[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.
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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
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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
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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
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[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)
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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
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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
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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)
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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
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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
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HEALTH RESOURCES AND SERVICES ADMINISTRATION
Federal Funds
General and special funds:
Health Resources and Services
For carrying out titles II, III, VII, VIII, X, XII, 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).)