.
    Note.--The adjustment to loans receivable represents interest, which 
had not previously been reflected in cumulative outstanding balances.

    This account records all cash flows to and from the Government 
resulting from HEAL loan guarantees committed prior to 1992.

                              DATA ON LOANS

                                     1998 actual  1999 est.   2000 est.
Dollar volume of loans insured ($ in 
millions)...........................        84.9
Number of students..................       6,581
Average value of loans..............      12,906

                        Statement of Operations (in millions of dollars)

-----------------------------------------------------------------------------------------------
Identification code   75-4305-0-3-552    1997 actual    1998 actual     1999 est.      2000 est.
-----------------------------------------------------------------------------------------------
0101  Revenue...........................          74             48            57             52
0102  Expense...........................         -57            -38           -57            -52
                                        ------------ --------------  ------------  -------------
0109  Net loss..........................          17             10
-----------------------------------------------------------------------------------------------

                             Balance Sheet (in millions of dollars)

-----------------------------------------------------------------------------------------------
Identification code   75-4305-0-3-552    1997 actual    1998 actual     1999 est.      2000 est.
-----------------------------------------------------------------------------------------------
    ASSETS:
      Net value of assets related to 
          pre-1992 direct loans 
          receivable and acquired 
          defaulted guaranteed loans 
          receivable:

1701    Defaulted guaranteed loans, 
          gross.........................         470            470           494            500

[[Page 433]]

1702    Interest receivable.............           6              5             5              5
1704    Defaulted guaranteed loans and 
          interest receivable, net......         476            475           499            505
                                        ------------ --------------  ------------  -------------
1799      Value of assets related to 
            loan guarantees.............         476            475           499            505
1801  Other Federal assets: Cash and 
        other monetary assets...........          57             38            57             52
                                        ------------ --------------  ------------  -------------
1999    Total assets....................         533            513           556            557
    LIABILITIES:
2104  Federal liabilities: Resources 
        payable to Treasury.............           3              2             5              6
2201  Non-Federal liabilities: Accounts 
        payable.........................          47             29            40             34
                                        ------------ --------------  ------------  -------------
2999    Total liabilities...............          50             31            45             40
    NET POSITION:
3300  Cumulative results of operations..         483            482           511            517
                                        ------------ --------------  ------------  -------------
3999    Total net position..............         483            482           511            517
                                        ------------ --------------  ------------  -------------
4999  Total liabilities and net position         533            513           556            557
-----------------------------------------------------------------------------------------------

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4305-0-3-552      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
25.2  Other services....................           6           6           6
42.0  Insurance claims and indemnities..          32          51          46
                                           ---------   ---------  ----------
99.9    Total new obligations...........          38          57          52
---------------------------------------------------------------------------

                                

               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, $1,000,000, 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, 1999, 
as included in Public Law 105-277, section 101(f).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9931-0-3-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Operating expenses: Interest 
        subsidies, private..............           4           4           4
01.01 Capital investment: Direct loans..                       1           1
                                           ---------   ---------  ----------
10.00   Total new obligations...........           4           5           5
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          57          50          39
22.00 New budget authority (gross)......           3           6           4
22.60 Redemption of debt................          -6         -12         -12
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......          54          44          31
23.95 Total new obligations.............          -4          -5          -5
24.40 Unobligated balance available, end 
        of year.........................          50          39          26
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

40.00   Appropriation...................          -5           1           1
      Permanent:

68.00   Spending authority from 
          offsetting collections: 
          Offsetting collections (cash).           8           5           3
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................           3           6           4
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year          15          15          19
73.10 Total new obligations.............           4           5           5
73.20 Total outlays (gross).............          -4          -1          -1
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..          15          19          23
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority           4           1           1
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

        Offsetting collections (cash) 
            from:
          Non-Federal sources:
88.40       Principal repaid on loans 
              not sold..................          -2          -1          -2
88.40       Principal collections from 
              FFB.......................          -6          -4          -1
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........          -8          -5          -3
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................          -5           1           1
90.00 Outlays...........................          -4          -4          -2
---------------------------------------------------------------------------

               Status of Direct Loans (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9931-0-3-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Cumulative balance of direct loans 
                outstanding:
1210  Outstanding, start of year........          24          17          10
1251  Repayments: Repayments and 
        prepayments.....................          -7          -7         -10
                                           ---------   ---------  ----------
1290    Outstanding, end of year........          17          10
---------------------------------------------------------------------------

             Status of Guaranteed Loans (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9931-0-3-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Cumulative balance of guaranteed loans 
                outstanding:
2210  Outstanding, start of year........         142          82          42
2251  Repayments and prepayments........         -60         -40         -30
                                           ---------   ---------  ----------
2290    Outstanding, end of year........          82          42          12
----------------------------------------------------------------------------

    Memorandum:
2299  Guaranteed amount of guaranteed 
        loans outstanding, end of year..          82          42          12
---------------------------------------------------------------------------

    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 75-9931-0-3-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
33.0  Investments and loans.............                       1           1
41.0  Grants, subsidies, and 
        contributions...................           4           3           3
43.0  Interest and dividends............                       1           1
                                           ---------   ---------  ----------
99.9    Total new obligations...........           4           5           5
---------------------------------------------------------------------------

                                

  

                               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:

[[Page 434]]

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, 1999, as included in Public Law 105-277, section 
101(f).)

              Unavailable Collections (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8175-0-7-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Balance, start of year:
01.99 Balance, start of year............       1,193       1,264       1,373
    Receipts:
02.01 Deposits..........................         116         112         113
02.03 Interest income...................          16          67          73
                                           ---------   ---------  ----------
02.99   Total receipts..................         132         179         186
                                           ---------   ---------  ----------
04.00 Total: Balances and collections...       1,325       1,443       1,559
    Appropriation:
05.01 Vaccine injury compensation 
        program trust fund..............         -61         -70         -70
                                           ---------   ---------  ----------
05.99 Subtotal appropriation............         -61         -70         -70
07.99 Total balance, end of year........       1,264       1,373       1,489
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8175-0-7-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Compensation: Claims for post--FY 
        1989 injuries...................          52          60          60
      Administrative expenses:

01.03   Claims processing (Claims Court)           2           3           3
01.04   Claims processing (Public Health 
          Service)......................           3           3           3
01.05   Claims processing (Dept. of 
          Justice)......................           7           4           4
                                           ---------   ---------  ----------
01.91     Total, administrative expenses          12          10          10
                                           ---------   ---------  ----------
10.00   Total new obligations...........          64          70          70
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................           3
22.00 New budget authority (gross)......          61          70          70
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......          64          70          70
23.95 Total new obligations.............         -64         -70         -70
----------------------------------------------------------------------------

    New budget authority (gross), detail:
40.26 Appropriation (trust fund, 
        definite).......................           9          10          10
40.27 Appropriation (trust fund, 
        indefinite).....................          52          60          60
                                           ---------   ---------  ----------
43.00   Appropriation (total)...........          61          70          70
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............          64          70          70
73.20 Total outlays (gross).............         -64         -70         -70
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority          61          70          70
86.93 Outlays from current balances.....           3
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........          64          70          70
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................          61          70          70
90.00 Outlays...........................          64          70          70
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.01 Total investments, start of year: 
        U.S. securities: Par value......       1,256       1,285
92.02 Total investments, end of year: 
        U.S. securities: Par value......       1,285
---------------------------------------------------------------------------

    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.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8175-0-7-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
25.2  Other services....................           3           3           3
25.3  Purchases of goods and services 
        from Government accounts........           9           7           7
42.0  Insurance claims and indemnities..          52          60          60
                                           ---------   ---------  ----------
99.9    Total new obligations...........          64          70          70
---------------------------------------------------------------------------

                                


 
                          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, [$1,950,322,000] 
$2,094,922,000, 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 [$373,801,000] $398,442,000 for contract 
medical care shall remain available for obligation until September 30, 
[2000] 2001: Provided further, That of the funds provided, up to 
$17,000,000 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 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, [2000] 2001: 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: Provided further, That, notwithstanding any other provision of 
law, of the amounts provided herein, not to exceed [$203,781,000] 
$238,781,000 shall be for payments to tribes and tribal organizations 
for contract or grant support costs associated with contracts, grants, 
self-governance compacts or annual funding agreements between the Indian 
Health Service and a tribe or tribal organization pursuant to the Indian 
Self-Determination Act of 1975, as amended, prior to or during fiscal 
year [1999: Provided further, That funds provided to the Ponca Indian 
Tribe of Nebraska in previous fiscal years that were retained by the 
tribe to carry out the programs and functions of the Indian Health 
Service may be used by the tribe to obtain approved clinical space to 
carry out the program] 2000. (Department of the Interior and Related 
Agencies Appropriations Act, 1999, as included in Public Law 105-277, 
section 101(e).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0390-0-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   Clinical services...............       1,477       1,543       1,643
00.02   Preventive health...............          82          87          92
00.03   Urban health....................          25          26          29

[[Page 435]]

00.04   Indian health professions.......          29          30          30
00.05   Tribal management...............           2           2           2
00.06   Direct operations...............          47          49          51
00.07   Self-governance.................          11           9           9
00.08   Contract support costs..........         169         204         239
00.09   Diabetes funds..................          27          33          30
09.01 Reimbursable program..............         402         436         436
                                           ---------   ---------  ----------
10.00   Total new obligations...........       2,271       2,419       2,561
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................         105         103         100
22.00 New budget authority (gross)......       2,273       2,416       2,561
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       2,378       2,519       2,661
23.95 Total new obligations.............      -2,271      -2,419      -2,561
23.98 Unobligated balance expiring......          -4
24.40 Unobligated balance available, end 
        of year.........................         103         100         100
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

40.00   Appropriation...................       1,841       1,950       2,095
      Permanent:

62.00   Transferred from HCFA for 
          Diabetes......................          30          30          30
68.00   Spending authority from 
          offsetting collections: 
          Offsetting collections (cash).         402         436         436
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       2,273       2,416       2,561
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         476         483         493
73.10 Total new obligations.............       2,271       2,419       2,561
73.20 Total outlays (gross).............      -2,264      -2,409      -2,481
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         483         493         573
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority       1,631       1,521       1,634
86.93 Outlays from current balances.....         213         434         374
86.97 Outlays from new permanent 
        authority.......................         420         454         461
86.98 Outlays from permanent balances...                                  12
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       2,264       2,409       2,481
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............        -179        -143        -143
88.40     Non-Federal sources...........        -223        -293        -293
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........        -402        -436        -436
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       1,871       1,980       2,125
90.00 Outlays...........................       1,862       1,973       2,045
---------------------------------------------------------------------------

    The Indian Health Services account provides medical care, public 
health services, and health professions training opportunities to 
American Indians and Alaska Natives. An estimated $564 million will be 
administered by tribal governments under self-governance compacts in FY 
2000.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0390-0-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........         363         382         398
11.3      Other than full-time permanent          16          17          18
11.5      Other personnel compensation..          31          33          34
                                           ---------   ---------  ----------
11.9        Total personnel compensation         410         432         450
12.1    Civilian personnel benefits.....         120         126         133
13.0    Benefits for former personnel...           6           6           7
21.0    Travel and transportation of 
          persons.......................          29          30          30
22.0    Transportation of things........          11          11          12
23.1    Rental payments to GSA..........           9           9           9
23.2    Rental payments to others.......                                   3
23.3    Communications, utilities, and 
          miscellaneous charges.........          20          21          21
24.0    Printing and reproduction.......           2           2           2
25.1    Advisory and assistance services          11          11          11
25.2    Other services..................          63          66          67
25.3    Purchases of goods and services 
          from Government accounts......          25          26          26
25.4    Operation and maintenance of 
          facilities....................          19          19          20
25.5    Research and development 
          contracts.....................           1           1           1
25.6    Medical care....................         208         216         221
25.7    Operation and maintenance of 
          equipment.....................          13          13          14
25.8    Subsistence and support of 
          persons.......................           8           9           9
26.0    Supplies and materials..........          88          91          92
31.0    Equipment.......................          22          23          23
32.0    Land and structures.............           2           2           2
41.0    Grants, subsidies, and 
          contributions.................         800         867         970
43.0    Interest and dividends..........           2           2           2
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..       1,869       1,983       2,125
99.0  Reimbursable obligations..........         402         436         436
                                           ---------   ---------  ----------
99.9    Total new obligations...........       2,271       2,419       2,561
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0390-0-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Direct:
      Total compensable workyears:

1001    Full-time equivalent employment.       9,814       9,981      10,104
1011    Exempt Full-time equivalent 
          employment....................          14          14
    Reimbursable:
2001  Total compensable workyears: Full-
        time equivalent employment......       3,192       3,233       3,233
---------------------------------------------------------------------------

                                

                        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, [$289,465,000] $281,407,000, 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 the 
health facility at Fort Defiance, Arizona up to $29,000,000 for fiscal 
year 2000, up to $24,000,000 for fiscal year 2001, and up to $10,000,000 
for fiscal year 2002; for construction of a replacement of the health 
facility at Parker, Arizona, up to $7,058,000 for fiscal year 2000, and 
up to $10,234,000 for fiscal year 2001. (Department of the Interior and 
Related Agencies Appropriations Act, 1999, as included in Public Law 
105-277, section 101(e).)

              Unavailable Collections (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0391-0-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Balance, start of year:
01.99 Balance, start of year............
    Receipts:
02.01 Rent and charges for quarters, 
        Indian Health Service, HHS......           5           5           5
    Appropriation:
05.01 Indian health facilities..........          -5          -5          -5
07.99 Total balance, end of year........
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0391-0-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   Sanitation and health facilities         112         130         135
00.02   Maintenance.....................          48          46          53
00.03   Facilities and environmental 
          health........................          90         108         120

[[Page 436]]

00.04   Equipment.......................          13          13          14
                                           ---------   ---------  ----------
01.00     Total direct program..........         263         297         322
09.01 Reimbursable program..............          10          10          10
                                           ---------   ---------  ----------
10.00   Total new obligations...........         273         307         332
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          11          22          22
22.00 New budget authority (gross)......         273         307         332
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................          11
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         295         329         354
23.95 Total new obligations.............        -273        -307        -332
24.40 Unobligated balance available, end 
        of year.........................          22          22          22
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

40.00   Appropriation...................         258         292         317
      Permanent:

60.25   Appropriation (special fund, 
          indefinite)...................           5           5           5
68.00   Spending authority from 
          offsetting collections: 
          Offsetting collections (cash).          10          10          10
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................         273         307         332
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         392         355         383
73.10 Total new obligations.............         273         307         332
73.20 Total outlays (gross).............        -299        -279        -308
73.45 Adjustments in unexpired accounts.         -11
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         355         383         407
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority          99          88          95
86.93 Outlays from current balances.....         185         176         198
86.97 Outlays from new permanent 
        authority.......................          15          15          15
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         299         279         308
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.45   Offsetting collections (cash) 
          from: Offsetting governmental 
          collections...................         -10         -10         -10
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         263         297         322
90.00 Outlays...........................         288         269         298
---------------------------------------------------------------------------

    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      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........          44          48          51
11.3      Other than full-time permanent           5           5           6
11.5      Other personnel compensation..           2           2           3
                                           ---------   ---------  ----------
11.9        Total personnel compensation          51          55          60
12.1    Civilian personnel benefits.....          14          15          16
21.0    Travel and transportation of 
          persons.......................           4           4           4
22.0    Transportation of things........           3           3           3
23.3    Communications, utilities, and 
          miscellaneous charges.........           6           6           6
25.1    Advisory and assistance services                       3           2
25.2    Other services..................          87         122          94
25.3    Purchases of goods and services 
          from Government accounts......                                  16
25.4    Operation and maintenance of 
          facilities....................          18          14          45
25.6    Medical care....................          15                      11
25.7    Operation and maintenance of 
          equipment.....................                      12
26.0    Supplies and materials..........          11          11          11
31.0    Equipment.......................           3           3           4
32.0    Land and structures.............          13          11          11
41.0    Grants, subsidies, and 
          contributions.................          38          38          39
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..         263         297         322
99.0  Reimbursable obligations..........          10          10          10
                                           ---------   ---------  ----------
99.9    Total new obligations...........         273         307         332
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0391-0-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
1001  Total compensable workyears: Full-
        time equivalent employment......       1,447       1,461       1,468
---------------------------------------------------------------------------

                                

            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 passenger 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. 2651-2653) 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 with respect to functions transferred by the Indian Health Service 
to tribes or tribal organizations, the Indian Health Service is 
authorized to provide goods and services to those entities, on a 
reimbursable basis, including payment in advance with subsequent 
adjustment, and the reimbursements received therefrom, along with the 
funds received from those entities pursuant to the Indian Self-
Determination Act, may be credited to the same or subsequent 
appropriation account which provided the funding, said amounts to remain 
available until expended: Provided further, That, heretofore and 
hereafter and notwithstanding any other provision of law, funds 
available to the Indian

[[Page 437]]

Health Service in this Act or any other Act for Indian self-
determination or self-governance contract or grant support costs may be 
expended only for costs directly attributable to contracts, grants and 
compacts pursuant to the Indian Self-Determination Act and no funds 
appropriated by this or any other Act shall be available for any 
contract support costs or indirect costs associated with any contract, 
grant, cooperative agreement, self-governance compact, or funding 
agreement entered into between an Indian tribe or tribal organization 
and any entity other than 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, 1999, as included in Public Law 
105-277, section 101(e).)

                                


 
               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, XIX and XXVI 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, 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, [$2,558,520,000] $2,769,440,000, of which [$17,800,000] 
$39,800,000 shall remain available until expended for equipment and 
construction and renovation of facilities, 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 [$67,793,000] $109,573,000 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 notwithstanding 
any other provison of law, a single contract or related contracts for 
the development and construction of the infectious disease laboratory 
through the General Services Administration 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: Provided further, 
That hereinafter obligations may be incurred related to agreement with 
private entities without receipt of advance payment].
    In addition, $51,000,000, to be derived from the Violent Crime 
Reduction Trust Fund, for carrying out sections 40151 and 40261 of 
Public Law 103-322. (Department of Health and Human Services 
Appropriations Act, 1999, as included in Public Law 105-277 section 
101(f).)

              Unavailable Collections (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0943-0-1-999      1998 actual   1999 est.   2000 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      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   Preventive health block grant...         149         150         120
00.02   Prevention centers..............           8          14          14
00.03   Sexually transmitted diseases...         112         124         131
00.04   Immunization....................         430         421         526
00.05   Infectious diseases.............         231         258         301
00.06   Other chronic and environmental 
          diseases......................         414         474         493
00.07   Tobacco.........................          28          74         101
00.08   Occupational safety and health..         152         200         212
00.09   Mine safety and health..........          36
00.10   Epidemic services...............          67          86          85
00.11   Health statistics...............          26          27
00.12   HIV.............................         625         657         666
00.13   Prevention research.............                      15          15
00.14   Buildings and facilities........          64          75          40
00.15   Office of the director..........          33          30          30
00.16   Violent crime reduction programs          51          51          51
00.17   Eliminating racial and ethnic 
          disparities...................                      10          35
09.01 Reimbursable program..............         148         148         189
                                           ---------   ---------  ----------
10.00   Total new obligations...........       2,574       2,814       3,009
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          52          56           4
22.00 New budget authority (gross)......       2,576       2,761       3,012
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................           4
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       2,632       2,817       3,016
23.95 Total new obligations.............      -2,574      -2,814      -3,009
23.98 Unobligated balance expiring......          -1
24.40 Unobligated balance available, end 
        of year.........................          56           4           8
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

40.00   Appropriation...................       2,336       2,558       2,768
41.00   Transferred to other accounts...          -4
42.00   Transferred from other accounts.          52          51          51
                                           ---------   ---------  ----------
43.00     Appropriation (total).........       2,384       2,610       2,820
      Permanent:

60.25   Appropriation (special fund, 
          indefinite)...................           1           1           1
62.00   Transferred from other accounts.           3           3           3
                                           ---------   ---------  ----------
63.00     Appropriation (total).........           4           4           4
        Spending authority from 
            offsetting collections:
68.00     Offsetting collections (cash).         148         148         189
68.10     From Federal sources: Change 
            in receivables and unpaid, 
            unfilled orders.............          40
                                           ---------   ---------  ----------
68.90       Spending authority from 
              offsetting collections 
              (total)...................         188         148         189
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       2,576       2,761       3,012
----------------------------------------------------------------------------

    Change in unpaid obligations:
      Unpaid obligations, start of year:

72.40   Obligated balance, start of year       2,070       2,042       2,299
72.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............           5          45          45
                                           ---------   ---------  ----------
72.99     Total unpaid obligations, 
            start of year...............       2,075       2,087       2,344
73.10 Total new obligations.............       2,574       2,814       3,009
73.20 Total outlays (gross).............      -2,558      -2,557      -2,844
73.45 Adjustments in unexpired accounts.          -4
      Unpaid obligations, end of year:

74.40   Obligated balance, end of year..       2,042       2,299       2,464
74.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............          45          45          45
                                           ---------   ---------  ----------
74.99     Total unpaid obligations, end 
            of year.....................       2,087       2,344       2,509
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority         918         915         989
86.93 Outlays from current balances.....       1,491       1,490       1,662
86.97 Outlays from new permanent 
        authority.......................         148         151         192
86.98 Outlays from permanent balances...           1           1           1
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       2,558       2,557       2,844
----------------------------------------------------------------------------

[[Page 438]]



    Offsets:
      Against gross budget authority and outlays:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............        -147        -147        -188
88.40     Non-Federal sources...........          -1          -1          -1
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........        -148        -148        -189
88.95 From Federal sources: Change in 
        receivables and unpaid, unfilled 
        orders..........................         -40
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       2,388       2,613       2,823
90.00 Outlays...........................       2,410       2,409       2,655
---------------------------------------------------------------------------

                          [Dollars in millions]

                                        1998         1999        2000
Distribution of budget authority by 
    account:
  Disease control, research and 
    training........................       2,337       2,563       2,773
  Violent crime reduction programs..          51          51          51
Distribution of outlays by account:
  Disease control, research and 
    training........................       2,388       2,362       2,585
  Violent crime reduction programs..          22          47          70

    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. 

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0943-0-1-999      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........         272         306         322
11.3      Other than full-time permanent          18          21          23
11.5      Other personnel compensation..          15          16          17
                                           ---------   ---------  ----------
11.9        Total personnel compensation         305         343         362
12.1    Civilian personnel benefits.....          91          99         104
21.0    Travel and transportation of 
          persons.......................          26          27          28
22.0    Transportation of things........           5           5           5
23.1    Rental payments to GSA..........          16          18          24
23.2    Rental payments to others.......           2           2           3
23.3    Communications, utilities, and 
          miscellaneous charges.........          24          27          29
24.0    Printing and reproduction.......           6           7           8
25.1    Advisory and assistance services           4          11          15
25.2    Other services..................          48          55          58
25.3    Purchases of goods and services 
          from Government accounts......          90          95          96
25.4    Operation and maintenance of 
          facilities....................          11          12          14
25.5    Research and development 
          contracts.....................         164         178         190
25.7    Operation and maintenance of 
          equipment.....................          23          24          25
26.0    Supplies and materials..........          98         126         130
31.0    Equipment.......................          53          55          57
32.0    Land and structures.............          23          34          54
41.0    Grants, subsidies, and 
          contributions.................       1,437       1,548       1,618
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..       2,426       2,666       2,820
99.0  Reimbursable obligations..........         148         148         189
                                           ---------   ---------  ----------
99.9    Total new obligations...........       2,574       2,814       3,009
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0943-0-1-999      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Direct:
      Total compensable workyears:

1001    Full-time equivalent employment.       6,076       6,508       6,555
1011    Exempt Full-time equivalent 
          employment....................          16          66
    Reimbursable:
2001  Total compensable workyears: Full-
        time equivalent employment......       1,012       1,013       1,141
---------------------------------------------------------------------------

                                

                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 of the Public Health 
Service Act with respect to cancer, [$2,927,187,000] $2,732,795,000. 
(Department of Health and Human Services Appropriations Act, 1999, as 
included in Public Law 105-277, section 101(f).)

                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, [$1,793,697,000] $1,759,806,000. 
(Department of Health and Human Services Appropriations Act, 1999, as 
included in Public Law 105-277, section 101(f).)

         National Institute of Dental and Craniofacial Research

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to dental disease, [$234,338,000] $225,709,000. 
(Department of Health and Human Services Appropriations Act, 1999, as 
included in Public Law 105-277, section 101(f).)

    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, 
[$994,218,000] $1,002,747,000. (Department of Health and Human Services 
Appropriations Act, 1999, as included in Public Law 105-277, section 
101(f).)

         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, 
[$903,278,000] $890,816,000. (Department of Health and Human Services 
Appropriations Act, 1999, as included in Public Law 105-277, section 
101(f).)

          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, 
[$1,570,102,000] $789,156,000. (Department of Health and Human Services 
Appropriations Act, 1999, as included in Public Law 105-277, section 
101(f).)

             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, [$1,197,825,000] 
$1,194,068,000. (Department of Health and Human Services Appropriations 
Act, 1999, as included in Public Law 105-277, section 101(f).)

        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, 
[$750,982,000] $694,114,000. (Department of Health and Human Services 
Appropriations Act, 1999, as included in Public Law 105-277, section 
101(f).)

                         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, 
[$395,857,000] $395,935,000. (Department of Health and Human Services 
Appropriations Act, 1999, as included in Public Law 105-277, section 
101(f).)

           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, 
[$375,743,000] $390,718,000. (Department of Health and Human Services 
Appropriations Act, 1999, as included in Public Law 105-277, section 
101(f).)

[[Page 439]]

                       National Institute on Aging

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to aging, [$596,521,000] $612,599,000. 
(Department of Health and Human Services Appropriations Act, 1999, as 
included in Public Law 105-277, section 101(f).)

  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, [$308,164,000] $309,953,000. (Department of Health and Human 
Services Appropriations Act, 1999, as included in Public Law 105-277, 
section 101(f).)

    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, 
[$229,887,000] $235,297,000. (Department of Health and Human Services 
Appropriations Act, 1999, as included in Public Law 105-277, section 
101(f).)

                 National Institute of Nursing Research

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to nursing research, [$69,834,000] $65,335,000. 
(Department of Health and Human Services Appropriations Act, 1999, as 
included in Public Law 105-277, section 101(f).)

           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, [$259,747,000] 
$248,916,000. (Department of Health and Human Services Appropriations 
Act, 1999, as included in Public Law 105-277, section 101(f).)

                    National Institute on Drug Abuse

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to drug abuse, [$603,274,000] $429,246,000. 
(Department of Health and Human Services Appropriations Act, 1999, as 
included in Public Law 105-277, section 101(f).)

                   National Institute of Mental Health

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to mental health, [$861,208,000] $758,892,000. 
(Department of Health and Human Services Appropriations Act, 1999, as 
included in Public Law 105-277, section 101(f).)

                National Human Genome Research Institute

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to human genome research, [$264,892,000] 
$271,536,000. (Department of Health and Human Services Appropriations 
Act, 1999, as included in Public Law 105-277, section 101(f).)

                 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, [$554,819,000] $469,684,000: 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 $30,000,000 shall be for 
extramural facilities construction grants. (Department of Health and 
Human Services ppropriations Act, 1999, as included in Public Law 105-
277, section 101(f).)

       National Center for Complementary and Alternative Medicine

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to complementary and alternative medicine, 
$50,168,000, to be available for obligation through September 30, 2001.

                  John E. Fogarty International Center

    For carrying out the activities at the John E. Fogarty International 
Center, [$35,426,000] $23,498,000. (Department of Health and Human 
Services Appropriations Act, 1999, as included in Public Law 105-277, 
section 101(f).)

                      National Library of Medicine

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to health information communications, 
[$181,309,000] $181,443,000, of which $4,000,000 shall be available 
until expended for improvement of information systems: Provided, That in 
fiscal year [1999] 2000, 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, 
1999, as included in Public Law 105-277, section 101(f).)

                         Office of the Director

                      (including transfer of funds)

    For carrying out the responsibilities of the Office of the Director, 
National Institutes of Health, [$306,559,000, of which $43,493,000 shall 
be for the Office of AIDS Research] $218,153,000: Provided, That funding 
shall be available for the purchase of not to exceed twenty-nine 
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 or any other Act to all National Institutes of Health 
appropriations to activities the Director may so designate: Provided 
further, That no such appropriation shall be 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 
third party payments for the cost of clinical services that are incurred 
in National Institutes of Health research facilities 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 
$500,000 shall be available to carry out section 499 of the Public 
Health Service Act: Provided further, That, notwithstanding section 
499(k)(10) of the Public Health Service Act, funds from the National 
Foundation for Biomedical Research may be transferred to the National 
Institutes of Health: Provided further, That $50,000,000 shall be 
available to carry out section 404E of the Public Health Service Act]. 
(Department of Health and Human Services Appropriations Act, 1999, as 
included in Public Law 105-277, section 101(f).)

          Office of AIDS Research (Including Transfer of Funds)

    For carrying out part D of title XXIII of the Public Health Service 
Act, $1,833,826,000: Provided, That the Director of the Office of AIDS 
Research shall transfer funds from this appropriation as authorized by 
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, [$237,519,000] $108,376,000, to remain 
available until expended[, of which $90,000,000 of the fiscal year 1999 
funds shall be for the clinical research center and $40,000,000 shall 
become available on October 1, 1999 and $9,143,000 shall be for the 
Vaccine Facility: 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]. (Department of 
Health and Human Services Appropriations Act, 1999, as included in 
Public Law 105-277, section 101(f).)

              Unavailable Collections (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9915-0-1-552      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Balance, start of year:
01.99 Balance, start of year............
    Receipts:
02.01 Cooperative research and 
        development agreements, NIH.....          15          15          15
    Appropriation:
05.01 National Institutes of Health.....         -15         -15         -15
07.99 Total balance, end of year........
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9915-0-1-552      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   National Cancer Institute.......       2,551       2,927       2,733

[[Page 440]]

00.02   National Heart, Lung, and Blood 
          Institute.....................       1,526       1,794       1,760
00.03   National Institute of Dental and 
          Craniofacial Research.........         210         234         226
00.04   National Institute of Diabetes 
          and Digestive and Kidney 
          Disease.......................         897       1,021       1,030
00.05   National Institute of 
          Neurological Disorders and 
          Stroke........................         778         903         891
00.06   National Institute of Allergy 
          and Infectious Diseases.......       1,352       1,570         789
00.07   National Institute of General 
          Medical Sciences..............       1,062       1,198       1,194
00.08   National Institute of Child 
          Health and Human Development..         672         751         694
00.09   National Eye Institute..........         354         396         396
00.10   National Institute of 
          Environmental Health Sciences.         329         376         391
00.11   National Institute on Aging.....         517         597         613
00.12   National Institute of Arthritis 
          and Musculoskeletal and Skin 
          Disease.......................         274         308         310
00.13   National Institute on Deafness 
          and Other Communication 
          Disorder......................         200         230         235
00.14   National Institute of Nursing 
          Research......................          63          70          65
00.15   National Institute of Alcohol 
          Abuse and Alcoholism..........         226         260         249
00.16   National Institute on Drug Abuse         537         603         429
00.17   National Institute of Mental 
          Health........................         748         861         759
00.18   National Center for Research 
          Resources.....................         452         555         470
00.19   National Human Genome Research 
          Institute.....................         218         265         272
00.20   John E. Fogarty International 
          Center........................          28          34          23
00.21   National Library of Medicine....         162         181         181
00.22   Office of the Director..........         295         307         218
00.23   Office of AIDS Research.........                               1,834
00.24   Buildings and facilities........         235         197         108
00.25   Cooperative research and 
          development agreements........          19          15          15
00.26   Royalities......................          22          24          24
00.27   National Center for 
          Complementary and Alternative 
          Medicine......................                                  50
09.00 Reimbursable program..............       1,117       1,160       1,187
                                           ---------   ---------  ----------
10.00   Total new obligations...........      14,844      16,837      17,146
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................         197         147         123
22.00 New budget authority (gross)......      14,799      16,814      17,162
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......      14,996      16,961      17,285
23.95 Total new obligations.............     -14,844     -16,837     -17,146
23.98 Unobligated balance expiring......          -4
24.40 Unobligated balance available, end 
        of year.........................         147         123         139
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

40.00   Appropriation...................      13,648      15,612      15,893
41.00   Transferred to other accounts...         -25
42.00   Transferred from other accounts.           9
                                           ---------   ---------  ----------
43.00     Appropriation (total).........      13,632      15,612      15,893
      Permanent:

60.25   Appropriation (special fund, 
          indefinite)...................          15          15          15
62.00   Transferred from other accounts.          27          27          27
                                           ---------   ---------  ----------
63.00     Appropriation (total).........          42          42          42
65.00   Advance appropriation (definite)                                  40
        Spending authority from 
            offsetting collections:
68.00     Offsetting collections (cash).         811       1,160       1,187
68.10     From Federal sources: Change 
            in receivables and unpaid, 
            unfilled orders.............         314
                                           ---------   ---------  ----------
68.90       Spending authority from 
              offsetting collections 
              (total)...................       1,125       1,160       1,187
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................      14,799      16,814      17,162
----------------------------------------------------------------------------

    Change in unpaid obligations:
      Unpaid obligations, start of year:

72.40   Obligated balance, start of year      10,973      12,119      13,762
72.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............       3,670       3,984       3,984
                                           ---------   ---------  ----------
72.99     Total unpaid obligations, 
            start of year...............      14,643      16,103      17,746
73.10 Total new obligations.............      14,844      16,837      17,146
73.20 Total outlays (gross).............     -13,312     -15,194     -16,655
73.40 Adjustments in expired accounts...         -72
      Unpaid obligations, end of year:

74.40   Obligated balance, end of year..      12,119      13,762      14,253
74.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............       3,984       3,984       3,984
                                           ---------   ---------  ----------
74.99     Total unpaid obligations, end 
            of year.....................      16,103      17,746      18,237
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority       3,880       4,682       4,773
86.93 Outlays from current balances.....       8,414       9,313      10,645
86.97 Outlays from new permanent 
        authority.......................       1,015       1,199       1,237
86.98 Outlays from permanent balances...           2
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........      13,312      15,194      16,655
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........        -811      -1,160      -1,187
88.95 From Federal sources: Change in 
        receivables and unpaid, unfilled 
        orders..........................        -314
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................      13,674      15,654      15,975
90.00 Outlays...........................      12,501      14,034      15,468
---------------------------------------------------------------------------

                          [Dollars in millions]

                                        1998         1999        2000
Distribution of budget authority by 
    account:
  National Cancer Institute.........       2,551       2.927       2,733
  National Heart, Lung, and Blood 
    Institute.......................       1,526       1,794       1,760
  National Institute of Dental and 
    Craniofacial Research...........         210         234         226
  National Institute of Diabetes and 
    Digestive and Kidney Diseases...         897       1,021       1,030
  National Institute of Neurological 
    Disorder and Stroke.............         779         903         891
  National Institute of Allergy and 
    Infectious Diseases.............       1,352       1,570         789
  National Institute of General 
    Medical Sciences................       1,062       1,198       1,194
  National Institute of Child Health 
    and Human Development...........         672         751         694
  National Eye Institute............         354         396         396
  National Institute of 
    Environmental Health Sciences...         329         376         391
  National Institute on Aging.......         517         597         613
  National Institute of Arthritis 
    and Musculoskeletal and Skin 
    Diseases........................         273         308         310
  National Institute on Deafness and 
    Other Communication Disorders...         200         230         235
  National Institute of Nursing 
    Research........................          64          70          65
  National Institute on Alcohol 
    Abuse and Alcoholism............         226         260         249
  National Institute on Drug Abuse..         537         603         429
  National Institute of Mental 
    Health..........................         748         861         759
  National Center for Research 
    Resources.......................         452         555         470
  National Human Genome Research 
    Institute.......................         219         265         272
  National Center for Complementary 
    and Alternative Medicine........                                  50
  John E. Fogarty International 
    Center..........................          28          35          23
  National Library of Medicine......         161         181         181
  Office of the Director............         295         307         218
  Office of AIDS Research...........                               1,834
  Buildings and Facilities..........         207         197         148
                                    ------------------------------------
      Subtotal......................      13,659      15,639      15,960
  Cooperative Research and 
    Development Agreements..........          15          15          15
                                    ------------------------------------
      Total Budget Authority, NIH...      13,674      15,654      15,975
                                    ====================================

                          [Dollars in millions]

                                        1998         1999        2000
Distribution of outlays by account:
  National Cancer Institute.........       2,381       2,613       2,651
  National Heart, Lung, and Blood 
    Institute.......................       1,389       1,575       1,692
  National Institute of Dental and 
    Craniofacial Research...........         200         214         216
  National Institute of Diabetes and 
    Digestive and Kidney Diseases...         814         922         995
  National Institute of Neurological 
    Disorders and Stroke............         721         805         858
  National Institute of Allergy and 
    Infectious Diseases.............       1,211       1,390         755
  National Institute of General 
    Medical Sciences................         992       1,090       1,160
  National Institute of Child Health 
    and Human Development...........         627         694         674
  National Eye Institute............         339         366         385
  National Institute of 
    Environmental Health Sciences...         312         336         373
  National Institute on Aging.......         471         526         585
  National Institute of Arthritis 
    and Musculoskeletal and Skin 
    Diseases........................         252         282         301
  National Institute on Deafness and 
    Other Communication Disorders...         187         206         227
  National Institute of Nursing 
    Research........................          60          64          63
  National Institute on Alcohol 
    Abuse and Alcoholism............         203         232         240
  National Institute on Drug Abuse..         500         538         409
  National Institute of Mental 
    Health..........................         689         769         734

[[Page 441]]

  National Center for Research 
    Resources.......................         416         478         448
  National Human Genome Research 
    Institute.......................         197         229         260
  National Center for Complementary 
    and Alternative Medicine........                                  21
  John E. Fogarty International 
    Center..........................          29          28          22
  National Library of Medicine......         153         169         177
  Office of the Director............         273         288         230
  Office of AIDS Research...........                               1,769
  Buildings and Facilities..........         125         205         208
  Service and Supply Fund/Management 
    Fund............................         -57
                                    ------------------------------------
      Subtotal Outlays..............      12,484      14,019      15,453
  Cooperative Research and 
    Development Agreements..........          17          15          15
                                    ------------------------------------
      Total Outlays, NIH............      12,501      14,034      15,468
                                    ====================================
    Note: The total amount for FY 1999 AIDS research was $1,775,523,000 
which was jointly determined by the Director of NIH and the Director of the 
Office of AIDS Research pursuant to section 209 of P.L. 105-277. $1,723,030 
was made available to OAR. This amount is net of the $43,493,000 in AIDS 
funds earmarked in P.L. 105-277 in the Office of the Director account. 
Amounts available under section 4921 of P.L. 105-33 for research on diabetes 
are included in the National Institute of Diabetes and Digestive and Kidney 
Disorders.

    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.

    NIH research and related activities are included in the 21st Century 
Research Fund. 

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9915-0-1-552      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........         507         554         597
11.3      Other than full-time permanent         107         124         132
11.5      Other personnel compensation..          34          35          36
11.8      Special personal services 
            payments....................          92          93          97
                                           ---------   ---------  ----------
11.9        Total personnel compensation         740         806         862
12.1    Civilian personnel benefits.....         152         171         185
21.0    Travel and transportation of 
          persons.......................          22          26          25
22.0    Transportation of things........           4           5           6
23.1    Rental payments to GSA..........           5           8           7
23.2    Rental payments to others.......           7          14          15
23.3    Communications, utilities, and 
          miscellaneous charges.........          39          38          40
24.0    Printing and reproduction.......          13          14          14
25.1    Advisory and assistance services          29          35          35
25.2    Other services..................         442         457         381
25.3    Purchases of goods and services 
          from Government accounts......         789         908         900
25.4    Operation and maintenance of 
          facilities....................         104         119          93
25.5    Research and development 
          contracts.....................         842         924         911
25.6    Medical care....................          11          12          13
25.7    Operation and maintenance of 
          equipment.....................          25          36          36
26.0    Supplies and materials..........         137         153         156
31.0    Equipment.......................         120         130         125
32.0    Land and structures.............                       1           1
41.0    Grants, subsidies, and 
          contributions.................      10,243      11,818      12,151
42.0    Insurance claims and indemnities           3           3           3
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..      13,727      15,678      15,959
99.0  Reimbursable obligations..........       1,117       1,159       1,187
                                           ---------   ---------  ----------
99.9    Total new obligations...........      14,844      16,837      17,146
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-9915-0-1-552      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Direct:
      Total compensable workyears:

1001    Full-time equivalent employment.      10,876      11,637      12,071
1011    Exempt Full-time equivalent 
          employment....................          21          33
    Reimbursable:
2001  Total compensable workyears: Full-
        time equivalent employment......       4,283       4,580       4,580
---------------------------------------------------------------------------

                                


 
        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, and 
section 301 of the Public Health Service Act with respect to program 
management, [$2,488,005,000: Provided, That of the amount provided, 
$300,000 shall be for the Philadelphia City-wide Improvement and 
Planning Agency] $2,726,505,000, of which $100,000,000 shall become 
available on October 1, 2000 and remain available until September 30, 
2001. (Department of Health and Human Services Appropriations Act, 1999, 
as included in Public Law 105-277, section 101(f).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1362-0-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   Mental health and substance 
          abuse activities..............         504         561         595
00.02   Mental health partnership.......         275         289         359
00.03   Substance abuse partnership.....       1,310       1,585       1,615
00.04   Substance abuse partnership 
          temporary supplement 
          (mandatory)...................          50
00.05   Program management..............          55          53          58
09.01 Reimbursable program..............          20          22          22
                                           ---------   ---------  ----------
10.00   Total new obligations...........       2,214       2,510       2,649
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......       2,217       2,510       2,649
23.95 Total new obligations.............      -2,214      -2,510      -2,649
23.98 Unobligated balance expiring......          -4
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

40.00   Appropriation...................       2,147       2,488       2,627
      Permanent:

65.00   Advance appropriation (definite)          50
68.00   Spending authority from 
          offsetting collections: 
          Offsetting collections (cash).          20          22          22
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       2,217       2,510       2,649
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year       1,642       1,620       1,777
73.10 Total new obligations.............       2,214       2,510       2,649
73.20 Total outlays (gross).............      -2,254      -2,353      -2,541
73.40 Adjustments in expired accounts...          20
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..       1,620       1,777       1,885
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority         970       1,110       1,169
86.93 Outlays from current balances.....       1,245       1,199       1,347
86.97 Outlays from new permanent 
        authority.......................          39          22          22
86.98 Outlays from permanent balances...                      22           3
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       2,254       2,353       2,541
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........         -20         -22         -22
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       2,197       2,488       2,627
90.00 Outlays...........................       2,236       2,331       2,519
---------------------------------------------------------------------------

    This program provides Federal support for treatment and prevention 
in the areas of alcoholism, drug abuse, and mental health.


[[Page 442]]



               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1362-0-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........          34          37          38
11.3      Other than full-time permanent           1           1           1
11.5      Other personnel compensation..           1           1           1
                                           ---------   ---------  ----------
11.9        Total personnel compensation          36          39          40
12.1    Civilian personnel benefits.....           7           8           9
21.0    Travel and transportation of 
          persons.......................           2           1           1
23.1    Rental payments to GSA..........           4           5           5
23.3    Communications, utilities, and 
          miscellaneous charges.........           1           1           1
24.0    Printing and reproduction.......           4           4           4
25.1    Advisory and assistance services          14          15          16
25.2    Other services..................         159         164         169
25.3    Purchases of goods and services 
          from Government accounts......          23          24          25
31.0    Equipment.......................           2           2           2
41.0    Grants, subsidies, and 
          contributions.................       1,942       2,225       2,355
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..       2,194       2,488       2,627
99.0  Reimbursable obligations..........          20          22          22
                                           ---------   ---------  ----------
99.9    Total new obligations...........       2,214       2,510       2,649
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-1362-0-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: Full-
        time equivalent employment......         549         574         565
    Reimbursable:
      Total compensable workyears:

2001    Full-time equivalent employment.           2           2          94
2011    Exempt Full-time equivalent 
          employment....................          68          92
---------------------------------------------------------------------------

                                


 
               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, [$100,408,000] 
$26,667,000; 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 
[$70,647,000] $179,588,000. (Department of Health and Human Services 
Appropriations Act, 1999, as included in Public Law 105-277, section 
101(f).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1700-0-1-552      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

01.01   Research on health costs, 
          quality, and outcomes.........          88          98          25
01.04   Program support.................           2           2           2
09.00 Reimbursable program..............          68          82         191
                                           ---------   ---------  ----------
10.00   Total new obligations...........         158         182         218
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......         160         182         218
23.95 Total new obligations.............        -158        -182        -218
24.40 Unobligated balance available, end 
        of year.........................           2
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

40.00   Appropriation...................          90         100          27
      Permanent:

        Spending authority from 
            offsetting collections:
68.00     Offsetting collections (cash).          69          82         191
68.10     From Federal sources: Change 
            in receivables and unpaid, 
            unfilled orders.............           1
                                           ---------   ---------  ----------
68.90       Spending authority from 
              offsetting collections 
              (total)...................          70          82         191
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................         160         182         218
----------------------------------------------------------------------------

    Change in unpaid obligations:
      Unpaid obligations, start of year:

72.40   Obligated balance, start of year         129         139         137
72.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............           6           7           7
                                           ---------   ---------  ----------
72.99     Total unpaid obligations, 
            start of year...............         135         146         144
73.10 Total new obligations.............         158         182         218
73.20 Total outlays (gross).............        -145        -183        -281
73.40 Adjustments in expired accounts...          -2                      -2
      Unpaid obligations, end of year:

74.40   Obligated balance, end of year..         139         137          72
74.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............           7           7           7
                                           ---------   ---------  ----------
74.99     Total unpaid obligations, end 
            of year.....................         146         144          79
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority         -10          10           3
86.93 Outlays from current balances.....          87          91          87
86.97 Outlays from new permanent 
        authority.......................          69          82         191
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         145         183         281
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........         -69         -82        -191
88.95 From Federal sources: Change in 
        receivables and unpaid, unfilled 
        orders..........................          -1
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................          90         100          27
90.00 Outlays...........................          77         101          90
---------------------------------------------------------------------------

    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      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........          10          13           2
11.3      Other than full-time permanent           3           2
                                           ---------   ---------  ----------
11.9        Total personnel compensation          13          15           2
12.1    Civilian personnel benefits.....           3           3
21.0    Travel and transportation of 
          persons.......................                       1
23.1    Rental payments to GSA..........           2           3
23.3    Communications, utilities, and 
          miscellaneous charges.........           1           1
24.0    Printing and reproduction.......           1           1
25.2    Other services..................           5           5           1
25.3    Purchases of goods and services 
          from Government accounts......           3           2
25.5    Research and development 
          contracts.....................          16          24           4
31.0    Equipment.......................           1           1
41.0    Grants, subsidies, and 
          contributions.................          45          44          20
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..          90         100          27
99.0  Reimbursable obligations..........          68          82         191
                                           ---------   ---------  ----------
99.9    Total new obligations...........         158         182         218
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-1700-0-1-552      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: Full-
        time equivalent employment......         200         211          26

[[Page 443]]

    Reimbursable:
2001  Total compensable workyears: Full-
        time equivalent employment......          60          64         259
---------------------------------------------------------------------------

                                


 
                  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, [$74,593,733,000] $86,087,393,000, to remain 
available until expended: Provided, That beginning in fiscal year 2000 
and thereafter, for expenses incurred by Medicaid under title XXI of the 
Social Security Act, Medicaid may accept as reimbursement in advance 
amounts from the ``State Children's Health Insurance Fund,'' such 
amounts to remain available as provided under title XXI.
    For making, after May 31, [1999] 2000, payments to States under 
title XIX of the Social Security Act for the last quarter of fiscal year 
[1999] 2000 for unanticipated costs, incurred for the current fiscal 
year, such sums as may be necessary.
    For making payments to States or in the case of section 1928 on 
behalf of States, under title XIX of the Social Security Act for the 
first quarter of fiscal year [2000, $28,733,605,000] 2001, 
$30,589,003,000, 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, 1999, as included in Public Law 105-277, section 
101(f).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0512-0-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Medicaid vendor payments..........      99,137     102,265     108,258
00.02 State and local administration....       4,973       5,740       6,018
00.03 Vaccine purchases.................         385         528         545
09.00 Medicare Part B premium transfer..                      60          90
09.01 State Children's Health Insurance 
        Program.........................                                 475
                                           ---------   ---------  ----------
10.00   Total new obligations...........     104,495     108,594     115,386
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................       6,890       6,012
22.00 New budget authority (gross)......      99,591     102,582     115,386
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................       4,026
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......     110,507     108,594     115,386
23.95 Total new obligations.............    -104,495    -108,594    -115,386
24.40 Unobligated balance available, end 
        of year.........................       6,012
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

40.00   Appropriation...................      71,602      74,594      86,087
40.05   Appropriation (indefinite)......                     127
                                           ---------   ---------  ----------
43.00     Appropriation (total).........      71,602      74,721      86,087
      Permanent:

65.00   Advance appropriation (definite)      27,989      27,801      28,734
        Spending authority from 
            offsetting collections:
          Offsetting collections (cash):
68.00       Offsetting collections 
              (cash)....................                      60          90
68.00       Offsetting collections 
              (cash)....................                                 475
                                           ---------   ---------  ----------
68.90       Spending authority from 
              offsetting collections 
              (total)...................                      60         565
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................      99,591     102,582     115,386
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year       6,268       5,504       5,504
73.10 Total new obligations.............     104,495     108,594     115,386
73.20 Total outlays (gross).............    -101,234    -108,594    -115,386
73.45 Adjustments in unexpired accounts.      -4,026
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..       5,504       5,504       5,504
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority      60,087      69,217      80,583
86.93 Outlays from current balances.....      13,158      11,516       5,504
86.97 Outlays from new permanent 
        authority.......................      27,989      27,861      29,299
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........     101,234     108,594     115,386
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

        Offsetting collections (cash) 
            from:
          Federal sources:
88.00       Federal sources.............                     -60         -90
88.00       Federal sources.............                                -475
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........                     -60        -565
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................      99,591     102,522     114,821
90.00 Outlays...........................     101,234     108,534     114,821
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1998 actual  1999 est.   2000 est.
Enacted/requested:
  Budget Authority..................      99,591     102,522     114,821
  Outlays...........................     101,234     108,534     114,821
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                                -161
  Outlays...........................                                -161
                                    ------------------------------------
Total:
  Budget Authority..................      99,591     102,522     114,660
  Outlays...........................     101,234     108,534     114,660
                                    ====================================

    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.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0512-0-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
41.0  Direct obligations: Grants, 
        subsidies, and contributions....     104,495     108,534     114,821
99.0  Reimbursable obligations: 
        Subtotal, reimbursable 
        obligations.....................                      60         565
                                           ---------   ---------  ----------
99.9    Total new obligations...........     104,495     108,594     115,386
---------------------------------------------------------------------------

                                

                      Grants to States for Medicaid

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0512-4-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations (object 
        class 41.0).....................                                -161
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                -161
23.95 Total new obligations.............                                 161
----------------------------------------------------------------------------

    New budget authority (gross), detail:
40.00 Appropriation.....................                                -161
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                -161
73.20 Total outlays (gross).............                                 161
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority                                -161
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                -161
90.00 Outlays...........................                                -161
---------------------------------------------------------------------------



[[Page 444]]



    This schedule reflects the effects of proposals contained 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, [$62,953,000,000] $69,289,100,000. 
(Department of Health and Human Services Appropriations Act, 1999, as 
included in Public Law 105-277, section 101(f).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0580-0-1-571      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Supplementary medical insurance 
        (SMI)...........................      59,919      61,879      68,690
00.02 Hospital insurance for uninsured 
        (HI)............................         -52         555         349
00.03 Federal uninsured payment (HI)....          86          97         121
00.04 Program management (HI)...........         101         125         129
00.06 Federal payments from taxation of 
        OASDI benefits (HI).............       5,067       6,213       6,416
00.08 Fraud and abuse control, FBI......          56          66          76
00.10 Fraud and abuse control, criminal 
        fines...........................           3           4           4
00.11 Fraud and abuse control, civil 
        monetary penalties..............           2           2           2
00.12 Other.............................           2
                                           ---------   ---------  ----------
10.00   Total new obligations...........      65,184      68,941      75,787
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......      66,033      69,238      75,787
23.95 Total new obligations.............     -65,184     -68,941     -75,787
23.98 Unobligated balance expiring......        -849        -297
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

40.00   Appropriation...................      60,904      62,953      69,289
      Permanent:

60.00   Appropriation...................          56          66          76
60.05   Appropriation (indefinite)......       5,073       6,219       6,422
                                           ---------   ---------  ----------
63.00     Appropriation (total).........       5,129       6,285       6,498
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................      66,033      69,238      75,787
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............      65,184      68,941      75,787
73.20 Total outlays (gross).............     -65,184     -68,941     -75,787
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority      60,055      62,656      69,289
86.97 Outlays from new permanent 
        authority.......................       5,129       6,285       6,498
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........      65,184      68,941      75,787
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................      66,033      69,238      75,787
90.00 Outlays...........................      65,184      68,941      75,787
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1998 actual  1999 est.   2000 est.
Enacted/requested:
  Budget Authority..................      66,033      69,238      75,787
  Outlays...........................      65,184      68,941      75,787
Legislative proposal, not subject to 
    PAYGO:
  Budget Authority..................                                -469
  Outlays...........................                                -469
                                    ------------------------------------
Total:
  Budget Authority..................      66,033      69,238      75,318
  Outlays...........................      65,184      68,941      75,318
                                    ====================================

    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. Since 
1992, amounts have been included for non-Medicare activities of HCFA 
Program Management.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0580-0-1-571      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
41.0  Grants, subsidies, and 
        contributions...................      65,049      68,164      75,188
42.0  Insurance claims and indemnities..          34         652         470
92.0  Undistributed.....................         101         125         129
                                           ---------   ---------  ----------
99.9    Total new obligations...........      65,184      68,941      75,787
---------------------------------------------------------------------------

                                

                   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      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Supplementary medical insurance 
        (SMI)...........................                                -469
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................                                -469
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                -469
23.95 Total new obligations.............                                 469
----------------------------------------------------------------------------

    New budget authority (gross), detail:
40.00 Appropriation.....................                                -469
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                -469
73.20 Total outlays (gross).............                                 469
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority                                -469
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                -469
90.00 Outlays...........................                                -469
---------------------------------------------------------------------------

    This schedule reflects the effects of the Medicare proposals 
contained in the Budget on the Payments to Health Care Trust Funds 
account.

                                

                           Program Management

    For carrying out, except as otherwise provided, titles XI, XVIII, 
XIX and XXI of the Social Security Act, titles XIII and XXVII of the 
Public Health Service Act, and the Clinical Laboratory Improvement 
Amendments of 1988, not to exceed [$1,946,500,000] $2,016,126,000, 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 and such 
sums as may be collected from authorized user fees and the sale of data, 
which shall remain available until expended, and together with 
administrative fees collected relative to Medicare overpayment recovery 
activities, which shall be transferred to the Health Care Fraud and 
Abuse Control (HCFAC) account and 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 shall be credited to and available for carrying out the purposes of 
this appropriation: [Provided further, That $1,000,000 shall be for 
carrying out section 4021 of Public Law 105-33:] Provided further, That 
[$45,000,000] $18,000,000 appropriated under this heading for the 
[transition to a single Part A and Part B processing system and for Year 
2000 century date change conversion requirements of external contractor 
systems] managed care system redesign shall remain available until

[[Page 445]]

expended: [Provided further, That $2,000,000 of the amount available for 
research, demonstration, and evaluation activities shall be available to 
continue carrying out demonstration projects on Medicaid coverage of 
community-based attendant care services for people with disabilities 
which ensures maximum control by the consumer to select and manage their 
attendant care services: Provided further, That funds appropriated under 
this heading may be obligated to increase Medicare provider audits and 
implement the Department's corrective action plan to the Chief Financial 
Officer's audit of the Health Care Financing Administration's oversight 
of Medicare:] Provided further, That the Secretary of Health and Human 
Services is directed to collect, in aggregate, [$95,000,000] 
$100,000,000 in fees in fiscal year [1999] 2000 from Medicare+Choice 
organizations pursuant to section 1857(e)(2) of the Social Security Act 
and from eligible organizations with risk-sharing contracts under 
section 1876 of that Act pursuant to section 1876(k)(4)(D) of that Act. 
(Department of Health and Human Services Appropriations Act, 1999, as 
included in Public Law 105-277, section 101(f).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0511-0-1-550      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   Research, demonstrations, and 
          evaluation projects...........          51          50          55
00.02   Medicare contractors............       1,192       1,290       1,274
00.04   State certification.............         153         171         204
00.05   Administrative costs............         367         456         483
                                           ---------   ---------  ----------
00.91     Total direct program..........       1,763       1,967       2,016
      Reimbursable program:

08.01   CLIA............................          33          43          43
08.02   Other reimbursements............          95          97         102
                                           ---------   ---------  ----------
08.91     Total reimbursable program....         128         140         145
                                           ---------   ---------  ----------
10.00   Total new obligations...........       1,891       2,107       2,161
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          18          55          35
22.00 New budget authority (gross)......       1,932       2,087       2,161
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................           2
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       1,952       2,142       2,196
23.95 Total new obligations.............      -1,891      -2,107      -2,161
23.98 Unobligated balance expiring......          -6
24.40 Unobligated balance available, end 
        of year.........................          55          35          35
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

42.00   Transferred from other accounts.          44
                                           ---------   ---------  ----------
43.00     Appropriation (total).........          44
      Permanent:

        Spending authority from 
            offsetting collections:
          Offsetting collections (cash):
68.00       Offsetting collections 
              (cash)....................       1,631       1,947       2,016
68.00       Offsetting collections 
              (cash)....................         143         140         145
68.15     From Federal sources: 
            Adjustments to receivables 
            and unpaid, unfilled orders.         114
                                           ---------   ---------  ----------
68.90       Spending authority from 
              offsetting collections 
              (total)...................       1,888       2,087       2,161
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       1,932       2,087       2,161
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         495         280         280
73.10 Total new obligations.............       1,891       2,107       2,161
73.20 Total outlays (gross).............      -1,733      -2,107      -2,161
73.40 Adjustments in expired accounts...        -370
73.45 Adjustments in unexpired accounts.          -2
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         280         280         280
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................       1,732       2,087       2,161
86.98 Outlays from permanent balances...           1          20
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       1,733       2,107       2,161
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............      -1,631      -1,947      -2,016
88.40     Non-Federal sources...........        -143        -140        -145
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........      -1,774      -2,087      -2,161
88.96 From Federal sources: Adjustment 
        to receivables and unpaid, 
        unfilled orders.................        -114
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................          44
90.00 Outlays...........................         -40          20
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1998 actual  1999 est.   2000 est.
Enacted/requested:
  Budget Authority..................          44
  Outlays...........................         -41          20
Legislative proposal, not subject to 
    PAYGO:
  Budget Authority..................
  Outlays...........................
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                                  10
  Outlays...........................                                  10
                                    ------------------------------------
Total:
  Budget Authority..................          44                      10
  Outlays...........................         -41          20          10
                                    ====================================

    Program management activities include funding for research, Medicare 
contractors, survey and certification, CLIA, Medicare + Choice, and 
administrative costs. 

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0511-0-1-550      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

      Personnel compensation:

11.1    Full-time permanent.............         227         269         285
11.3    Other than full-time permanent..           5           5           5
11.5    Other personnel compensation....           2           2           4
                                           ---------   ---------  ----------
11.9      Total personnel compensation..         234         276         294
12.1  Civilian personnel benefits.......          46          53          56
21.0  Travel and transportation of 
        persons.........................           6           7          11
23.1  Rental payments to GSA............          13          25          21
23.3  Communications, utilities, and 
        miscellaneous charges...........          22          19          18
24.0  Printing and reproduction.........          22          28          29
25.1  Advisory and assistance services..           3           5           5
25.2  Other services....................         318         372         416
25.3  Purchases of goods and services 
        from Government accounts........          16           7          17
25.6  Medical care......................       1,163       1,286       1,270
26.0  Supplies and materials............           2           1           1
31.0  Equipment.........................          13           7           2
32.0  Land and structures...............          10          10          10
41.0  Grants, subsidies, and 
        contributions...................          23          11          11
                                           ---------   ---------  ----------
99.9    Total new obligations...........       1,891       2,107       2,161
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0511-0-1-550      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: Full-
        time equivalent employment......       3,942       4,267       4,232
    Allocation account:
3001  Total compensable workyears: Full-
        time equivalent employment......                                  50
---------------------------------------------------------------------------

                                

                           Program Management

              (Legislative proposal, not subject to PAYGO)

    Contingent upon enactment of authorization to establish fees to 
cover administrative costs of the Health Care Financing Administration 
and its contractors, such fees may be collected and credited to this 
account as offsetting collections, to remain available until expended 
for authorized purposes: Provided, That upon enactment of such 
authorizing legislation, the amount appropriated for fiscal year 2000 
from the

[[Page 446]]

Federal Hospital Insurance and Federal Supplementary Medical Insurance 
Trust Funds shall be reduced by $194,450,000: Provided further, That 
contingent upon enactment of an amendment to section 1857(e)(2) of the 
Social Security Act which increases fees, the Secretary of Health and 
Human Services is directed to collect, in aggregate, $150,000,000 in 
user fees in fiscal year 2000 from Medicare+Choice organizations to 
implement the Medicare+Choice education campaign.

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0511-2-1-550      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.02   Medicare contractor 
          appropriation.................                                 -93
00.03   Survey and certification 
          appropriation.................                                 -65
00.04   Federal administration 
          appropriation.................                                 -37
                                           ---------   ---------  ----------
01.92   Total direct program/
          appropriation.................                                -194
      Reimbursable program:

09.02   Medicare + Choice Information 
          Campaign......................                                  50
09.03   Initial survey and certification                                  10
09.04   Survey and certification 
          recertification...............                                  55
09.05   Duplicate and unprocessable 
          claims........................                                  18
09.06   Paper claims....................                                  55
09.07   Provider enrollment.............                                  20
09.08   Health plan applications........                                  37
                                           ---------   ---------  ----------
09.09   Total reimbursable program......                                 244
                                           ---------   ---------  ----------
10.00   Total new obligations...........                                  50
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                  50
23.95 Total new obligations.............                                 -50
----------------------------------------------------------------------------

    New budget authority (gross), detail:
68.00 Spending authority from offsetting 
        collections (gross): Offsetting 
        collections (cash)..............                                  50
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                  50
73.20 Total outlays (gross).............                                 -50
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................                                  50
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............                                 194
88.40     Non-Federal sources...........                                -244
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........                                 -50
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................
---------------------------------------------------------------------------

    The Budget includes $194.5 million in new user fees to finance HCFA 
activities. Proposed fees include: a duplicate or unprocessable claims 
fee; a paper claims fee; a physician, provider, and supplier enrollment 
registration fee, a managed care organization application and renewal 
fee; an initial survey and certification fee; and a recertification fee. 
If the authorizing legislation is enacted, the amount appropriated from 
the Federal Hospital Insurance and Federal Supplementary Medical 
Insurance Trust Funds will be reduced by $194.5 million. Additional 
appropriations language is being proposed contingent upon the enactment 
of authorizing legislation. The authorizing legislation will be proposed 
to authorize the collection and spending of the fee subject to 
appropriations action. Contingent upon the enactment of authorizing 
legislation, the budget also authorizes the Secretary to collect up to 
$150 million in user fees to finance the Medicare+Choice education 
campaign, $50 million more than is currently authorized. Additional 
appropriations language is being proposed contingent upon the enactment 
of authorizing legislation. The authorizing legislation will be proposed 
to authorize the collection and spending of the fee subject to 
appropriations action.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0511-2-1-550      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
25.2  Direct obligations: Other services                                -194
99.0  Reimbursable obligations: 
        Subtotal, reimbursable 
        obligations.....................                                 244
                                           ---------   ---------  ----------
99.9    Total new obligations...........                                  50
---------------------------------------------------------------------------

                                

                           Program Management

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0511-4-1-550      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   Research, demonstrations, and 
          evaluation projects...........                                  10
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................                                  10
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                  10
23.95 Total new obligations.............                                 -10
----------------------------------------------------------------------------

    New budget authority (gross), detail:
60.00 Appropriation.....................                                  10
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                  10
73.20 Total outlays (gross).............                                 -10
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................                                  10
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                  10
90.00 Outlays...........................                                  10
---------------------------------------------------------------------------

    This schedule reflects the effects on the Program Management account 
of the Administration's proposal to create a time-limited demonstration 
of Medicare coverage of patient care costs associated with Medicare 
beneficiary participation in certain clinical trials for cancer.

                                

                 State Children's Health Insurance Fund

    [Sec. 706. (a) Section 2104(c) of the Social Security Act (42 U.S.C. 
1397dd(c)) is amended by adding at the end the following new paragraph:
        ``(4) Additional allotment.--
            ``(A) In general.--In addition to the allotment under 
        paragraph (1), the Secretary shall allot each commonwealth and 
        territory described in paragraph (3) the applicable percentage 
        specified in paragraph (2) of the amount appropriated under 
        subparagraph (B).
            ``(B) Appropriations.--For purposes of providing allotments 
        pursuant to subparagraph (A), there is appropriated, out of any 
        money in the Treasury not otherwise appropriated $32,000,000 for 
        fiscal year 1999.''.
    (b) Section 2104(b)(1) of such Act (42 U.S.C. 1397dd(b)(1)) is 
amended by inserting ``(determined without regard to paragraph (4) 
thereof)'' after ``subsection (c)''.] (Departments of Labor, Health and 
Human Services, and Education, and Related Agencies Appropriations Act, 
1999, as included in Public Law 105-277, section 101(f).)

[[Page 447]]

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0515-0-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total obligations (object class 
        41.0)...........................       3,750       4,732       4,215
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................                     485
22.00 New budget authority (gross)......       4,235       4,247       4,215
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       4,235       4,732       4,215
23.95 Total new obligations.............      -3,750      -4,732      -4,215
24.40 Unobligated balance available, end 
        of year.........................         485
----------------------------------------------------------------------------

    New budget authority (gross), detail:
60.00 Appropriation.....................       4,295       4,307       4,275
61.00 Transferred to other accounts.....         -60         -60         -60
                                           ---------   ---------  ----------
63.00   Appropriation (total)...........       4,235       4,247       4,215
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year                   3,745       7,040
73.10 Total new obligations.............       3,750       4,732       4,215
73.20 Total outlays (gross).............          -5      -1,437      -1,900
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..       3,745       7,040       9,355
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................           5          32         475
86.98 Outlays from permanent balances...                   1,405       1,425
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........           5       1,437       1,900
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       4,235       4,247       4,215
90.00 Outlays...........................           5       1,437       1,900
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1998 actual  1999 est.   2000 est.
Enacted/requested:
  Budget Authority..................       4,235       4,247       4,215
  Outlays...........................           5       1,437       1,900
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                                  34
  Outlays...........................                                  36
                                    ------------------------------------
Total:
  Budget Authority..................       4,235       4,247       4,249
  Outlays...........................           5       1,437       1,936
                                    ====================================

    The Balanced Budget Act of 1997 established the Children's Health 
Insurance Program (CHIP) under Title XXI of the Social Security Act. 
Title XXI provides Federal matching funds to States to enable them to 
extend coverage to uninsured children from low-income families. States 
are able to use Title XXI funds for obtaining health benefit coverage 
for uninsured children through a CHIP State program, a CHIP Medicaid 
expansion program, or a combination of both.

                                

                 State Children's Health Insurance Fund

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0515-4-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total obligations (object class 
        41.0)...........................                                  34
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                  34
23.95 Total new obligations.............                                 -34
----------------------------------------------------------------------------

    New budget authority (gross), detail:
60.00 Appropriation.....................                                  34
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year                                   2
73.10 Total new obligations.............                                  34
73.20 Total outlays (gross).............                                 -36
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..                       2
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................                                  34
86.98 Outlays from permanent balances...                                   2
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........                                  36
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                  34
90.00 Outlays...........................                                  36
---------------------------------------------------------------------------

    This schedule reflects the effects of the CHIP proposals contained 
in the Budget on the State Children's Health Insurance Fund.

                                

      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 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 [1999] 2000, 
no commitments for direct loans or loan guarantees shall be made. 
(Department of Health and Human Services Appropriations Act, 1999, as 
included in Public Law 105-277, section 101(f).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4420-0-3-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          10          11          11
22.00 New budget authority (gross)......           2           2           1
22.60 Redemption of debt................          -1          -1          -1
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......          11          12          11
24.40 Unobligated balance available, end 
        of year.........................          11          11          11
----------------------------------------------------------------------------

    New budget authority (gross), detail:
68.00 Spending authority from offsetting 
        collections (gross): Offsetting 
        collections (cash)..............           2           2           1
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.40   Offsetting collections (cash) 
          from: Other...................          -2          -2          -1
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................          -2          -2          -1
---------------------------------------------------------------------------

                                

  

                               Trust Funds

                  Federal Hospital Insurance Trust Fund

              Unavailable Collections (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8005-0-7-571      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Balance, start of year:
01.99 Balance, start of year............     115,440     116,434     116,938
    Receipts:
02.01 Transfers from general fund (FICA 
        taxes)..........................     110,455     118,474     122,677
02.02 Receipts from Railroad Retirement 
        Board...........................         381         404         410
02.03 Transfers from general fund (SECA 
        taxes)..........................       9,029       8,485       8,895
02.04 Federal employer contributions 
        (FICA)..........................       1,825       1,886       1,983
02.05 Postal service employer 
        contributions (FICA)............         607         610         638
02.07 Interest received by trust funds..       9,115       9,112       9,068
02.08 Other proprietary receipts from 
        the public......................           1
02.09 Transfers from general fund (FICA 
        taxes), legislative proposal 
        subject to PAYGO................                                   2
02.10 Taxation on OASDI benefits........       5,067       6,213       6,416
02.11 Deposits by States................          -2

[[Page 448]]

02.12 Interest payments by Railroad 
        Retirement Board................          39          39          37
02.13 Payments from the general fund 
        (uninsured and program 
        management).....................         136         777         599
02.14 Payments for military service 
        credits.........................          67          71          63
02.15 Premiums collected for uninsured 
        individuals not otherwise 
        eligible........................       1,320       1,352       1,393
02.16 FBI, Payment from the general fund          56          66          76
02.17 Criminal fines, transfers from the 
        general fund....................           3           4           4
02.18 Civil monetary penalties, 
        transfers from the general fund.           2           2           2
02.20 Civil penalties and damages.......         103         108         113
02.21 Transfers from DOD, HI............                       2          11
                                           ---------   ---------  ----------
02.99   Total receipts..................     138,204     147,605     152,387
                                           ---------   ---------  ----------
04.00 Total: Balances and collections...     253,644     264,039     269,325
    Appropriation:
05.01 Federal hospital insurance trust 
        fund............................    -136,537    -146,337    -145,985
05.02 Health care fraud and abuse 
        control account.................        -659        -764        -864
05.04 Federal hospital insurance trust 
        fund, legislative proposal 
        subject to PAYGO................                                 163
05.05 Federal hospital insurance trust 
        fund, legislative proposal, 
        discretionary offset............                                 645
05.06 Federal hospital insurance trust 
        fund, legislative proposal not 
        subject to PAYGO................                                 116
                                           ---------   ---------  ----------
05.99 Subtotal appropriation............    -137,196    -147,101    -145,925
06.10 Unobligated balance returned to 
        receipts........................         -14
07.99 Total balance, end of year........     116,434     116,938     123,400
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8005-0-7-571      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Benefit payments, HI..............     134,283     130,990     136,116
00.02 Administration, HI................       1,209       1,346       1,436
00.03 Peer review organizations, HI.....          36         553          89
00.04 Research, HI......................          31          30          33
00.05 HI partial transfer of home health 
        to SMI..........................         978      13,417       8,311
                                           ---------   ---------  ----------
10.00   Total new obligations...........     136,537     146,336     145,985
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......     136,537     146,336     145,985
23.95 Total new obligations.............    -136,537    -146,336    -145,985
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

40.26   Appropriation (trust fund, 
          definite).....................       1,196       1,331       1,423
      Permanent:

60.27   Appropriation (trust fund, 
          indefinite)...................     136,348     145,510     150,098
60.28   Appropriation (unavailable 
          balances).....................      -1,007        -504      -5,536
                                           ---------   ---------  ----------
63.00     Appropriation (total).........     135,341     145,005     144,562
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................     136,537     146,336     145,985
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         505         352         669
73.10 Total new obligations.............     136,537     146,336     145,985
73.20 Total outlays (gross).............    -136,690    -146,019    -146,107
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         352         669         547
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority       1,077       1,211       1,301
86.93 Outlays from current balances.....         127         130         145
86.97 Outlays from new permanent 
        authority.......................     135,108     144,456     144,136
86.98 Outlays from permanent balances...         378         221         524
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........     136,690     146,019     146,107
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................     136,537     146,336     145,985
90.00 Outlays...........................     136,690     146,019     146,107
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.01 Total investments, start of year: 
        U.S. securities: Par value......     116,621     118,250     117,633
92.02 Total investments, end of year: 
        U.S. securities: Par value......     118,250     117,633     123,973
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1998 actual  1999 est.   2000 est.
Enacted/requested:
  Budget Authority..................     136,537     146,336     145,985
  Outlays...........................     136,690     146,018     146,106
Legislative proposal, not subject to 
    PAYGO:
  Budget Authority..................                                -116
  Outlays...........................                                -116
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                                -163
  Outlays...........................                                -163
Legislative proposal, discretionary 
    offset:
  Budget Authority..................                                -645
  Outlays...........................                                -645
                                    ------------------------------------
Total:
  Budget Authority..................     136,537     146,336     145,061
  Outlays...........................     136,690     146,018     145,182
                                    ====================================

    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:

                  Status of Funds (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8005-0-7-571      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Unexpended balance, start of year:
0100  Treasury balance..................        -619      -1,342           2
0101  U.S. Securities: Par value........     116,621     118,250     117,633
                                           ---------   ---------  ----------
0199    Total balance, start of year....     116,002     116,908     117,635
    Cash income during the year:
      Governmental receipts:

        Governmental receipts:
0200      FHI trust fund, transfers from 
            general fund (FICA taxes)...     110,455     118,474     122,677
0200      FHI trust fund, transfers from 
            general fund (FICA taxes)...                                   2
0201    FHI trust fund, transfers from 
          general fund (SECA taxes).....       9,029       8,485       8,895
0205    FHI trust fund, receipts from 
          Railroad Retirement Board.....         381         404         410
0206    HCFAC: Civil penalties and 
          damages.......................         103         108         113
0207    FHI trust fund, deposits by 
          States........................          -2
      Proprietary receipts:

0221    FHI trust fund, premiums 
          collected for uninsured 
          individuals not otherwise 
          eligible......................       1,320       1,352       1,393
0222    Other proprietary receipts......           1
      Intragovernmental transactions:

0240    FHI trust fund, Federal employer 
          contributions (FICA)..........       1,825       1,886       1,983
0241    FHI trust fund, Postal Service 
          employer contributions (FICA).         607         610         638
0242    FHI trust fund, Federal payment 
          for transitional coverage for 
          uninsured Federal employees...          86          97         121
0243    FHI trust fund, Federal payment 
          for transitional coverage for 
          the uninsured.................         -52         555         349
0245    FHI trust fund, general fund 
          transfer, Program management 
          (HI)..........................         102         125         129
0246    FHI trust fund, Federal payments 
          for OASDI taxes...............       5,067       6,213       6,416
0248    FHI trust fund, interest payment 
          from Railroad Retirement Board          39          39          37
0249    FHI trust fund, interest on 
          investments...................       9,115       9,112       9,068
0251    FHI trust fund, transfer from 
          Department of Defense for 
          military service credits......          67          71          63
0252    HCFAC: FBI......................          56          66          76
0253    HCFAC: Criminal fines...........           3           4           4
0254    HCFAC: Civil monetary penalties.           2           2           2
0255    Other intragovernmental 
          transactions..................                       2          11
      Offsetting collections:

0281    HCFAC user fees.................           1
0297  Income under present law..........     138,205     147,605     152,385
0298  Income under proposed legislation.                                   2
                                           ---------   ---------  ----------
0299    Total cash income...............     138,205     147,605     152,387
    Cash outgo during year:
0500  Benefit payments..................    -134,321    -130,989    -136,115

[[Page 449]]

      Cash outgo during the year (-):

0501    Benefit payments (proposed 
          legislation)..................                                 163
0501    Benefit payments (proposed 
          legislation)..................                                 645
0502  Administration....................      -1,171      -1,311      -1,415
0503  Administration....................                                 116
0504  Peer review organizations.........        -188        -270        -233
0505  Research..........................         -32         -31         -32
0506  HCFAC.............................        -609        -860        -864
0507  HI partial transfer of home health 
        to SMI..........................        -978     -13,417      -8,311
0597  Outgo under present law (-).......    -137,299    -146,878    -146,970
0598  Outgo under proposed legislation 
        (-).............................                                 924
                                           ---------   ---------  ----------
0599  Total cash outgo (-)..............    -137,299    -146,878    -146,046
    Unexpended balance, end of year:
0700  Treasury Balance..................      -1,342           2           3
0701  U.S. Securities: Par value........     118,250     117,633     123,973
                                           ---------   ---------  ----------
0799    Total balance, end of year......     116,908     117,635     123,976
---------------------------------------------------------------------------

                Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8005-0-7-571      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

      Grants, subsidies, and contributions:

41.0    Payment for health insurance 
          experiments and demonstration 
          projects......................          31          30          33
41.0    Payment for peer review 
          organization (PRO) activities.          36         553          89
42.0  Insurance claims and indemnities..     134,283     130,990     136,116
      Undistributed:

92.0    HI Partial Transfer of Home 
          Health to SMI.................         978      13,417       8,311
92.0    Reimbursement for administrative 
          expenses for other than SSA 
          LAE...........................          44          45          46
92.0    Purchases of goods and services.         639         737         784
93.0  Administrative expenses: Portion 
        of limitation on salaries and 
        expenses: Social Security 
        Administration..................         526         564         606
                                           ---------   ---------  ----------
99.9    Total new obligations...........     136,537     146,336     145,985
---------------------------------------------------------------------------

                                

                  Federal Hospital Insurance Trust Fund

                (Legislative proposal, subject to PAYGO) 

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8005-2-7-571      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations (object 
        class 92.0).....................                                -116
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                -116
23.95 Total new obligations.............                                 116
----------------------------------------------------------------------------

    New budget authority (gross), detail:
40.26 Appropriation (trust fund, 
        definite).......................                                -116
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                -116
73.20 Total outlays (gross).............                                 116
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority                                -116
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                -116
90.00 Outlays...........................                                -116
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.01 Total investments, start of year: 
        U.S. securities: Par value......
92.02 Total investments, end of year: 
        U.S. securities: Par value......                                 116
---------------------------------------------------------------------------

    This schedule reflects the effects of the HCFA user fees proposed in 
this Budget on the Hospital Insurance Trust Fund.

                                

                  Federal Hospital Insurance Trust Fund

                (Legislative proposal, subject to PAYGO) 

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8005-4-7-571      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations (object 
        class 42.0).....................                                -163
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                -163
23.95 Total new obligations.............                                 163
----------------------------------------------------------------------------

    New budget authority (gross), detail:
60.27 Appropriation (trust fund, 
        indefinite).....................                                   2
60.28 Appropriation (unavailable 
        balances).......................                                -165
                                           ---------   ---------  ----------
63.00   Appropriation (total)...........                                -163
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                -163
73.20 Total outlays (gross).............                                 163
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................                                -163
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                -163
90.00 Outlays...........................                                -163
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.01 Total investments, start of year: 
        U.S. securities: Par value......
92.02 Total investments, end of year: 
        U.S. securities: Par value......                                 163
---------------------------------------------------------------------------

    This schedule reflects the effects of the Medicare proposals 
contained in the Budget on the Hospital Insurance Trust Fund.

                                

                  Federal Hospital Insurance Trust Fund

               (Legislative proposal, subject to offset) 

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8005-6-7-571      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations (object 
        class 42.0).....................                                -645
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                -645
23.95 Total new obligations.............                                 645
----------------------------------------------------------------------------

    New budget authority (gross), detail:
60.28 Appropriation (unavailable 
        balances).......................                                -645
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                -645
73.20 Total outlays (gross).............                                 645
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................                                -645
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                -645
90.00 Outlays...........................                                -645
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.01 Total investments, start of year: 
        U.S. securities: Par value......
92.02 Total investments, end of year: 
        U.S. securities: Par value......                                 645
---------------------------------------------------------------------------

    This schedule reflects the effects on the Hospital Insurance Trust 
Fund of the Medicare proposals contained in this Budget used to offset 
discretionary spending.

[[Page 450]]

                                

               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      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Medicare integrity program........         499         560         630
00.02 FBI fraud and abuse control.......          56          66          76
00.03 Other fraud and abuse control.....         104         138         158
09.01 Reimbursable......................           1
                                           ---------   ---------  ----------
10.00   Total new obligations...........         660         764         864
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......         660         764         864
23.95 Total new obligations.............        -660        -764        -864
----------------------------------------------------------------------------

    New budget authority (gross), detail:
60.26 Appropriation (trust fund, 
        definite).......................         659         764         864
68.00 Spending authority from offsetting 
        collections: Offsetting 
        collections (cash)..............           1
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................         660         764         864
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year          57         122          26
73.10 Total new obligations.............         660         764         864
73.20 Total outlays (gross).............        -609        -860        -864
73.40 Adjustments in expired accounts...          14
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         122          26          26
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................         552         764         864
86.98 Outlays from permanent balances...          57          96
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         609         860         864
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........          -1
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         659         764         864
90.00 Outlays...........................         608         860         864
---------------------------------------------------------------------------

    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      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

      Direct obligations:

25.6    Medical care (HCFA).............         499         560         630
92.0    Undistributed (FBI).............          56          66          76
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..         555         626         706
      Allocation Account:

        Personnel compensation:
          Full-time permanent:
11.1        Full-time permanent (OIG)...          43          57          69
11.1        Full-time permanent (DoJ)...          11          13          14
11.1        Full-time permanent (OGC)...           1           1           2
11.3      Other than full-time permanent 
            (DoJ).......................           2           2           2
11.8      Special personal services 
            payments (DOJ)..............           1                       1
                                           ---------   ---------  ----------
11.9        Total personnel compensation          58          73          88
        Civilian personnel benefits:
12.1      Civilian personnel benefits 
            (OIG).......................           9          13          15
12.1      Civilian personnel benefits 
            (DoJ).......................           3           4           4
        Travel and transportation of 
            persons:
21.0      Travel and transportation of 
            persons (OIG)...............           3           5           6
21.0      Travel and transportation of 
            persons (DoJ)...............           1           1           1
        Rental payments to GSA:
23.1      Rental payments to GSA (OIG)..           6           9          10
23.1      Rental payments to GSA (DoJ)..           2           3           3
23.1      Rental payments to GSA (OGC)..           1           1           1
23.3    Communications, utilities, and 
          miscellaneous charges (DOJ)...           1           1           1
        Other services:
25.2      Other services (DoJ)..........           5           6           6
25.2      Other services (HCFA).........           1
25.2      Other services (HRSA).........           1           2
        Purchases of goods and services 
            from Government accounts:
25.3      Purchases of goods and 
            services from Government 
            accounts (OIG)..............           9          13          16
25.3      Purchases of goods and 
            services from Government 
            accounts (DoJ)..............           2           2           2
26.0    Supplies and materials (OIG)....           1           1           1
31.0    Equipment (OIG).................           1           2           3
41.0    Grants, subsidies, and 
          contributions (AoA)...........           1           2           1
                                           ---------   ---------  ----------
99.0      Subtotal, allocation account..         105         138         158
                                           ---------   ---------  ----------
99.9    Total new obligations...........         660         764         864
---------------------------------------------------------------------------

    This schedule reflects estimated distribution of the allocation 
account. Actual FY 2000 distribution will be determined by the Secretary 
of HHS and the Attorney General.

                                     1998 actual  1999 est.   2000 est.
Department of Justice (DOJ).........          28          32          34
Office of the Inspector General, HHS          72         100         120
Health Care Financing Administration           1           0           0
Office of General Counsel, HHS......           2           2           3
Administration on Aging.............           1           1           1
Other HHS...........................           1           3           0
                                    ------------------------------------
    Total...........................         105         138         158
                                    ====================================

                                

           Federal Supplementary Medical Insurance Trust Fund

              Unavailable Collections (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8004-0-7-571      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Balance, start of year:
01.99 Balance, start of year............      34,808      40,395      45,654
    Receipts:
02.01 Federal contributions.............      59,919      61,879      68,690
02.02 Interest received by trust fund...       2,606       2,887       2,928
02.03 Other proprietary receipts from 
        the public......................           3
02.05 Premiums collected for the aged...      17,153      17,529      18,914
02.06 Premiums collected for the 
        disabled........................       2,274       2,418       2,662
02.07 Transfers from DOD, SMI...........                       1          11
02.09 Premiums collected for the aged, 
        proposed legislation............                                -118
02.10 Premiums collected for the 
        disabled, proposed legislation..                                 -17
02.12 Federal contributions, proposed 
        legislation not subject to PAYGO                                -469
                                           ---------   ---------  ----------
02.99   Total receipts..................      81,955      84,714      92,601
                                           ---------   ---------  ----------
04.00 Total: Balances and collections...     116,763     125,109     138,255
    Appropriation:
05.01 Federal supplementary medical 
        insurance trust fund............     -76,368     -79,455     -94,023
05.02 Federal supplementary medical 
        insurance trust fund, adjustment 
        to 1996 Continuing Resolution 
        level...........................                                 455
05.03 Federal supplementary medical 
        insurance trust fund, proposed 
        legislation.....................                                 115
05.04 Federal supplementary medical 
        insurance trust fund, 
        legislative proposal, not 
        subject to PAYGO................                                  78
                                           ---------   ---------  ----------
05.99 Subtotal appropriation............     -76,368     -79,455     -93,375
07.99 Total balance, end of year........      40,395      45,654      44,880
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8004-0-7-571      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Benefit payments, SMI.............      74,804      77,595      92,210
00.02 Administration, SMI...............       1,511       1,642       1,679

[[Page 451]]

00.03 Peer review organizations, SMI....          33         138          22
00.04 Research, SMI.....................          20          20          22
00.06 Transfer to Medicaid for payment 
        of SMI premiums.................                      60          90
09.01 HI partial transfer of home health         978      13,417       8,311
                                           ---------   ---------  ----------
10.00   Total new obligations...........      77,346      92,872     102,334
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......      77,346      92,872     102,334
23.95 Total new obligations.............     -77,346     -92,872    -102,334
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

40.26   Appropriation (trust fund, 
          definite).....................       1,527       1,658       1,697
      Permanent:

60.27   Appropriation (trust fund, 
          indefinite)...................      80,428      83,056      91,508
60.28   Appropriation (unavailable 
          balances).....................                                 818
60.45   Portion precluded from 
          obligation....................      -5,587      -5,259
                                           ---------   ---------  ----------
63.00     Appropriation (total).........      74,841      77,797      92,326
68.00   Spending authority from 
          offsetting collections: 
          Offsetting collections (cash).         978      13,417       8,311
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................      77,346      92,872     102,334
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         398         494         545
73.10 Total new obligations.............      77,346      92,872     102,334
73.20 Total outlays (gross).............     -77,250     -92,821    -102,368
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         494         545         511
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority       1,261       1,411       1,464
86.93 Outlays from current balances.....         170         236         228
86.97 Outlays from new permanent 
        authority.......................      75,787      91,097     100,621
86.98 Outlays from permanent balances...          32          77          55
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........      77,250      92,821     102,368
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........        -978     -13,417      -8,311
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................      76,368      79,455      94,023
90.00 Outlays...........................      76,272      79,404      94,057
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.01 Total investments, start of year: 
        U.S. securities: Par value......      34,464      39,502      46,199
92.02 Total investments, end of year: 
        U.S. securities: Par value......      39,502      46,199      45,391
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1998 actual  1999 est.   2000 est.
Enacted/requested:
  Budget Authority..................      76,368      79,455      94,023
  Outlays...........................      76,272      79,404      94,057
Legislative proposal, not subject to 
    PAYGO:
  Budget Authority..................                                 -78
  Outlays...........................                                 -78
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                                -115
  Outlays...........................                                -115
Legislative proposal, discretionary 
    offset:
  Budget Authority..................                                -455
  Outlays...........................                                -455
                                    ------------------------------------
Total:
  Budget Authority..................      76,368      79,455      93,375
  Outlays...........................      76,272      79,404      93,409
                                    ====================================

    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      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Unexpended balance, start of year:
0100  Treasury balance..................         742       1,387
0101  U.S. Securities: Par value........      34,464      39,502      46,199
                                           ---------   ---------  ----------
0199    Total balance, start of year....      35,206      40,889      46,199
    Cash income during the year:
      Proprietary receipts:

0221    Premiums collected for the aged, 
          FSMI Fund.....................      17,153      17,529      18,914
0222    Premiums collected for the aged, 
          FSMI Fund, proposed 
          legislation...................                                -118
        Proprietary receipts:
0223      Premiums collected for the 
            disabled, FSMI Fund.........       2,274       2,418       2,662
0223      Premiums collected for the 
            disabled, FSMI Fund, 
            proposed legislation........                                 -17
0225    Other Proprietary receipts......           3
      Intragovernmental transactions:

0240    Federal contributions, FSMI Fund      59,919      61,879      68,690
0241    Federal contributions, FSMI 
          Fund, proposed legislation....                                -469
0242    Interest received by trust fund, 
          FSMI Fund.....................       2,606       2,887       2,928
0243    Intragovernmental transactions..                       1          11
      Offsetting collections:

0280    HI Partial Transfer of Home 
          Health........................         978      13,417       8,311
0297  Income under present law..........      82,933      98,131     101,516
0298  Income under proposed legislation.                                -604
                                           ---------   ---------  ----------
0299    Total cash income...............      82,933      98,131     100,912
    Cash outgo during year:
      Cash outgo during the year (-):

0501    Benefit payments & ESRD.........     -74,808     -77,599     -92,214
0501    Benefit payments, proposed 
          legislation...................                                 115
0501    Benefit payments, proposed 
          legislation (-)...............                                 455
0502  Administration....................      -1,410      -1,627      -1,671
0503  Administration....................                                  78
0504  Peer review organizations.........         -33         -98         -61
0505  Research..........................         -21         -20         -21
0506  HI Partial Transfer of Home Health        -978     -13,417      -8,311
0507  Transfer to Medicaid for payment 
        of SMI premiums.................                     -60         -90
0597  Outgo under present law (-).......     -77,250     -92,821    -102,368
0598  Outgo under proposed legislation 
        (-).............................                                 648
                                           ---------   ---------  ----------
0599  Total cash outgo (-)..............     -77,250     -92,821    -101,720
    Unexpended balance, end of year:
0700  Treasury balance..................       1,387
0701  U.S. Securities: Par value........      39,502      46,199      45,391
                                           ---------   ---------  ----------
0799    Total balance, end of year......      40,889      46,199      45,391
---------------------------------------------------------------------------

    Note.--This status of funds table displays the gross outlay and 
income effect on the SMI trust fund of the administrative mechanism used 
to implement the home health transfer policy authorized in PL 105-33. 
Showing the net outlay and income effect of this administrative 
mechanism requires the following substitutions to the table above:

 
                                         FY 1999            FY 2000
 
  line 0280: HI partial transfer
   of Home Health.................              line deleted
  line 0501: Benefit payments and
   ESRD...........................            -91,012           -100,521
  line 0506: HI partial transfer
   of Home Health.................            +13,417             +8,311
 

    The totals would also be decreased in FYs 1999 and 2000 by $13,417 
and $8,311 respectively, so as to leave end of year balances unchanged.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8004-0-7-571      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

      Direct obligations:

        Grants, subsidies, and 
            contributions:
41.0      Payment for peer review 
            organization (PRO) activity.          33         138          22
41.0      Payment for health insurance 
            experiments and 
            demonstration projects......          20          20          22
42.0    Insurance claims and indemnities      74,804      77,655      92,300
92.0    Undistributed...................       1,093       1,200       1,198
93.0    Administrative expenses: Portion 
          of limitation on salaries and 
          expenses: Social Security 
          Administration................         418         442         481
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..      76,368      79,455      94,023
99.0  Reimbursable obligations..........         978      13,417       8,311
                                           ---------   ---------  ----------
99.9    Total new obligations...........      77,346      92,872     102,334
---------------------------------------------------------------------------

[[Page 452]]



                                

           Federal Supplementary Medical Insurance Trust Fund

              (Legislative proposal, not subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8004-2-7-571      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations (object 
        class 92.0).....................                                 -78
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                 -78
23.95 Total new obligations.............                                  78
----------------------------------------------------------------------------

    New budget authority (gross), detail:
40.26 Appropriation (trust fund, 
        definite).......................                                 -78
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                 -78
73.20 Total outlays (gross).............                                  78
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority                                 -78
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                 -78
90.00 Outlays...........................                                 -78
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.01 Total investments, start of year: 
        U.S. securities: Par value......
92.02 Total investments, end of year: 
        U.S. securities: Par value......                                  78
---------------------------------------------------------------------------

    This schedule reflects the effects of the HCFA user fees proposed in 
this Budget on the Supplemental Medical Insurance Trust Fund.

                                

           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      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations (object 
        class 42.0).....................                                -115
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                -115
23.95 Total new obligations.............                                 115
----------------------------------------------------------------------------

    New budget authority (gross), detail:
60.27 Appropriation (trust fund, 
        indefinite).....................                                -149
60.28 Appropriation (unavailable 
        balances).......................                                  34
                                           ---------   ---------  ----------
63.00   Appropriation (total)...........                                -115
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                -115
73.20 Total outlays (gross).............                                 115
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................                                -115
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                -115
90.00 Outlays...........................                                -115
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.01 Total investments, start of year: 
        U.S. securities: Par value......
92.02 Total investments, end of year: 
        U.S. securities: Par value......                                 115
---------------------------------------------------------------------------

    This schedule reflects the effects of the Medicare proposals 
contained in the Budget on the Supplementary Medical Insurance Trust 
Fund.

                                

           Federal Supplementary Medical Insurance Trust Fund

              (Legislative proposal, discretionary offset)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8004-6-7-571      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations (object 
        class 42.0).....................                                -455
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                -455
23.95 Total new obligations.............                                 455
----------------------------------------------------------------------------

    New budget authority (gross), detail:
60.27 Appropriation (trust fund, 
        indefinite).....................                                -455
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                -455
73.20 Total outlays (gross).............                                 455
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................                                -455
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                -455
90.00 Outlays...........................                                -455
---------------------------------------------------------------------------

    This schedule reflects the effects on the Supplemental Medical 
Insurance Trust Fund of the Medicare proposals contained in this Budget 
used to offset discretionary spending.

                                

                 Allocation Received From Other Accounts

    Note.--Obligations incurred under allocations from other accounts 
are included in the schedule of the parent appropriation as follows: 
Health Care Financing Administration: ``Health Care Fraud and Abuse 
Control Account.''

                                


 
                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      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 State family assistance grant.....      16,489      16,489      16,489
00.02 State penalties...................                                 -30
00.03 Territories--family assistance 
        grants..........................          78          78          78
00.05 Bonus to reward decrease in 
        illegitimacy....................                     100         100
00.06 Supplemental grants for population 
        increases.......................          79         160         243
00.07 Bonus to reward high performance 
        States..........................                     200         200
00.08 Tribal work programs..............           7           7           7
                                           ---------   ---------  ----------
10.00   Total obligations (object class 
          41.0).........................      16,653      17,034      17,087
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......      16,672      17,053      17,087
23.95 Total new obligations.............     -16,653     -17,034     -17,087
23.98 Unobligated balance expiring......         -19         -19
----------------------------------------------------------------------------

    New budget authority (gross), detail:
60.05 Appropriation (indefinite)........      16,672      17,053      17,087
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year       3,807       7,212      10,921
73.10 Total new obligations.............      16,653      17,034      17,087
73.20 Total outlays (gross).............     -13,284     -13,071     -14,496
73.40 Adjustments in expired accounts...          36        -254
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..       7,212      10,921      13,512
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................      10,894       9,877       9,079

[[Page 453]]

86.98 Outlays from permanent balances...       2,390       3,194       5,417
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........      13,284      13,071      14,496
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................      16,672      17,053      17,087
90.00 Outlays...........................      13,284      13,071      14,496
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1998 actual  1999 est.   2000 est.
Enacted/requested:
  Budget Authority..................      16,672      17,053      17,087
  Outlays...........................      13,284      13,071      14,496
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................
  Outlays...........................                                -364
Legislative proposal, discretionary 
    offset:
  Budget Authority..................                                 -83
  Outlays...........................                                 -45
                                    ------------------------------------
Total:
  Budget Authority..................      16,672      17,053      17,004
  Outlays...........................      13,284      13,071      14,087
                                    ====================================

    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 low-income families with children.

    This account also includes Federal loans for State welfare programs, 
established by section 406 of the Social Security Act as amended.

                                

                 Temporary Assistance for Needy Families

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1552-4-1-609      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations (object 
        class 41.0).....................                                 236
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
23.95 Total new obligations.............                                -236
24.40 Unobligated balance available, end 
        of year.........................                                -236
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                 236
73.20 Total outlays (gross).............                                 364
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..                                 600
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................                                -364
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................                                -364
---------------------------------------------------------------------------

    This reflects interactions with the Administration's proposal on the 
allocation of common State administrative costs between the Medicaid and 
Temporary Assistance for Needy Families programs.

    This proposal also reduces the cap on TANF transfers to SSBG from 10 
percent to 4.25 percent in 2000, consistent with the level already 
enacted for 2001.

                                

                 Temporary Assistance for Needy Families

              (Legislative proposal, discretionary offset)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1552-6-1-609      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total obligations (object class 
        41.0)...........................                                 -83
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                 -83
23.95 Total new obligations.............                                  83
----------------------------------------------------------------------------

    New budget authority (gross), detail:
60.05 Appropriation (indefinite)........                                 -83
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                 -83
73.20 Total outlays (gross).............                                  45
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..                                 -38
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................                                 -45
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                 -83
90.00 Outlays...........................                                 -45
---------------------------------------------------------------------------

    The Administration will propose legislation that freezes TANF 
supplemental grant funds in 2000 at the 1999 level for all eligible 
states, and will apply the offset to discretionary spending.

                                

                            Contingency Fund

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1522-0-1-609      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total obligations (object class 
        41.0)...........................           2                      11
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................                   1,958       1,958
22.00 New budget authority (gross)......       1,960
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       1,960       1,958       1,958
23.95 Total new obligations.............          -2                     -11
24.40 Unobligated balance available, end 
        of year.........................       1,958       1,958       1,947
----------------------------------------------------------------------------

    New budget authority (gross), detail:
60.00 Appropriation.....................       1,960
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............           2                      11
73.20 Total outlays (gross).............          -2                      -3
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..                                   8
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................           2
86.98 Outlays from permanent balances...                                   3
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........           2                       3
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       1,960
90.00 Outlays...........................           2                       3
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1998 actual  1999 est.   2000 est.
Enacted/requested:
  Budget Authority..................       1,960
  Outlays...........................           2                       3
Legislative proposal, not subject to 
    PAYGO:
  Budget Authority..................                              -1,644

[[Page 454]]

  Outlays...........................
                                    ------------------------------------
Total:
  Budget Authority..................       1,960                  -1,644
  Outlays...........................           2                       3
                                    ====================================

                                

                            Contingency Fund

              (Legislative proposal, not subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1522-2-1-609      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                              -1,644
24.40 Unobligated balance available, end 
        of year.........................                              -1,644
----------------------------------------------------------------------------

    New budget authority (gross), detail:
40.36 Unobligated balance rescinded.....                              -1,644
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                              -1,644
90.00 Outlays...........................
---------------------------------------------------------------------------

    The Budget proposes authorizing action that reduces budget authority 
by $1.6 billion in FY 2000, repeals the existing Contingency Fund 
authority, and creates a new uncapped fund that could more effectively 
respond to State needs in the event of an unforeseen economic downturn.

                                

 [Family Support] Payments to States for Child Support Enforcement and 
                         Family Support Programs

    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), [to remain available until 
expended, $1,989,000,000; and for such purposes] for the first quarter 
of fiscal year [2000, $750,000,000] 2001, $650,000,000, to remain 
available until expended.
    For making payments to each State for carrying out the program of 
Aid to Families with Dependent Children under title IV-A of the Social 
Security Act before the effective date of the program of Temporary 
Assistance to Needy Families (TANF) with respect to such State, such 
sums as may be necessary: 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, 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 and the Act of July 5, 1960 (24 
U.S.C. ch. 9), for the last three months of the current year for 
unanticipated costs, incurred for the current fiscal year, such sums as 
may be necessary. (Department of Health and Human Services 
Appropriations Act, 1999, as included in Public Law 105-277, section 
101(f).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1501-0-1-609      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Child support enforcement (CSE):

        Benefit payments:
00.01     State child support 
            administrative costs........       2,143       2,573       2,823
00.02     Federal incentive/hold 
            harmless payments to States.         403         426         419
00.03     Access and visitation grants..          10          10          10
                                           ---------   ---------  ----------
00.91   Subtotal, child support 
          enforcement...................       2,556       3,009       3,252
01.02 Payments to territories...........          38          38          38
01.03 Repatriation......................           1           1           1
                                           ---------   ---------  ----------
01.91   Subtotal, other payments........          39          39          39
      Aid to families with dependent children (AFDC) 
          payments:

02.01   AFDC benefit payments...........          98          35
02.02   Emergency assistance............         309          65
02.03   State and local welfare 
          administration................         174
02.04   AFDC/JOBS child care............          26
02.05   At-risk child care..............           9
                                           ---------   ---------  ----------
02.91     Subtotal, AFDC Programs.......         616         100
                                           ---------   ---------  ----------
10.00   Total obligations (object class 
          41.0).........................       3,211       3,148       3,291
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................       2,696       1,564       2,591
22.00 New budget authority (gross)......       1,010       3,075       1,169
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................       1,069       1,100
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       4,775       5,739       3,760
23.95 Total new obligations.............      -3,211      -3,148      -3,291
24.40 Unobligated balance available, end 
        of year.........................       1,564       2,591         469
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

40.00   Appropriation...................                   1,989
      Permanent:

65.00   Advance appropriation (definite)         607         660         750
68.00   Spending authority from 
          offsetting collections: 
          Offsetting collections (cash).         403         426         419
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       1,010       3,075       1,169
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year       1,952       1,520         404
73.10 Total new obligations.............       3,211       3,148       3,291
73.20 Total outlays (gross).............      -2,574      -3,164      -3,369
73.45 Adjustments in unexpired accounts.      -1,069      -1,100
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..       1,520         404         326
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority                   1,520
86.93 Outlays from current balances.....       1,564         558       2,200
86.97 Outlays from new permanent 
        authority.......................       1,010       1,086       1,169
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       2,574       3,164       3,369
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.40   Offsetting collections (cash) 
          from: Non-Federal sources.....        -403        -426        -419
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         607       2,649         750
90.00 Outlays...........................       2,171       2,738       2,950
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1998 actual  1999 est.   2000 est.
Enacted/requested:
  Budget Authority..................         607       2,649         750
  Outlays...........................       2,171       2,738       2,950
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                                  -9
  Outlays...........................                                  -9
                                    ------------------------------------
Total:
  Budget Authority..................         607       2,649         741
  Outlays...........................       2,171       2,738       2,941
                                    ====================================

    AFDC expenditure claims for the period prior to States' transition 
to the Temporary Assistance to Needy Families Program have been lower 
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 fiscal year 2000. The account is 
expected to return to its traditional appropriations cycle after then. 
As a result of P.L. 104-93, the Federal share of collections

[[Page 455]]

is no longer used to reduce the budget authority requested in this 
account. Instead, spending authority from collections is limited to 
incentive and hold harmless payments. The net Federal share of 
collections after incentive and hold harmless payments are made to 
States is returned to the treasury in a receipt account. The text table 
below shows the traditional display of child support enforcement costs:

             Net Federal Costs of Child Support Enforcement

                        (In millions of dollars)

                                        1998         1999        2000
Gross Federal share of collections..      -1,348      -1,371      -1,384
Federal incentive payments to States         389         385         354
Hold harmless payments..............          14          41          65
State child support administrative 
costs...............................       2,143       2,573       2,823
Access and visitation grants........          10          10          10
                                    ------------------------------------
    Subtotal........................       1,208       1,638       1,868
                                    ====================================

                                

  Payments to States for Child Support Enforcement and Family Support 
                                Programs

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1501-4-1-609      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Child support enforcement (CSE):

        Benefit payments:
00.01     State child support 
            administrative costs........                                  -9
00.02     Federal incentive/hold 
            harmless payments to States.                                 -65
                                           ---------   ---------  ----------
10.00   Total obligations (object class 
          41.0).........................                                 -74
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                 -74
23.95 Total new obligations.............                                  74
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

40.00   Appropriation...................                                  -9
      Permanent:

68.00   Spending authority from 
          offsetting collections: 
          Offsetting collections (cash).                                 -65
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................                                 -74
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                 -74
73.20 Total outlays (gross).............                                  74
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority                                  -9
86.97 Outlays from new permanent 
        authority.......................                                 -65
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........                                 -74
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.40   Offsetting collections (cash) 
          from: Non-Federal sources.....                                  65
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                  -9
90.00 Outlays...........................                                  -9
---------------------------------------------------------------------------

    This proposal: (1) conforms the match rate for paternity testing 
with the basic administrative match rate; (2) repeals the hold harmless 
provision established in welfare reform; and, (3) starting in 2001, 
requires review of child support orders for families receiving welfare 
at least every three years.

                                

                    Low Income Home Energy Assistance

    For making payments under title XXVI of the Omnibus Budget 
Reconciliation Act of 1981, $1,100,000,000, to be available for 
obligation in the period October 1, [1999] 2000 through September 30, 
[2000] 2001.
    For making payments under title XXVI of such Act, $300,000,000: 
Provided, That these funds are hereby designated by Congress to be 
emergency requirements pursuant to section 251(b)(2)(A) of the Balanced 
Budget and Deficit Emergency 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. (Department of 
Health and Human Services Appropriations Act, 1999, as included in 
Public Law 105-277, section 101(f).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1502-0-1-609      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total obligations (object class 
        41.0)...........................       1,160       1,100       1,100
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......       1,160       1,100       1,100
23.95 Total new obligations.............      -1,160      -1,100      -1,100
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

40.15   Appropriation (emergency).......                     300         300
40.60   Contingent emergency 
          appropriation not available 
          for obligations...............                    -300        -300
                                           ---------   ---------  ----------
43.00     Appropriation (total).........
      Permanent:

60.65   Contingent emergency 
          appropriation released........         160
65.00   Advance appropriation (definite)       1,000       1,100       1,100
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       1,160       1,100       1,100
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         351         377         343
73.10 Total new obligations.............       1,160       1,100       1,100
73.20 Total outlays (gross).............      -1,132      -1,134      -1,135
73.40 Adjustments in expired accounts...          -2
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         377         343         308
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.93 Outlays from current balances.....         300         302          56
86.97 Outlays from new permanent 
        authority.......................         825         814         814
86.98 Outlays from permanent balances...           7          18         264
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       1,132       1,134       1,135
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       1,160       1,100       1,100
90.00 Outlays...........................       1,132       1,134       1,135
---------------------------------------------------------------------------

    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), [$415,000,000] $423,000,000, to remain available through 
September 30, 2002: Provided, That funds appropriated pursuant to 
section 414(a) of the Immigration and Nationality Act under Public Law 
[104-208] 105-78 for fiscal year [1997] 1998, and under Public Law 105-
277 for fiscal year 1999 shall be available for the costs of assistance 
provided and other activities [conducted in such year and in fiscal 
years 1998 and 1999] through September 30, 2001.
    For carrying out section 5 of the Torture Victims Relief Act of 1998 
(Public Law 105-320), $7,500,000, to remain available until

[[Page 456]]

expended. (Department of Health and Human Services Appropriations Act, 
1999, as included in Public Law 105-277, section 101(f).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1503-0-1-609      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Refugee and entrant assistance....         411         435         435
00.02 Assistance for treatment of 
        torture victims.................                                   8
                                           ---------   ---------  ----------
10.00   Total new obligations...........         411         435         443
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................           2           2           2
22.00 New budget authority (gross)......         423         435         443
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         425         437         445
23.95 Total new obligations.............        -411        -435        -443
23.98 Unobligated balance expiring......         -12
24.40 Unobligated balance available, end 
        of year.........................           2           2           2
----------------------------------------------------------------------------

    New budget authority (gross), detail:
40.00 Appropriation.....................         420         415         431
50.00 Reappropriation...................           3          20          12
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................         423         435         443
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         437         511         509
73.10 Total new obligations.............         411         435         436
73.20 Total outlays (gross).............        -326        -420        -430
73.40 Adjustments in expired accounts...         -12         -17
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         511         509         517
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority         123         131         133
86.93 Outlays from current balances.....         202         289         296
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         326         420         430
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         423         435         443
90.00 Outlays...........................         326         420         430
---------------------------------------------------------------------------

    States are subsidized for administering the refugee assistance 
program. Funds are also provided to assist in the rehabilitation of 
victims of torture.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1503-0-1-609      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
25.2  Other services....................           1           1           1
25.3  Purchases of goods and services 
        from Government accounts........           1           1           1
41.0  Grants, subsidies, and 
        contributions...................         409         433         441
                                           ---------   ---------  ----------
99.9    Total new obligations...........         411         435         443
---------------------------------------------------------------------------

                                

  [Family Preservation and Support] Promoting Safe and Stable Families

    For carrying out section 430 of the Social Security Act, 
[$275,000,000] $295,000,000. (Department of Health and Human Services 
Appropriations Act, 1999, as included in Public Law 105-277, section 
101(f).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1512-0-1-506      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Grants to States and Tribes.......         235         259         279
00.02 Training and technical assistance.           4           6           6
00.03 State court assessment activities.                      10          10
                                           ---------   ---------  ----------
10.00   Total new obligations...........         239         275         295
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......         255         275         295
23.95 Total new obligations.............        -239        -275        -295
23.98 Unobligated balance expiring......         -16
----------------------------------------------------------------------------

    New budget authority (gross), detail:
40.00 Appropriation.....................         255         275         295
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         293         274         325
73.10 Total new obligations.............         239         275         295
73.20 Total outlays (gross).............        -214        -224        -258
73.40 Adjustments in expired accounts...         -44
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         274         325         362
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority          28          33          35
86.93 Outlays from current balances.....         186         191         222
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         214         224         258
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         255         275         295
90.00 Outlays...........................         214         224         258
---------------------------------------------------------------------------

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1512-0-1-506      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
25.1  Advisory and assistance services..           4           6           6
41.0  Grants, subsidies, and 
        contributions...................         235         269         289
                                           ---------   ---------  ----------
99.9    Total new obligations...........         239         275         295
---------------------------------------------------------------------------

                                

           Job Opportunities and Basic Skills Training Program

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1509-0-1-504      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         158          77          23
73.20 Total outlays (gross).............         -48         -39         -15
73.40 Adjustments in expired accounts...         -33         -15
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..          77          23           8
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.93 Outlays from current balances.....          48          39          15
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................          48          39          15
---------------------------------------------------------------------------

    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      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year           7          11          11
73.20 Total outlays (gross).............           4
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..          11          11          11
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.93 Outlays from current balances.....          -4
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................

[[Page 457]]

90.00 Outlays...........................          -4
---------------------------------------------------------------------------

                                

                    Child Care Entitlement to States

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1550-0-1-609      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Mandatory child care..............       1,219       1,221       1,225
00.02 Matching child care...............         846         941       1,136
00.03 Training and technical assistance.           5           5           6
                                           ---------   ---------  ----------
10.00   Total new obligations...........       2,070       2,167       2,367
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......       2,070       2,167       2,367
23.95 Total new obligations.............      -2,070      -2,167      -2,367
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

50.00   Reappropriation.................           3
      Permanent:

60.00   Appropriation...................       2,067       2,167       2,367
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       2,070       2,167       2,367
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         569         608         473
73.10 Total new obligations.............       2,070       2,167       2,367
73.20 Total outlays (gross).............      -2,028      -2,302      -2,460
73.40 Adjustments in expired accounts...          -3
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         608         473         380
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................       1,523       1,725       2,019
86.98 Outlays from permanent balances...         505         577         441
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       2,028       2,302       2,460
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       2,070       2,167       2,367
90.00 Outlays...........................       2,028       2,302       2,460
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1998 actual  1999 est.   2000 est.
Enacted/requested:
  Budget Authority..................       2,070       2,167       2,367
  Outlays...........................       2,028       2,302       2,460
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                               1,755
  Outlays...........................                               1,200
                                    ------------------------------------
Total:
  Budget Authority..................       2,070       2,167       4,122
  Outlays...........................       2,028       2,302       3,660
                                    ====================================

    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).

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1550-0-1-609      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
25.1  Advisory and assistance services..           5           5           6
41.0  Grants, subsidies, and 
        contributions...................       2,065       2,162       2,361
                                           ---------   ---------  ----------
99.9    Total new obligations...........       2,070       2,167       2,367
---------------------------------------------------------------------------

                                

                    Child Care Entitlement to States

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1550-4-1-609      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Early learning fund...............                                 600
00.02 Matching funds to States..........                               1,129
00.03 Tribal mandatory funds............                                  23
00.04 Training and technical assistance.                                   3
                                           ---------   ---------  ----------
10.00   Total new obligations...........                               1,755
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                               1,755
23.95 Total new obligations.............                              -1,755
----------------------------------------------------------------------------

    New budget authority (gross), detail:
60.00 Appropriation.....................                               1,755
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                               1,755
73.20 Total outlays (gross).............                              -1,200
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..                                 555
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................                               1,200
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                               1,755
90.00 Outlays...........................                               1,200
---------------------------------------------------------------------------

    This legislative proposal will provide child care funding for low-
income working families and provide challenge grants to communities to 
support programs to improve early learning and the quality and safety of 
child care for children ages zero to five.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1550-4-1-609      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
25.1  Advisory and assistance services..                                   3
41.0  Grants, subsidies, and 
        contributions...................                               1,752
                                           ---------   ---------  ----------
99.9    Total new obligations...........                               1,755
---------------------------------------------------------------------------

                                

    Payments to States for the Child Care and Development Block Grant

    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), to become available on October 1, [1999] 2000 and remain 
available through September 30, [2000] 2001, $1,182,672,000: Provided, 
That $19,120,000 shall be available for child care resource and referral 
and school-aged child care activities: [Provided further, That of the 
funds provided for fiscal year 1999 under Public Law 105-78, $50,000,000 
shall be reserved by the States for activities authorized under section 
658G of the Omnibus Budget Reconciliation Act of 1981 (the Child Care 
and Development Block Grant Act of 1990), such funds to be in addition 
to the amounts required to be reserved by States under such section 
658G:] Provided further, That of the funds provided for fiscal year 
[2000] 2001, $222,672,000 shall be reserved by the States for activities 
authorized under section 658G of the Omnibus Budget Reconciliation Act 
of 1981 (The Child Care and Development Block Grant Act of 1990), such 
funds to be in addition to the amounts required to be reserved by the 
States under such section 658G: Provided further, That of the funds 
provided for fiscal year [2000] 2001, $10,000,000 shall be for use by 
the Secretary for child care research, demonstration and evaluation 
activities (directly or by grants or contracts). (Department of Health 
and Human Services Appropriations Act, 1999, as included in Public Law 
105-277, section 101(f).)

[[Page 458]]

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1515-0-1-609      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Block grant payments to States....         999         997       1,180
00.02 Advisory and assistance services..           3           3           3
                                           ---------   ---------  ----------
10.00   Total new obligations...........       1,002       1,000       1,183
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......       1,002       1,000       1,183
23.95 Total new obligations.............      -1,002      -1,000      -1,183
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

40.00   Appropriation...................       1,000
42.00   Transferred from other accounts.           2
                                           ---------   ---------  ----------
43.00     Appropriation (total).........       1,002
      Permanent:

65.00   Advance appropriation (definite)                   1,000       1,183
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       1,002       1,000       1,183
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         515         410         406
73.10 Total new obligations.............       1,002       1,000       1,183
73.20 Total outlays (gross).............      -1,095      -1,004      -1,117
73.40 Adjustments in expired accounts...         -12
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         410         406         472
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority         725
86.93 Outlays from current balances.....         369         277         120
86.97 Outlays from new permanent 
        authority.......................                     727         857
86.98 Outlays from permanent balances...                                 140
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       1,095       1,004       1,117
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       1,002       1,000       1,183
90.00 Outlays...........................       1,095       1,004       1,117
---------------------------------------------------------------------------

    This appropriation helps low-income families pay for child care and 
related services and supports grants to states for child care quality 
activities.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1515-0-1-609      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
25.1  Advisory and assistance services..           3           3           3
41.0  Grants, subsidies, and 
        contributions...................         999         997       1,180
                                           ---------   ---------  ----------
99.9    Total new obligations...........       1,002       1,000       1,183
---------------------------------------------------------------------------

                                

                       Social Services Block Grant

    For making grants to States pursuant to section 2002 of the Social 
Security Act, [$1,909,000,000: Provided, That (1) notwithstanding 
section 2003(c) of such Act, as amended, the amount specified for 
allocation under such section for fiscal year 1999 shall be 
$1,909,000,000 and (2) notwithstanding subparagraph (B) of section 
404(d)(2) of such Act, the applicable percent specified under such 
subparagraph for a State to carry out State programs pursuant to title 
XX of such Act for fiscal years 1999 and 2000 shall be 10 percent] 
$2,380,000,000. (Department of Health and Human Services Appropriations 
Act, 1999, as included in Public Law 105-277, section 101(f).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1534-0-1-506      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total obligations (object class 
        41.0)...........................       2,299       1,909       2,380
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......       2,299       1,909       2,380
23.95 Total new obligations.............      -2,299      -1,909      -2,380
----------------------------------------------------------------------------

    New budget authority (gross), detail:
40.00 Appropriation.....................       2,299       1,909       2,380
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year       1,149       1,007         864
73.10 Total new obligations.............       2,299       1,909       2,380
73.20 Total outlays (gross).............      -2,441      -2,050      -2,445
73.40 Adjustments in expired accounts...                      -2
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..       1,007         864         799
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority       2,075       1,718       2,142
86.93 Outlays from current balances.....         366         332         303
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       2,441       2,050       2,445
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       2,299       1,909       2,380
90.00 Outlays...........................       2,441       2,050       2,445
---------------------------------------------------------------------------

    Social services block grant.--The proposed level will support grants 
to States for social services.

                                

                 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 [(including section 105(a)(2) of the Child Abuse 
Prevention and Treatment Act)], the Native American Programs Act of 
1974, title II of Public Law 95-266 (adoption opportunities), the 
Adoption and Safe Families Act of 1997 (Public Law 105-89), the 
Abandoned Infants Assistance Act of 1988, part B(1) of title IV and 
sections 413, 429A, 1110, and 1115 of the Social Security Act; for 
making payments under the Community Services Block Grant Act, section 
473A of the Social Security Act, and title IV of Public Law 105-285; 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, section 5 of the Torture 
Victims Relief Act of 1998 (Public Law 105-320), sections 40155, 40211 
and 40241 of Public Law 103-322 and section 126 and titles IV and V of 
Public Law 100-485, [$6,032,087,000, of which $10,000,000 shall be used 
to establish Individual Development Accounts, for the purpose of 
encouraging low-income families and individuals to acquire productive 
assets, contingent upon enactment of authorizing legislation, and] 
$6,587,953,000, of which $20,000,000, to remain available until 
September 30, [2000] 2001, shall be for grants to States for adoption 
incentive payments, as authorized by section 473A of title IV of the 
Social Security Act (42 U.S.C. 670-679); of which [$563,565,000] 
$500,000,000 shall be for making payments under the Community Services 
Block Grant Act; and of which [$4,660,000,000] $5,267,000,000 shall be 
for making payments under the Head Start Act[: Provided, That, 
notwithstanding section 640(a)(6), of the funds made available for the 
Head Start Act, $337,500,000 shall be set aside for the Head Start 
Program for Families with Infants and Toddlers (Early Head Start): 
Provided further, 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].

[[Page 459]]

    [In addition, $105,000,000, 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 1999 under section 429A(e), part 
B of title IV of the Social Security Act shall be reduced by 
$6,000,000.]
    [Funds appropriated for fiscal year 1999 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, 1999, as included in 
Public Law 105-277, section 101(f).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1536-0-1-506      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Head Start........................       4,346       4,660       5,267
      Social services programs:

        Children, youth, and families:
01.03     Runaway and homeless youth....          44          44          44
01.04     Runaway youth transitional 
            living......................          15          15          20
01.07     Child abuse state grants......          21          21          21
01.08     Child abuse discretionary 
            grants......................          14          14          14
01.09     Community based resource 
            centers.....................          33          33          33
01.11     Abandoned infants assistance..          12          12          12
01.14     Child welfare services........         291         292         292
01.15     Child welfare training........           6           7           7
01.16     Adoption Initiative...........                      20          20
01.17     Adoption opportunities........          23          25          27
01.19     Family violence grants........          10
01.20     Social services and income 
            maintenance research........          26          27           6
        Developmental disabilities:
01.23     State grants..................          65          65          65
01.24     Protection and advocacy.......          27          27          27
01.25     Special projects..............           5          10          10
01.26     University affiliated projects          17          17          17
01.28   Native American programs........          37          35          35
                                           ---------   ---------  ----------
01.91     Subtotal social services 
            programs....................         646         664         648
02.01 ACF Federal administration........         143         144         151
                                           ---------   ---------  ----------
02.93   Total Head Start, social 
          services programs, Federal 
          administration................       5,135       5,468       6,068
      Community services programs:

03.01   Community services block grants.         490         500         500
03.03   Community food and nutrition....           4           5
03.04   Community services discretionary          33          34
03.05   National youth sports...........          14          15
03.06 Individual development accounts...                      10          20
                                           ---------   ---------  ----------
03.91   Subtotal, community services....         541         564         520
                                           ---------   ---------  ----------
04.00   Total direct programs...........       5,676       6,032       6,588
09.01 Reimbursable program..............          13          13          13
                                           ---------   ---------  ----------
10.00   Total new obligations...........       5,689       6,045       6,601
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................           3
22.00 New budget authority (gross)......       5,689       6,045       6,601
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       5,692       6,045       6,601
23.95 Total new obligations.............      -5,689      -6,045      -6,601
23.98 Unobligated balance expiring......          -2
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

40.00   Appropriation...................       5,683       6,032       6,588
41.00   Transferred to other accounts...          -6
                                           ---------   ---------  ----------
43.00     Appropriation (total).........       5,677       6,032       6,588
      Permanent:

68.00   Spending authority from 
          offsetting collections: 
          Offsetting collections (cash).          13          13          13
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       5,690       6,045       6,601
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year       3,605       3,951       4,097
73.10 Total new obligations.............       5,689       6,045       6,601
73.20 Total outlays (gross).............      -5,342      -5,854      -6,223
73.40 Adjustments in expired accounts...          -1         -45
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..       3,951       4,097       4,475
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority       2,384       2,463       2,688
86.93 Outlays from current balances.....       2,945       3,378       3,522
86.97 Outlays from new permanent 
        authority.......................          13          13          13
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       5,342       5,854       6,223
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........         -13         -13         -13
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       5,676       6,032       6,588
90.00 Outlays...........................       5,329       5,841       6,210
---------------------------------------------------------------------------

    Head Start.--The proposed level will enable Head Start projects to 
continue comprehensive early childhood development services and is 
consistent with the President's goal to serve 1 million children by 
2002, including a doubling of the number of infants and toddlers in 
Early Head Start. The proposed level will allow Head Start to expand 
beyond the 1999 enrollment level of 835,000 slots, adding 35,000 pre-
school slots and 7,000 Early Head Start slots in 2000, for total 
enrollment of 877,000.

    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.

    Adoption Incentive Payments.--The proposed level includes $20 
million for bonus payments to States that increase the number of 
children adopted from the foster care system.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1536-0-1-506      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........          90          92          95
11.3      Other than full-time permanent           2           1           1
                                           ---------   ---------  ----------
11.9        Total personnel compensation          92          93          96
12.1    Civilian personnel benefits.....          16          17          17
21.0    Travel and transportation of 
          persons.......................           2           2           3
23.1    Rental payments to GSA..........          12          13          14
23.3    Communications, utilities, and 
          miscellaneous charges.........           2           2           2
24.0    Printing and reproduction.......           1           1           2
25.1    Advisory and assistance services          64          64          57
25.2    Other services..................           6           5           4
25.3    Purchases of goods and services 
          from Government accounts......          19          15          15
25.7    Operation and maintenance of 
          equipment.....................           1           2           2
31.0    Equipment.......................           3           1           1
41.0    Grants, subsidies, and 
          contributions.................       5,458       5,817       6,375
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..       5,676       6,032       6,588
99.0  Reimbursable obligations..........          13          13          13
                                           ---------   ---------  ----------
99.9    Total new obligations...........       5,689       6,045       6,601
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-1536-0-1-506      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
1001  Total compensable workyears: Full-
        time equivalent employment......       1,569       1,530       1,510
---------------------------------------------------------------------------

                                

                    Violent Crime Reduction Programs

    For activities authorized by sections 40155, 40211, and 40241 of 
Public Law 103-322, $118,500,000, to remain available until expended, of 
which $101,000,000 shall be derived from the Violent Crime Reduction 
Trust Fund: Provided, That $102,300,000 shall be for Family Violence 
(including 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.

[[Page 460]]

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8605-0-1-754      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Family violence/battered women's 
        shelters and domestic violence 
        hotline.........................          77          90         104
00.02 Education and prevention grants to 
        reduce sexual abuse of runaway, 
        homeless and street youth.......          15          15          15
                                           ---------   ---------  ----------
10.00   Total new obligations...........          92         105         119
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......          93         105         119
23.95 Total new obligations.............         -92        -105        -119
23.98 Unobligated balance expiring......          -1
----------------------------------------------------------------------------

    New budget authority (gross), detail:
40.00 Appropriation.....................                                  18
42.00 Transferred from other accounts...          93         105         101
                                           ---------   ---------  ----------
43.00   Appropriation (total)...........          93         105         119
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year          28          82         108
73.10 Total new obligations.............          92         105         119
73.20 Total outlays (gross).............         -39         -79        -105
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..          82         108         122
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority          17          19          21
86.93 Outlays from current balances.....          22          60          84
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........          39          79         105
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................          93         105         119
90.00 Outlays...........................          39          79         105
---------------------------------------------------------------------------

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8605-0-1-754      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
25.1  Advisory and assistance services..           2           2           2
41.0  Grants, subsidies, and 
        contributions...................          90         103         117
                                           ---------   ---------  ----------
99.9    Total new obligations...........          92         105         119
---------------------------------------------------------------------------

                                

              Children's Research and Technical Assistance 

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1553-0-1-609      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Training and technical assistance.          13          14          13
00.02 Federal parent locator service....          35          30          28
00.03 Child welfare study...............                                   6
00.04 Welfare research..................                                  15
00.05 Evaluation of welfare to work.....           9           9
00.06 Evaluation of abstinence education           3           3
09.01 Reimbursable program..............           3           3           3
                                           ---------   ---------  ----------
09.09   Reimbursable program--subtotal 
          line..........................           3           3           3
                                           ---------   ---------  ----------
10.00   Total new obligations...........          63          59          65
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          11           4
22.00 New budget authority (gross)......          56          55          65
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......          67          59          65
23.95 Total new obligations.............         -63         -59         -65
24.40 Unobligated balance available, end 
        of year.........................           4
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

41.00   Transferred to other accounts...          -2
      Permanent:

60.00   Appropriation...................          55          52          62
68.00   Spending authority from 
          offsetting collections: 
          Offsetting collections (cash).           3           3           3
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................          56          55          65
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year          40          65          72
73.10 Total new obligations.............          63          59          65
73.20 Total outlays (gross).............         -38         -52         -58
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..          65          72          79
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................          25          12          48
86.98 Outlays from permanent balances...          13          40          10
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........          38          52          58
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.40   Offsetting collections (cash) 
          from: Non-Federal sources.....          -3          -3          -3
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................          53          52          62
90.00 Outlays...........................          35          49          55
---------------------------------------------------------------------------

    This account 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.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1553-0-1-609      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

      Direct obligations:

21.0    Travel and transportation of 
          persons.......................           1           1           1
23.3    Communications, utilities, and 
          miscellaneous charges.........           1           1           1
25.1    Advisory and assistance services          14          14          11
25.2    Other services..................          19          14          14
25.3    Purchases of goods and services 
          from Government accounts......          19          20          17
25.7    Operation and maintenance of 
          equipment.....................           3           3           3
31.0    Equipment.......................           1           1           1
41.0    Grants, subsidies, and 
          contributions.................           2           2          14
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..          60          56          62
99.0  Reimbursable obligations..........           3           3           3
                                           ---------   ---------  ----------
99.9    Total new obligations...........          63          59          65
---------------------------------------------------------------------------

                                

       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, [$3,764,000,000] $4,272,000,000.
    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 [2000, $1,355,000,000] 2001, $1,538,000,000. (Department of Health 
and Human Services Appropriations Act, 1999, as included in Public Law 
105-277, section 101(f).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1545-0-1-506      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Foster care.......................       3,540       3,983       4,537
00.02 Independent living................          70          70          70
00.03 Adoption assistance...............         701         869       1,020
                                           ---------   ---------  ----------
10.00   Total obligations (object class 
          41.0).........................       4,311       4,922       5,627
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......       4,311       4,922       5,627
23.95 Total new obligations.............      -4,311      -4,922      -5,627
----------------------------------------------------------------------------

[[Page 461]]



    New budget authority (gross), detail:
      Current:

40.00   Appropriation...................       3,200       3,764       4,272
      Permanent:

65.00   Advance appropriation (definite)       1,111       1,158       1,355
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       4,311       4,922       5,627
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         829         688         673
73.10 Total new obligations.............       4,311       4,922       5,627
73.20 Total outlays (gross).............      -4,451      -4,939      -5,485
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         688         673         815
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority       2,868       3,309       3,730
86.93 Outlays from current balances.....         629         613         580
86.97 Outlays from new permanent 
        authority.......................         954       1,017       1,175
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       4,451       4,939       5,485
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       4,311       4,922       5,627
90.00 Outlays...........................       4,451       4,939       5,485
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1998 actual  1999 est.   2000 est.
Enacted/requested:
  Budget Authority..................       4,311       4,922       5,627
  Outlays...........................       4,451       4,939       5,485
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                                  40
  Outlays...........................                                   6
                                    ------------------------------------
Total:
  Budget Authority..................       4,311       4,922       5,667
  Outlays...........................       4,451       4,939       5,491
                                    ====================================

    Foster care.--The proposed level will support eligible low-income 
children who must be placed outside the home. An average of 339,000 
children per month will be served in 2000.

    Adoption assistance.--The proposed funding level will support 
subsidies for families adopting eligible low-income children with 
special needs. An average of 217,000 children per month will be served 
in 2000.

                                

       Payments to States for Foster Care and Adoption Assistance

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1545-4-1-506      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Independent living................                                  35
00.02 Grants to support transitional 
        living expenses.................                                   5
                                           ---------   ---------  ----------
10.00   Total obligations (object class 
          41.0).........................                                  40
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                  40
23.95 Total new obligations.............                                 -40
----------------------------------------------------------------------------

    New budget authority (gross), detail:
40.00 Appropriation.....................                                  40
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                  40
73.20 Total outlays (gross).............                                  -6
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..                                  36
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority                                   6
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                  40
90.00 Outlays...........................                                   6
---------------------------------------------------------------------------

    This proposal assists children aging out of the foster care system 
by providing additional funding for supportive services under the 
Independent Living Program and grants to States to fund the living 
expenses of children in transitional living programs.

                                


 
                         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, and [sections 339A,] section 398[, 
and 399] of the Public Health Service Act, [$882,020,000: Provided, That 
notwithstanding section 308(b)(1) of the Older Americans Act of 1965, as 
amended, 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] $923,055,000: 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, Alaska and 
Hawaiian Native communities to be served. (Department of Health and 
Human Services Appropriations Act, 1999, as included in Public Law 105-
277, section 101(f).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0142-0-1-506      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
01.01 Supportive services and centers...         300         300         300
01.02 Preventive health.................          16          16          16
01.05 Congregate meals..................         374         374         374
01.06 Home-delivered meals..............         112         112         147
01.07 In-home services..................          10          10          10
01.08 Grants to Indian tribes...........          18          18          18
01.09 State and local innovations and 
        projects of national 
        significance....................          10          18          18
01.10 Federal administration............          15          15          17
01.12 Health disparities interventions..                                   4
01.13 Alzheimer's disease demonstration 
        grants to States................                       6           6
01.14 Grants to States for the 
        protection of vulnerable older 
        Americans.......................           9          12          12
                                           ---------   ---------  ----------
10.00   Total new obligations...........         865         882         923
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......         865         882         923
23.95 Total new obligations.............        -865        -882        -923
----------------------------------------------------------------------------

    New budget authority (gross), detail:
40.00 Appropriation.....................         865         882         923
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         223         260         279
73.10 Total new obligations.............         865         882         923
73.20 Total outlays (gross).............        -828        -864        -890
73.40 Adjustments in expired accounts...          -1
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         260         279         312
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority         622         621         647
86.93 Outlays from current balances.....         206         243         243
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         828         864         890
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         865         882         923
90.00 Outlays...........................         828         864         890
---------------------------------------------------------------------------

[[Page 462]]



                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1998 actual  1999 est.   2000 est.
Enacted/requested:
  Budget Authority..................         865         882         923
  Outlays...........................         828         864         890
Legislative proposal, not subject to 
    PAYGO:
  Budget Authority..................                                 125
  Outlays...........................                                  81
                                    ------------------------------------
Total:
  Budget Authority..................         865         882       1,048
  Outlays...........................         828         864         971
                                    ====================================

    Administration on Aging.--The proposed level will 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      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
11.1  Personnel compensation: Full-time 
        permanent.......................           9           9          10
12.1  Civilian personnel benefits.......           1           2           2
23.1  Rental payments to GSA............           1           1           1
25.2  Other services....................           4           4           5
41.0  Grants, subsidies, and 
        contributions...................         850         866         905
                                           ---------   ---------  ----------
99.9    Total new obligations...........         865         882         923
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0142-0-1-506      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: Full-
        time equivalent employment......         120         130         142
    Allocation account:
3001  Total compensable workyears: Full-
        time equivalent employment......           1           4          13
---------------------------------------------------------------------------

                                

                         Aging Services Programs

              (Legislative proposal, not subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0142-2-1-506      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
01.01 Formula grants to states..........                                 110
01.02 Competitive innovation grants.....                                  13
01.03 Collaborative national activities.                                   2
                                           ---------   ---------  ----------
10.00   Total new obligations...........                                 125
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                 125
23.95 Total new obligations.............                                -125
----------------------------------------------------------------------------

    New budget authority (gross), detail:
40.00 Appropriation.....................                                 125
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                 125
73.20 Total outlays (gross).............                                 -81
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..                                  44
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority                                  81
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                 125
90.00 Outlays...........................                                  81
---------------------------------------------------------------------------

    This legislative proposal will establish a state grant program to 
support families that care for elderly relatives who are chronically ill 
or disabled. Funded activities will include information, education, 
counseling, and respite services.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0142-2-1-506      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
25.1  Advisory and assistance services..                                   2
41.0  Grants, subsidies, and 
        contributions...................                                 123
                                           ---------   ---------  ----------
99.9    Total new obligations...........                                 125
---------------------------------------------------------------------------

                                


 
                         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 the 
United States-Mexico Border Health Commission Act, [$180,051,000] 
$185,561,000, together with [$5,851,000] $6,851,000, 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, $1,000,000 shall be available until expended for extramural 
construction: Provided further, That $890,000 shall be for a contract 
with the National Academy of Sciences to conduct a study of all the 
available scientific literature examining the cause-and-effect 
relationship between repetitive tasks in the workplace and 
musculoskeletal disorders: Provided further, That said contract shall be 
awarded not later than January 1, 1999]. (Department of Health and Human 
Services Appropriations Act, 1999, as included in Public Law 105-277, 
section 101(f).)

                         Office for Civil Rights

    For expenses necessary for the Office for Civil Rights, 
[$17,345,000], $18,845,000, 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, 1999

                             Policy Research

    For carrying out, to the extent not otherwise provided, research 
studies under section 1110 of the Social Security Act, $14,000,000. 
(Department of Health and Human Services Appropriations Act, 1999, as 
included in Public Law 105-277, section 101(f).)

            Public Health and Social Services Emergency Fund

    For expenses necessary to support activities related to countering 
potential biological, disease and chemical threats to civilian 
populations, [$216,922,000: Provided, That the entire amount is hereby 
designated by Congress to be emergency requirements pursuant to section 
251(b)(2)(A) of the Balanced Budget and Emergency Deficit Control Act of 
1985, as amended: Provided further, That the entire amount shall be 
available only to the extent that an official budget request for 
$216,922,000, 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 of 1985, as amended, is transmitted by 
the President to the Congress: Provided further, That of the amount 
provided under this heading, $51,000,000, to remain available until 
expended, shall be for pharmaceutical and vaccine stockpiling activities 
at the Centers for Disease Control and Prevention; and $3,000,000 shall 
be for the renovation and modernization of the Noble Army Hospital 
facility at Fort McClellan, Alabama; and $322,000 shall be in payment to 
the health department of Calhoun County, Michigan: Provided further, 
That no funds shall be obligated until the Department of Health and 
Human Services submits an operating plan to the House and Senate 
Committees on Appropriations] $186,022,000; Provided, That this amount 
is distributed as follows: Centers for Disease Control and Prevention, 
$118,000,000; Office of the Secretary, $30,000,000; Office of Emergency 
Preparedness, $24,622,000; and Food and Drug Administration, 
$13,400,000: Provided further, That the Secretary of HHS may trans

[[Page 463]]

fer some or all of these funds to other Department of Health and Human 
Services accounts in this title to carry out these purposes. In 
addition, $50,000,000 shall be made available for minority AIDS 
prevention and treatment activities, and $150,000,000 shall be made 
available for the Department's Year 2000 computer conversion activities. 
(Department of Health and Human Services Appropriations Act, 1999, as 
included in Public Law 105-277, section 101(f).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9912-0-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct activities:

00.01   General departmental management.         177         186         193
00.02   Office for Civil Rights.........          20          21          22
00.03   Policy research.................          14          14          14
00.04   Public Health and Social 
          Services Emergency Fund.......           1         425         386
09.01 Reimbursable program..............          78          88          88
                                           ---------   ---------  ----------
10.00   Total new obligations...........         290         734         703
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          25          20
22.00 New budget authority (gross)......         295         713         702
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................           1
22.21 Unobligated balance transferred to 
        other accounts..................          -6
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         315         733         702
23.95 Total new obligations.............        -290        -734        -703
23.98 Unobligated balance expiring......          -5
24.40 Unobligated balance available, end 
        of year.........................          20
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

40.00   Appropriation...................         202         428         604
41.00   Transferred to other accounts...                      -1
42.00   Transferred from other accounts.                     189
                                           ---------   ---------  ----------
43.00     Appropriation (total).........         202         616         604
      Permanent:

        Spending authority from 
            offsetting collections:
68.00     Offsetting collections (cash).          48          97          98
68.10     From Federal sources: Change 
            in receivables and unpaid, 
            unfilled orders.............          45
                                           ---------   ---------  ----------
68.90       Spending authority from 
              offsetting collections 
              (total)...................          93          97          98
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................         295         713         702
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         196         193         365
73.10 Total new obligations.............         290         734         703
73.20 Total outlays (gross).............        -239        -562        -623
73.40 Adjustments in expired accounts...          -7
73.45 Adjustments in unexpired accounts.          -1
      Unpaid obligations, end of year:

74.40   Obligated balance, end of year..         193         365         445
74.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............          45
                                           ---------   ---------  ----------
74.99     Total unpaid obligations, end 
            of year.....................         238         365         445
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority         128         352         314
86.93 Outlays from current balances.....          63         114         210
86.97 Outlays from new permanent 
        authority.......................          48          97          98
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         239         562         623
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........         -48         -97         -98
88.95 From Federal sources: Change in 
        receivables and unpaid, unfilled 
        orders..........................         -45
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         202         616         604
90.00 Outlays...........................         191         465         525
---------------------------------------------------------------------------

                          [Dollars in millions]

                                     1998 actual  1999 est.   2000 est.
Distribution of budget authority by 
    account:
  General departmental management...         171         180         186
  Office for Civil Rights...........          16          17          19
  Policy research...................          14          14          14
  Public Health and Social Services 
    Emergency Fund..................                     406         386
    Year 2000 computer conversion...                     189         150
    Bioterrorism....................                     134         186
    Minority AIDS/Other.............                      83          50
Distribution of outlays by account:
  General departmental management...         170         189         187
  Office for Civil Rights...........          15          19          19
  Policy research...................           5          15          14
  Public Health and Social Services 
    Emergency Fund..................           1         242         305

    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; 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.

    The Public Health and Social Services Emergency Fund supports three 
main activities in both the FY 1999 appropriation and FY 2000 Budget: 
Year 2000 computer conversion, preparing for and responding to the 
medical and public health consequences of potential bioterrorist events, 
and minority AIDS prevention and treatment. In FY 1999, $189,053,000 was 
appropriated for Year 2000 computer conversion activities; $133,600,000 
was provided for bioterrorism activities; and $50,000,000 for minority 
AIDS prevention and treatment. In FY 2000, a total of $150,000,000 is 
provided for HHS' Year 2000 computer conversion activities; $186,022,000 
is provided for bioterrorism; and $50,000,000 is provided for minority 
AIDS prevention and treatment.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9912-0-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........          78          89         100
11.3      Other than full-time permanent           3           3           3
11.5      Other personnel compensation..           1           2           4
                                           ---------   ---------  ----------
11.9        Total personnel compensation          82          94         107
12.1    Civilian personnel benefits.....          16          18          20
21.0    Travel and transportation of 
          persons.......................           2           5           9
23.1    Rental payments to GSA..........          13          14          15
23.2    Rental payments to others.......                       1           2
23.3    Communications, utilities, and 
          miscellaneous charges.........           4           5           5
24.0    Printing and reproduction.......           1           1           2
25.1    Advisory and assistance services                      18           1
25.2    Other services..................          13          42          48
25.3    Purchases of goods and services 
          from Government accounts......          20          29          32
25.4    Operation and maintenance of 
          facilities....................           3           3           4
25.5    Research and development 
          contracts.....................           6          12          42
25.6    Medical care....................                      99         121
25.7    Operation and maintenance of 
          equipment.....................           3          11           6
26.0    Supplies and materials..........           1          58          58
31.0    Equipment.......................           4          44          15
41.0    Grants, subsidies, and 
          contributions.................          44         192         128
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..         212         646         615
99.0  Reimbursable obligations..........          78          88          88
                                           ---------   ---------  ----------
99.9    Total new obligations...........         290         734         703
---------------------------------------------------------------------------

[[Page 464]]



                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-9912-0-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: Full-
        time equivalent employment......       1,239       1,344       1,444
    Reimbursable:
2001  Total compensable workyears: Full-
        time equivalent employment......         155         167         167
    Allocation account:
3001  Total compensable workyears: Full-
        time equivalent employment......          20          24          28
---------------------------------------------------------------------------

                                

                Public Health Services for the Uninsured

              (Legislative proposal, not subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0138-2-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations (object 
        class 41.0).....................                                  25
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                  25
23.95 Total new obligations.............                                 -25
----------------------------------------------------------------------------

    New budget authority (gross), detail:
40.00 Appropriation.....................                                  25
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                  25
73.20 Total outlays (gross).............                                  -4
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..                                  21
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority                                   4
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                  25
90.00 Outlays...........................                                   4
---------------------------------------------------------------------------

    The public health initiative will assist communities and safety-net 
providers to develop and expand integrated care systems to improve 
quality standards and accessibility to health care for the uninsured. By 
coordinating service delivery and establishing accountability within the 
health care system, the initiative will assure adequate patient care, 
improve the quality of care provided, and allow more uninsured people to 
get health services.

                                

                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, for payments under the 
Retired Serviceman's Family Protection Plan and Survivor Benefit Plan, 
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, 1999, as 
included in Public Law 105-277, section 101(f).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0379-0-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Retirement payments...............         150         159         172
00.02 Survivors' benefits...............          11          12          12
00.03 Medical care......................          28          29          30
00.04 Military service credits..........           2           2           1
                                           ---------   ---------  ----------
10.00   Total new obligations...........         191         202         215
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......         191         202         215
23.95 Total new obligations.............        -191        -202        -215
----------------------------------------------------------------------------

    New budget authority (gross), detail:
40.05 Appropriation (indefinite)........         191         202         215
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year          19          23          26
73.10 Total new obligations.............         191         202         215
73.20 Total outlays (gross).............        -186        -201        -213
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..          23          26          29
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority         173         183         195
86.93 Outlays from current balances.....          13          16          18
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         186         201         213
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         191         202         215
90.00 Outlays...........................         186         201         213
---------------------------------------------------------------------------

    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      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
13.0  Benefits for former personnel.....         161         171         184
25.2  Other services....................          28          29          30
25.3  Purchases of goods and services 
        from Government accounts........           2           2           1
                                           ---------   ---------  ----------
99.9    Total new obligations...........         191         202         215
---------------------------------------------------------------------------

                                

                         Health Activities Funds

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9913-0-1-552      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year          10          10           9
73.20 Total outlays (gross).............          -1          -1          -1
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..          10           9           8
----------------------------------------------------------------------------

    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.

[[Page 465]]

                                

Intragovernmental funds:

                      HHS Service and Supply Fund 

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9941-0-4-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
09.01 Program support center............         281         271         282
09.02 Federal employee occupational 
        health..........................          84         103         120
09.03 OS activities.....................           7           7           7
                                           ---------   ---------  ----------
10.00   Total new obligations...........         372         381         409
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          42          35          35
22.00 New budget authority (gross)......         359         381         409
22.22 Unobligated balance transferred 
        from other accounts.............           6
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         407         416         444
23.95 Total new obligations.............        -372        -381        -409
24.40 Unobligated balance available, end 
        of year.........................          35          35          35
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Spending authority from offsetting 
          collections:

68.00   Offsetting collections (cash)...         317         381         409
68.10   From Federal sources: Change in 
          receivables and unpaid, 
          unfilled orders...............          42
                                           ---------   ---------  ----------
68.90     Spending authority from 
            offsetting collections 
            (total).....................         359         381         409
----------------------------------------------------------------------------

    Change in unpaid obligations:
      Unpaid obligations, start of year:

72.40   Obligated balance, start of year         -14         -41
72.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............         131         173         173
                                           ---------   ---------  ----------
72.99     Total unpaid obligations, 
            start of year...............         117         132         173
73.10 Total new obligations.............         372         381         409
73.20 Total outlays (gross).............        -357        -340        -409
      Unpaid obligations, end of year:

74.40   Obligated balance, end of year..         -41
74.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............         173         173         173
                                           ---------   ---------  ----------
74.99     Total unpaid obligations, end 
            of year.....................         132         173         173
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................         359         381         409
86.98 Outlays from permanent balances...          -2         -41
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         357         340         409
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........        -317        -381        -409
88.95 From Federal sources: Change in 
        receivables and unpaid, unfilled 
        orders..........................         -42
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................          41         -41
---------------------------------------------------------------------------

    The HHS Service and Supply Fund (SSF) provides common centralized 
services to HHS components. The Program Support Center (PSC) line 
includes activities such as personnel and payroll administration, 
financial management operations, and a wide array of administrative 
services, including acquisitions management, building and property 
management, and technical support. The Office of the Secretary (OS) 
activities line includes the fund manager, departmental contracts and 
grants, audit resolution, OS graphics, and the regional health 
administrators. The Federal Employee Occupational Health (FOH) program 
is also funded through the SSF. FOH includes clinical services, 
environmental health services and employee assistance programs.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9941-0-4-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

      Personnel compensation:

11.1    Full-time permanent.............          54          60          62
11.3    Other than full-time permanent..           9           9          10
11.5    Other personnel compensation....           3           3           3
                                           ---------   ---------  ----------
11.9      Total personnel compensation..          66          72          75
12.1  Civilian personnel benefits.......          14          15          16
21.0  Travel and transportation of 
        persons.........................           2           3           4
22.0  Transportation of things..........           2           2           2
23.1  Rental payments to GSA............          10          12          12
23.3  Communications, utilities, and 
        miscellaneous charges...........          35          39          41
24.0  Printing and reproduction.........           1           1           1
25.1  Advisory and assistance services..           8           7           7
25.2  Other services....................         102         103         113
25.3  Purchases of goods and services 
        from Government accounts........          25          25          26
26.0  Supplies and materials............          98          96         105
31.0  Equipment.........................           9           6           7
                                           ---------   ---------  ----------
99.9    Total new obligations...........         372         381         409
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-9941-0-4-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
2001  Total compensable workyears: Full-
        time equivalent employment......       1,216       1,260       1,260
---------------------------------------------------------------------------

                                

                               Trust Funds

                        Miscellaneous Trust Funds

              Unavailable Collections (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9971-0-7-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Balance, start of year:
01.99 Balance, start of year............
    Receipts:
02.01 Contributions, Indian health 
        facilities, Health Services 
        Administration..................          35          35          35
02.02 Gifts and contributions, 
        Miscellaneous trust funds.......          17          17          17
02.03 Interest, Miscellaneous trust 
        funds...........................           1           1           1
                                           ---------   ---------  ----------
02.99   Total receipts..................          53          53          53
    Appropriation:
05.01 Miscellaneous trust funds.........         -53         -53         -53
07.99 Total balance, end of year........
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9971-0-7-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.02 Gifts.............................          25          18          18
00.03 Contributions, Indian health 
        facilities......................          42          35          35
                                           ---------   ---------  ----------
10.00   Total new obligations...........          67          53          53
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          37          27          27
22.00 New budget authority (gross)......          53          53          53
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................           4
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......          94          80          80
23.95 Total new obligations.............         -67         -53         -53
24.40 Unobligated balance available, end 
        of year.........................          27          27          27
----------------------------------------------------------------------------

    New budget authority (gross), detail:
60.27 Appropriation (trust fund, 
        indefinite).....................          53          53          53
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year          88          96         103
73.10 Total new obligations.............          67          53          53
73.20 Total outlays (gross).............         -56         -46         -48
73.45 Adjustments in unexpired accounts.          -4
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..          96         103         108
----------------------------------------------------------------------------

[[Page 466]]



    Outlays (gross), detail:
86.97 Outlays from new permanent 
        authority.......................          13          12          12
86.98 Outlays from permanent balances...          43          34          36
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........          56          46          48
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................          53          53          53
90.00 Outlays...........................          56          46          48
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.01 Total investments, start of year: 
        U.S. securities: Par value......          14          13          13
92.02 Total investments, end of year: 
        U.S. securities: Par value......          13          13          13
---------------------------------------------------------------------------

                          [Dollars in millions]

                                        1998         1999        2000
Distribution of budget authority by 
    account:
  Gifts.............................          18          18          18
  Contributions, Indian health 
    facilities......................          35          35          35
Distribution of outlays by account:
  Gifts.............................          16          17          18
  Contributions, Indian health 
    facilities......................          40          29          30

    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      1998 actual   1999 est.   2000 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..........           2           2           2
25.2  Other services....................           3           2           2
25.3  Purchases of goods and services 
        from Government accounts........           1           1           1
25.4  Operation and maintenance of 
        facilities......................           6           3           3
25.5  Research and development contracts           3           3           3
25.7  Operation and maintenance of 
        equipment.......................          13          12          12
26.0  Supplies and materials............           5           2           2
31.0  Equipment.........................           1
32.0  Land and structures...............          16          14          14
41.0  Grants, subsidies, and 
        contributions...................          10           7           7
                                           ---------   ---------  ----------
99.9    Total new obligations...........          67          53          53
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-9971-0-7-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
1001  Total compensable workyears: Full-
        time equivalent employment......          76          76          76
---------------------------------------------------------------------------

                                


 
                     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, [$29,000,000] $31,500,000. (Department of Health and Human 
Services Appropriations Act, 1999, as included in Public Law 105-277, 
section 101(f).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0128-0-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Direct program....................          32          29          32
09.01 Reimbursable program..............           9          14          14
                                           ---------   ---------  ----------
10.00   Total new obligations...........          41          43          46
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................           1           1           1
22.00 New budget authority (gross)......          41          43          46
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......          42          44          47
23.95 Total new obligations.............         -41         -43         -46
24.40 Unobligated balance available, end 
        of year.........................           1           1           1
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Current:

40.00   Appropriation...................          32          29          32
      Permanent:

68.00   Spending authority from 
          offsetting collections: 
          Offsetting collections (cash).           9          14          14
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................          41          43          46
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year          13           3           4
73.10 Total new obligations.............          41          43          46
73.20 Total outlays (gross).............         -50         -42         -46
73.40 Adjustments in expired accounts...          -1                      -1
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..           3           4           3
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new current authority          31          26          29
86.93 Outlays from current balances.....          10           2           3
86.97 Outlays from new permanent 
        authority.......................           9          14          14
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........          50          42          46
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........          -9         -14         -14
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................          32          29          32
90.00 Outlays...........................          41          28          32
---------------------------------------------------------------------------

    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 (OIG), the Health Insurance Portability 
and Accountability Act of 1996 makes available mandatory funding for use 
by the OIG 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 
OIG:

                          (In millions of dollars)

                                         1998 actual   1999 est.   2000 est.
Budget Authority:
  Discretionary appropriations..........          32          29          32
  Mandatory (HCFAC Account).............          72         100         120
                                           ---------   ---------  ----------
      Total.............................         104         129         152
Outlays:
  Discretionary appropriations..........          41          28          32
  Mandatory (HCFAC Account).............          66         100         120
                                           ---------   ---------  ----------
      Total.............................         107         128         152

    This schedule reflects estimated distribution of mandatory funds 
from the HCFAC account in FY 2000. Actual FY 2000 distribution will be 
determined by the Secretary of HHS and the Attorney General.

[[Page 467]]

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0128-0-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------

      Direct obligations:

11.1    Personnel compensation: Full-
          time permanent................          19          18          19
12.1    Civilian personnel benefits.....           4           4           4
21.0    Travel and transportation of 
          persons.......................           2           2           2
23.1    Rental payments to GSA..........           2           2           2
25.3    Purchases of goods and services 
          from Government accounts......           4           3           4
31.0    Equipment.......................           1                       1
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..          32          29          32
99.0  Reimbursable obligations..........           9          14          14
                                           ---------   ---------  ----------
99.9    Total new obligations...........          41          43          46
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0128-0-1-551      1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: Full-
        time equivalent employment......         312         283         292
    Reimbursable:
2001  Total compensable workyears: Full-
        time equivalent employment......          20          59          56
    Allocation account:
3001  Total compensable workyears: Full-
        time equivalent employment......         834         963       1,060
---------------------------------------------------------------------------

                                

                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.''

                                


 
                      GENERAL FUND RECEIPT ACCOUNTS

                           (in millions of dollars)

----------------------------------------------------------------------------
                                         1998 actual   1999 est.   2000 est.
----------------------------------------------------------------------------
Offsetting receipts from the public:
  75-310700  Federal share of child 
    support collections.................       1,007         945         965
    Legislative proposal, subject to 
      PAYGO.............................                                  65
                                           ---------   ---------  ----------
General Fund Offsetting receipts from 
 the public.............................       1,007         945       1,030
---------------------------------------------------------------------------

                                


 
                           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 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 Executive Level III.
    Sec. 205. [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.] 
Notwithstanding section 241(a) of the Public Health Service Act, such 
portion as the Secretary shall determine, but not more than 1.5 percent, 
of any amounts appropriated for programs authorized under the PHS Act 
shall be made available for the evaluation (directly, or by grants or 
contracts) of the implementation and effectiveness of such programs.
    [Sec. 206. None of the funds appropriated in this Act or subsequent 
Departments of Labor, Health and Human Services, and Education, and 
Related Agencies Appropriations Acts, 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. [207] 206. 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 (except the Public 
Health and Social Services Emergency Fund) shall be increased by more 
than 3 percent by any such transfer: Provided, That the Appropriations 
Committees of both Houses of Congress are notified at least fifteen days 
in advance of any transfer.
    Sec. [208] 207. 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.
    [Sec. 209. 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. 210. Funds appropriated in this Act or subsequent Departments 
of Labor, Health and Human Services, and Education, and Related Agencies 
Appropriations Acts, for the National Institutes of Health may be used 
to provide transit subsidies in amounts consistent with the 
transportation subsidy programs authorized under section 629 of Public 
Law 101-509 to non-FTE bearing positions including trainees, visiting 
fellows and volunteers.]
    Sec. [211] 208. None of the funds appropriated in this Act may be 
made available to any entity under title X of the Public Health Service 
Act unless the applicant for the award certifies to the Secretary that 
it encourages family participation in the decision of minors to seek 
family planning services and that it provides counseling to minors on 
how to resist attempts to coerce minors into engaging in sexual 
activities.
    [Sec. 212. Subsection (b)(1)(H) of section 401 of the Public Health 
Service Act (42 U.S.C. 281 (b)(1)(H)) is amended by striking ``National 
Institute of Dental Research'' and inserting ``National Institute of 
Dental and Craniofacial Research''.]
    Sec. [213. (a) The final rule entitled ``Organ Procurement and 
Transplantation Network'', promulgated by the Secretary of Health and 
Human Services on April 2, 1998 (63 FR 16295 et seq.) (relating to part 
121 of title 42, Code of Federal Regulations), shall not become 
effective before the expiration of the 1-year period beginning on the 
date of the enactment of this Act.
    (b)(1) The Institute of Medicine under contract with and subject to 
review by the Comptroller General, in consultation with the Secretary 
and with the Organ Procurement and Transplantation Network (in this 
section referred to as the ``OPTN''), shall conduct a review of the 
current polices of the OPTN and the final rule specified in subsection 
(a) in order to determine the following:
        (A) The potential impact on access to transplantation services 
    for low-income populations and for racial and ethnic minority 
    groups. With respect to State policies in carrying out the program 
    under title XIX of the Social Security Act, the determination made 
    under this subparagraph shall include determining the impact of such 
    policies regarding payment for services for patients that are 
    provided to the patients outside of the States in which the patients 
    reside.
        (B) With respect to organ procurement organizations (qualified 
    under section 371 of the Public Health Service Act):

[[Page 468]]

                (i) The potential impact on the ability of the 
            organizations to facilitate an appropriate rate of organ 
            donation within the service areas of the organizations.
                (ii) The reasons underlying the variations in 
            performance among such organizations.
                (iii) The potential impact of requiring sharing of 
            organs based on medical criteria instead of geography on the 
            ability of the organizations to facilitate an appropriate 
            rate of organ donation within the service areas of the 
            organizations.
        (C) The potential impact on waiting times for organ transplants, 
    including determinations specific to the various geographic regions 
    of the United States, and if practicable, waiting times for each 
    transplant center by organ and medical status category. The 
    determination made under this subparagraph shall include determining 
    the impact of recent changes made by the OPTN in patient listing 
    criteria and in measures of medical status.
        (D) The potential impact on patient survival rates and organ 
    failure rates which lead to retransplantation, including any 
    variance by income status, ethnicity, gender, race, or blood type.
        (E) The potential impact on the costs of organ transplantation 
    services.
        (F) The potential impact on the liability, under State laws and 
    procedures regarding peer review, of members of the OPTN.
        (G) The potential impact on the confidential status of 
    information that relates to the transplantation of organs.
        (H) Recommendations, if any, to change existing policies and the 
    final rule.
    (2)(A) Not later than May 1, 1999, the Comptroller General of the 
United States shall submit to the congressional committees specified in 
subparagraph (B) a report describing the results of the review conducted 
under paragraph (1).
    (B) The congressional committees referred to in subparagraph (A) are 
the Committee on Commerce of the House of Representatives, the Committee 
on Appropriations of the House, the Committee on Labor and Human 
Resources of the Senate, and the Committee on Appropriations of the 
Senate.
    (c)(1) Beginning promptly after the date of the enactment of this 
Act, the Secretary may conduct a series of discussions with the OPTN in 
order to resolve issues raised by the final rule referred to in 
subsection (a).
    (2) The Secretary and the OPTN may utilize the services of a 
mediator in conducting the discussions under paragraph (1). An 
individual may not be selected to serve as the mediator unless the 
Secretary and the OPTN both approve the selection of the individual to 
so serve, and the individual agrees that, not later than June 30, 1999, 
the individual will submit to the congressional committees specified in 
subsection (b)(2)(B) a report describing the extent of progress that has 
been made through the discussions under paragraph (1).
    (d)(1) Beginning on the date of enactment of this Act, the OPTN 
shall provide to the Secretary, the Institutes of Medicine, and the 
Comptroller General, upon request, any data necessary to assess the 
effectiveness of the Nation's organ donation, procurement and organ 
allocation systems, or to assess the quality of care provided to all 
transplant patients, and analysis of such data in a scientifically and 
clinically valid manner. If necessary, the OPTN may provide additional 
data as they deem appropriate.
    (2) The OPTN shall make available to the public timely and accurate 
program-specific information on the performance of transplant programs. 
These data shall be updated as frequently as possible, and the OPTN 
shall work to shorten the time period for data collection and analysis 
in producing its center-specific outcomes report, including severity 
adjusted long term survival rates. Such data shall also include such 
other cost or performance information including but not limited to 
transplant program-specific information on waiting time within medical 
status, organ waitings, and refusal of organ offers.
    (e) Data provided under subsection (d) shall be specific (if 
possible) to individual transplant centers and must be determined in a 
scientifically and clinically valid manner.
    (f) Any disclosure of patient specific medical information under 
subsection (d) shall be subject to the restrictions contained in the 
Freedom of Information Act, the Privacy Act, and State laws.
    (g) Of the amount appropriated in this title for ``Office of the 
Secretary--general departmental management'', $500,000 shall, not later 
than 30 days after the date of the enactment of this Act, be transferred 
to the Comptroller General for purposes of carrying out the studies 
required and specified in this section.
    (h) For purposes of this section:
        (1) The term ``Comptroller General'' means the Comptroller 
    General of the United States.
        (2) The term ``Organ Procurement and Transplantation Network'' 
    means the network operated under section 372 of the Public Health 
    Service Act.
        (3) The term ``Secretary'' means the Secretary of Health and 
    Human Services.] 209. (a)(1) In fiscal year 2000 and thereafter, the 
    Organ Procurement and Transplantation Network (``OPTN'') shall 
    provide to the Secretary, upon request, any data necessary to assess 
    the effectiveness of the Nation's organ donation, procurement and 
    organ allocation systems, or to assess the quality of care provided 
    to all transplant patients, and analysis of such data in a 
    scientifically and clinically valid manner. If necessary, the OPTN 
    may provide additional data as they deem appropriate.
    (2) The OPTN shall make available to the public timely and accurate 
program-specific information on the performance of transplant programs. 
These data shall be updated as frequently as possible, and the OPTN 
shall work to shorten the time period for data collection and analysis 
in producing its center-specific outcomes report, including severity 
adjusted long term survival rates. Such data shall also include such 
other cost or performance information including but not limited to 
transplant program-specific information on waiting time within medical 
status, organ waitings, and refusal of organ offers.
    (b) Data provided under subsection (a) shall be specific (if 
possible) to individual transplant centers and must be determined in a 
scientifically and clinically valid manner.
    (c) Any disclosure of patient specific medical information under 
subsection (a) shall be subject to the restrictions contained in the 
Freedom of Information Act, the Privacy Act, and State laws.
    (d) For purposes of this section:
        (1) The term ``Organ Procurement and Transportation Network'' 
    means the network operated under section 372 of the Public Health 
    Service Act.
        (2) The term ``Secretary'' means the Secretary of Health and 
    Human Services.
    [Sec. 214. (a) Section 2003(c) of the Social Security Act (42 U.S.C. 
1397b(c)) is amended by striking paragraph (8) and inserting the 
following:
        ``(8) $2,299,000,000 for the fiscal year 1998;''.
    (b) The amendment made by this section takes effect immediately 
after the amendments made by section 8401 of the Transportation Equity 
Act for the 21st Century take effect.]
    [Sec. 215. The Consolidated Laboratory Building (Building 50) at the 
National Institutes of Health is hereby named the Louis Stokes 
Laboratories.]
    Sec. [216] 210. None of the funds appropriated by this Act 
(including funds appropriated to any trust fund) may be used to carry 
out the Medicare+Choice program if the Secretary denies participation in 
such program to an otherwise eligible entity (including a Provider 
Sponsored Organization) because the entity informs the Secretary that it 
will not provide, pay for, provide coverage of, or provide referrals for 
abortions: Provided, That the Secretary shall make appropriate 
prospective adjustments to the capitation payment to such an entity 
(based on an actuarially sound estimate of the expected costs of 
providing the service to such entity's enrollees): Provided further, 
That nothing in this section shall be construed to change the Medicare 
program's coverage for such services and a Medicare+Choice organization 
described in this section shall be responsible for informing enrollees 
where to obtain information about all Medicare covered services.
    [Sec. 217. The Vaccine Research Facility (Building 40) at the 
National Institutes of Health is hereby named the Dale and Betty Bumpers 
Vaccine Research Facility.]
    [Sec. 218. (a) Mental Health.--Section 1918(b) of the Public Health 
Service Act (42 U.S.C. 300x-7(b)) is amended to read as follows:
    ``(b) Minimum Allotments for States.--
        ``(1) In general.--With respect to fiscal year 1999, the amount 
    of the allotment of a State under section 1911 shall not be less 
    than the amount the State received under section 1911 for fiscal 
    year 1998.''.
    (b) Substance Abuse.--Section 1933(b) of the Public Health Service 
Act (42 U.S.C. 300x-33(b)) is amended to read as follows:
    ``(b) Minimum Allotments for States.--
        ``(1) In general.--With respect to fiscal year 1999, the amount 
    of the allotment of a State under section 1921 shall not be less 
    than the amount the State received under section 1921 for fiscal

[[Page 469]]

    year 1998 increased by 30.65 percent of the percentage by which the 
    amount allotted to the States for fiscal year 1999 exceeds the 
    amount allotted to the States for fiscal year 1998.
        ``(2) Limitation.--
                ``(A) In general.--Except as provided in subparagraph 
            (B), a State shall not receive an allotment under section 
            1921 for fiscal year 1999 in an amount that is less than an 
            amount equal to 0.375 percent of the amount appropriated 
            under section 1935(a) for such fiscal year.
                ``(B) Exception.--In applying subparagraph (A), the 
            Secretary shall ensure that no State receives an increase in 
            its allotment under section 1921 for fiscal year 1999 (as 
            compared to the amount allotted to the State in the fiscal 
            year 1998) that is in excess of an amount equal to 300 
            percent of the percentage by which the amount appropriated 
            under section 1935(a) for fiscal year 1999 exceeds the 
            amount appropriated for the prior fiscal year.
        ``(3) Only for the purposes of calculating minimum allotments 
    under this subsection, any reference to the amount appropriated 
    under section 1935(a) for fiscal year 1998, allotments to States 
    under section 21 and any references to amounts received by States in 
    fiscal year 1998 shall include amounts appropriated or received 
    under the amendments made by section 105 of the Contract with 
    America Advancement Act of 1996 (Public Law 104-121).''.
    (c) Effective Date.--
        (1) In general.--The amendments made by subsections (a) and (b) 
    shall become effective as if enacted on October 1, 1998 and shall 
    only apply during fiscal year 1999.
        (2) Application.--Upon the expiration of the fiscal year 
    described in paragraph (1), the provisions of sections 1918(b) and 
    1933(b) of the Public Health Service Act (42 U.S.C. 300x-7(b) and 
    300x-33(b)), as in effect on September 30, 1998, shall be applied as 
    if the amendments made by this section had not been enacted.]
    Sec. [219] 211. Notwithstanding any other provision of law, no 
provider of services under title X of the Public Health Service Act 
shall be exempt from any State law requiring notification or the 
reporting of child abuse, child molestation, sexual abuse, rape, or 
incest. (Department of Health and Human Services Appropriations Act, 
1999, as included in Public Law 105-277, section 101(f).)