[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 433]]


                 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; [$1,186,072,000] $1,306,178,000, of which not to 
exceed [$145,434,000] $149,273,000 in prescription drug user fees 
authorized by 21 U.S.C. 379(h) may be credited to this appropriation and 
remain available until expended: Provided, That [fees derived from 
applications received during fiscal year 2000 shall be subject to the 
fiscal year 2000 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) $269,245,000 shall be for the Center for Food Safety 
and Applied Nutrition and related field activities in the Office of 
Regulatory Affairs; (2) $309,026,000 shall be for the Center for Drug 
Evaluation and Research and related field activities in the Office of 
Regulatory Affairs, of which no less than $11,542,000 shall be available 
for grants and contracts awarded under section 5 of the Orphan Drug Act 
(21 U.S.C. 360ee); (3) $132,092,000 shall be for the Center for 
Biologics Evaluation and Research and for related field activities in 
the Office of Regulatory Affairs; (4) $48,821,000 shall be for the 
Center for Veterinary Medicine and for related field activities in the 
Office of Regulatory Affairs; (5) $154,271,000 shall be for the Center 
for Devices and Radiological Health and for related field activities in 
the Office of Regulatory Affairs, of which $1,000,000 shall be for 
premarket review, enforcement and oversight activities related to users 
and manufacturers of all reprocessed medical devices as authorized by 
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 321 et seq.), and of 
which no less than $55,500,000 and 522 full-time equivalent positions 
shall be for premarket application review activities to meet statutory 
review times; (6) $34,536,000 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) 
$100,180,000 shall be for payments to the General Services 
Administration for rent and related costs; and (10) $78,046,000 shall be 
for other activities, including the Office of the Commissioner; the 
Office of Policy; the Office of the Senior Associate Commissioner; the 
Office of International and Constituent Relations; the Office of Policy, 
Legislation, and Planning; 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 $104,954,000 
shall be for payments to the General Services Administration for rent 
and related costs.
    In addition, mammography user fees authorized by 42 U.S.C. 263(b) 
may be credited to this account, to remain available until expended.
    In addition, export certification user fees authorized by 21 U.S.C. 
381, as amended, 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,] to 
remain available until expended $31,350,000, and to become available on 
October 1, 2001, $23,000,000. (7 U.S.C. 2209b). (Agriculture, Rural 
Development, Food and Drug Administration, and Related Agencies 
Appropriations Act, 2000.)

              Unavailable Collections (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9911-0-1-554      1999 actual   2000 est.   2001 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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   Foods...........................         235         267         303
00.02   Drugs...........................         338         357         414
00.03   Devices and radiological 
          products......................         146         154         172
00.04   National center for 
          toxicological research........          32          34          38
00.05   Tobacco.........................          34          34          39
00.06   Other activities................          75          72          66
00.07   Other rent and rent related 
          activities....................          26          26          26
00.08   Rental payments.................          83          94          99
00.09   Buildings and facilities........          16          11          31
00.10   CRADAs..........................           1           1           1
09.01 Reimbursable program..............         156         181         200
                                           ---------   ---------  ----------
10.00   Total new obligations...........       1,142       1,231       1,389
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          95         106         106
22.00 New budget authority (gross)......       1,147       1,231       1,389
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................           6
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       1,248       1,337       1,495
23.95 Total new obligations.............      -1,142      -1,231      -1,389
24.40 Unobligated balance available, end 
        of year.........................         106         106         108
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................         982       1,052       1,188
40.75   Reduction pursuant to P.L. 106-
          51............................          -2
40.76   Reduction pursuant to P.L. 106-
          113...........................                      -3
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............         980       1,049       1,188
      Mandatory:

60.25   Appropriation (special fund, 
          indefinite)...................           1           1           1
      Spending authority from offsetting 
          collections:

        Discretionary:
68.00     Offsetting collections (cash).         164         181         200
68.10     From Federal sources: Change 
            in receivables and unpaid, 
            unfilled orders.............           2
                                           ---------   ---------  ----------
68.90       Spending authority from 
              offsetting collections 
              (total discretionary).....         166         181         200
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       1,147       1,231       1,389
----------------------------------------------------------------------------

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

72.40   Obligated balance, start of year         324         330         333
72.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............                       2           2
                                           ---------   ---------  ----------
72.99     Total unpaid obligations, 
            start of year...............         324         332         335
73.10 Total new obligations.............       1,142       1,231       1,389
73.20 Total outlays (gross).............      -1,112      -1,228      -1,393
73.40 Adjustments in expired accounts 
        (net)...........................         -18
73.45 Adjustments in unexpired accounts.          -6
      Unpaid obligations, end of year:

74.40   Obligated balance, end of year..         330         333         329
74.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............           2           2           2
                                           ---------   ---------  ----------

[[Page 434]]


74.99     Total unpaid obligations, end 
            of year.....................         332         335         331
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................         930         958       1,098
86.93 Outlays from discretionary 
        balances........................         182         269         294
86.97 Outlays from new mandatory 
        authority.......................                       1           1
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       1,112       1,228       1,393
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.40   Offsetting collections (cash) 
          from: Non-Federal sources.....        -164        -181        -200
      Against gross budget authority only:

88.95   From Federal sources: Change in 
          receivables and unpaid, 
          unfilled orders...............          -2
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         981       1,050       1,189
90.00 Outlays...........................         948       1,047       1,193
---------------------------------------------------------------------------

                        [In millions of dollars]

                                        1999         2000        2001
Distribution of budget authority by 
    account:
  Salaries and expenses.............         886         944       1,058
  Rental payments (FDA).............          83          94          99
  Buildings and facilities..........          16          11          31
Distribution of outlays by account:
  Salaries and expenses.............         839         926       1,074
  Rental payments (FDA).............          83          98          99
  Buildings and facilities..........          26          23          18

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1999 actual  2000 est.   2001 est.
Enacted/requested:
  Budget Authority..................         981       1,050       1,189
  Outlays...........................         948       1,047       1,193
Legislative proposal, not subject to 
    PAYGO:
  Budget Authority..................
  Outlays...........................
                                    ------------------------------------
Total:
  Budget Authority..................         981       1,050       1,189
  Outlays...........................         948       1,047       1,193
                                    ====================================

    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 $163.2 million (+13 percent) increase over the FY 2000 
enacted program level. The Budget includes $1,156.9 million for Salaries 
and expenses, which includes funding for the food safety initiative and 
tobacco regulation, as well as initiatives for the reporting of medical 
errors and the prevention of illegal sales of prescription drugs over 
the Internet. Of the Salaries and expenses amount, $99.1 million will be 
used for payments to the General Services Administration for rent and 
rent related costs (an additional $5.9 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 
$189.9 million for user fees, an increase of $24.7 million in user fees 
over FY 2000, which will be used to finance FDA activities. Of the 
$189.9 million in user fees, $19.5 million consists of new user fees 
related to the review of direct food additive petitions, food export 
certificates, and for the review of medical device applications, which 
are represented in the legislative proposal schedule. The buildings and 
facilities appropriation of $31.4 million provides funds for projects 
related to the repair, construction, alteration, and improvement of all 
buildings and facilities of FDA, including a replacement laboratory in 
Los Angeles. 

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9911-0-1-554      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........         443         480         522
11.3      Other than full-time permanent          28          30          32
11.5      Other personnel compensation..          16          17          19
                                           ---------   ---------  ----------
11.9        Total personnel compensation         487         527         573
12.1    Civilian personnel benefits.....         112         121         132
21.0    Travel and transportation of 
          persons.......................          19          19          21
22.0    Transportation of things........           2           2           3
23.1    Rental payments to GSA..........          83          94          99
23.2    Rental payments to others.......           5           5           7
23.3    Communications, utilities, and 
          miscellaneous charges.........          20          20          20
24.0    Printing and reproduction.......           2           3           3
25.1    Advisory and assistance services          12          12          19
25.2    Other services..................          62          62          90
25.3    Purchases of goods and services 
          from Government accounts......          43          44          55
25.4    Operation and maintenance of 
          facilities....................          24          24          25
25.5    Research and development 
          contracts.....................          16          16          17
25.7    Operation and maintenance of 
          equipment.....................          19          19          20
26.0    Supplies and materials..........          14          14          18
31.0    Equipment.......................          29          30          41
32.0    Land and structures.............          15          15          23
41.0    Grants, subsidies, and 
          contributions.................          20          21          21
42.0    Insurance claims and indemnities           2           2           2
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..         986       1,050       1,189
99.0  Reimbursable obligations..........         156         181         200
                                           ---------   ---------  ----------
99.9    Total new obligations...........       1,142       1,231       1,389
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-9911-0-1-554      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: Full-
        time equivalent employment......       7,851       7,994       8,203
    Reimbursable:
2001  Total compensable workyears: Full-
        time equivalent employment......       1,013         978       1,164
    Allocation account:
3001  Total compensable workyears: Full-
        time equivalent employment......          14           2
---------------------------------------------------------------------------

                                

                          Salaries and Expenses

              (Legislative proposal, not subject to PAYGO)

    Contingent upon the enactment of authorizing legislation, up to 
$19,483,000 derived from fees assessed for activities related to the 
review of direct food additive petitions, the issuing of food export 
certificates, 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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
09.01 Additive user fees................                                  19
                                           ---------   ---------  ----------
10.00   Total new obligations...........                                  19
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                  19
23.95 Total new obligations.............                                 -19
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

68.00   Spending authority from 
          offsetting collections 
          (gross): Offsetting 
          collections (cash)............                                  19
----------------------------------------------------------------------------

[[Page 435]]



    Change in unpaid obligations:
73.10 Total new obligations.............                                  19
73.20 Total outlays (gross).............                                 -19
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................                                  19
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.40   Offsetting collections (cash) 
          from: Non-Federal sources.....                                 -19
----------------------------------------------------------------------------

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

    The Budget includes $189.9 million in user fees, of which $19.5 
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 appropriations action.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9911-2-1-554      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
99.0  Reimbursable obligations: 
        Subtotal, reimbursable 
        obligations.....................                                  19
                                           ---------   ---------  ----------
99.9    Total new obligations...........                                  19
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-9911-2-1-554      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
2001  Total compensable workyears: Full-
        time equivalent employment......                                 108
---------------------------------------------------------------------------
                                             -------

                                

Public enterprise funds:

           Revolving Fund for Certification and Other Services

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4309-0-3-554      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations.............           7           4           4
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................           6           3           3
22.00 New budget authority (gross)......           4           4           4
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......          10           7           7
23.95 Total new obligations.............          -7          -4          -4
24.40 Unobligated balance available, end 
        of year.........................           3           3           3
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

69.00   Offsetting collections (cash)...           4           4           4
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year           2           1           1
73.10 Total new obligations.............           7           4           4
73.20 Total outlays (gross).............          -7          -4          -4
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..           1           1           1
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................           4           4           4
86.98 Outlays from mandatory balances...           3
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........           7           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...........................           3
---------------------------------------------------------------------------

    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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
11.1  Personnel compensation: Full-time 
        permanent.......................           2           2           2
12.1  Civilian personnel benefits.......                       1           1
23.1  Rental payments to GSA............           1
25.2  Other services....................           3           1           1
31.0  Equipment.........................           1
                                           ---------   ---------  ----------
99.9    Total new obligations...........           7           4           4
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-4309-0-3-554      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
2001  Total compensable workyears: Full-
        time equivalent employment......          32          35          35
---------------------------------------------------------------------------

                                

         Administrative Provision, Food and Drug Administration

    Effective October 1, 2000, (1) the functions and authorities related 
to fish or fishery products under the Agricultural Marketing Act of 
1946, 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 (``HHS''); (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 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 (``FDA''); and (B) all assets and liabilities of the 
Department of Commerce 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 relating to the activities specified in clause (1) shall remain in 
effect until modified by the Secretary of HHS; (4) the Secretary of HHS 
is authorized to promulgate, without comment, a final rule transferring 
to title 21, Code of Federal Regulations, regulations of the Secretary 
of Commerce necessary to carry out the activities specified in clause 
(1); (5) all activities of such seafood inspection unit 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 FDA on or before September 30, 2005, such unit will be 
deemed a distinct competitive area within the FDA, under 5 CFR 351.402.

[[Page 436]]

                                


 
              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, 
[$4,584,721,000, of which $150,000 shall remain available until expended 
for interest subsidies on loan guarantees made prior to fiscal year 1981 
under part B of title VII of the Public Health Service Act, and of which 
$122,182,000 shall be available for the construction and renovation of 
health care and other facilities, and] $4,681,337,000, 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, [$238,932,000] $273,932,000 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 [$528,000,000] $554,000,000 shall 
be for State AIDS Drug Assistance Programs authorized by section 2616 of 
the Public Health Service Act: Provided further, That of the funds made 
available under this heading, $90,000,000 shall be for grants for 
reducing infant mortality consistent with the methods used in the 
Healthy Start Infant Mortality Demonstration Project grants from 1991 
through 2000: Provided further, That such funds will be available first 
to continue making grants to Healthy Start grantees that were awarded 
funds on or before January 15, 2000, whose current grant award continues 
in FY 2001: Provided further, That if the total amount of such grant 
awards is less than $90,000,000, at least 95% of the remaining funds 
shall be available for States, under the cost sharing provisions of 
section 503 of such Act, according to the ratio that infant mortality in 
each State bears to the total of infant mortality in the United States, 
as measured by the Centers for Disease Control and Prevention for the 
most recently available calendar year, and up to 5% of remaining funds 
shall be available for States for technical assistance: Provided 
further, That these grants use those Healthy Start methods that have 
been proven successful and are designed to reduce infant mortality 
within high-incidence areas by 50% over 5 years: Provided further, That 
each State shall include in its annual audit report, as required by 
section 506 of such Act, an additional section reporting on Healthy 
Start: Provided further, That sections 507, 508, and 509 of such Act 
apply to said State allotments: Provided further, That, notwithstanding 
section 502(a)(1) of the Social Security Act, not to exceed 
[$109,307,000] $109,148,000 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 
under this heading, $40,000,000 shall be available for children's 
hospitals graduate medical education payments, subject to authorization: 
Provided further, That of the amount provided under this heading, 
$900,000 shall be for the American Federation of Negro Affairs Education 
and Research Fund.] Provided further, That notwithstanding section 
757(b)2 of the Public Health Service Act, $28,587,000 shall be available 
under section 751, $3,765,000 under section 752, $4,720,000 under 
section 754, and $3,838,000 under section 755. (Department of Health and 
Human Services Appropriations Act, 2000, as enacted by section 
1000(a)(4) of the Consolidated Appropriations Act, 2000 (P.L. 106-113).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0350-0-1-550      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   Health centers..................         919       1,014       1,064
00.02   National Health Service Corps...          37          38          38
00.03   National Health Service Corps 
          recruitment...................          78          79          79
00.04   Hansen's disease center.........          22          20          17
00.09   Payment to Hawaii for the 
          treatment of Hansen's disease.           2           2           2
00.10   Black lung clinics..............           5           6           6
00.11   Nursing loan repayment..........           2           2           2
00.12   Health professions..............         302         342         298
00.13   Maternal and child health block 
          grant.........................         700         709         799
00.14   Healthy start...................         105          90
00.15   Universal newborn hearing.......                       3           3
00.16   Emergency medical services......          15          17          15
00.17   Poison control centers..........                       3           1
00.18   HIV/AIDS........................       1,411       1,595       1,720
00.19   Organ transplantation...........          10          10          15
00.20   Health care facilities..........          65         112
00.21   Bone marrow donor registry......          18          18          18
00.22   Rural health policy development.          12          33           6
00.23   Rural health outreach grants....          38          36          38
00.24   Rural health flexiblity grants..          25          25          25
00.25   Office for the advancement of 
          telehealth....................                                   6
00.26   Program management..............         119         125         124
00.27   Family planning.................         215         239         274
00.28   Abstinence education............          49          50          50
00.29   Health care access for the 
          uninsured.....................                      25         125
00.30   One-time access demos...........                      15
00.31   Health centers tort claims fund.           5           5           5
00.32   Health centers guarantee program 
          account.......................                       3           1
                                           ---------   ---------  ----------
03.00   Total direct programs...........       4,154       4,616       4,731
09.01 Reimbursable program..............         100         124         127
                                           ---------   ---------  ----------
10.00   Total new obligations...........       4,254       4,740       4,858
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          47          50          48
22.00 New budget authority (gross)......       4,257       4,738       4,858
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................           2
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       4,306       4,788       4,906
23.95 Total new obligations.............      -4,254      -4,740      -4,858
23.98 Unobligated balance expiring or 
        withdrawn.......................          -2
24.40 Unobligated balance available, end 
        of year.........................          50          48          48
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................       4,108       4,585       4,681
40.75   Reduction pursuant to P.L. 106-
          51............................          -1
40.76   Reduction pursuant to P.L. 106-
          113...........................                     -21
41.00   Transferred to other accounts...          -1
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............       4,106       4,564       4,681
      Mandatory:

60.00   Appropriation...................          50          50          50
      Discretionary:

68.00   Spending authority from 
          offsetting collections: 
          Offsetting collections (cash).         101         121         123
      Mandatory:

69.00   Offsetting collections (cash)...                       3           4
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       4,257       4,738       4,858
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year       2,726       3,078       3,353
73.10 Total new obligations.............       4,254       4,740       4,858
73.20 Total outlays (gross).............      -3,859      -4,444      -4,746
73.40 Adjustments in expired accounts 
        (net)...........................         -41         -21           4
73.45 Adjustments in unexpired accounts.          -2
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..       3,078       3,353       3,469
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................       1,611       1,837       1,922
86.93 Outlays from discretionary 
        balances........................       2,218       2,562       2,771

[[Page 437]]

86.97 Outlays from new mandatory 
        authority.......................          10          15          16
86.98 Outlays from mandatory balances...          20          30          38
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       3,859       4,444       4,746
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............         -85        -106        -106
88.40     Non-Federal sources...........         -16         -18         -21
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........        -101        -124        -127
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       4,156       4,614       4,731
90.00 Outlays...........................       3,758       4,320       4,619
---------------------------------------------------------------------------

                          [Dollars in millions]

                                        1999         2000        2001
Distribution of budget authority by 
    account:
  Health resources and services.....       4,151       4,609       4,726
  Health centers malpractice claims.           5           5           5
Distribution of outlays by account:
  Health resources and services.....       3,753       4,315       4,614
  Health centers malpractice claims.           5           5           5

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

----------------------------------------------------------------------------
Identification code 75-0350-0-1-550      1999 actual   2000 est.   2001 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...........                      26          10
                                           ---------   ---------  ----------
2159    Total loan guarantee levels.....                     100          51
    Guaranteed loan subsidy (in percent):
2320  Facilities loan subsidy rate......        2.26        0.71        0.43
2320  Managed care network development 
        loan subsidy rate...............        8.59        8.19        7.71
2320  Managed care plan loan subsidy 
        rate............................        5.11        4.16        3.93
                                           ---------   ---------  ----------
2329    Weighted average subsidy rate...        4.27        3.10        2.11
    Guaranteed loan subsidy budget authority:
2330  Facilities loan subsidy budget 
        authority.......................
2330  Managed care network development 
        loan subsidy budget authority...                       2           1
2330  Managed care plan loan subsidy 
        budget authority................                       1
                                           ---------   ---------  ----------
2339    Total subsidy budget authority..                       3           1
    Guaranteed loan subsidy outlays:
2340  Facilities loan subsidy outlays...
2340  Managed care network development 
        loan subsidy outlays............                       2           1
2340  Managed care plan loan subsidy 
        outlays.........................                       1
                                           ---------   ---------  ----------
2349    Total subsidy outlays...........                       3           1
----------------------------------------------------------------------------

    Administrative expense data:
3510  Administrative expenses...........           1           1           1
3580  Outlays from balances.............
3590  Outlays for administrative 
        expenses........................           1           1           1
---------------------------------------------------------------------------

    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. In FY 2001, Healthy Start will become a separate grant program 
within the maternal and child health block grant.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0350-0-1-550      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........          97         103         105
11.3      Other than full-time permanent           3           4           4
11.5      Other personnel compensation..           4           4           4
                                           ---------   ---------  ----------
11.9        Total personnel compensation         104         111         113
12.1    Civilian personnel benefits.....          26          28          28
21.0    Travel and transportation of 
          persons.......................           4           5           6
22.0    Transportation of things........           1           1           1
23.1    Rental payments to GSA..........          10          12          12
23.3    Communications, utilities, and 
          miscellaneous charges.........           5           5           5
24.0    Printing and reproduction.......           1           1           1
25.1    Advisory and assistance services          45          50          50
25.2    Other services..................          51          87         124
25.3    Purchases of goods and services 
          from Government accounts......          55          60          62
25.4    Operation and maintenance of 
          facilities....................           2           1           1
25.6    Medical care....................           1           1           1
25.7    Operation and maintenance of 
          equipment.....................           3           4           3
26.0    Supplies and materials..........           2           3           3
31.0    Equipment.......................           3           4           4
41.0    Grants, subsidies, and 
          contributions.................       3,836       4,238       4,312
42.0    Insurance claims and indemnities           5           5           5
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..       4,154       4,616       4,731
99.0  Reimbursable obligations..........         100         124         127
                                           ---------   ---------  ----------
99.9    Total new obligations...........       4,254       4,740       4,858
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0350-0-1-550      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Direct:
      Total compensable workyears:

1001    Full-time equivalent employment.       1,607       1,744       1,681
1011    Exempt Full-time equivalent 
          employment....................          82
    Reimbursable:
2001  Total compensable workyears: Full-
        time equivalent employment......         199         241         241
    Allocation account:
3001  Total compensable workyears: Full-
        time equivalent employment......           5          11          11
---------------------------------------------------------------------------

                                

                      Vaccine Injury Compensation 

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0320-0-1-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations (object 
        class 42.0).....................          47          52
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          61         115          64
22.00 New budget authority (gross)......         100
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................           1
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         162         115          64
23.95 Total new obligations.............         -47         -52
24.40 Unobligated balance available, end 
        of year.........................         115          64          64
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................         100
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year           2           5
73.10 Total new obligations.............          47          52
73.20 Total outlays (gross).............         -43         -57
73.45 Adjustments in unexpired accounts.          -1
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..           5
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.98 Outlays from mandatory balances...          43          57
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         100
90.00 Outlays...........................          43          57
---------------------------------------------------------------------------

    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

[[Page 438]]

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 2001 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.

                                

             Payment to the Ricky Ray Hemophilia Relief Fund

    For payment to the Ricky Ray Hemophilia Relief Fund, as provided by 
Public Law 105-369, and for administrative expenses, $100,000,000, of 
which up to $10,000,000 may be used for administrative expenses.

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0355-0-1-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations (object 
        class 92.0).....................                                 100
----------------------------------------------------------------------------

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

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................                                 100
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                 100
73.20 Total outlays (gross).............                                -100
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................                                 100
----------------------------------------------------------------------------

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

    These amounts will be paid to the Ricky Ray hemophilia relief fund. 
The Ricky Ray hemophilia relief fund was established pursuant to Public 
Law 105-369 and serves as a source of funds to pay claims to eligible 
individuals on behalf of persons with HIV and a blood clotting disorder, 
who were treated with an anti-hemophiliac factor between July 1982 and 
December 1987.

                                

Credit accounts:

             Health Center Guaranteed Loan Financing Account

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4442-0-3-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................           1           1           5
22.00 New financing authority (gross)...                       4           2
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......           1           5           7
24.40 Unobligated balance available, end 
        of year.........................           1           5           7
----------------------------------------------------------------------------

    New financing authority (gross), detail:
      Discretionary:

68.00   Spending authority from 
          offsetting collections 
          (gross): (Federal sources: 
          From program account).........                       4           3
----------------------------------------------------------------------------

    Offsets:
      Against gross financing authority and 
          financing disbursements:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............                      -3          -1
88.40     Premium income................                      -1          -2
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........                      -4          -3
----------------------------------------------------------------------------

    Net financing authority and financing 
        disbursements:
89.00 Financing authority...............                                  -1
90.00 Financing disbursements...........                      -4          -3
---------------------------------------------------------------------------

             Status of Guaranteed Loans (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4442-0-3-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Position with respect to appropriations act 
                limitation on commitments:
2111  Limitation on guaranteed loans 
        made by private lenders.........                     100          51
                                           ---------   ---------  ----------
2150    Total guaranteed loan 
          commitments...................                     100          51
----------------------------------------------------------------------------

    Cumulative balance of guaranteed loans 
                outstanding:
2210  Outstanding, start of year........           9           9         109
2231  Disbursements of new guaranteed 
        loans...........................                     100          51
2261  Adjustments: Terminations for 
        default that result in loans 
        receivable......................
                                           ---------   ---------  ----------
2290    Outstanding, end of year........           9         109         160
----------------------------------------------------------------------------

    Memorandum:
2299  Guaranteed amount of guaranteed 
        loans outstanding, end of year..           9         109         160
----------------------------------------------------------------------------

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

2331    Disbursements for guaranteed 
          loan claims...................
2351    Repayments of loans receivable..
---------------------------------------------------------------------------

    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 2000 and FY 2001. 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    1998 actual    1999 actual     2000 est.      2001 est.
-----------------------------------------------------------------------------------------------
    ASSETS:
      Investments in US securities:

1106    Federal assets: Receivables, net           9              9           109            160
                                        ------------ --------------  ------------  -------------
1999    Total assets....................           9              9           109            160
    LIABILITIES:
2204  Non-Federal liabilities: 
        Liabilities for loan guarantees.           9              9           109            160
                                        ------------ --------------  ------------  -------------
2999    Total liabilities...............           9              9           109            160
                                        ------------ --------------  ------------  -------------
4999  Total liabilities and net position           9              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] $3,679,000. (Department of Health and Human Services 
Appropriations Act, 2000, as enacted by section 1000(a)(4) of the 
Consolidated Appropriations Act, 2000 (P.L. 106-113).)

[[Page 439]]

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0340-0-1-552      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.09 Administrative expenses subject to 
        limitation......................           4           4           4
                                           ---------   ---------  ----------
10.00   Total new obligations...........           4           4           4
----------------------------------------------------------------------------

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

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................           4           4           4
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year           2           2
73.10 Total new obligations.............           4           4           4
73.20 Total outlays (gross).............          -3          -6          -4
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..           2
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................           2           4           4
86.93 Outlays from discretionary 
        balances........................           1           2
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........           3           6           4
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................           4           4           4
90.00 Outlays...........................           3           6           4
---------------------------------------------------------------------------

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

----------------------------------------------------------------------------
Identification code 75-0340-0-1-552      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Guaranteed loan levels supportable by subsidy 
                budget authority:
2150  Loan guarantee levels.............
                                           ---------   ---------  ----------
2159    Total loan guarantee levels.....
    Guaranteed loan subsidy (in percent):
2320  Subsidy rate......................        0.00        0.00        0.00
                                           ---------   ---------  ----------
2329    Weighted average subsidy rate...        0.00        0.00        0.00
    Guaranteed loan subsidy budget authority:
2330  Subsidy budget authority..........
                                           ---------   ---------  ----------
2339    Total subsidy budget authority..
    Guaranteed loan subsidy outlays:
2340  Subsidy outlays...................
                                           ---------   ---------  ----------
2349    Total subsidy outlays...........
----------------------------------------------------------------------------

    Administrative expense data:
3510  Budget authority..................           4           4           4
3580  Outlays from balances.............           1           2
3590  Outlays from new authority........           2           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 administrative expenses are estimated on a 
cash basis. 

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0340-0-1-552      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
11.1  Personnel compensation: Full-time 
        permanent.......................           2           2           2
25.3  Purchases of goods and services 
        from Government accounts........           1           1           1
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..           3           3           3
99.5  Below reporting threshold.........           1           1           1
                                           ---------   ---------  ----------
99.9    Total new obligations...........           4           4           4
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0340-0-1-552      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Total compensable workyears:
1001  Full-time equivalent employment...          17          24          24
1011  Exempt Full-time equivalent 
        employment......................           7
---------------------------------------------------------------------------

                                

           Health Education Assistance Loans Financing Account

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4304-0-3-552      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Death and disability claims.......           2           1           1
00.02 Default claims....................           9          22          28
                                           ---------   ---------  ----------
10.00   Total new obligations...........          11          23          29
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................         259         295         303
22.00 New financing authority (gross)...          48          31          33
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         307         326         336
23.95 Total new obligations.............         -11         -23         -29
24.40 Unobligated balance available, end 
        of year.........................         295         303         307
----------------------------------------------------------------------------

    New financing authority (gross), detail:
      Discretionary:

68.00   Spending authority from 
          offsetting collections 
          (gross): Offsetting 
          collections (cash)............          48          31          33
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............          11          23          29
73.20 Total financing disbursements 
        (gross).........................         -11         -23         -29
87.00 Total financing disbursements 
        (gross).........................          11          23          29
----------------------------------------------------------------------------

    Offsets:
      Against gross financing authority and 
          financing disbursements:

        Offsetting collections (cash) 
            from:
88.25     Interest on uninvested funds..         -45         -29         -29
88.40     Recoveries of defaulted loans.          -3          -2          -4
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........         -48         -31         -33
----------------------------------------------------------------------------

    Net financing authority and financing 
        disbursements:
89.00 Financing authority...............
90.00 Financing disbursements...........         -37          -8          -4
---------------------------------------------------------------------------

             Status of Guaranteed Loans (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4304-0-3-552      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Position with respect to appropriations act 
                limitation on commitments:
2111  Limitation on guaranteed loans 
        made by private lenders.........
                                           ---------   ---------  ----------
2150    Total guaranteed loan 
          commitments...................
----------------------------------------------------------------------------

    Cumulative balance of guaranteed loans 
                outstanding:
2210  Outstanding, start of year........       1,562       1,551       1,528
      Adjustments:

2261    Terminations for default that 
          result in loans receivable....          -9         -22         -28
2263    Terminations for default that 
          result in claim payments......          -2          -1          -2
                                           ---------   ---------  ----------
2290    Outstanding, end of year........       1,551       1,528       1,498
----------------------------------------------------------------------------

    Memorandum:
2299  Guaranteed amount of guaranteed 
        loans outstanding, end of year..       1,551       1,528       1,498
----------------------------------------------------------------------------

[[Page 440]]


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

2310    Outstanding, start of year......          32          38          57
2331    Disbursements for guaranteed 
          loan claims...................           9          22          28
2351    Repayments of loans receivable..          -3          -3          -4
                                           ---------   ---------  ----------
2390      Outstanding, end of year......          38          57          81
---------------------------------------------------------------------------

    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    1998 actual    1999 actual     2000 est.      2001 est.
-----------------------------------------------------------------------------------------------
    ASSETS:
1101  Federal assets: Fund balances with 
        Treasury........................         247            295           303            307
      Non-Federal assets:

1201    Investments in non-Federal 
          securities, net...............          22             45            29             29
1206    Receivables, net................           5              3             2              4
                                        ------------ --------------  ------------  -------------
1999    Total assets....................         274            343           334            340
    LIABILITIES:
2204  Non-Federal liabilities: 
        Liabilities for loan guarantees.       1,562          1,551         1,528          1,498
                                        ------------ --------------  ------------  -------------
2999    Total liabilities...............       1,562          1,551         1,528          1,498
    NET POSITION:
3300  Cumulative results of operations..      -1,287         -1,208        -1,194         -1,158
                                        ------------ --------------  ------------  -------------
3999    Total net position..............      -1,287         -1,208        -1,194         -1,158
                                        ------------ --------------  ------------  -------------
4999  Total liabilities and net position         275            343           334            340
-----------------------------------------------------------------------------------------------

                                

          Health Education Assistance Loans Liquidating Account

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4305-0-3-552      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Death and disability claims.......           4           5           5
00.02 Defaulted loans...................          20          23          18
00.03 Debt collection...................           3           7           7
                                           ---------   ---------  ----------
10.00   Total new obligations...........          27          35          30
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          18
22.00 New budget authority (gross)......          57          35          30
22.40 Capital transfer to general fund..         -48
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......          27          35          30
23.95 Total new obligations.............         -27         -35         -30
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.05   Appropriation (indefinite)......          37          15          10
69.00 Offsetting collections (cash).....          20          20          20
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................          57          35          30
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year           5          13
73.10 Total new obligations.............          27          35          30
73.20 Total outlays (gross).............         -20         -48         -30
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..          13
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................          20          35          30
86.98 Outlays from mandatory balances...                      13
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........          20          48          30
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

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

    Net budget authority and outlays:
89.00 Budget authority..................          37          15          10
90.00 Outlays...........................                      28          10
---------------------------------------------------------------------------

             Status of Guaranteed Loans (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4305-0-3-552      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Cumulative balance of guaranteed loans 
                outstanding:
2210  Outstanding, start of year........       1,412       1,343       1,260
2251  Repayments and prepayments........         -58         -69         -75
      Adjustments:

2261    Terminations for default that 
          result in loans receivable....          -9         -12          -9
2263    Terminations for default that 
          result in claim payments......          -2          -2          -3
                                           ---------   ---------  ----------
2290    Outstanding, end of year........       1,343       1,260       1,173
----------------------------------------------------------------------------

    Memorandum:
2299  Guaranteed amount of guaranteed 
        loans outstanding, end of year..       1,343       1,260       1,173
----------------------------------------------------------------------------

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

2310    Outstanding, start of year......         494         496         475
2331    Disbursements for guaranteed 
          loan claims...................          20          23          18
2351    Repayments of loans receivable..         -15         -15         -15
2361    Write-offs of loans receivable..         -29         -29         -29
2364    Other adjustments, net..........          26
                                           ---------   ---------  ----------
2390      Outstanding, end of year......         496         475         449
---------------------------------------------------------------------------

    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.

                        Statement of Operations (in millions of dollars)

-----------------------------------------------------------------------------------------------
Identification code   75-4305-0-3-552    1998 actual    1999 actual     2000 est.      2001 est.
-----------------------------------------------------------------------------------------------
0101  Revenue...........................          48             45            35             30
0102  Expense...........................         -38            -27           -35            -30
                                        ------------ --------------  ------------  -------------
0105  Net income or loss (-)............          10             18
-----------------------------------------------------------------------------------------------

                             Balance Sheet (in millions of dollars)

-----------------------------------------------------------------------------------------------
Identification code   75-4305-0-3-552    1998 actual    1999 actual     2000 est.      2001 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            496           475            449
1702    Interest receivable.............           5              6             6              6
                                        ------------ --------------  ------------  -------------
1704      Defaulted guaranteed loans and 
            interest receivable, net....         475            502           481            455
                                        ------------ --------------  ------------  -------------
1799      Value of assets related to 
            loan guarantees.............         475            502           481            455
1801  Other Federal assets: Cash and 
        other monetary assets...........          38             27            35             30
                                        ------------ --------------  ------------  -------------
1999    Total assets....................         513            529           516            485
    LIABILITIES:
2104  Federal liabilities: Resources 
        payable to Treasury.............           2              2             6              6
2201  Non-Federal liabilities: Accounts 
        payable.........................          29             20            23             18
                                        ------------ --------------  ------------  -------------
2999    Total liabilities...............          31             22            29             24

[[Page 441]]

    NET POSITION:
3300  Cumulative results of operations..         482            507           487            461
                                        ------------ --------------  ------------  -------------
3999    Total net position..............         482            507           487            461
                                        ------------ --------------  ------------  -------------
4999  Total liabilities and net position         513            529           516            485
-----------------------------------------------------------------------------------------------

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4305-0-3-552      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
25.2  Other services....................           8           8           8
42.0  Insurance claims and indemnities..          19          27          22
                                           ---------   ---------  ----------
99.9    Total new obligations...........          27          35          30
---------------------------------------------------------------------------

                                

               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, 
2000, as enacted by section 1000(a)(4) of the Consolidated 
Appropriations Act, 2000 (P.L. 106-113).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9931-0-3-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Operating expenses: Interest 
        subsidies, private..............           2           3           3
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................           2           3           3
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          50          48          40
22.00 New budget authority (gross)......           4           7           5
22.60 Portion applied to repay debt.....          -4         -12         -12
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......          50          43          33
23.95 Total new obligations.............          -2          -3          -3
24.40 Unobligated balance available, end 
        of year.........................          48          40          30
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................           1           1
60.36   Unobligated balance rescinded...          -3
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................          -2           1
69.00 Offsetting collections (cash).....           6           6           5
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................           4           7           5
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year          15          15          14
73.10 Total new obligations.............           2           3           3
73.20 Total outlays (gross).............          -3          -4          -4
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..          15          14          13
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................           1           1
86.98 Outlays from mandatory balances...           2           3           4
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........           3           4           4
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

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

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

               Status of Direct Loans (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9931-0-3-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Cumulative balance of direct loans 
                outstanding:
1210  Outstanding, start of year........          17          15           8
1251  Repayments: Repayments and 
        prepayments.....................          -6          -7          -8
1264  Write-offs for default: Other 
        adjustments, net................           4
                                           ---------   ---------  ----------
1290    Outstanding, end of year........          15           8
---------------------------------------------------------------------------

             Status of Guaranteed Loans (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9931-0-3-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Cumulative balance of guaranteed loans 
                outstanding:
2210  Outstanding, start of year........          82          45          15
2251  Repayments and prepayments........         -37         -30         -15
                                           ---------   ---------  ----------
2290    Outstanding, end of year........          45          15
----------------------------------------------------------------------------

    Memorandum:
2299  Guaranteed amount of guaranteed 
        loans outstanding, end of year..          45          15
---------------------------------------------------------------------------

    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. Unobligated balances will be used to pay defaults and interest 
subsidy payments.

                                

  

                               Trust Funds

             Vaccine Injury Compensation Program Trust Fund

    For payments from the Vaccine Injury Compensation Program Trust 
Fund, such sums as may be necessary for claims associated with vaccine-
related injury or death with respect to vaccines administered after 
September 30, 1988, pursuant to subtitle 2 of title XXI of the Public 
Health Service Act, to remain available until expended: Provided, That 
for necessary administrative expenses, not to exceed [$3,000,000] 
$2,992,000 shall be available from the Trust Fund to the Secretary of 
Health and Human Services. (Department of Health and Human Services 
Appropriations Act, 2000, as enacted by section 1000(a)(4) of the 
Consolidated Appropriations Act, 2000 (P.L. 106-113).)

              Unavailable Collections (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8175-0-7-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Balance, start of year:
01.99 Balance, start of year............       1,264       1,398       1,528
    Receipts:
02.01 Deposits..........................         130         131         134
02.03 Interest income...................          64          71          77
                                           ---------   ---------  ----------
02.99   Total receipts..................         194         202         211
                                           ---------   ---------  ----------
04.00 Total: Balances and collections...       1,458       1,600       1,739
    Appropriation:
05.01 Vaccine injury compensation 
        program trust fund..............         -60         -72        -124
                                           ---------   ---------  ----------
05.99 Subtotal appropriation............         -60         -72        -124
                                           ---------   ---------  ----------

[[Page 442]]


07.99 Total balance, end of year........       1,398       1,528       1,615
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8175-0-7-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Compensation: Claims for post--FY 
        1989 injuries...................          53          62         114
      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)......................           2           4           4
                                           ---------   ---------  ----------
01.91     Total, administrative expenses           7          10          10
                                           ---------   ---------  ----------
10.00   Total new obligations...........          60          72         124
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................           2           1
22.00 New budget authority (gross)......          60          72         124
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......          62          73         124
23.95 Total new obligations.............         -60         -72        -124
24.40 Unobligated balance available, end 
        of year.........................           1
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.26   Appropriation (trust fund, 
          definite).....................           7          10          10
      Mandatory:

60.27   Appropriation (trust fund, 
          indefinite)...................          53          62         114
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................          60          72         124
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year                       1
73.10 Total new obligations.............          60          72         124
73.20 Total outlays (gross).............         -60         -73        -124
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..           1
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................           5          10          10
86.93 Outlays from discretionary 
        balances........................           2           1
86.97 Outlays from new mandatory 
        authority.......................          53          62         114
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........          60          73         124
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................          60          72         124
90.00 Outlays...........................          60          73         124
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.01 Total investments, start of year: 
        U.S. securities: Par value......       1,285       1,431       1,528
92.02 Total investments, end of year: 
        U.S. securities: Par value......       1,431       1,528       1,615
---------------------------------------------------------------------------

    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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
25.2  Other services....................           3           3           3
25.3  Purchases of goods and services 
        from Government accounts........           4           7           7
42.0  Insurance claims and indemnities..          53          62         114
                                           ---------   ---------  ----------
99.9    Total new obligations...........          60          72         124
---------------------------------------------------------------------------

                                

                    Ricky Ray Hemophilia Relief Fund

              Unavailable Collections (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8074-0-7-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Balance, start of year:
01.99 Balance, start of year............
    Receipts:
02.01 Payments from the general fund....                      75         100
    Appropriation:
05.01 Ricky Ray hemophilia relief fund..                     -75        -100
                                           ---------   ---------  ----------
07.99 Total balance, end of year........
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8074-0-7-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations.............                      75         100
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                      75         100
23.95 Total new obligations.............                     -75        -100
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.27   Appropriation (trust fund, 
          indefinite)...................                      75         100
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                      75         100
73.20 Total outlays (gross).............                     -75        -100
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................                      75         100
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                      75         100
90.00 Outlays...........................                      75         100
---------------------------------------------------------------------------

    These amounts will be paid to the Ricky Ray hemophilia relief fund. 
The Ricky Ray hemophilia relief fund was established pursuant to Public 
Law 105-369 and serves as a source of funds to pay claims to eligible 
individuals on behalf of persons with HIV and a blood clotting disorder, 
who were treated with an anti-hemophiliac factor between July 1982 and 
December 1987.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8074-0-7-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
25.2  Other services....................                       5           5
42.0  Insurance claims and indemnities..                      70          95
                                           ---------   ---------  ----------
99.9    Total new obligations...........                      75         100
---------------------------------------------------------------------------

                                


 
                          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, [$2,078,967,000], 
$2,271,055,000 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] $18,000,000 
shall remain available

[[Page 443]]

until expended, for the Indian Catastrophic Health Emergency Fund: 
Provided further, That [$395,290,000] $429,672,000 for contract medical 
care shall remain available for obligation until September 30, [2001] 
2002: 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 1-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, 
[2001] 2002: 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 [$228,781,000] $268,781,000 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 (herein ``contracts/compacts'') 
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 [2000] 2001, of which not to exceed 
[$10,000,000 may be used for such costs associated with] $40,000,000 is 
available first for new and expanded [contracts, grants, self-governance 
compacts or annual funding agreements] contracts/compacts, which shall 
receive contract support costs at, and not greater than, the minimum 
percentage of need funded for existing contracts/compacts in fiscal year 
2001: Provided further, That any remaining portion of the $40,000,000 
shall be used for contract support costs for existing contracts/
compacts: Provided further, That funds available for the Indian Health 
Care Improvement Fund may be used, as needed, to carry out activities 
typically funded under the Indian Health Facilities account. (Department 
of the Interior and Related Agencies Appropriations Act, 2000, as 
enacted by section 1000(a)(3) of the Consolidated Appropriations Act, 
2000 (P.L. 106-113).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0390-0-1-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   Clinical services...............       1,524       1,632       1,769
00.02   Preventive health...............          86          92         103
00.03   Urban health....................          27          28          31
00.04   Indian health professions.......          29          30          33
00.05   Tribal management...............           2           2           2
00.06   Direct operations...............          48          51          54
00.07   Self-governance.................           9          10          10
00.08   Contract support costs..........         204         229         269
00.09   Diabetes funds..................          34          30          30
09.01 Reimbursable program..............         561         582         582
                                           ---------   ---------  ----------
10.00   Total new obligations...........       2,524       2,686       2,883
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................         103         115         115
22.00 New budget authority (gross)......       2,539       2,686       2,883
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................           1
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       2,643       2,801       2,998
23.95 Total new obligations.............      -2,524      -2,686      -2,883
23.98 Unobligated balance expiring or 
        withdrawn.......................          -4
24.40 Unobligated balance available, end 
        of year.........................         115         115         115
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................       1,950       2,079       2,271
40.75   Reduction pursuant to P.L. 106-
          51............................          -2
40.76   Reduction pursuant to P.L. 106-
          113...........................                      -5
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............       1,948       2,074       2,271
      Mandatory:

62.00   Transferred from HCFA for 
          Diabetes......................          30          30          30
      Discretionary:

68.00   Spending authority from 
          offsetting collections: 
          Offsetting collections (cash).         561         582         582
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       2,539       2,686       2,883
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         484         481         514
73.10 Total new obligations.............       2,524       2,686       2,883
73.20 Total outlays (gross).............      -2,490      -2,653      -2,882
73.40 Adjustments in expired accounts 
        (net)...........................         -36
73.45 Adjustments in unexpired accounts.          -1
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         481         514         515
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................       2,061       2,154       2,331
86.93 Outlays from discretionary 
        balances........................         399         469         521
86.97 Outlays from new mandatory 
        authority.......................          23          23          23
86.98 Outlays from mandatory balances...           7           7           7
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       2,490       2,653       2,882
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............        -286        -288        -288
88.40     Non-Federal sources...........        -275        -294        -294
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........        -561        -582        -582
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       1,978       2,104       2,301
90.00 Outlays...........................       1,930       2,071       2,300
---------------------------------------------------------------------------

    The Indian health services account provides medical care, public 
health services, and health professions training opportunities to 
American Indians and Alaska Natives. An estimated $592 million will be 
administered by tribal governments under self-governance compacts in FY 
2001.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0390-0-1-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........         312         334         357
11.3      Other than full-time permanent          14          15          16
11.5      Other personnel compensation..          29          36          38
                                           ---------   ---------  ----------
11.9        Total personnel compensation         355         385         411
12.1    Civilian personnel benefits.....          99         105         114
13.0    Benefits for former personnel...           2           3           4
21.0    Travel and transportation of 
          persons.......................          28          31          31
22.0    Transportation of things........          10          11          11
23.1    Rental payments to GSA..........           8           8           8
23.2    Rental payments to others.......           3           9           9
23.3    Communications, utilities, and 
          miscellaneous charges.........          21          24          24
24.0    Printing and reproduction.......           1           1           1
25.1    Advisory and assistance services           7          13          13
25.2    Other services..................          66          25          30
25.3    Purchases of goods and services 
          from Government accounts......          24          25          25
25.4    Operation and maintenance of 
          facilities....................          -5           4           4
25.5    Research and development 
          contracts.....................                       1           1
25.6    Medical care....................         182         191         232
25.7    Operation and maintenance of 
          equipment.....................          -2          16          16
25.8    Subsistence and support of 
          persons.......................           1           5           5
26.0    Supplies and materials..........          95         139         139
31.0    Equipment.......................          24           9          10
32.0    Land and structures.............           1           1           1
41.0    Grants, subsidies, and 
          contributions.................       1,043       1,098       1,212
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..       1,963       2,104       2,301
99.0  Reimbursable obligations..........         561         582         582
                                           ---------   ---------  ----------
99.9    Total new obligations...........       2,524       2,686       2,883
---------------------------------------------------------------------------

[[Page 444]]



                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0390-0-1-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Direct:
      Total compensable workyears:

1001    Full-time equivalent employment.      10,376      10,433      10,546
1011    Exempt Full-time equivalent 
          employment....................           1
    Reimbursable:
2001  Total compensable workyears: Full-
        time equivalent employment......       2,916       2,916       2,916
    Allocation account:
3001  Total compensable workyears: Full-
        time equivalent employment......           2
---------------------------------------------------------------------------

                                

                        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, [$318,580,000] $290,795,000, 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: [Provided 
further, That notwithstanding any provision of law governing Federal 
construction, $3,000,000 of the funds provided herein shall be provided 
to the Hopi Tribe to reduce the debt incurred by the Tribe in providing 
staff quarters to meet the housing needs associated with the new Hopi 
Health Center:] Provided further, That not to exceed $500,000 shall be 
used by the Indian Health Service to purchase TRANSAM equipment from the 
Department of Defense for distribution to the Indian Health Service and 
tribal facilities: Provided further, That not to exceed $500,000 shall 
be used by the Indian Health Service to obtain ambulances for the Indian 
Health Service and tribal facilities in conjunction with an existing 
interagency agreement between the Indian Health Service and the General 
Services Administration: Provided further, That not to exceed $500,000 
shall be placed in a Demolition Fund, available until expended, to be 
used by the Indian Health Service for demolition of Federal buildings[: 
Provided further, That from within existing funds, the Indian Health 
Service may purchase up to 5 acres of land for expanding the parking 
facilities at the Indian Health Service hospital in Tahlequah, 
Oklahoma].
    In addition, to remain available until expended: for construction of 
a replacement health facility at Fort Defiance, Arizona, up to 
$38,715,000; for construction of a replacement health facility at 
Parker, Arizona, up to $7,578,000; and for construction of a replacement 
health facility at Winnebago, Nebraska, up to $12,286,000 and, to become 
available October 1, 2001 and remain available until expended, up to 
$17,541,000. (Department of the Interior and Related Agencies 
Appropriations Act, 2000, as enacted by section 1000(a)(3) of the 
Consolidated Appropriations Act, 2000 (P.L. 106-113).)

              Unavailable Collections (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0391-0-1-551      1999 actual   2000 est.   2001 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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   Sanitation and health facilities         122         143         162
00.02   Maintenance.....................          40          48          50
00.03   Facilities and environmental 
          health........................          95         117         130
00.04   Equipment.......................          12          14          12
                                           ---------   ---------  ----------
01.00     Total direct program..........         269         322         354
09.01 Reimbursable program..............          11          12          12
                                           ---------   ---------  ----------
10.00   Total new obligations...........         280         334         366
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          22          72          72
22.00 New budget authority (gross)......         318         334         366
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................          11
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         351         406         438
23.95 Total new obligations.............        -280        -334        -366
24.40 Unobligated balance available, end 
        of year.........................          72          72          72
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................         292         319         349
40.76   Reduction pursuant to P.L. 106-
          113...........................                      -2
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............         292         317         349
      Mandatory:

60.25   Appropriation (special fund, 
          indefinite)...................           5           5           5
      Discretionary:

68.00   Spending authority from 
          offsetting collections: 
          Offsetting collections (cash).          21          12          12
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................         318         334         366
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         356         335         346
73.10 Total new obligations.............         280         334         366
73.20 Total outlays (gross).............        -290        -323        -340
73.45 Adjustments in unexpired accounts.         -11
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         335         346         372
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................         109         105         117
86.93 Outlays from discretionary 
        balances........................         176         212         218
86.97 Outlays from new mandatory 
        authority.......................           5           5           5
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         290         323         340
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........         -21         -12         -12
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         297         322         354
90.00 Outlays...........................         269         311         328
---------------------------------------------------------------------------

    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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........          46          50          54
11.3      Other than full-time permanent           3           4           4
11.5      Other personnel compensation..           1           1           1
                                           ---------   ---------  ----------
11.9        Total personnel compensation          50          55          59
12.1    Civilian personnel benefits.....          13          14          15
21.0    Travel and transportation of 
          persons.......................           4           5           5
22.0    Transportation of things........           3           3           3
23.3    Communications, utilities, and 
          miscellaneous charges.........          11          11          11
25.1    Advisory and assistance services           1           1           1

[[Page 445]]

25.2    Other services..................         115         146         169
25.3    Purchases of goods and services 
          from Government accounts......           5           5           5
25.4    Operation and maintenance of 
          facilities....................          12          10          10
25.7    Operation and maintenance of 
          equipment.....................           2           1           1
26.0    Supplies and materials..........           6           7           7
31.0    Equipment.......................           7           2           2
32.0    Land and structures.............           2          17          17
41.0    Grants, subsidies, and 
          contributions.................          38          45          49
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..         269         322         354
99.0  Reimbursable obligations..........          11          12          12
                                           ---------   ---------  ----------
99.9    Total new obligations...........         280         334         366
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0391-0-1-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
1001  Total compensable workyears: Full-
        time equivalent employment......       1,231       1,264       1,301
---------------------------------------------------------------------------

                                

            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 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, 2000, as enacted by section 1000(a)(3) of 
the Consolidated Appropriations Act, 2000 (P.L. 106-113).)

                                


 
               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, [$2,910,761,000] $3,239,487,000, of which [$60,000,000] 
$127,074,000 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 [$71,690,000] $76,690,000 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 provision 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 not to exceed $10,000,000 may be available for making grants under 
section 1509 of the Public Health Service Act to not more than 10 
States[: Provided further, That of the amount provided under this 
heading, $3,000,000 shall be for the Center for Environmental Medicine 
and Toxicology at the University of Mississippi Medical Center at 
Jackson; $2,000,000 shall be for the University of Mississippi 
phytomedicine project; $500,000 shall be for the Alaska aviation safety 
initiative; and $1,000,000 shall be for the University of South Alabama 
birth defects monitoring and prevention activities.
    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]. In addition, to become available on October 1 of 
the fiscal year specified and remain available until expended for 
construction of Laboratory Building 18: $20,840,000 for fiscal year 2002 
and $20,840,000 for fiscal year 2003. (Department of Health and Human 
Services Appropriations Act, 2000, as enacted by section 1000(a)(4) of 
the Consolidated Appropriations Act, 2000 (P.L. 106-113).)

              Unavailable Collections (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0943-0-1-999      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Balance, start of year:
01.99 Balance, start of year............
    Receipts:
02.01 Cooperative research and 
        development agreements, Centers 
        for Disease Control.............           2           2           2

[[Page 446]]

    Appropriation:
05.01 Disease control, research, and 
        training........................          -2          -2          -2
                                           ---------   ---------  ----------
07.99 Total balance, end of year........
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0943-0-1-999      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   Preventive health block grant...         150         135         179
00.02   Prevention centers..............          13          18          15
00.03   Sexually transmitted diseases...         124         136         151
00.04   Immunization....................         420         490         530
00.05   Infectious diseases.............         257         294         329
00.06   Other chronic and environmental 
          diseases......................         475         553         583
00.07   Tobacco.........................          74         101         106
00.08   Occupational safety and health..         200         215         220
00.10   Epidemic services...............          86          86          86
00.11   Health statistics...............          27          33          33
00.12   HIV.............................         657         695         795
00.13   Prevention research.............          15          15          15
00.14   Buildings and facilities........          45         100         127
00.15   Office of the director..........          30          38          36
00.16   Violent crime reduction programs          51          50
00.17   Eliminating racial and ethnic 
          disparities...................          10          30          35
09.01 Reimbursable program..............         180         189         195
                                           ---------   ---------  ----------
10.00   Total new obligations...........       2,814       3,178       3,435
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          56          43          22
22.00 New budget authority (gross)......       2,791       3,157       3,439
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................          11
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       2,858       3,200       3,461
23.95 Total new obligations.............      -2,814      -3,178      -3,435
23.98 Unobligated balance expiring or 
        withdrawn.......................          -1
24.40 Unobligated balance available, end 
        of year.........................          43          22          27
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................       2,559       2,911       3,239
40.75   Reduction pursuant to P.L. 106-
          51............................          -3
40.76   Reduction pursuant to P.L. 106-
          113...........................                     -19
41.00   Transferred to other accounts...          -1
42.00   Transferred from other accounts.          51          71
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............       2,606       2,963       3,239
      Mandatory:

60.25   Appropriation (special fund, 
          indefinite)...................           2           2           2
62.00   Transferred from other accounts.           3           3           3
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................           5           5           5
      Discretionary:

68.00   Spending authority from 
          offsetting collections: 
          Offsetting collections (cash).         180         189         195
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       2,791       3,157       3,439
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year       2,042       2,223       2,518
73.10 Total new obligations.............       2,814       3,178       3,435
73.20 Total outlays (gross).............      -2,610      -2,881      -3,228
73.40 Adjustments in expired accounts 
        (net)...........................         -13
73.45 Adjustments in unexpired accounts.         -11
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..       2,223       2,518       2,724
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................       1,133       1,211       1,329
86.93 Outlays from discretionary 
        balances........................       1,470       1,664       1,893
86.97 Outlays from new mandatory 
        authority.......................           5           5           5
86.98 Outlays from mandatory balances...           2           1           1
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       2,610       2,881       3,228
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............        -178        -187        -193
88.40     Non-Federal sources...........          -2          -2          -2
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........        -180        -189        -195
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       2,611       2,968       3,244
90.00 Outlays...........................       2,430       2,692       3,033
---------------------------------------------------------------------------

                          [Dollars in millions]

                                        1999         2000        2001
Distribution of budget authority by 
    account:
  Disease control, research and 
    training........................       2,560       2,918       3,244
  Violent crime reduction programs..          51          50
Distribution of outlays by account:
  Disease control, research and 
    training........................       2,382       2,658       2,996
  Violent crime reduction programs..          48          34          37

    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 in FY 1999 and FY 2000. In FY 2001, the activities 
funded through the trust fund in FY 2000 are maintained at the same 
funding level of $51 million, and displayed in FY 2001 within the 
activity lines for the preventive health block grant ($45 million) and 
other chronic and environmental diseases ($6 million). 

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0943-0-1-999      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........         304         335         368
11.3      Other than full-time permanent           7           9          10
11.5      Other personnel compensation..          16          17          18
                                           ---------   ---------  ----------
11.9        Total personnel compensation         327         361         396
12.1    Civilian personnel benefits.....          97         104         112
21.0    Travel and transportation of 
          persons.......................          26          31          34
22.0    Transportation of things........           5           6           7
23.1    Rental payments to GSA..........          19          22          24
23.2    Rental payments to others.......           2           3           3
23.3    Communications, utilities, and 
          miscellaneous charges.........          24          26          28
24.0    Printing and reproduction.......           7           9          10
25.1    Advisory and assistance services          24          29          31
25.2    Other services..................          50          56          60
25.3    Purchases of goods and services 
          from Government accounts......          71          80          87
25.4    Operation and maintenance of 
          facilities....................          12          57          62
25.5    Research and development 
          contracts.....................         123         133         145
25.6    Medical care....................           3           5           5
25.7    Operation and maintenance of 
          equipment.....................          10          13          14
26.0    Supplies and materials..........          23          30          39
31.0    Equipment.......................          38          43          47
32.0    Land and structures.............          14          38          41
41.0    Grants, subsidies, and 
          contributions.................       1,759       1,943       2,095
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..       2,634       2,989       3,240
99.0  Reimbursable obligations..........         180         189         195
                                           ---------   ---------  ----------
99.9    Total new obligations...........       2,814       3,178       3,435
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0943-0-1-999      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Direct:
      Total compensable workyears:

1001    Full-time equivalent employment.       6,381       6,582       6,796
1011    Exempt Full-time equivalent 
          employment....................           4
    Reimbursable:
2001  Total compensable workyears: Full-
        time equivalent employment......         972       1,114       1,124

[[Page 447]]

    Allocation account:
3001  Total compensable workyears: Full-
        time equivalent employment......         133         226         140
---------------------------------------------------------------------------

                                

                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, [$3,332,317,000] $3,249,730,000. 
(Department of Health and Human Services Appropriations Act, 2000, as 
enacted by section 1000(a)(4) of the Consolidated Appropriations Act, 
2000 (P.L. 106-113).)

                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, [$2,040,291,000] $2,069,582,000. 
(Department of Health and Human Services Appropriations Act, 2000, as 
enacted by section 1000(a)(4) of the Consolidated Appropriations Act, 
2000 (P.L. 106-113).)

         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, [$270,253,000] $263,075,000. 
(Department of Health and Human Services Appropriations Act, 2000, as 
enacted by section 1000(a)(4) of the Consolidated Appropriations Act, 
2000 (P.L. 106-113).)

    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, 
[$1,147,588,000] $1,186,266,000. (Department of Health and Human 
Services Appropriations Act, 2000, as enacted by section 1000(a)(4) of 
the Consolidated Appropriations Act, 2000 (P.L. 106-113).)

         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, 
[$1,034,886,000] $1,050,412,000. (Department of Health and Human 
Services Appropriations Act, 2000, as enacted by section 1000(a)(4) of 
the Consolidated Appropriations Act, 2000 (P.L. 106-113).)

          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, 
[$1,803,063,000] $935,166,000. (Department of Health and Human Services 
Appropriations Act, 2000, as enacted by section 1000(a)(4) of the 
Consolidated Appropriations Act, 2000 (P.L. 106-113).)

             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, [$1,361,668,000] 
$1,389,492,000. (Department of Health and Human Services Appropriations 
Act, 2000, as enacted by section 1000(a)(4) of the Consolidated 
Appropriations Act, 2000 (P.L. 106-113).)

        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, 
[$862,884,000] $810,501,000. (Department of Health and Human Services 
Appropriations Act, 2000, as enacted by section 1000(a)(4) of the 
Consolidated Appropriations Act, 2000 (P.L. 106-113).)

                         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, 
[$452,706,000] $462,776,000. (Department of Health and Human Services 
Appropriations Act, 2000, as enacted by section 1000(a)(4) of the 
Consolidated Appropriations Act, 2000 (P.L. 106-113).)

           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, 
[$444,817,000] $460,971,000. (Department of Health and Human Services 
Appropriations Act, 2000, as enacted by section 1000(a)(4) of the 
Consolidated Appropriations Act, 2000 (P.L. 106-113).)

                       National Institute on Aging

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to aging, [$690,156,000] $721,651,000. 
(Department of Health and Human Services Appropriations Act, 2000, as 
enacted by section 1000(a)(4) of the Consolidated Appropriations Act, 
2000 (P.L. 106-113).)

  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, [$351,840,000] $363,479,000. (Department of Health and Human 
Services Appropriations Act, 2000, as enacted by section 1000(a)(4) of 
the Consolidated Appropriations Act, 2000 (P.L. 106-113).)

    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, 
[$265,185,000] $276,418,000. (Department of Health and Human Services 
Appropriations Act, 2000, as enacted by section 1000(a)(4) of the 
Consolidated Appropriations Act, 2000 (P.L. 106-113).)

                 National Institute of Nursing Research

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to nursing research, [$90,000,000] $84,714,000. 
(Department of Health and Human Services Appropriations Act, 2000, as 
enacted by section 1000(a)(4) of the Consolidated Appropriations Act, 
2000 (P.L. 106-113).)

           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, [$293,935,000] 
$288,578,000. (Department of Health and Human Services Appropriations 
Act, 2000, as enacted by section 1000(a)(4) of the Consolidated 
Appropriations Act, 2000 (P.L. 106-113).)

                    National Institute on Drug Abuse

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to drug abuse, [$689,448,000] $496,294,000. 
(Department of Health and Human Services Appropriations Act, 2000, as 
enacted by section 1000(a)(4) of the Consolidated Appropriations Act, 
2000 (P.L. 106-113).)

                   National Institute of Mental Health

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to mental health, [$978,360,000] $896,059,000. 
(Department of Health and Human Services Appropriations Act, 2000, as 
enacted by section 1000(a)(4) of the Consolidated Appropriations Act, 
2000 (P.L. 106-113).)

                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, [$337,322,000] 
$353,427,000. (Department of Health and Human Services Appropriations 
Act, 2000, as enacted by section 1000(a)(4) of the Consolidated 
Appropriations Act, 2000 (P.L. 106-113).)

                 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, [$680,176,000] $602,728,000: 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 $72,500,000 shall be for 
extramural facilities construction grants. (Department of Health and 
Human Services ppropriations Act, 2000, as enacted by section

[[Page 448]]

1000(a)(4) of the Consolidated Appropriations Act, 2000 (P.L. 106-113).)

       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, 
[$68,753,000] $71,362,000. (Department of Health and Human Services 
ppropriations Act, 2000, as enacted by section 1000(a)(4) of the 
Consolidated Appropriations Act, 2000 (P.L. 106-113).)

                  John E. Fogarty International Center

    For carrying out the activities at the John E. Fogarty International 
Center, [$43,723,000] $32,532,000. (Department of Health and Human 
Services Appropriations Act, 2000, as enacted by section 1000(a)(4) of 
the Consolidated Appropriations Act, 2000 (P.L. 106-113).)

                      National Library of Medicine

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to health information communications, 
[$215,214,000] $224,942,000, of which $4,000,000 shall be available 
until expended for improvement of information systems: Provided, That in 
fiscal year [2000] 2001, 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, 
2000, as enacted by section 1000(a)(4) of the Consolidated 
Appropriations Act, 2000 (P.L. 106-113).)

                         Office of the Director

                      (including transfer of funds)

    For carrying out the responsibilities of the Office of the Director, 
National Institutes of Health, [$283,509,000, of which $44,953,000 shall 
be for the Office of AIDS Research] $262,456,000: Provided, That funding 
shall be available for the purchase of not to exceed [29] 20 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 the National Institutes of Health 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 
National Institutes of Health 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 Foundation for the National Institutes of Health may be 
transferred to the National Institutes of Health] Provided further, That 
the Director of NIH may establish an extramural clinical loan repayment 
program in order to provide recruitment and retention incentives for 
clinical researchers: Provided further, That the Director of the Office 
of Research on Minority Health, in consultation with the Advisory 
Council for the Office of Research on Minority Health and the Institutes 
and Centers, may, in exceptional circumstances, fund peer-reviewed 
grants for innovative projects that address high priority areas of 
minority health. (Department of Health and Human Services Appropriations 
Act, 2000, as enacted by section 1000(a)(4) of the Consolidated 
Appropriations Act, 2000 (P.L. 106-113).)

                         Office of AIDS Research

                      (including transfer of funds)

    For carrying out part D of title XXIII of the Public Health Service 
Act, $2,111,224,000: Provided, That the Director of the Office of AIDS 
Research shall transfer funds from this appropriation as authorized by 
subsection 2353(d) of such 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, [$135,376,000] $148,900,000, to remain 
available until expended, of which $47,300,000 shall be for the 
neuroscience research center.
    In addition, to become available on October 1, 2001 and remain 
available until expended, for the neuroscience research center, 
$26,000,000. (Department of Health and Human Services Appropriations 
Act, 2000, as enacted by section 1000(a)(4) of the Consolidated 
Appropriations Act, 2000 (P.L. 106-113).)

              Unavailable Collections (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9915-0-1-552      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Balance, start of year:
01.99 Balance, start of year............
    Receipts:
02.01 Cooperative research and 
        development agreements, NIH.....          13          13          13
    Appropriation:
05.01 National Institutes of Health.....         -13         -13         -13
                                           ---------   ---------  ----------
07.99 Total balance, end of year........
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9915-0-1-552      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   National Cancer Institute.......       2,918       3,315       3,250
00.02   National Heart, Lung, and Blood 
          Institute.....................       1,788       2,029       2,070
00.03   National Institute of Dental and 
          Craniofacial Research.........         234         269         263
00.04   National Institute of Diabetes 
          and Digestive and Kidney 
          Disease.......................       1,018       1,168       1,213
00.05   National Institute of 
          Neurological Disorders and 
          Stroke........................         900       1,029       1,050
00.06   National Institute of Allergy 
          and Infectious Diseases.......       1,565       1,778         935
00.07   National Institute of General 
          Medical Sciences..............       1,203       1,354       1,390
00.08   National Institute of Child 
          Health and Human Development..         749         858         811
00.09   National Eye Institute..........         395         450         463
00.10   National Institute of 
          Environmental Health Sciences.         374         442         461
00.11   National Institute on Aging.....         594         686         722
00.12   National Institute of Arthritis 
          and Musculoskeletal and Skin 
          Disease.......................         307         350         364
00.13   National Institute on Deafness 
          and Other Communication 
          Disorder......................         229         264         276
00.14   National Institute of Mental 
          Health........................         858         973         896
00.15   National Institute on Drug Abuse         611         687         496
00.16   Natinal Institute on Alcohol 
          Abuse and Alcoholism..........         259         292         289
00.17   National Institute of Nursing 
          Research......................          70          90          85
00.18   National Human Genome Research 
          Institute.....................         279         336         353
00.19   National Center for Research 
          Resources.....................         562         677         603
00.20   National Center for 
          Complementary and Alternative 
          Medicine......................          40          68          71
00.21   John F. Fogarty International 
          Center........................          35          44          33
00.22   National Library of Medicine....         181         214         225
00.23   Office of the Director..........         256         282         262
00.24   Office of AIDS Research.........                               2,111
00.25   Buildings and facilities........         217         165         148
00.26   Cooperative research and 
          development agreements........          16          13          13
00.27   Royalities......................          45
09.00 Reimbursable program..............       1,038       1,187       1,215
                                           ---------   ---------  ----------
10.00   Total new obligations...........      16,741      19,020      20,068
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................         147         161         161
22.00 New budget authority (gross)......      16,756      19,020      20,068
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......      16,903      19,181      20,229
23.95 Total new obligations.............     -16,741     -19,020     -20,068
23.98 Unobligated balance expiring or 
        withdrawn.......................          -1
24.40 Unobligated balance available, end 
        of year.........................         161         161         161
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................      15,612      17,913      18,813
40.75   Reduction pursuant to P.L. 106-
          51............................         -10
40.76   Reduction pursuant to P.L. 106-
          113...........................                    -100

[[Page 449]]

41.00   Transferred to other accounts...          -5         -20
42.00   Transferred from other accounts.          10
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............      15,607      17,793      18,813
      Mandatory:

60.25   Appropriation (special fund, 
          indefinite)...................          13          13          13
62.00   Transferred from other accounts.          27          27          27
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................          40          40          40
      Spending authority from offsetting 
          collections:

        Discretionary:
68.00     Offsetting collections (cash).         949       1,187       1,215
68.10     From Federal sources: Change 
            in receivables and unpaid, 
            unfilled orders.............         160
                                           ---------   ---------  ----------
68.90       Spending authority from 
              offsetting collections 
              (total discretionary).....       1,109       1,187       1,215
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................      16,756      19,020      20,068
----------------------------------------------------------------------------

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

72.40   Obligated balance, start of year      12,119      13,898      16,194
72.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............       3,984       4,144       4,144
                                           ---------   ---------  ----------
72.99     Total unpaid obligations, 
            start of year...............      16,103      18,042      20,338
73.10 Total new obligations.............      16,741      19,020      20,068
73.20 Total outlays (gross).............     -14,764     -16,725     -19,080
73.40 Adjustments in expired accounts 
        (net)...........................         -38
      Unpaid obligations, end of year:

74.40   Obligated balance, end of year..      13,898      16,194      17,182
74.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............       4,144       4,144       4,144
                                           ---------   ---------  ----------
74.99     Total unpaid obligations, end 
            of year.....................      18,042      20,338      21,326
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................       5,549       5,998       6,606
86.93 Outlays from discretionary 
        balances........................       9,190      10,692      12,435
86.97 Outlays from new mandatory 
        authority.......................          14          14          14
86.98 Outlays from mandatory balances...          11          21          25
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........      14,764      16,725      19,080
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........        -949      -1,187      -1,215
      Against gross budget authority only:

88.95   From Federal sources: Change in 
          receivables and unpaid, 
          unfilled orders...............        -160
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................      15,647      17,833      18,853
90.00 Outlays...........................      13,815      15,538      17,865
---------------------------------------------------------------------------

                          [Dollars in millions]

                                        1999         2000        2001
Distribution of budget authority by 
    account:
  National Cancer Institute.........       2,918       3,315       3,250
  National Heart, Lung, and Blood 
    Institute.......................       1,788       2,029       2,070
  National Institute of Dental and 
    Craniofacial Research...........         234         269         263
  National Institute of Diabetes and 
    Digestive and Kidney Diseases...       1,018       1,168       1,213
  National Institute of Neurological 
    Disorder and Stroke.............         900       1,029       1,050
  National Institute of Allergy and 
    Infectious Diseases.............       1,565       1,778         935
  National Institute of General 
    Medical Sciences................       1,203       1,354       1,390
  National Institute of Child Health 
    and Human Development...........         749         858         811
  National Eye Institute............         395         450         463
  National Institute of 
    Environmental Health Sciences...         374         442         461
  National Institute on Aging.......         595         686         722
  National Institute of Arthritis 
    and Musculoskeletal and Skin 
    Diseases........................         307         350         364
  National Institute on Deafness and 
    Other Communication Disorders...         229         264         276
  National Institute of Nursing 
    Research........................          70          90          85
  National Institute on Alcohol 
    Abuse and Alcoholism............         259         292         289
  National Institute on Drug Abuse..         611         687         496
  National Institute of Mental 
    Health..........................         858         973         896
  National Center for Research 
    Resources.......................         562         677         603
  National Human Genome Research 
    Institute.......................         279         336         353
  National Center for Complementary 
    and Alternative Medicine........          50          68          71
  John E. Fogarty International 
    Center..........................          35          44          33
  National Library of Medicine......         181         214         225
  Office of the Director............         256         282         262
  Office of AIDS Research...........                               2,111
  Buildings and Facilities..........         197         165         148
                                    ------------------------------------
      Subtotal......................      15,633      17,820      18,840
  Cooperative Research and 
    Development Agreements..........          13          13          13
                                    ------------------------------------
      Total Budget Authority, NIH...      15,646      17,833      18,853
                                    ====================================

                          [Dollars in millions]

                                        1999         2000        2001
Distribution of outlays by account:
  National Cancer Institute.........       2,617       2,906       3,110
  National Heart, Lung, and Blood 
    Institute.......................       1,539       1,749       1,949
  National Institute of Dental and 
    Craniofacial Research...........         212         234         248
  National Institute of Diabetes and 
    Digestive and Kidney Diseases...         903       1,014       1,145
  National Institute of Neurological 
    Disorders and Stroke............         776         899         996
  National Institute of Allergy and 
    Infectious Diseases.............       1,375       1,549         871
  National Institute of General 
    Medical Sciences................       1,076       1,202       1,322
  National Institute of Child Health 
    and Human Development...........         675         755         771
  National Eye Institute............         352         391         440
  National Institute of 
    Environmental Health Sciences...         335         380         441
  National Institute on Aging.......         518         592         676
  National Institute of Arthritis 
    and Musculoskeletal and Skin 
    Diseases........................         267         309         345
  National Institute on Deafness and 
    Other Communication Disorders...         197         226         261
  National Institute of Nursing 
    Research........................          63          70          79
  National Institute on Alcohol 
    Abuse and Alcoholism............         228         254         272
  National Institute on Drug Abuse..         539         596         464
  National Institute of Mental 
    Health..........................         738         849         841
  National Center for Research 
    Resources.......................         460         557         554
  National Human Genome Research 
    Institute.......................         228         280         330
  National Center for Complementary 
    and Alternative Medicine........           3          40          65
  John E. Fogarty International 
    Center..........................          24          35          29
  National Library of Medicine......         161         193         215
  Office of the Director............         309         247         240
  Office of AIDS Research...........                               1,981
  Buildings and Facilities..........         198         198         208
  Service and Supply Fund/Management 
    Fund............................           3
                                    ------------------------------------
      Subtotal Outlays..............      13,796      15,525      17,853
  Cooperative Research and 
    Development Agreements..........          19          13          13
                                    ------------------------------------
      Total Outlays, NIH............      13,815      15,538      17,866
                                    ====================================
    Note: The total amount for FY 2000 AIDS research was $2,006,368,000 
which was jointly determined by the Director of NIH and the Director of the 
Office of AIDS Research pursuant to section 208 of P.L. 106-113. 
$1,961,654,000 was made available to OAR. This amount is net of the 
$44,714,000 in AIDS funds earmarked in P.L. 106-113 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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........         520         602         647
11.3      Other than full-time permanent         123         142         153
11.5      Other personnel compensation..          36          32          34
11.8      Special personal services 
            payments....................          89         106         114
                                           ---------   ---------  ----------
11.9        Total personnel compensation         768         882         948
12.1    Civilian personnel benefits.....         170         196         215
21.0    Travel and transportation of 
          persons.......................          26          27          28
22.0    Transportation of things........           4           4           4
23.1    Rental payments to GSA..........           7           8           9
23.2    Rental payments to others.......          19          18          19
23.3    Communications, utilities, and 
          miscellaneous charges.........          36          39          40
24.0    Printing and reproduction.......          15          16          17
25.1    Advisory and assistance services          47          39          40
25.2    Other services..................         313         503         493
25.3    Purchases of goods and services 
          from Government accounts......       1,116       1,014       1,151
25.4    Operation and maintenance of 
          facilities....................         224         118         120
25.5    Research and development 
          contracts.....................         857         958         986

[[Page 450]]

25.6    Medical care....................          11          13          12
25.7    Operation and maintenance of 
          equipment.....................          39          33          34
26.0    Supplies and materials..........         162         156         159
31.0    Equipment.......................         154         158         163
41.0    Grants, subsidies, and 
          contributions.................      11,735      13,651      14,415
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..      15,703      17,833      18,853
99.0  Reimbursable obligations..........       1,038       1,187       1,215
                                           ---------   ---------  ----------
99.9    Total new obligations...........      16,741      19,020      20,068
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-9915-0-1-552      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Direct:
      Total compensable workyears:

1001    Full-time equivalent employment.      10,986      12,058      12,432
1011    Exempt Full-time equivalent 
          employment....................          22
    Reimbursable:
2001  Total compensable workyears: Full-
        time equivalent employment......       4,321       4,615       4,638
---------------------------------------------------------------------------

                                


 
        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, [$2,654,953,000] $2,823,016,000: Provided, That in addition 
to amounts provided herein, $12,000,000 shall be available from amounts 
available under section 241 of the Public Health Services Act, to carry 
out the National Household Survey on Drug Abuse. (Department of Health 
and Human Services Appropriations Act, 2000, as enacted by section 
1000(a)(4) of the Consolidated Appropriations Act, 2000 (P.L. 106-113).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1362-0-1-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   Mental health and substance 
          abuse activities..............         556         637         716
00.02   Mental health partnership.......         289         356         416
00.03   Substance abuse partnership.....       1,585       1,600       1,631
00.05   Program management..............          56          59          60
09.01 Reimbursable program..............          33          40          40
                                           ---------   ---------  ----------
10.00   Total new obligations...........       2,519       2,692       2,863
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......       2,520       2,692       2,863
23.95 Total new obligations.............      -2,519      -2,692      -2,863
23.98 Unobligated balance expiring or 
        withdrawn.......................          -1
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................       2,488       2,655       2,823
40.76   Reduction pursuant to P.L. 106-
          113...........................                      -3
41.00   Transferred to other accounts...          -1
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............       2,487       2,652       2,823
68.00 Spending authority from offsetting 
        collections: Offsetting 
        collections (cash)..............          33          40          40
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       2,520       2,692       2,863
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year       1,620       1,852       2,053
73.10 Total new obligations.............       2,519       2,692       2,863
73.20 Total outlays (gross).............      -2,247      -2,491      -2,688
73.40 Adjustments in expired accounts 
        (net)...........................         -40
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..       1,852       2,053       2,228
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................       1,086       1,109       1,164
86.93 Outlays from discretionary 
        balances........................       1,161       1,382       1,524
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       2,247       2,491       2,688
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........         -33         -40         -40
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       2,487       2,652       2,823
90.00 Outlays...........................       2,214       2,451       2,648
---------------------------------------------------------------------------

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

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1362-0-1-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........          35          40          42
11.3      Other than full-time permanent           1           1           1
11.5      Other personnel compensation..           1           1           1
                                           ---------   ---------  ----------
11.9        Total personnel compensation          37          42          44
12.1    Civilian personnel benefits.....           8           9          10
21.0    Travel and transportation of 
          persons.......................           1           1           1
23.1    Rental payments to GSA..........           5           5           6
23.3    Communications, utilities, and 
          miscellaneous charges.........           1           1           1
24.0    Printing and reproduction.......           4           4           4
25.1    Advisory and assistance services          11          16          18
25.2    Other services..................         152         169         175
25.3    Purchases of goods and services 
          from Government accounts......          46          50          52
31.0    Equipment.......................           1           2           2
41.0    Grants, subsidies, and 
          contributions.................       2,218       2,351       2,508
42.0    Insurance claims and indemnities           2           2           2
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..       2,486       2,652       2,823
99.0  Reimbursable obligations..........          33          40          40
                                           ---------   ---------  ----------
99.9    Total new obligations...........       2,519       2,692       2,863
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-1362-0-1-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: Full-
        time equivalent employment......         559         612         612
    Reimbursable:
      Total compensable workyears:

2001    Full-time equivalent employment.           2          74          74
2011    Exempt Full-time equivalent 
          employment....................          71
---------------------------------------------------------------------------

                                


 
               AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

                              Federal Funds

General and special funds:

    [Health Care Policy and Research] Healthcare Research and Quality

    For carrying out titles III and IX of the Public Health Service Act, 
and part A of title XI of the Social Security Act, [$111,424,000; in 
addition,] amounts received from Freedom of Information Act fees, 
reimbursable and interagency agreements, and the sale of data

[[Page 451]]

[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 [$88,576,000] $249,943,000. (Department of Health and Human 
Services Appropriations Act, 2000, as enacted by section 1000(a)(4) of 
the Consolidated Appropriations Act, 2000 (P.L. 106-113).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1700-0-1-552      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

01.01   Research on health costs, 
          quality, and outcomes.........          98         108
01.04   Program support.................           2           2
09.00 Reimbursable program..............          82         100         261
                                           ---------   ---------  ----------
10.00   Total new obligations...........         182         210         261
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................           2           2           2
22.00 New budget authority (gross)......         182         210         261
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         184         212         263
23.95 Total new obligations.............        -182        -210        -261
23.98 Unobligated balance expiring or 
        withdrawn.......................
24.40 Unobligated balance available, end 
        of year.........................           2           2
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................         100         111
40.76   Reduction pursuant to P.L. 106-
          113...........................                      -1
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............         100         110
68.00 Spending authority from offsetting 
        collections: Offsetting 
        collections (cash)..............          82         100         261
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................         182         210         261
----------------------------------------------------------------------------

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

72.40   Obligated balance, start of year         139         154         138
72.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............           7           7           7
                                           ---------   ---------  ----------
72.99     Total unpaid obligations, 
            start of year...............         146         161         145
73.10 Total new obligations.............         182         210         261
73.20 Total outlays (gross).............        -161        -220        -353
73.40 Adjustments in expired accounts 
        (net)...........................          -6          -6          -2
      Unpaid obligations, end of year:

74.40   Obligated balance, end of year..         154         138          46
74.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............           7           7           7
                                           ---------   ---------  ----------
74.99     Total unpaid obligations, end 
            of year.....................         161         145          53
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................          65         110         261
86.93 Outlays from discretionary 
        balances........................          96         110          92
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         161         220         353
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........         -82        -100        -261
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         100         110
90.00 Outlays...........................          79         120          92
---------------------------------------------------------------------------

    This activity supports the development of scientific evidence and 
tools to improve the quality, safety, and effectiveness of all aspects 
of the health care system, and initiatives to disseminate and translate 
scientific findings into health care practice.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1700-0-1-552      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........          11          13
11.3      Other than full-time permanent           2           2
                                           ---------   ---------  ----------
11.9        Total personnel compensation          13          15
12.1    Civilian personnel benefits.....           3           4
21.0    Travel and transportation of 
          persons.......................                       1
23.1    Rental payments to GSA..........           3           2
23.3    Communications, utilities, and 
          miscellaneous charges.........           1           1
24.0    Printing and reproduction.......           1           1
25.2    Other services..................           7           7
25.3    Purchases of goods and services 
          from Government accounts......           3           3
25.5    Research and development 
          contracts.....................          26          21
31.0    Equipment.......................           1           1
41.0    Grants, subsidies, and 
          contributions.................          42          54
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..         100         110
99.0  Reimbursable obligations..........          82         100         261
                                           ---------   ---------  ----------
99.9    Total new obligations...........         182         210         261
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-1700-0-1-552      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: Full-
        time equivalent employment......         194         226
    Reimbursable:
2001  Total compensable workyears: Full-
        time equivalent employment......          59          59         294
---------------------------------------------------------------------------

                                


 
                  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, [$86,087,393,000] $93,586,251,000, to remain 
available until expended.
    For making, after May 31, [2000] 2001, payments to States under 
title XIX of the Social Security Act for the last quarter of fiscal year 
[2000] 2001 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 [2001, $30,589,003,000] 2002, 
$36,207,551,000, 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, 2000, as enacted by section 1000(a)(4) of the 
Consolidated Appropriations Act, 2000 (P.L. 106-113).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0512-0-1-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Medicaid vendor payments..........     104,775     109,272     116,448
00.02 State and local administration....       5,836       6,380       7,258
00.03 Vaccine purchases.................         531         465         469
09.00 Medicare Part B premium transfer..                      50          60
                                           ---------   ---------  ----------
10.00   Total new obligations...........     111,142     116,167     124,235
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................       6,012       1,117
22.00 New budget authority (gross)......     102,394     115,050     124,235
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................       3,852
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......     112,258     116,167     124,235
23.95 Total new obligations.............    -111,142    -116,167    -124,235
24.40 Unobligated balance available, end 
        of year.........................       1,117
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................      74,594      86,087      93,586

[[Page 452]]

60.05   Appropriation (indefinite)......                     179
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................      74,594      86,266      93,586
65.00   Advance appropriation...........      27,801      28,734      30,589
69.00 Offsetting collections (cash).....                      50          60
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................     102,395     115,050     124,235
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year       5,504       4,751       4,751
73.10 Total new obligations.............     111,142     116,167     124,235
73.20 Total outlays (gross).............    -108,043    -116,167    -124,235
73.45 Adjustments in unexpired accounts.      -3,852
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..       4,751       4,751       4,751
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................      96,526     115,050     124,235
86.98 Outlays from mandatory balances...      11,516       1,117
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........     108,043     116,167     124,235
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........                     -50         -60
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................     102,394     115,000     124,175
90.00 Outlays...........................     108,043     116,117     124,175
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1999 actual  2000 est.   2001 est.
Enacted/requested:
  Budget Authority..................     102,395     115,000     124,175
  Outlays...........................     108,042     116,117     124,175
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                                 663
  Outlays...........................                                 663
                                    ------------------------------------
Total:
  Budget Authority..................     102,395     115,000     124,838
  Outlays...........................     108,042     116,117     124,838
                                    ====================================
                                      ==========

    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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
41.0  Direct obligations: Grants, 
        subsidies, and contributions....     111,142     116,117     124,175
99.0  Reimbursable obligations: 
        Subtotal, reimbursable 
        obligations.....................                      50          60
                                           ---------   ---------  ----------
99.9    Total new obligations...........     111,142     116,167     124,235
---------------------------------------------------------------------------

                                

                      Grants to States for Medicaid

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0512-4-1-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations (object 
        class 41.0).....................                                 663
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                 663
23.95 Total new obligations.............                                -663
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................                                 663
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                 663
73.20 Total outlays (gross).............                                -663
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................                                 663
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                 663
90.00 Outlays...........................                                 663
---------------------------------------------------------------------------

    This schedule reflects the effects of proposals contained in the 
Budget on the Grants to States for Medicaid account.

                                

                     State Grants and Demonstrations

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0897-0-1-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Infrastructure grants.............                                  20
00.02 Coverage demonstrations...........                                  42
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................                                  62
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                  62
23.95 Total new obligations.............                                 -62
24.40 Unobligated balance available, end 
        of year.........................
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................                                  62
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                  62
73.20 Total outlays (gross).............                                 -16
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..                                  46
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................                                  16
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                  62
90.00 Outlays...........................                                  16
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1999 actual  2000 est.   2001 est.
Enacted/requested:
  Budget Authority..................                                  62
  Outlays...........................                                  16
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                                  10
  Outlays...........................                                  10
                                    ------------------------------------
Total:
  Budget Authority..................                                  72
  Outlays...........................                                  26
                                    ====================================

    This account includes funds for: grants to develop and establish 
State infrastructures to support working individuals with disabilities 
(sec. 203 of P.L. 106-170), and demonstration of health care coverage of 
workers with potentially severe disabilities (sec. 204 of P.L. 106-170).

[[Page 453]]

                                

                     State Grants and Demonstrations

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0897-4-1-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
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:
      Mandatory:

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 mandatory 
        authority.......................                                  10
----------------------------------------------------------------------------

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

    The Budget contains $10 million in FY 2001 for competitive 
demonstration grants to States. The demonstrations will assess eligible 
individuals' access to programs addressing the needs of the homeless and 
improve coordination among these programs.

                                

                   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, [$69,289,100,000] $70,381,600,000. 
(Department of Health and Human Services Appropriations Act, 2000, as 
enacted by section 1000(a)(4) of the Consolidated Appropriations Act, 
2000 (P.L. 106-113).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0580-0-1-571      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Supplementary medical insurance 
        (SMI)...........................      62,171      65,063      69,777
00.02 Hospital insurance for uninsured 
        (HI)............................         555         349         321
00.03 Federal uninsured payment (HI)....          97         121         132
00.04 Program management (HI)...........          96         129         152
00.06 Federal payments from taxation of 
        OASDI benefits (HI).............       6,552       7,190       6,878
00.08 Fraud and abuse control, FBI......          66          76          88
00.10 Fraud and abuse control, criminal 
        fines...........................          36          40          44
00.13 Fraud and abuse, civil monetary 
        penalties.......................                       5           6
00.14 Fraud and abuse control, 
        administrative fees.............           2
00.15 Other (SMI).......................          14
                                           ---------   ---------  ----------
10.00   Total new obligations...........      69,589      72,973      77,398
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          14
22.00 New budget authority (gross)......      69,609      76,600      77,398
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......      69,623      76,600      77,398
23.95 Total new obligations.............     -69,589     -72,973     -77,398
23.98 Unobligated balance expiring or 
        withdrawn.......................         -34      -3,627
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

        Appropriation:
60.00     Appropriation.................          66          76          88
60.00     Appropriation.................      62,953      69,289      70,382
60.05   Appropriation (indefinite)......       6,590       7,235       6,928
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................      69,609      76,600      77,398
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............      69,589      72,973      77,398
73.20 Total outlays (gross).............     -69,589     -72,973     -77,398
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................      69,589      72,973      77,398
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................      69,609      76,600      77,398
90.00 Outlays...........................      69,589      72,973      77,398
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1999 actual  2000 est.   2001 est.
Enacted/requested:
  Budget Authority..................      69,609      76,600      77,398
  Outlays...........................      69,589      72,973      77,398
Legislative proposal, not subject to 
    PAYGO:
  Budget Authority..................                              15,120
  Outlays...........................                              15,120
                                    ------------------------------------
Total:
  Budget Authority..................      69,609      76,600      92,518
  Outlays...........................      69,589      72,973      92,518
                                    ====================================

    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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
41.0  Grants, subsidies, and 
        contributions...................      69,033      72,374      76,793
42.0  Insurance claims and indemnities..         460         470         453
92.0  Undistributed.....................          96         129         152
                                           ---------   ---------  ----------
99.9    Total new obligations...........      69,589      72,973      77,398
---------------------------------------------------------------------------

                                

                 Payments to the Health Care Trust Funds

              (Legislative proposal, not subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0580-2-1-571      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.02 SMI premium match match--savings 
        proposals.......................                                -280
00.03 Surplus transfer for HI solvency..                              15,400
                                           ---------   ---------  ----------
10.00   Total new obligations...........                              15,120
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                              15,120
23.95 Total new obligations.............                             -15,120
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................                                -280
60.05   Appropriation (indefinite)......                              15,400
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................                              15,120
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                              15,120
73.20 Total outlays (gross).............                             -15,120
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................                              15,120
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                              15,120

[[Page 454]]

90.00 Outlays...........................                              15,120
---------------------------------------------------------------------------

    This schedule reflects the effects of the Medicare proposals 
contained in the Budget on the Payments to the health care trust funds 
account.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0580-2-1-571      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
41.0  Grants, subsidies, and 
        contributions...................                                -280
92.0  Undistributed.....................                              15,400
                                           ---------   ---------  ----------
99.9    Total new obligations...........                              15,120
---------------------------------------------------------------------------

                                

                           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 [$1,994,548,000] $2,086,302,000, 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 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 $18,000,000 appropriated under 
this heading for the managed care system redesign shall remain available 
until 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 $3,000,000 
of the amount available for research, demonstration, and evaluation 
activities shall be awarded to an application from the University of 
Pennsylvania Medical Center, the University of Louisville Sciences 
Center, and St. Vincent's Hospital in Montana to conduct a demonstration 
to reduce hospitalizations among high-risk patients with congestive 
heart failure: Provided further, That $2,000,000 of the amount available 
for research, demonstration, and evaluation activities shall be awarded 
to the AIDS Healthcare Foundation in Los Angeles: Provided further, That 
$100,000 of the amount available for research, demonstration, and 
evaluation activities shall be awarded to Littleton Regional Hospital in 
New Hampshire, to assist in the development of rural emergency medical 
services: Provided further, That $250,000 of the amount available for 
research, demonstration, and evaluation activities shall be awarded to 
the University of Missouri-Kansas City to test behavorial interventions 
of nursing home residents with moderate to severe dementia: Provided 
further, That $1,000,000 of the amount available for research, 
demonstration, and evaluation activities shall be awarded for a 
children's hospice care demonstration program in Virginia, Florida, 
Kentucky, New York, and Utah: Provided further, That $150,000 of the 
amount available for research, demonstration, and evaluation activities 
shall be awarded to L.A. Care Health Plan in Los Angeles, California for 
a Medicaid outreach demonstration project to provide access to medical 
care for uninsured workers: Provided further, That $500,000 of the 
amount available for research, demonstration, and evaluation activities 
shall be awarded to the Baystate Medical Center in Springfield, 
Massachusetts for the Partners for a Healthier Community childhood 
immunization demonstration project: Provided further, That $250,000 
shall be awarded to the Shelby County Regional Medical Center to 
establish a Master Patient Index to determine patient Medicaid/TennCare 
eligibility:] Provided further, That the Secretary of Health and Human 
Services is directed to collect[, in aggregate, $95,000,000 in] fees in 
fiscal year [2000] 2001 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: Provided further, That 
administrative fees collected relative to Medicare overpayment recovery 
activities shall be transferred to the Health Care Fraud and Abuse 
Control (HCFAC) account, to be used for Medicare Integrity Program (MIP) 
activities in addition to the amounts already specified, and shall 
remain available until expended. (Department of Health and Human 
Services Appropriations Act, 2000, as enacted by section 1000(a)(4) of 
the Consolidated Appropriations Act, 2000 (P.L. 106-113).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0511-0-1-550      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   Medicare contractors............       1,256       1,264       1,301
00.02   Federal administration..........         455         483         496
00.03   State survey and certification..         175         205         234
00.04   Research, demonstrations, and 
          evaluation projects...........          50          62          55
                                           ---------   ---------  ----------
01.00   Total direct program............       1,936       2,014       2,086
09.01 CLIA..............................          34          43          43
09.03 Other reimbursements..............           3           1           2
09.06 Medicare+Choice...................          91          95          19
                                           ---------   ---------  ----------
09.09   Total reimbursable program......         128         139          64
                                           ---------   ---------  ----------
10.00   Total new obligations...........       2,063       2,153       2,150
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          15          88          67
22.00 New budget authority (gross)......       2,082       2,133       2,150
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................          64
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       2,161       2,221       2,217
23.95 Total new obligations.............      -2,063      -2,153      -2,150
23.98 Unobligated balance expiring or 
        withdrawn.......................         -10
24.40 Unobligated balance available, end 
        of year.........................          88          67          67
----------------------------------------------------------------------------

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

        Discretionary:
          Offsetting collections (cash):
68.00       Offsetting collections 
              (cash)....................       1,812       1,993       2,086
68.00       Offsetting collections 
              (cash)....................         134         140          64
68.10     From Federal sources: Change 
            in receivables and unpaid, 
            unfilled orders.............         286
68.15     From Federal sources: 
            Adjustments to receivables 
            and unpaid, unfilled orders.        -149
68.75     Reduction pursuant to P.L. 
            106-51......................          -1
                                           ---------   ---------  ----------
68.90       Spending authority from 
              offsetting collections 
              (total discretionary).....       2,082       2,133       2,150
----------------------------------------------------------------------------

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

72.40   Obligated balance, start of year         280          74          74
72.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............         377         663         663
                                           ---------   ---------  ----------
72.99     Total unpaid obligations, 
            start of year...............         657         737         737
73.10 Total new obligations.............       2,063       2,153       2,150
73.20 Total outlays (gross).............      -1,914      -2,153      -2,150
73.40 Adjustments in expired accounts 
        (net)...........................          -5
73.45 Adjustments in unexpired accounts.         -64
      Unpaid obligations, end of year:

74.40   Obligated balance, end of year..          74          74          74
74.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............         663         663         663
                                           ---------   ---------  ----------
74.99     Total unpaid obligations, end 
            of year.....................         737         737         737
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................       1,524       2,133       2,150
86.93 Outlays from discretionary 
        balances........................         389          20
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       1,914       2,153       2,150
----------------------------------------------------------------------------

[[Page 455]]



    Offsets:
      Against gross budget authority and outlays:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............      -1,812      -1,993      -2,086
88.40     Non-Federal sources...........        -134        -140         -64
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........      -1,946      -2,133      -2,150
      Against gross budget authority only:

88.95   From Federal sources: Change in 
          receivables and unpaid, 
          unfilled orders...............        -286
88.96   From Federal sources: Adjustment 
          to receivables and unpaid, 
          unfilled orders...............         149
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................          -1
90.00 Outlays...........................         -32          20
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1999 actual  2000 est.   2001 est.
Enacted/requested:
  Budget Authority..................          -1
  Outlays...........................         -33          20
Legislative proposal, not subject to 
    PAYGO:
  Budget Authority..................
  Outlays...........................
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                                 250
  Outlays...........................                                 250
                                    ------------------------------------
Total:
  Budget Authority..................          -1                     250
  Outlays...........................         -33          20         250
                                    ====================================

    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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........         246         280         291
11.3      Other than full-time permanent           8           5           8
11.5      Other personnel compensation..           5           4           5
                                           ---------   ---------  ----------
11.9        Total personnel compensation         259         289         304
12.1    Civilian personnel benefits.....          51          55          59
21.0    Travel and transportation of 
          persons.......................          11          11           8
23.1    Rental payments to GSA..........          19          21          22
23.3    Communications, utilities, and 
          miscellaneous charges.........          22           6           8
24.0    Printing and reproduction.......           8           9           8
25.1    Advisory and assistance services           6           1           1
25.2    Other services..................         443         318         349
25.3    Purchases of goods and services 
          from Government accounts......           9          17           8
25.6    Medical care....................       1,055       1,260       1,297
26.0    Supplies and materials..........           3           1           1
31.0    Equipment.......................          31           2           2
32.0    Land and structures.............          10          10          10
41.0    Grants, subsidies, and 
          contributions.................           8          13           9
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..       1,935       2,013       2,086
99.0  Reimbursable obligations..........         128         140          64
                                           ---------   ---------  ----------
99.9    Total new obligations...........       2,063       2,153       2,150
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0511-0-1-550      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: Full-
        time equivalent employment......       4,139       4,233       4,353
    Reimbursable:
2001  Total compensable workyears: Full-
        time equivalent employment......          80          80          82
    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 2001 
from the Federal Hospital Insurance and Federal Supplementary Medical 
Insurance Trust Funds shall be reduced by $220,000,000: Provided 
further, That contingent upon enactment of an amendment to section 
1857(e)(2) of the Social Security Act which increases the aggregate 
amount of user fees from Medicare+Choice organizations, the Secretary of 
Health and Human Services is directed to collect up to $150,000,000 in 
fiscal year 2001 which shall be credited to this account as offsetting 
collections and remain available until expended to implement the 
Medicare+Choice education campaign: Provided further, That contingent 
upon enactment of authorizing legislation, the Secretary is directed to 
collect up to $4,300,000 in fiscal year 2001 which shall be credited to 
this account as offsetting collections and remain available until 
expended for the purposes of operating a nursing home criminal abuse 
registry.

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0511-2-1-550      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.01   Medicare contractor 
          appropriation.................                                -136
00.02   Federal administration 
          appropriation.................                                 -21
00.03   State survey and certification 
          appropriation.................                                 -63
                                           ---------   ---------  ----------
01.00   Total direct program............                                -220
09.01 User fee for duplicate and 
        unprocessable claims............                                  53
09.02 User fee for paper claims.........                                  83
09.03 User fee for initial survey and 
        certification...................                                  13
09.04 User fee for recertification 
        (survey)........................                                  50
09.05 User fee for processing health 
        plan applications...............                                  21
09.06 HMO user fee: Medicare+Choice 
        beneficiary information campaign                                 131
09.07 User fee for background checks in 
        nursing home patient abuse 
        registry........................                                   4
                                           ---------   ---------  ----------
09.09   Total reimbursable program......                                 355
                                           ---------   ---------  ----------
10.00   Total new obligations...........                                 135
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                 135
23.95 Total new obligations.............                                -135
----------------------------------------------------------------------------

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

        Discretionary:
          Offsetting collections (cash):
68.00       Offsetting collections 
              (cash)....................                                -220
68.00       Offsetting collections 
              (cash)....................                                 355
                                           ---------   ---------  ----------
68.90       Spending authority from 
              offsetting collections 
              (total discretionary).....                                 135
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                 135
73.20 Total outlays (gross).............                                -135
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................                                 135
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

        Offsetting collections (cash) 
            from:
88.00     Federal sources...............                                 220
88.40     Non-Federal sources...........                                -355
                                           ---------   ---------  ----------
88.90       Total, offsetting 
              collections (cash)........                                -135
----------------------------------------------------------------------------

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

    The Budget includes $220 million in new user fees to finance HCFA 
activities. Proposed fees include: a duplicate or

[[Page 456]]

unprocessable claims fee, a paper claims 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 $220 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. 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 
$4.3 million in user fees to finance the operation of a nursing home 
criminal abuse registry. 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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

      Direct obligations:

25.2    Other services..................                                 -84
25.6    Medical care....................                                -136
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..                                -220
99.0  Reimbursable obligations..........                                 355
                                           ---------   ---------  ----------
99.9    Total new obligations...........                                 135
---------------------------------------------------------------------------

                                

                           Program Management

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0511-4-1-550      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct program:

00.04   Research, demonstrations, and 
          evaluation projects...........                                 250
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................                                 250
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                 250
23.95 Total new obligations.............                                -250
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................                                 250
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                 250
73.20 Total outlays (gross).............                                -250
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................                                 250
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                 250
90.00 Outlays...........................                                 250
---------------------------------------------------------------------------

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

                                

                 State Children's Health Insurance Fund 

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0515-0-1-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Grants, subsidies, and 
        contributions...................       4,732       4,249       4,249
00.02 Advisory and assistance services..                      10
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................       4,732       4,259       4,249
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................         485
22.00 New budget authority (gross)......       4,247       4,259       4,249
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       4,732       4,259       4,249
23.95 Total new obligations.............      -4,732      -4,259      -4,249
24.40 Unobligated balance available, end 
        of year.........................
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

        Appropriation:
60.00     Appropriation, BBRA Sec. 702..       4,307       4,275       4,275
60.00     Appropriation, BBRA for 
            territories.................                      34          34
60.00     Appropriation, BBRA Sec. 703..                      10
61.00   Transferred to other accounts...         -60         -60         -60
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................       4,247       4,259       4,249
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year       3,745       7,912      10,871
73.10 Total new obligations.............       4,732       4,259       4,249
73.20 Total outlays (gross).............        -565      -1,300      -1,905
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..       7,912      10,871      13,215
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................          43         200
86.98 Outlays from mandatory balances...         522       1,100       1,905
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         565       1,300       1,905
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       4,247       4,259       4,249
90.00 Outlays...........................         565       1,300       1,905
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1999 actual  2000 est.   2001 est.
Enacted/requested:
  Budget Authority..................       4,247       4,259       4,249
  Outlays...........................         565       1,300       1,905
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                                 212
  Outlays...........................                                 212
                                    ------------------------------------
Total:
  Budget Authority..................       4,247       4,259       4,461
  Outlays...........................         565       1,300       2,117
                                    ====================================

    The Balanced Budget Act of 1997 established the State children's 
health insurance program (SCHIP) 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 SCHIP program, a SCHIP 
Medicaid expansion program, or a combination of both.

[[Page 457]]

                                

                 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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations (object 
        class 41.0).....................                                 212
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                 212
23.95 Total new obligations.............                                -212
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................                                 212
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                 212
73.20 Total outlays (gross).............                                -212
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................                                 212
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                 212
90.00 Outlays...........................                                 212
---------------------------------------------------------------------------

    This schedule reflects the effects of the SCHIP 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 [2000] 2001, 
no commitments for direct loans or loan guarantees shall be made. 
(Department of Health and Human Services Appropriations Act, 2000, as 
enacted by section 1000(a)(4) of the Consolidated Appropriations Act, 
2000 (P.L. 106-113).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4420-0-3-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

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

    New budget authority (gross), detail:
      Mandatory:

69.00   Offsetting collections (cash)...           2           1
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

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

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

    The last loan commitments from the HMO loan fund were made in 1983. 
The schedule above reflects receipts on outstanding loans and payments 
to the Federal Financing Bank.

                                

  

                               Trust Funds

                  Federal Hospital Insurance Trust Fund

              Unavailable Collections (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8005-0-7-571      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Balance, start of year:
01.99 Balance, start of year............     116,434     137,807     162,730
    Receipts:
02.00 Interest on investments, 
        legislative proposal, not 
        subject to PAYGO................                                 264
02.01 Transfers from general fund (FICA 
        taxes)..........................     123,360     126,602     133,621
02.02 Receipts from Railroad Retirement 
        Board...........................         388         388         393
02.03 Transfers from general fund (SECA 
        taxes)..........................       8,520       9,525       9,681
02.04 Federal employer contributions 
        (FICA)..........................       1,894       1,980       2,029
02.05 Postal service employer 
        contributions (FICA)............         611         633         659
02.07 Interest received by trust funds..       9,244      11,010      12,242
02.08 Other proprietary receipts from 
        the public......................           2
02.10 Taxation on OASDI benefits........       6,552       7,190       6,878
02.12 Interest payments by Railroad 
        Retirement Board................          42          36          38
02.13 Payments from the general fund 
        (uninsured and program 
        management).....................         749         599         605
02.14 Payments for military service 
        credits.........................          71          63          64
02.15 Premiums collected for uninsured 
        individuals not otherwise 
        eligible........................       1,401       1,379       1,426
02.16 FBI, Payment from the general fund          66          76          88
02.17 Criminal fines, transfers from the 
        general fund....................          41          40          44
02.18 Civil monetary penalties, 
        transfers from the general fund.           5           5           6
02.20 Civil penalties and damages.......          69          81          90
02.21 Transfers from DOD, HI............                      11          14
02.23 Payment to extend solvency, 
        legislative proposal not subject 
        to PAYGO........................                              15,400
                                           ---------   ---------  ----------
02.99   Total receipts..................     153,015     159,618     183,542
                                           ---------   ---------  ----------
04.00 Total: Balances and collections...     269,449     297,425     346,272
    Appropriation:
05.01 Federal hospital insurance trust 
        fund............................    -130,873    -133,832    -144,750
05.02 Health care fraud and abuse 
        control account.................        -764        -864        -950
05.04 Proposed legislation subject to 
        PAYGO...........................                                 185
05.06 Proposed legislation not subject 
        to PAYGO........................                                  74
                                           ---------   ---------  ----------
05.99 Subtotal appropriation............    -131,637    -134,696    -145,441
06.10 Unobligated balance returned to 
        receipts........................          -5
06.20 Reduction pursuant to Public Law 
        106-113.........................                       1
                                           ---------   ---------  ----------
07.99 Total balance, end of year........     137,807     162,730     200,831
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8005-0-7-571      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Benefit payments, HI..............     129,221     129,216     139,869
00.02 Administration, HI................       1,264       1,360       1,428
00.03 Peer review organizations, HI.....         177         495          71
00.04 Research, HI......................          32          41          37
00.05 HI partial transfer of home health 
        to SMI..........................         179       2,718       3,345
                                           ---------   ---------  ----------
10.00   Total new obligations...........     130,873     133,830     144,750
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......     130,873     133,831     144,750
23.95 Total new obligations.............    -130,873    -133,830    -144,750
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.26   Appropriation (trust fund, 
          definite).....................       1,297       1,363       1,425
40.76   Reduction pursuant to P.L. 106-
          113...........................                      -1
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............       1,297       1,361       1,425
      Mandatory:

60.27   Appropriation (trust fund, 
          indefinite)...................     150,954     157,393     165,502
60.28   Appropriation (unavailable 
          balances).....................     -21,378     -24,924     -22,177
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................     129,576     132,469     143,325
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................     130,873     133,831     144,750
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         352         465         564
73.10 Total new obligations.............     130,873     133,830     144,750
73.20 Total outlays (gross).............    -130,759    -133,731    -145,023

[[Page 458]]

74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         465         564         291
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................       1,118       1,168       1,225
86.93 Outlays from discretionary 
        balances........................         130         170         186
86.97 Outlays from new mandatory 
        authority.......................     129,289     132,097     143,234
86.98 Outlays from mandatory balances...         221         295         378
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........     130,759     133,731     145,023
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................     130,873     133,831     144,750
90.00 Outlays...........................     130,759     133,731     145,023
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.01 Total investments, start of year: 
        U.S. securities: Par value......     118,250     153,767     163,444
92.02 Total investments, end of year: 
        U.S. securities: Par value......     153,767     163,444     185,612
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1999 actual  2000 est.   2001 est.
Enacted/requested:
  Budget Authority..................     130,873     133,830     144,750
  Outlays...........................     130,758     133,730     145,023
Legislative proposal, not subject to 
    PAYGO:
  Budget Authority..................                                 -74
  Outlays...........................                                 -74
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                                -185
  Outlays...........................                                -185
                                    ------------------------------------
Total:
  Budget Authority..................     130,873     133,830     144,491
  Outlays...........................     130,758     133,730     144,764
                                    ====================================

    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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Unexpended balance, start of year:
0100  Treasury balance..................      -1,343     -15,346
0101  U.S. Securities: Par value........     118,250     153,767     163,444
                                           ---------   ---------  ----------
0199    Total balance, start of year....     116,909     138,421     163,443
    Cash income during the year:
      Governmental receipts:

0200    FHI trust fund, transfers from 
          general fund (FICA taxes).....     123,360     126,602     133,621
0201    FHI trust fund, transfers from 
          general fund (SECA taxes).....       8,520       9,525       9,681
0205    FHI trust fund, receipts from 
          Railroad Retirement Board.....         388         388         393
0206    HCFAC: Civil penalties and 
          damages.......................          69          81          90
      Proprietary receipts:

0221    FHI trust fund, premiums 
          collected for uninsured 
          individuals not otherwise 
          eligible......................       1,401       1,379       1,426
0222    Other proprietary receipts......           2
      Intragovernmental transactions:

0240    FHI trust fund, Federal employer 
          contributions (FICA)..........       1,894       1,980       2,029
0241    FHI trust fund, Postal Service 
          employer contributions (FICA).         611         633         659
0242    FHI trust fund, Federal payment 
          for transitional coverage for 
          uninsured Federal employees...          97         121         132
0243    FHI trust fund, Federal payment 
          for transitional coverage for 
          the uninsured.................         555         349         321
0245    FHI trust fund, general fund 
          transfer, program management 
          (HI)..........................          96         129         152
0246    FHI trust fund, Federal payments 
          for OASDI taxes...............       6,552       7,190       6,878
0248    FHI trust fund, interest payment 
          from Railroad Retirement Board          42          36          38
0249    FHI trust fund, interest on 
          investments...................       9,244      11,010      12,242
0250    Interest on investments, 
          legislative proposal not 
          subject to PAYGO..............                                 264
0251    FHI trust fund, transfer from 
          Department of Defense for 
          military service credits......          71          63          64
0252    HCFAC: FBI......................          66          76          88
0253    HCFAC: Criminal fines...........          41          40          44
0254    HCFAC: Civil monetary penalties.           5           5           6
0255    Other intragovernmental 
          transactions..................                      11          14
0256    Payment to extend solvency, 
          legislative proposal not 
          subject to PAYGO..............                              15,400
      Offsetting collections:

0280    HCFAC user fees.................           3           4
0297  Income under present law..........     153,017     159,622     167,878
0298  Income under proposed legislation.                              15,664
                                           ---------   ---------  ----------
0299    Total cash income...............     153,018     159,622     183,542
    Cash outgo during year:
0500  Benefit Payments..................    -129,107    -129,216    -139,869
0501  Benefit payments, legislative 
        proposal subject to PAYGO.......                                 185
0502  Administration....................      -1,264      -1,344      -1,415
0503  Administration, legislative 
        proposal not subject to PAYGO...                                  74
0504  Peer Review Organizations.........        -177        -418        -358
0505  Research..........................         -32         -35         -37
0506  HCFAC.............................        -744        -868        -950
0507  HI Partial Transfer of Home Health 
        to SMI..........................        -179      -2,718      -3,345
0597  Outgo under present law (-).......    -131,503    -134,599    -145,974
0598  Outgo under proposed legislation 
        (-).............................                                 259
                                           ---------   ---------  ----------
0599  Total cash outgo (-)..............    -131,503    -134,599    -145,714
    Unexpended balance, end of year:
0700  Treasury Balance..................     -15,346
0701  U.S. Securities: Par value........     153,767     163,444     201,271
                                           ---------   ---------  ----------
0799    Total balance, end of year......     138,421     163,443     201,271
---------------------------------------------------------------------------

                Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8005-0-7-571      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

      Grants, subsidies, and contributions:

41.0    Payment for health insurance 
          experiments and demonstration 
          projects......................          32          41          37
41.0    Payment for peer review 
          organization (PRO) activities.         177         495          71
42.0  Insurance claims and indemnities..     129,221     129,216     139,869
      Undistributed:

92.0    HI Partial Transfer of Home 
          Health to SMI.................         179       2,718       3,345
92.0    Reimbursement for administrative 
          expenses for other than SSA 
          LAE...........................          48          40          40
92.0    Purchases of goods and services.         720         764         807
93.0  Administrative expenses: Portion 
        of limitation on salaries and 
        expenses: Social Security 
        Administration..................         496         556         581
                                           ---------   ---------  ----------
99.9    Total new obligations...........     130,873     133,830     144,750
---------------------------------------------------------------------------

                                

                  Federal Hospital Insurance Trust Fund

              (Legislative proposal, not subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8005-2-7-571      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.02 Administration....................                                 -74
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 92.0)...................                                 -74
----------------------------------------------------------------------------

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

    New budget authority (gross), detail:
      Discretionary:

40.26   Appropriation (trust fund, 
          definite).....................                                 -74
      Mandatory:

60.27   Appropriation (trust fund, 
          indefinite)...................                              15,400
60.28   Appropriation (unavailable 
          balances).....................                             -15,400
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................
                                           ---------   ---------  ----------

[[Page 459]]


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 discretionary 
        authority.......................                                 -74
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                 -74
90.00 Outlays...........................                                 -74
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.02 Total investments, end of year: 
        U.S. securities: Par value......                              15,474
---------------------------------------------------------------------------

    This schedule reflects the effects of the HCFA user fees proposed in 
the 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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations (object 
        class 42.0).....................                                -185
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                -185
23.95 Total new obligations.............                                 185
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.28   Appropriation (unavailable 
          balances).....................                                -185
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                -185
73.20 Total outlays (gross).............                                 185
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................                                -185
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                -185
90.00 Outlays...........................                                -185
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.02 Total investments, end of year: 
        U.S. securities: Par value......                                 185
---------------------------------------------------------------------------

    This schedule reflects the effects of Medicare proposals contained 
in the Budget on the Hospital Insurance trust fund.

                                

               Health Care Fraud and Abuse Control Account

                 (federal hospital insurance trust fund)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8393-0-7-571      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Medicare integrity program........         551         630         680
00.02 FBI fraud and abuse control.......          66          76          88
00.03 Other fraud and abuse control.....         135         158         182
09.01 Reimbursable......................           3           4
                                           ---------   ---------  ----------
10.00   Total new obligations...........         755         868         950
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......         767         868         950
23.95 Total new obligations.............        -755        -868        -950
23.98 Unobligated balance expiring or 
        withdrawn.......................         -11
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.26   Appropriation (trust fund, 
          definite).....................         764         864         950
69.00 Offsetting collections (cash).....           3           4
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................         767         868         950
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         123         149         149
73.10 Total new obligations.............         755         868         950
73.20 Total outlays (gross).............        -744        -868        -950
73.40 Adjustments in expired accounts 
        (net)...........................          16
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         149         149         149
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................         663         868         950
86.98 Outlays from mandatory balances...          82
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         744         868         950
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........          -3          -4
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         764         864         950
90.00 Outlays...........................         742         864         950
---------------------------------------------------------------------------

    P.L. 104-191 established the Health Care Fraud and Abuse Control 
(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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

      Direct obligations:

25.6    Medical care (HCFA).............         551         630         680
92.0    Undistributed (FBI).............          66          76          88
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..         617         706         768
      Allocation Account:

        Personnel compensation:
          Full-time permanent:
11.1        Full-time permanent (OIG)...          54          70          74
11.1        Full-time permanent (DoJ)...          14          16          18
11.1        Full-time permanent (OGC)...           1           2           2
          Other than full-time 
              permanent:
11.3        Other than full-time 
              permanent (DOJ)...........                       1           1
11.3        Other than full-time 
              permanent (OIG)...........                                   1
11.5      Other personnel compensation 
            (OIG).......................                                   1
          Special personal services 
              payments:
11.8        Special personal services 
              payments (DOJ)............           1                       1
11.8        Special personal services 
              payments (AoA)............           1                       1
                                           ---------   ---------  ----------
11.9        Total personnel compensation          71          89          99
        Civilian personnel benefits:
12.1      Civilian personnel benefits 
            (OIG).......................          13          15          17
12.1      Civilian personnel benefits 
            (DoJ).......................           4           4           4
        Travel and transportation of 
            persons:
21.0      Travel and transportation of 
            persons (OIG)...............           5           6           6
21.0      Travel and transportation of 
            persons (DoJ)...............                       1           1
22.0    Transportation of things (OIG)..                                   1
        Rental payments to GSA:
23.1      Rental payments to GSA (OIG)..           8           8           8
23.1      Rental payments to GSA (DoJ)..           3           3           3
23.1      Rental payments to GSA (OGC)..           1                       1
23.3    Communications, utilities, and 
          miscellaneous charges (OIG)...           1           1           2
        Other services:
25.2      Other services (DoJ)..........           6           8          16
25.2      Other services (OIG)..........                                   2
25.2      Other services (HRSA).........           2
        Purchases of goods and services 
            from Government accounts:
25.3      Purchases of goods and 
            services from Government 
            accounts (OIG)..............           1           2          12
25.3      Purchases of goods and 
            services from Government 
            accounts (DoJ)..............                       2           1
25.5    Research and development 
          contracts (OIG)...............          12          17
25.7    Operation and maintenance of 
          equipment (HRSA)..............           4
26.0    Supplies and materials (OIG)....           1           1           2

[[Page 460]]

        Equipment:
31.0      Equipment (OIG)...............           5           4           4
31.0      Equipment (DOJ)...............                                   1
41.0    Grants, subsidies, and 
          contributions (AoA)...........           1           1           2
                                           ---------   ---------  ----------
99.0      Subtotal, allocation account..         138         162         182
                                           ---------   ---------  ----------
99.9    Total new obligations...........         755         868         950
---------------------------------------------------------------------------

    This schedule reflects estimated distribution of the allocation 
account. This allocation assumes $12.5 million within HCFAC would be 
used for oversight of HCFA's contractor initiative and $3.5 million 
would fund incentive grants for States to develop Medicaid error rates. 
The non-HHS/DoJ amounts would be distributed based on competitive 
criteria established by HHS and DoJ.

                                     1999 actual  2000 est.   2001 est.
Department of Justice (DOJ).........          28          34          34
Office of the Inspector General, HHS         100         124         124
Health Care Financing Administration         551         630         680
Office of General Counsel, HHS......           2           2           0
Other HHS...........................           8           2           2
Other non-HHS/non-DOJ...............           0           0          22
                                    ------------------------------------
    Total...........................         689         794         862
                                    ====================================

                                

           Federal Supplementary Medical Insurance Trust Fund

              Unavailable Collections (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8004-0-7-571      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Balance, start of year:
01.99 Balance, start of year............      40,875      45,615      44,386
    Receipts:
02.00 Interest on investments, 
        legislative proposal not subject 
        to PAYGO........................                                   9
02.01 Federal contributions.............      62,185      65,063      69,777
02.02 Interest received by trust fund...       2,926       3,080       2,940
02.03 Other proprietary receipts from 
        the public......................           7
02.05 Premiums collected for the aged...      17,722      17,773      19,065
02.06 Premiums collected for the 
        disabled........................       2,438       2,583       2,849
02.07 Transfers from DOD, SMI...........                      11          14
02.09 Premiums collected for the aged, 
        legislative proposal subject to 
        PAYGO...........................                                -160
02.10 Premiums collected for the 
        disabled, legislative proposal 
        subject to PAYGO................                                 -20
02.12 Federal contributions, legislative 
        proposal not subject to PAYGO...                                -280
                                           ---------   ---------  ----------
02.99   Total receipts..................      85,278      88,510      94,194
                                           ---------   ---------  ----------
04.00 Total: Balances and collections...     126,153     134,125     138,580
    Appropriation:
05.01 Federal supplementary medical 
        insurance trust fund............     -80,538     -89,740     -98,782
05.03 Legislative proposal subject to 
        PAYGO...........................                                 685
05.04 Legislative proposal not subject 
        to PAYGO........................                                 146
                                           ---------   ---------  ----------
05.99 Subtotal appropriation............     -80,538     -89,740     -97,951
06.20 Reduction pursuant to Public Law 
        xx-xxx..........................                       1
                                           ---------   ---------  ----------
07.99 Total balance, end of year........      45,615      44,386      40,629
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8004-0-7-571      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Benefit payments, SMI.............      78,972      87,856      96,928
00.02 Administration, SMI...............       1,494       1,690       1,758
00.03 Peer review organizations, SMI....          56         124          18
00.04 Research, SMI.....................          16          20          18
00.06 Transfer to Medicaid for payment 
        of SMI premiums.................                      50          60
09.01 HI partial transfer of home health         179       2,718       3,345
                                           ---------   ---------  ----------
10.00   Total new obligations...........      80,717      92,458     102,127
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......      80,717      92,457     102,127
23.95 Total new obligations.............     -80,717     -92,458    -102,127
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.26   Appropriation (trust fund, 
          definite).....................       1,506       1,706       1,772
40.76   Reduction pursuant to P.L. 106-
          113...........................                      -1
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............       1,506       1,706       1,772
      Mandatory:

60.27   Appropriation (trust fund, 
          indefinite)...................      83,772      86,804      92,873
60.28   Appropriation (unavailable 
          balances).....................                   1,230       4,137
60.45   Portion precluded from 
          obligation....................      -4,740
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................      79,032      88,034      97,010
69.00 Offsetting collections (cash).....         179       2,718       3,345
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................      80,717      92,457     102,127
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year          14          34          98
73.10 Total new obligations.............      80,717      92,458     102,127
73.20 Total outlays (gross).............     -80,697     -92,394    -102,165
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..          34          98          60
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................       1,506       1,697       1,763
86.93 Outlays from discretionary 
        balances........................                       3
86.97 Outlays from new mandatory 
        authority.......................      79,191      90,694     100,359
86.98 Outlays from mandatory balances...                                  43
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........      80,697      92,394     102,165
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........        -179      -2,718      -3,345
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................      80,538      89,739      98,782
90.00 Outlays...........................      80,518      89,676      98,820
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.01 Total investments, start of year: 
        U.S. securities: Par value......      39,502      26,528      44,484
92.02 Total investments, end of year: 
        U.S. securities: Par value......      26,528      44,484      40,318
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1999 actual  2000 est.   2001 est.
Enacted/requested:
  Budget Authority..................      80,538      89,740      98,782
  Outlays...........................      80,518      89,676      98,820
Legislative proposal, not subject to 
    PAYGO:
  Budget Authority..................                                -146
  Outlays...........................                                -146
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                                -685
  Outlays...........................                                -685
                                    ------------------------------------
Total:
  Budget Authority..................      80,538      89,740      97,951
  Outlays...........................      80,518      89,676      97,989
                                    ====================================

    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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Unexpended balance, start of year:
0100  Treasury balance..................       1,387      19,120

[[Page 461]]

0101  U.S. Securities: Par value........      39,502      26,528      44,484
                                           ---------   ---------  ----------
0199    Total balance, start of year....      40,889      45,649      44,484
    Cash income during the year:
      Proprietary receipts:

0221    Premiums collected for the aged, 
          FSMI fund.....................      17,722      17,773      19,065
0222    Premiums collected for the aged, 
          legislative proposal subject 
          to PAYGO......................                                -160
        Proprietary receipts:
0223      Premiums collected for the 
            disabled, FSMI fund.........       2,438       2,583       2,849
0223      Premiums collected for the 
            disabled, legislative 
            proposal subject to PAYGO...                                 -20
0225    Other proprietary receipts......           7
      Intragovernmental transactions:

        Intragovernmental transactions:
0240      Federal contributions, FSMI 
            fund........................      62,185      65,063      69,777
0240      Interest received by trust 
            fund, legislative proposal 
            not subject to PAYGO........                                   9
0241    Federal contributions, 
          legislative proposal not 
          subject to PAYGO..............                                -280
0242    Interest received by trust fund, 
          FSMI fund.....................       2,926       3,080       2,940
0243    Intragovernmental transactions..                      11          14
      Offsetting collections:

0280    HI partial transfer of home 
          health........................         179       2,718       3,345
0297  Income under present law..........      85,457      91,228      97,990
0298  Income under proposed legislation.                                -451
                                           ---------   ---------  ----------
0299    Total cash income...............      85,457      91,228      97,539
    Cash outgo during year:
      Cash outgo during the year (-):

0501    Benefit payments & ESRD.........     -78,972     -87,856     -96,928
0501    Benefit payments & ESRD, 
          legislative proposal subject 
          to PAYGO......................                                 685
0502  Administration....................      -1,494      -1,687      -1,749
0503  Administration, legislative 
        proposal not subject to PAYGO...                                 146
0504  Peer review organizations.........         -36         -66         -65
0505  Research..........................         -16         -17         -18
0506  HI partial transfer of home health        -179      -2,718      -3,345
0507  Transfer to Medicaid for payment 
        of SMI premiums.................                     -50         -60
0597  Outgo under present law (-).......     -80,697     -92,394    -102,165
0598  Outgo under proposed legislation 
        (-).............................                                 831
                                           ---------   ---------  ----------
0599  Total cash outgo (-)..............     -80,697     -92,394    -101,334
    Unexpended balance, end of year:
0700  Treasury balance..................      19,120
0701  U.S. Securities: Par value........      26,528      44,484      40,689
                                           ---------   ---------  ----------
0799    Total balance, end of year......      45,649      44,484      40,689
---------------------------------------------------------------------------

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8004-0-7-571      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

      Direct obligations:

        Grants, subsidies, and 
            contributions:
41.0      Payment for peer review 
            organization (PRO) activity.          56         124          18
41.0      Payment for health insurance 
            experiments and 
            demonstration projects......          16          20          18
42.0    Insurance claims and indemnities      78,972      87,910      96,992
92.0    Undistributed...................       1,064       1,204       1,241
93.0    Administrative expenses: Portion 
          of limitation on salaries and 
          expenses: Social Security 
          Administration................         430         482         513
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..      80,538      89,740      98,782
99.0  Reimbursable obligations..........         179       2,718       3,345
                                           ---------   ---------  ----------
99.9    Total new obligations...........      80,717      92,458     102,127
---------------------------------------------------------------------------

                                

           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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.02 Administration, SMI...............                                -146
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 92.0)...................                                -146
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                -146
23.95 Total new obligations.............                                 146
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.26   Appropriation (trust fund, 
          definite).....................                                -146
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                -146
73.20 Total outlays (gross).............                                 146
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................                                -146
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                -146
90.00 Outlays...........................                                -146
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.02 Total investments, end of year: 
        U.S. securities: Par value......                                 146
---------------------------------------------------------------------------

    This schedule reflects the effects of the HCFA user fees proposed in 
the 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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations (object 
        class 42.0).....................                                -685
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                -685
23.95 Total new obligations.............                                 685
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.27   Appropriation (trust fund, 
          indefinite)...................                                -460
60.28   Appropriation (unavailable 
          balances).....................                                -225
                                           ---------   ---------  ----------
62.50     Appropriation (total 
            mandatory)..................                                -685
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                -685
73.20 Total outlays (gross).............                                 685
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................                                -685
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                -685
90.00 Outlays...........................                                -685
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.02 Total investments, end of year: 
        U.S. securities: Par value......                                 225
---------------------------------------------------------------------------

    This schedule reflects the effects of Medicare proposals contained 
in the Budget on the Supplemental Medical Insurance trust fund.

                                

                 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.''

[[Page 462]]

                                


 
                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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 State family assistance grant.....      16,489      16,489      16,489
00.02 State penalties...................                                 -10
00.03 Territories--family assistance 
        grants..........................          78          78          78
00.04 Matching grants to territories....           3          15          15
00.05 Bonus to reward decrease in 
        illegitimacy....................         100         100         100
00.06 Supplemental grants for population 
        increases.......................         160         239         319
00.07 Bonus to reward high performance 
        States..........................                     200         200
00.08 Tribal work programs..............           7           7           7
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................      16,837      17,128      17,198
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................         721       1,561       1,122
22.00 New budget authority (gross)......      17,693      16,689      16,679
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......      18,414      18,250      17,801
23.95 Total new obligations.............     -16,837     -17,128     -17,198
23.98 Unobligated balance expiring or 
        withdrawn.......................         -16                      -3
24.40 Unobligated balance available, end 
        of year.........................       1,561       1,122         600
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.05   Appropriation (indefinite)......      17,693      16,689      16,679
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year       7,212      10,056      12,084
73.10 Total new obligations.............      16,837      17,128      17,198
73.20 Total outlays (gross).............     -14,161     -14,996     -15,742
73.40 Adjustments in expired accounts 
        (net)...........................         168        -104
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..      10,056      12,084      13,540
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................       9,924       9,160       8,661
86.98 Outlays from mandatory balances...       4,237       5,836       7,081
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........      14,161      14,996      15,742
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................      17,693      16,689      16,679
90.00 Outlays...........................      14,161      14,996      15,742
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1999 actual  2000 est.   2001 est.
Enacted/requested:
  Budget Authority..................      17,693      16,689      16,679
  Outlays...........................      14,161      14,996      15,742
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................
  Outlays...........................                                 208
Legislative proposal, discretionary 
    offset:
  Budget Authority..................                                -240
  Outlays...........................                                -122
                                    ------------------------------------
Total:
  Budget Authority..................      17,693      16,689      16,439
  Outlays...........................      14,161      14,996      15,828
                                    ====================================

    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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.20 Total outlays (gross).............                                -208
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..                                -208
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.98 Outlays from mandatory balances...                                 208
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................                                 208
---------------------------------------------------------------------------

    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.

                                

                 Temporary Assistance For Needy Families

              (Legislative proposal, discretionary offset)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1552-6-1-609      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations (object 
        class 41.0).....................                                -240
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                -240
23.95 Total new obligations.............                                 240
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.36   Unobligated balance rescinded...                                -240
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                -240
73.20 Total outlays (gross).............                                 122
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..                                -118
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.98 Outlays from mandatory balances...                                -122
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                -240
90.00 Outlays...........................                                -122
---------------------------------------------------------------------------

    The Administration will propose legislation that reduces TANF 
supplemental grant funds in 2001 to the 1998 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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................       1,958       1,958       1,958
24.40 Unobligated balance available, end 
        of year.........................       1,958       1,958       1,958
----------------------------------------------------------------------------

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

[[Page 463]]



                                

  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), $2,442,000,000, to remain 
available until expended; and for such purposes for the first quarter of 
fiscal year [2001, $650,000,000] 2002, $1,000,000,000, 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 3 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, 2000, as enacted by section 1000(a)(4) of the 
Consolidated Appropriations Act, 2000 (P.L. 106-113).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1501-0-1-609      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

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

        Benefit payments:
00.01     State child support 
            administrative costs........       2,513       2,819       3,058
00.02     Federal incentive/hold 
            harmless payments to States.         400         382         415
00.03     Access and visitation grants..          10          10          10
                                           ---------   ---------  ----------
00.91   Subtotal, child support 
          enforcement...................       2,923       3,211       3,483
01.02 Payments to territories...........          16          23          23
01.03 Repatriation......................           1           1           1
                                           ---------   ---------  ----------
01.91   Subtotal, other payments........          17          24          24
      Aid to families with dependent children (AFDC) 
          payments:

02.01   AFDC benefit payments...........          95          98
02.03   State and local welfare 
          administration................          13           2
02.04   AFDC/JOBS child care............           6
                                           ---------   ---------  ----------
02.91     Subtotal, AFDC programs.......         114         100
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................       3,054       3,335       3,507
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................       1,564       1,920
22.00 New budget authority (gross)......       3,049       1,415       3,507
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................         361
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       4,974       3,335       3,507
23.95 Total new obligations.............      -3,054      -3,335      -3,507
24.40 Unobligated balance available, end 
        of year.........................       1,920
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................       1,989         283       2,442
65.00   Advance appropriation...........         660         750         650
69.00 Offsetting collections (cash).....         400         382         415
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       3,049       1,415       3,507
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year       1,520       1,057         957
73.10 Total new obligations.............       3,054       3,335       3,507
73.20 Total outlays (gross).............      -3,156      -3,435      -3,474
73.45 Adjustments in unexpired accounts.        -361
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..       1,057         957         990
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................       3,049       1,415       2,978
86.98 Outlays from mandatory balances...         107       2,020         496
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       3,156       3,435       3,474
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.40   Offsetting collections (cash) 
          from: Non-Federal sources.....        -400        -382        -415
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       2,649       1,033       3,092
90.00 Outlays...........................       2,756       3,053       3,059
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1999 actual  2000 est.   2001 est.
Enacted/requested:
  Budget Authority..................       2,649       1,033       3,092
  Outlays...........................       2,756       3,053       3,059
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                                  32
  Outlays...........................                                  32
                                    ------------------------------------
Total:
  Budget Authority..................       2,649       1,033       3,124
  Outlays...........................       2,756       3,053       3,091
                                    ====================================

    This account provides for payments to States for child support 
enforcement and other family support programs including access and 
visitation programs for families. Spending authority from the Federal 
share of child support collections is used to pay incentive payments 
and, for a limited time, hold harmless payments to States. The remaining 
net Federal share of collections 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)

                                        1999         2000        2001
Gross Federal share of collections..      (1268)      (1233)      (1265)
Federal incentive payments to States         362         371         404
Hold harmless payments..............          38          11          11
State child support administrative 
costs...............................        2513        2819        3058
Access and visitation grants........          10          10          10
                                    ------------------------------------
    Subtotal........................        1655        1978        2218
                                    ====================================

                                

  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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

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

        Benefit payments:
00.01     State child support 
            administrative costs........                                  32
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................                                  32
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                  32
23.95 Total new obligations.............                                 -32
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................                                  32
----------------------------------------------------------------------------

    Change in unpaid obligations:
73.10 Total new obligations.............                                  32
73.20 Total outlays (gross).............                                 -32
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................                                  32
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                  32

[[Page 464]]

90.00 Outlays...........................                                  32
---------------------------------------------------------------------------

    This legislative proposal includes several provisions to increase 
child support collections and to direct more of these payments to 
families. The proposal would also conform the match rate for paternity 
testing with the basic administrative match rate.

                                

                    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, [2000] 2001 through September 30, 
[2001] 2002.
    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 Emergency Deficit Control Act of 1985: Provided further, That 
these funds shall be made available only after submission to Congress of 
a formal budget request by the President that includes designation of 
the entire amount of the request as an emergency requirement as defined 
in [the Balanced Budget and Emergency Deficit Control] such Act [of 
1985].
    [The $1,100,000,000 provided in the first paragraph under this 
heading in the Departments of Labor, Health and Human Services, and 
Education, and Related Agencies Appropriations Act, 1999 (as contained 
in section 101(f ) of division A of Public Law 105-277) is hereby 
designated by the Congress as an emergency requirement pursuant to 
section 251(b)(2)(A) of the Balanced Budget and Emergency Deficit 
Control Act of 1985: Provided, That such funds shall be available only 
if the President submits to the Congress one official budget request for 
$1,100,000,000 that includes designation of the entire amount as an 
emergency requirement pursuant to such section: Provided further, That 
such funds shall be distributed in accordance with section 2604 of the 
Omnibus Budget Reconciliation Act of 1981 (42 U.S.C. 8623), other than 
subsection (e) of such section.] (Department of Health and Human 
Services Appropriations Act, 2000, as enacted by section 1000(a)(4) of 
the Consolidated Appropriations Act, 2000 (P.L. 106-113).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1502-0-1-609      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations (object 
        class 41.0).....................       1,277       1,105       1,100
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......       1,277       1,400       1,400
23.95 Total new obligations.............      -1,277      -1,105      -1,100
23.98 Unobligated balance expiring or 
        withdrawn.......................                    -295        -300
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.15   Appropriation (emergency).......         300         300         300
40.60   Contingent emergency 
          appropriation not available 
          for obligations...............        -125
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............         175         300         300
50.00   Reappropriation.................           2
55.00   Advance appropriation...........       1,100       1,100       1,100
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       1,277       1,400       1,400
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         377         474         337
73.10 Total new obligations.............       1,277       1,105       1,100
73.20 Total outlays (gross).............      -1,176      -1,242      -1,105
73.40 Adjustments in expired accounts 
        (net)...........................          -4
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         474         337         332
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................         859         818         814
86.93 Outlays from discretionary 
        balances........................         317         424         291
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       1,176       1,242       1,105
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       1,275       1,400       1,400
90.00 Outlays...........................       1,176       1,242       1,105
---------------------------------------------------------------------------

    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), [$419,005,000] $422,804,000, to remain available through 
September 30, 2003: Provided, That funds appropriated pursuant to 
section 414(a) of the Immigration and Nationality Act under Public Law 
[105-78] 106-113 for fiscal year [1998 and under Public Law 105-277 for 
fiscal year 1999] 2000 shall be available for the costs of assistance 
provided and other activities through September 30, [2001] 2002.
    For carrying out section 5 of the Torture Victims Relief Act of 1998 
(Public Law 105-320), [$7,500,000] $9,765,000.
    [The $426,505,000 provided under this heading is hereby designated 
by the Congress as an emergency requirement pursuant to section 
251(b)(2)(A) of the Balanced Budget and Emergency Deficit Control Act of 
1985: Provided, That such funds shall be available only if the President 
submits to the Congress one official budget request for $426,505,000 
that includes designation of the entire amount as an emergency 
requirement pursuant to such section.] (Department of Health and Human 
Services Appropriations Act, 2000, as enacted by section 1000(a)(4) of 
the Consolidated Appropriations Act, 2000 (P.L. 106-113).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1503-0-1-609      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Refugee and entrant assistance....         465         447         423
00.02 Assistance for treatment of 
        torture victims.................                       7          10
                                           ---------   ---------  ----------
10.00   Total new obligations...........         465         454         433
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................           2           2           2
22.00 New budget authority (gross)......         481         454         433
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         483         454         433
23.95 Total new obligations.............        -465        -454        -433
23.98 Unobligated balance expiring or 
        withdrawn.......................         -16
24.40 Unobligated balance available, end 
        of year.........................           2           2           2
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................         415                     433
40.15   Appropriation (emergency).......                     427
40.76   Reduction pursuant to P.L. 106-
          113...........................                      -1
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............         415         426         433
50.00   Reappropriation.................          66          28
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................         481         454         433
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         511         587         574
73.10 Total new obligations.............         465         454         433
73.20 Total outlays (gross).............        -332        -444        -446
73.40 Adjustments in expired accounts 
        (net)...........................         -57         -23
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         587         574         561
----------------------------------------------------------------------------

[[Page 465]]



    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................         122         123         117
86.93 Outlays from discretionary 
        balances........................         210         321         329
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         332         444         446
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         481         454         433
90.00 Outlays...........................         332         444         446
---------------------------------------------------------------------------

    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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
25.1  Advisory and assistance services..           1           1           1
25.2  Other services....................           1           1           1
25.3  Purchases of goods and services 
        from Government accounts........          29           1           1
41.0  Grants, subsidies, and 
        contributions...................         434         451         430
                                           ---------   ---------  ----------
99.9    Total new obligations...........         465         454         433
---------------------------------------------------------------------------

                                

                   Promoting Safe and Stable Families

    For carrying out section 430 of the Social Security Act, 
[$295,000,000.] $305,000,000. (Department of Health and Human Services 
Appropriations Act, 2000, as enacted by section 1000(a)(4) of the 
Consolidated Appropriations Act, 2000 (P.L. 106-113).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1512-0-1-506      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Grants to States and Tribes.......         241         279         289
00.02 Training and technical assistance.           6           6           6
00.03 State court assessment activities.          10          10          10
                                           ---------   ---------  ----------
10.00   Total new obligations...........         257         295         305
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......         275         295         305
23.95 Total new obligations.............        -257        -295        -305
23.98 Unobligated balance expiring or 
        withdrawn.......................         -18
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................         275         295         305
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         274         322         331
73.10 Total new obligations.............         257         295         305
73.20 Total outlays (gross).............        -248        -286        -288
73.40 Adjustments in expired accounts 
        (net)...........................          39                     -13
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         322         331         335
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................          46          50          52
86.98 Outlays from mandatory balances...         202         236         236
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         248         286         288
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         275         295         305
90.00 Outlays...........................         248         286         288
---------------------------------------------------------------------------

    This program provides funds for a broad range of child welfare 
services, including family preservation and family support services.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1512-0-1-506      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
25.1  Advisory and assistance services..           6           6           6
41.0  Grants, subsidies, and 
        contributions...................         251         289         299
                                           ---------   ---------  ----------
99.9    Total new obligations...........         257         295         305
---------------------------------------------------------------------------

                                

           Job Opportunities and Basic Skills Training Program

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1509-0-1-504      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year          77          62          47
73.20 Total outlays (gross).............          -9          -8          -5
73.40 Adjustments in expired accounts 
        (net)...........................          -6          -7         -42
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..          62          47
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.98 Outlays from mandatory balances...           9           8           5
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................           9           8           5
---------------------------------------------------------------------------

    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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year          11           7           7
73.20 Total outlays (gross).............           1
73.40 Adjustments in expired accounts 
        (net)...........................          -5
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..           7           7           7
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.98 Outlays from mandatory balances...          -1
----------------------------------------------------------------------------

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

                                

                    Child Care Entitlement to States

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1550-0-1-609      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Mandatory child care..............       1,221       1,225       1,229
00.02 Matching child care...............         941       1,136       1,332
00.03 Training and technical assistance.           5           6           6
                                           ---------   ---------  ----------
10.00   Total new obligations...........       2,167       2,367       2,567
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......       2,167       2,367       2,567
23.95 Total new obligations.............      -2,167      -2,367      -2,567
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................       2,167       2,367       2,567
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         608         522         465
73.10 Total new obligations.............       2,167       2,367       2,567
73.20 Total outlays (gross).............      -2,254      -2,420      -2,556
73.40 Adjustments in expired accounts 
        (net)...........................           1          -4
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         522         465         476
----------------------------------------------------------------------------

[[Page 466]]



    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................       1,742       1,988       2,168
86.98 Outlays from mandatory balances...         512         432         388
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       2,254       2,420       2,556
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       2,167       2,367       2,567
90.00 Outlays...........................       2,254       2,420       2,556
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1999 actual  2000 est.   2001 est.
Enacted/requested:
  Budget Authority..................       2,167       2,367       2,567
  Outlays...........................       2,254       2,420       2,556
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                                 600
  Outlays...........................                                 402
                                    ------------------------------------
Total:
  Budget Authority..................       2,167       2,367       3,167
  Outlays...........................       2,254       2,420       2,958
                                    ====================================

    This account provides child care funding for welfare recipients and 
low-income working families and was 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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
25.1  Advisory and assistance services..           5           6           6
41.0  Grants, subsidies, and 
        contributions...................       2,162       2,361       2,561
                                           ---------   ---------  ----------
99.9    Total new obligations...........       2,167       2,367       2,567
---------------------------------------------------------------------------

                                

                    Child Care Entitlement to States

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1550-4-1-609      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Early learning fund...............                                 600
                                           ---------   ---------  ----------
10.00   Total new obligations...........                                 600
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                 600
23.95 Total new obligations.............                                -600
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................                                 600
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year
73.10 Total new obligations.............                                 600
73.20 Total outlays (gross).............                                -402
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..                                 198
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................                                 402
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                 600
90.00 Outlays...........................                                 402
---------------------------------------------------------------------------

    This legislative proposal will provide challenge grants to 
communities to support early childhood education for children under 
five, with a focus on language acquisition, emergent literacy, reading, 
numeracy, and other cognitive, physical, social, and emotional 
development activities aimed at improving readiness for school.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1550-4-1-609      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
25.1  Advisory and assistance services..                                   6
41.0  Grants, subsidies, and 
        contributions...................                                 594
                                           ---------   ---------  ----------
99.9    Total new obligations...........                                 600
---------------------------------------------------------------------------

                                

    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), in addition to amounts already appropriated for fiscal 
year 2001, $817,328,000; and to become available on October 1, [2000] 
2001 and remain available through September 30, [2001, $1,182,672,000] 
2002, $2,000,000,000: Provided, That of the funds appropriated for each 
of fiscal years 2001 and 2002, $19,120,000 shall be available for child 
care resource and referral and school-aged child care activities, of 
which $500,000 shall be for a toll-free child care services program 
hotline to be operated by Child Care Aware: Provided further, That of 
the funds [provided for fiscal year 2001, $172,672,000] appropriated for 
each of fiscal years 2001 and 2002, in addition to the amounts required 
to be reserved by the States under section 658G, $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 section 658G], 
of which $50,000,000 shall be for activities that improve the quality of 
infant and toddler child care: Provided further, That of the funds 
appropriated for each of fiscal years 2001 and 2002, $10,000,000 shall 
be for use by the Secretary for child care research, demonstration, and 
evaluation activities[: Provided further, That of the funds provided for 
fiscal year 2000 under Public Law 105-277, $500,000 shall be for a toll-
free child care services program hotline to be operated by Child Care 
Aware]. (Department of Health and Human Services Appropriations Act, 
2000, as enacted by section 1000(a)(4) of the Consolidated 
Appropriations Act, 2000 (P.L. 106-113).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1515-0-1-609      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Block grant payments to States....         997       1,170       1,985
00.02 Advisory and assistance services..           3           3           5
00.03 Research and evaluation fund......                      10          10
                                           ---------   ---------  ----------
10.00   Total new obligations...........       1,000       1,183       2,000
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......       1,000       1,183       2,000
23.95 Total new obligations.............      -1,000      -1,183      -2,000
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................       1,000                     817
55.00   Advance appropriation...........                   1,183       1,183
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       1,000       1,183       2,000
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         410         390         426
73.10 Total new obligations.............       1,000       1,183       2,000
73.20 Total outlays (gross).............      -1,032      -1,147      -1,720
73.40 Adjustments in expired accounts 
        (net)...........................          12
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         390         426         706
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................         668         787       1,335

[[Page 467]]

86.93 Outlays from discretionary 
        balances........................         364         360         385
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       1,032       1,147       1,720
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       1,000       1,183       2,000
90.00 Outlays...........................       1,032       1,147       1,720
---------------------------------------------------------------------------

    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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
25.1  Advisory and assistance services..           3           5           7
41.0  Grants, subsidies, and 
        contributions...................         997       1,178       1,993
                                           ---------   ---------  ----------
99.9    Total new obligations...........       1,000       1,183       2,000
---------------------------------------------------------------------------

                                

                       Social Services Block Grant

    [For making grants to States pursuant to section 2002 of the Social 
Security Act, $1,775,000,000: Provided, That notwithstanding section 
2003(c) of such Act, as amended, the amount specified for allocation 
under such section for fiscal year 2000 shall be $1,775,000,000.] 
(Department of Health and Human Services Appropriations Act, 2000, as 
enacted by section 1000(a)(4) of the Consolidated Appropriations Act, 
2000 (P.L. 106-113).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1534-0-1-506      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations (object 
        class 41.0).....................       1,909       1,775       1,700
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......       1,909       1,775       1,700
23.95 Total new obligations.............      -1,909      -1,775      -1,700
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................       1,909       1,775       1,700
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year       1,007         927       1,079
73.10 Total new obligations.............       1,909       1,775       1,700
73.20 Total outlays (gross).............      -1,993      -1,623      -1,932
73.40 Adjustments in expired accounts 
        (net)...........................           4                      -2
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         927       1,079         845
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................       1,677       1,349       1,496
86.98 Outlays from mandatory balances...         316         274         436
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       1,993       1,623       1,932
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       1,909       1,775       1,700
90.00 Outlays...........................       1,993       1,623       1,932
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1999 actual  2000 est.   2001 est.
Enacted/requested:
  Budget Authority..................       1,909       1,775       1,700
  Outlays...........................       1,993       1,623       1,932
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                                  75
  Outlays...........................                                  66
                                    ------------------------------------
Total:
  Budget Authority..................       1,909       1,775       1,775
  Outlays...........................       1,993       1,623       1,998
                                    ====================================

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

                                

                       Social Service Block Grant

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1534-4-1-506      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
10.00 Total new obligations (object 
        class 41.0).....................                                  75
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......                                  75
23.95 Total new obligations.............                                 -75
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................                                  75
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year
73.10 Total new obligations.............                                  75
73.20 Total outlays (gross).............                                 -66
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..                                   9
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................                                  66
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................                                  75
90.00 Outlays...........................                                  66
---------------------------------------------------------------------------

    This proposal increases FY 2001 funding for the Social services 
block grant by $75 million for a total of $1,775 million. Of this 
amount, $25 million will be available to support second-chance homes for 
teen-age parents.

                                

                 Children and Families Services Programs

                         (including rescissions)

    For carrying out, except as otherwise provided, the Runaway and 
Homeless Youth Act, the Developmental Disabilities Assistance and Bill 
of Rights Act, the Head Start Act, the Child Abuse Prevention and 
Treatment Act, the 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, [$6,734,133,000] $7,671,590,000, of which 
[$43,000,000] $41,791,000, to remain available until September 30, 
[2001] 2002, 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 [$587,065,000] $540,500,000 
shall be for making payments under the Community Services Block Grant 
Act; and of which [$5,267,000,000] $6,267,000,000 shall be for making 
payments under the Head Start Act, of which $1,400,000,000 shall become 
available October 1, [2000] 2001 and remain available through September 
30, [2001: Provided, That to the extent Community Services Block Grant 
funds are distributed as grant funds by a State to an eligible entity as 
provided under the Act, and have not been expended by such entity, they 
shall remain with such entity for carryover into the next fiscal year 
for expenditure by such entity consistent with program purposes: 
Provided further, That the Secretary shall establish procedures 
regarding the disposition of intangible property which permits grant 
funds, or intangible assets acquired with funds authorized under section 
680 of the Community Services Block Grant Act, as amended, to become the 
sole property

[[Page 468]]

of such grantees after a period of not more than 12 years after the end 
of the grant for purposes and uses consistent with the original grant: 
Provided further, That $1,700,000,000 of the amount provided for making 
payments under the Head Start Act is hereby designated by Congress as an 
emergency requirement pursuant to section 251(b)(2)(A) of the Balanced 
Budget and Emergency Deficit Control Act of 1985: Provided further, That 
such funds shall be available only if the President submits to the 
Congress one official budget request for $1,700,000,000 that includes 
designation of the entire amount as an emergency requirement pursuant to 
such section] 2002.
    [In addition, $101,000,000, 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 2000 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 2000 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, 2000, as enacted by 
section 1000(a)(4) of the Consolidated Appropriations Act, 2000 (P.L. 
106-113).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1536-0-1-506      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Head Start........................       4,658       3,867       6,267
      Social services programs:

        Children, youth, and families:
01.03     Runaway and homeless youth....          44          44          44
01.04     Runaway youth transitional 
            living......................          15          21          21
01.05     Strengthening of parent-
            adolescent relationships....                                  10
01.07     Child abuse state grants......          21          21          21
01.08     Child abuse discretionary 
            grants......................          14          18          18
01.09     Community based resource 
            centers.....................          33          33          33
01.11     Abandoned infants assistance..          12          12          12
01.14     Child welfare services........         292         292         292
01.15     Child welfare training........           7           7           7
01.16     Adoption initiative...........          20          42          42
01.17     Adoption opportunities........          25          27          27
01.19     Family violence grants........                      17
01.20     Social services and income 
            maintenance research........          26          28           7
        Developmental disabilities:
01.23     State grants..................          65          66          66
01.24     Protection and advocacy.......          27          28          28
01.25     Special projects..............          10          10          10
01.26     University affiliated projects          17          18          18
01.28   Native American programs........          36          35          44
                                           ---------   ---------  ----------
01.91     Subtotal social services 
            programs....................         664         719         701
02.01 ACF Federal administration........         144         148         165
                                           ---------   ---------  ----------
02.93   Total Head Start, social 
          services programs, Federal 
          administration................       5,466       4,734       7,132
      Community services programs:

03.01   Community services block grants.         500         528         510
03.03   Community food and nutrition....           5           6
03.04   Community services discretionary          33          35           5
03.05   National youth sports...........          15          15
03.06 Individual development accounts...          10          10          25
                                           ---------   ---------  ----------
03.91   Subtotal, community services....         563         594         540
                                           ---------   ---------  ----------
04.00   Total direct programs...........       6,029       5,328       7,672
09.01 Reimbursable program..............          14          14          14
                                           ---------   ---------  ----------
10.00   Total new obligations...........       6,043       5,342       7,686
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................                       1
22.00 New budget authority (gross)......       6,045       5,342       7,686
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......       6,045       5,343       7,686
23.95 Total new obligations.............      -6,043      -5,342      -7,686
23.98 Unobligated balance expiring or 
        withdrawn.......................          -2
24.40 Unobligated balance available, end 
        of year.........................           1
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................       6,032       3,634       6,272
40.15   Appropriation (emergency).......                   1,700
40.75   Reduction pursuant to P.L. 106-
          51............................          -1
40.76   Reduction pursuant to P.L. 106-
          113...........................                      -6
41.00   Transferred to other accounts...          -2
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............       6,029       5,328       6,272
55.00   Advance appropriation...........                               1,400
      Spending authority from offsetting 
          collections:

68.00   Offsetting collections (cash)...          20          14          14
68.10   From Federal sources: Change in 
          receivables and unpaid, 
          unfilled orders...............          -4
                                           ---------   ---------  ----------
68.90     Spending authority from 
            offsetting collections 
            (total discretionary).......          16          14          14
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       6,045       5,342       7,686
----------------------------------------------------------------------------

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

72.40   Obligated balance, start of year       3,951       4,261       3,322
72.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............           4
                                           ---------   ---------  ----------
72.99     Total unpaid obligations, 
            start of year...............       3,955       4,261       3,322
73.10 Total new obligations.............       6,043       5,342       7,686
73.20 Total outlays (gross).............      -5,723      -6,228      -7,027
73.40 Adjustments in expired accounts 
        (net)...........................         -15         -53
      Unpaid obligations, end of year:

74.40   Obligated balance, end of year..       4,261       3,322       3,981
74.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............
                                           ---------   ---------  ----------
74.99     Total unpaid obligations, end 
            of year.....................       4,261       3,322       3,981
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................       2,442       2,668       4,106
86.93 Outlays from discretionary 
        balances........................       3,281       3,560       2,921
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       5,723       6,228       7,027
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........         -20         -14         -14
      Against gross budget authority only:

88.95   From Federal sources: Change in 
          receivables and unpaid, 
          unfilled orders...............           4
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       6,029       5,328       7,672
90.00 Outlays...........................       5,703       6,214       7,013
---------------------------------------------------------------------------

    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 one 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 2000 enrollment level of 880,000 slots, adding approximately 
60,000 pre-school slots and 10,000 Early Head Start slots in 2001, for 
total enrollment of nearly 950,000.

    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 almost $42 
million for bonus payments to States that increase the number of 
children adopted from the foster care system.

    Individual development accounts (IDAs).--The Administration will 
transmit legislation to allow low-income working families to use IDAs to 
save for a car that helps them get or keep a job.

[[Page 469]]

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1536-0-1-506      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........          90          94         104
11.3      Other than full-time permanent           1           1           1
11.5      Other personnel compensation..           1           1           1
                                           ---------   ---------  ----------
11.9        Total personnel compensation          92          96         106
12.1    Civilian personnel benefits.....          17          18          19
21.0    Travel and transportation of 
          persons.......................           2           3           4
23.1    Rental payments to GSA..........          13          14          15
23.3    Communications, utilities, and 
          miscellaneous charges.........           2           2           2
24.0    Printing and reproduction.......           1           2           2
25.1    Advisory and assistance services          76          78          67
25.2    Other services..................           3           4           5
25.3    Purchases of goods and services 
          from Government accounts......          22          16          17
25.7    Operation and maintenance of 
          equipment.....................                       1           1
26.0    Supplies and materials..........           1                       1
31.0    Equipment.......................           1                       1
41.0    Grants, subsidies, and 
          contributions.................       5,799       5,094       7,432
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..       6,029       5,328       7,672
99.0  Reimbursable obligations..........          14          14          14
                                           ---------   ---------  ----------
99.9    Total new obligations...........       6,043       5,342       7,686
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-1536-0-1-506      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: Full-
        time equivalent employment......       1,507       1,498       1,560
    Allocation account:
3001  Total compensable workyears: Full-
        time equivalent employment......           2           2
---------------------------------------------------------------------------

                                

                    Violent Crime Reduction Programs

    For activities authorized by sections 40155, 40211, and 40241 of 
Public Law 103-322, $134,074,000, to remain available until expended, of 
which $116,918,000 shall be for Family Violence (including Battered 
Women's Shelters); $14,999,000 for Education and Prevention grants to 
reduce sexual abuse of runaway, homeless and street youth; and 
$2,157,000 for the National Domestic Violence Hotline.

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8605-0-1-754      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Family violence/battered women's 
        shelters and domestic violence 
        hotline.........................          89          86         119
00.02 Education and prevention grants to 
        reduce sexual abuse of runaway, 
        homeless and street youth.......          15          15          15
                                           ---------   ---------  ----------
10.00   Total new obligations...........         104         101         134
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......         105         101         134
23.95 Total new obligations.............        -104        -101        -134
23.98 Unobligated balance expiring or 
        withdrawn.......................          -1
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................                                 134
42.00   Transferred from other accounts.         105         101
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............         105         101         134
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year          82         116         114
73.10 Total new obligations.............         104         101         134
73.20 Total outlays (gross).............         -70        -103        -112
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         116         114         136
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................          19          32          43
86.93 Outlays from discretionary 
        balances........................          51          71          69
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........          70         103         112
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         105         101         134
90.00 Outlays...........................          70         103         112
---------------------------------------------------------------------------

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8605-0-1-754      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
25.1  Advisory and assistance services..           2           2           3
41.0  Grants, subsidies, and 
        contributions...................         102          99         131
                                           ---------   ---------  ----------
99.9    Total new obligations...........         104         101         134
---------------------------------------------------------------------------

                                

              Children's Research and Technical Assistance 

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1553-0-1-609      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Training and technical assistance.          13          15          12
00.02 Federal parent locator service....          23          30          25
00.03 Child welfare study...............                                   6
00.04 Welfare research..................                                  15
00.05 Evaluation of welfare to work.....           9
00.06 Evaluation of abstinence education           3
09.01 Reimbursable program..............           4           9          13
                                           ---------   ---------  ----------
09.09   Reimbursable program--subtotal 
          line..........................           4           9          13
                                           ---------   ---------  ----------
10.00   Total new obligations...........          52          54          71
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................           3           8           2
22.00 New budget authority (gross)......          56          48          71
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................           1
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......          60          56          73
23.95 Total new obligations.............         -52         -54         -71
24.40 Unobligated balance available, end 
        of year.........................           8           2           2
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................          52          39          58
69.00 Offsetting collections (cash).....           4           9          13
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................          56          48          71
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year          65          59          44
73.10 Total new obligations.............          52          54          71
73.20 Total outlays (gross).............         -57         -71         -68
73.40 Adjustments in expired accounts 
        (net)...........................           1
73.45 Adjustments in unexpired accounts.          -1
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..          59          44          47
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................          42          32          33
86.98 Outlays from mandatory balances...          15          39          35
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........          57          71          68
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.40   Offsetting collections (cash) 
          from: Non-Federal sources.....          -4          -9         -13
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................          52          39          58
90.00 Outlays...........................          53          62          55
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1999 actual  2000 est.   2001 est.
Enacted/requested:
  Budget Authority..................          52          39          58

[[Page 470]]

  Outlays...........................          53          62          55
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                                   1
  Outlays...........................                                   3
                                    ------------------------------------
Total:
  Budget Authority..................          52          39          59
  Outlays...........................          53          62          58
                                    ====================================

    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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

      Direct obligations:

21.0    Travel and transportation of 
          persons.......................           1           1           1
23.1    Rental payments to GSA..........                       1           1
23.3    Communications, utilities, and 
          miscellaneous charges.........           1           1           1
24.0    Printing and reproduction.......           1           1           1
25.1    Advisory and assistance services           3           5          13
25.2    Other services..................          11          14          11
25.3    Purchases of goods and services 
          from Government accounts......          26          15          14
25.7    Operation and maintenance of 
          equipment.....................           1           1           1
26.0    Supplies and materials..........           1           1           1
31.0    Equipment.......................           1           1           1
41.0    Grants, subsidies, and 
          contributions.................           2           4          13
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..          48          45          58
99.0  Reimbursable obligations..........           4           9          13
                                           ---------   ---------  ----------
99.9    Total new obligations...........          52          54          71
---------------------------------------------------------------------------

                                

              Children's Research and Technical Assistance

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1553-4-1-609      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.02 Federal parent locator service....                                   3
                                           ---------   ---------  ----------
10.00   Total new obligations...........                                   3
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................                                   2
22.00 New budget authority (gross)......                                   1
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......                                   3
23.95 Total new obligations.............                                  -3
24.40 Unobligated balance available, end 
        of year.........................                       2
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................                                   1
----------------------------------------------------------------------------

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

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................                                   1
86.98 Outlays from mandatory balances...                                   2
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........                                   3
----------------------------------------------------------------------------

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

    The legislative proposals for the child support enforcement program 
impact this account by changing the estimated funding levels for child 
support training and technical assistance and the Federal parent locator 
service. In addition, these proposals increase Federal administrative 
costs.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1553-4-1-609      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
25.2  Other services....................                                   1
31.0  Equipment.........................                                   2
                                           ---------   ---------  ----------
99.9    Total new obligations...........                                   3
---------------------------------------------------------------------------

                                

       Payments to States for Foster Care and Adoption Assistance

    For making payments to States or other non-Federal entities under 
title IV-E of the Social Security Act, [$4,307,300,000] $4,863,100,000. 
[of which $105,000,000 shall be for making payments under sections 470 
and 477 of title IV-E of the Social Security Act;]
    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 [2001, $1,538,000,000] 2002, $1,735,900,000. (Department of Health 
and Human Services Appropriations Act, 2000, as enacted by section 
1000(a)(4) of the Consolidated Appropriations Act, 2000 (P.L. 106-113).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1545-0-1-506      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Foster care.......................       3,982       4,537       5,063
00.02 Independent living................          70         105         140
00.03 Adoption assistance...............         826       1,020       1,198
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................       4,878       5,662       6,401
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......       4,922       5,662       6,401
23.95 Total new obligations.............      -4,878      -5,662      -6,401
23.98 Unobligated balance expiring or 
        withdrawn.......................         -43
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................       3,764       4,307       4,863
65.00   Advance appropriation...........       1,158       1,355       1,538
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................       4,922       5,662       6,401
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         688         853       1,025
73.10 Total new obligations.............       4,878       5,662       6,401
73.20 Total outlays (gross).............      -4,707      -5,490      -6,272
73.40 Adjustments in expired accounts 
        (net)...........................          -6
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         853       1,025       1,153
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................       4,231       4,911       5,596
86.98 Outlays from mandatory balances...         476         579         676
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........       4,707       5,490       6,272
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................       4,922       5,662       6,401
90.00 Outlays...........................       4,707       5,490       6,272
---------------------------------------------------------------------------

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

                                     1999 actual  2000 est.   2001 est.
Enacted/requested:
  Budget Authority..................       4,922       5,662       6,401
  Outlays...........................       4,707       5,490       6,272
Supplemental proposal:
  Budget Authority..................                      35

[[Page 471]]

  Outlays...........................                       5          21
Legislative proposal, subject to 
    PAYGO:
  Budget Authority..................                                   5
  Outlays...........................                                   1
                                    ------------------------------------
Total:
  Budget Authority..................       4,922       5,697       6,406
  Outlays...........................       4,707       5,495       6,294
                                    ====================================

    Foster care.--The proposed level will support eligible low-income 
children who must be placed outside the home. An average of 341,700 
children per month will be served in 2001.

    Adoption assistance.--The proposed funding level will support 
subsidies for families adopting eligible low-income children with 
special needs. An average of 256,400 children per month will be served 
in 2001.

                                

       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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Foster care.......................                                   5
                                           ---------   ---------  ----------
10.00   Total new obligations (object 
          class 41.0)...................                                   5
----------------------------------------------------------------------------

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

    New budget authority (gross), detail:
      Mandatory:

60.00   Appropriation...................                                   5
----------------------------------------------------------------------------

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

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

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

    This proposal supports a five-year project to enhance Tribal 
management of child welfare services.

                                


 
                         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 section 398 of the Public Health 
Service Act, [$934,285,000: 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:] $1,083,619,000, of which not less than $125,000,000 shall be for 
an expanded focus on respite and other assistance for families of 
vulnerable elderly, as authorized by section 341 of the Older Americans 
Act: 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, 
2000, as enacted by section 1000(a)(4) of the Consolidated 
Appropriations Act, 2000 (P.L. 106-113).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0142-0-1-506      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
01.01 Supportive services and centers...         300         310         450
01.02 Preventive health.................          16          16          16
01.05 Congregate meals..................         374         374         374
01.06 Home-delivered meals..............         112         147         147
01.07 In home services for the frail 
        elderly.........................          10
01.08 Grants to Indian tribes...........          18          18          23
01.09 State and local innovations and 
        projects of national 
        significance....................          18          32          36
01.10 Federal administration............          15          17          17
01.13 Alzheimer's disease demonstration 
        grants to States................           6           6           6
01.14 Grants to States for the 
        protection of vulnerable older 
        Americans.......................          12          13          13
                                           ---------   ---------  ----------
10.00   Total new obligations...........         882         933       1,084
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......         882         933       1,084
23.95 Total new obligations.............        -882        -933      -1,084
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................         882         934       1,084
40.76   Reduction pursuant to P.L. 106-
          113...........................                      -1
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............         882         933       1,084
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year         259         260         307
73.10 Total new obligations.............         882         933       1,084
73.20 Total outlays (gross).............        -879        -887      -1,020
73.40 Adjustments in expired accounts 
        (net)...........................
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..         260         307         371
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................         639         649         745
86.93 Outlays from discretionary 
        balances........................         240         237         275
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         879         887       1,020
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         882         933       1,084
90.00 Outlays...........................         879         887       1,020
---------------------------------------------------------------------------

    Administration on Aging.--The proposed level will provide continued 
funding for core formula grant programs that provide nutrition and 
supportive services through the aging network. Funding will also support 
an expanded focus on respite and other assistance for families of 
vulnerable elderly as authorized by section 341 of the Older Americans 
Act. These programs and the State and local innovations and projects of 
national significance are part of a comprehensive system of support for 
older people and their families.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0142-0-1-506      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
11.1  Personnel compensation: Full-time 
        permanent.......................           8          10          11
12.1  Civilian personnel benefits.......           1           2           2
23.1  Rental payments to GSA............           1           1           1
25.2  Other services....................           5           5           6
41.0  Grants, subsidies, and 
        contributions...................         867         915       1,064
                                           ---------   ---------  ----------
99.9    Total new obligations...........         882         933       1,084
---------------------------------------------------------------------------

[[Page 472]]



                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0142-0-1-506      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: Full-
        time equivalent employment......         116         142         154
    Allocation account:
3001  Total compensable workyears: Full-
        time equivalent employment......           4           5          13
---------------------------------------------------------------------------

                                


 
                         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, [$227,051,000, of 
which $20,000,000 shall become available on October 1, 2000, and shall 
remain available until September 30, 2001] $223,741,000, together with 
$5,851,000, to be transferred and expended as authorized by section 
201(g)(1) of the Social Security Act from the Hospital Insurance Trust 
Fund and the Supplemental Medical Insurance Trust Fund: Provided, That 
[$450,000 shall be for a contract with the National Academy of Sciences 
to conduct a study of the proposed tuberculosis standard promulgated by 
the Occupational Safety and Health Administration: Provided further, 
That said contract shall be awarded not later than 60 days after the 
enactment of this Act: Provided further, That said study shall be 
submitted to the Congress not later than 12 months after award of the 
contract: Provided further, That of the funds made available under this 
heading for carrying out title XX of the Public Health Service Act, 
$10,569,000 shall be for activities specified under section 2003(b)(2), 
of which $9,131,000 shall be for prevention service demonstration grants 
under section 510(b)(2) of title V of the Social Security Act, as 
amended, without application of the limitation of section 2010(c) of 
said title XX: Provided further, That $500,000 shall be available to the 
Office of the Surgeon General, within the Office of Public Health and 
Science, to prepare and disseminate the findings of the Surgeon 
General's report on youth violence, and to coordinate activities across 
the Department of Health and Human Services: Provided further, That the 
Secretary may transfer a portion of such funds to other Federal entities 
for youth violence prevention coordination activities: Provided further, 
That $2,000,000 shall be available to the Lawton Chiles Foundation] 
$20,000,000 appropriated under this heading in Public Law 106-113, to 
become available October 1, 2000, are hereby rescinded. (Department of 
Health and Human Services Appropriations Act, 2000, as enacted by 
section 1000(a)(4) of the Consolidated Appropriations Act, 2000 (P.L. 
106-113).)

                         Office for Civil Rights

    For expenses necessary for the Office for Civil Rights, 
[$18,838,000] $20,742,000, 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, 2000, as enacted by section 
1000(a)(4) of the Consolidated Appropriations Act, 2000 (P.L. 106-113).)

                             Policy Research

    For carrying out, to the extent not otherwise provided, research 
studies under section 1110 of the Social Security Act, [$17,000,000] 
$16,738,000. (Department of Health and Human Services Appropriations 
Act, 2000, as enacted by section 1000(a)(4) of the Consolidated 
Appropriations Act, 2000 (P.L. 106-113).)

            Public Health and Social Services Emergency Fund

    For public health and social services, $264,600,000, of which 
$208,600,000 is for expenses necessary to support activities related to 
countering potential biological, disease and chemical threats to 
civilian populations[, $214,600,000]: Provided, That this amount is 
distributed as follows: Centers for Disease Control and Prevention, 
[$155,000,000, of which $30,000,000 shall be for the Health Alert 
Network, $1,000,000 shall be for the Carnegie Mellon Research Institute, 
$1,000,000 shall be for the St. Louis University School of Public 
Health, $1,000,000 shall be for the University of Texas Medical Branch 
at Galveston, $1,000,000 shall be for the Noble Army Hospital of Alabama 
bioterrorism program and $1,000,000 shall be for the Johns Hopkins 
University Center for Civilian Biodefense] $148,500,000; Office of the 
Secretary, $30,000,000; [Agency for Health Care Policy and Research, 
$5,000,000,] and Office of Emergency Preparedness, [$24,600,000. In 
addition, for expenses necessary for the portion of the Global Health 
Initiative conducted by the Centers for Disease Control and Prevention, 
$69,000,000: Provided further, That this amount is distributed as 
follows: $35,000,000 shall be for international HIV/AIDS programs, 
$9,000,000 shall be for malaria programs, $5,000,000 shall be for global 
micronutrient malnutrition programs and $20,000,000 shall be for 
carrying out polio eradication activities. In addition, $150,000,000 for 
carrying out the Department's Year 2000 computer conversion activities, 
$5,000,000 for the environmental health laboratory at the Centers for 
Disease Control and Prevention, $50,000,000] $30,100,000: Provided 
further, That $50,000,000 of this amount is for minority AIDS prevention 
and treatment activities[, $20,000,000 for the National Institutes of 
Health challenge grant program, and $75,000,000 to support the Ricky Ray 
Hemophilia Relief Fund Act of 1998: Provided further, That 
notwithstanding any other provision of law, up to $10,000,000 of the 
amount provided for the Ricky Ray Hemophilia Relief Fund Act may be 
available for administrative expenses: Provided further, That the entire 
amount under this heading is hereby designated by the 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 under this heading shall be made 
available only after submission to the 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 of 1985, as amended: 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]. (Department of Health and Human Services 
Appropriations Act, 2000, as enacted by section 1000(a)(4) of the 
Consolidated Appropriations Act, 2000 (P.L. 106-113).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9912-0-1-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
      Direct activities:

00.01   General departmental management.         196         205         230
00.02   Office for Civil Rights.........          21          22          24
00.03   Policy research.................          14          17          17
00.04   Public health and social 
          services emergency fund.......         465         688         265
09.01 Reimbursable program..............          98          98         103
                                           ---------   ---------  ----------
10.00   Total new obligations...........         794       1,030         639
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          21         105
22.00 New budget authority (gross)......         881         925         637
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................           2
22.21 Unobligated balance transferred to 
        other accounts..................
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         904       1,030         637
23.95 Total new obligations.............        -794      -1,030        -639
23.98 Unobligated balance expiring or 
        withdrawn.......................          -5
24.40 Unobligated balance available, end 
        of year.........................         105
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................         221         826         526
40.15   Appropriation (emergency).......         217
40.75   Reduction pursuant to P.L. 106-
          51............................          -1
40.76   Reduction pursuant to P.L. 106-
          113...........................                      -2
41.00   Transferred to other accounts...          -1
42.00   Transferred from other accounts.         337
                                           ---------   ---------  ----------
43.00     Appropriation (total 
            discretionary)..............         773         824         526
55.00   Advance appropriation...........                                  20
55.35   Advance appropriation rescinded.                                 -20
                                           ---------   ---------  ----------

[[Page 473]]


55.90     Advance appropriation (total 
            discretionary)..............
      Spending authority from offsetting 
          collections:

68.00   Offsetting collections (cash)...         106         101         111
68.10   From Federal sources: Change in 
          receivables and unpaid, 
          unfilled orders...............           2
                                           ---------   ---------  ----------
68.90     Spending authority from 
            offsetting collections 
            (total discretionary).......         109         101         111
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................         881         925         637
----------------------------------------------------------------------------

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

72.40   Obligated balance, start of year         191         514         638
72.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............         109         111         111
                                           ---------   ---------  ----------
72.99     Total unpaid obligations, 
            start of year...............         300         625         749
73.10 Total new obligations.............         794       1,030         639
73.20 Total outlays (gross).............        -449        -906        -618
73.40 Adjustments in expired accounts 
        (net)...........................         -17
73.45 Adjustments in unexpired accounts.          -2
      Unpaid obligations, end of year:

74.40   Obligated balance, end of year..         514         638         659
74.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............         111         111         111
                                           ---------   ---------  ----------
74.99     Total unpaid obligations, end 
            of year.....................         625         749         770
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................         363         508         285
86.93 Outlays from discretionary 
        balances........................          86         398         333
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         449         906         618
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........        -106        -101        -111
      Against gross budget authority only:

88.95   From Federal sources: Change in 
          receivables and unpaid, 
          unfilled orders...............          -2
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         773         824         526
90.00 Outlays...........................         343         805         507
---------------------------------------------------------------------------

                          [Dollars in millions]

                                     1999 actual  2000 est.   2001 est.
Distribution of budget authority by 
    account:
  General departmental management...         193         206         224
  Office for Civil Rights...........          17          19          21
  Policy research...................          14          17          17
  Public Health and Social Services 
    Emergency Fund..................         547         583         265
    Year 2000 computer conversion...         324         150           0
    Bioterrorism....................         140         214         209
    Minority AIDS...................          50          50          50
    Other...........................          33         169           6
Distribution of outlays by account:
  General departmental management...         179         182         213
  Office for Civil Rights...........          18          21          24
  Policy research...................          15          13          16
  Public Health and Social Services 
    Emergency Fund..................         131         589         254

    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 two 
main activities: preparing for and responding to the medical and public 
health consequences of potential bioterrorist events and minority AIDS 
prevention and treatment. In FY 2000 it also supported Year 2000 
computer conversion activities and some activities that are being 
requested within HHS operating divisions in FY 2001. 

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9912-0-1-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

      Direct obligations:

        Personnel compensation:
11.1      Full-time permanent...........          80          93         102
11.3      Other than full-time permanent           6           7           8
11.5      Other personnel compensation..           2           2           2
                                           ---------   ---------  ----------
11.9        Total personnel compensation          88         102         112
12.1    Civilian personnel benefits.....          18          21          23
21.0    Travel and transportation of 
          persons.......................           3           4           4
23.1    Rental payments to GSA..........          11          13          14
23.3    Communications, utilities, and 
          miscellaneous charges.........           4           4           4
24.0    Printing and reproduction.......           1           1           1
25.1    Advisory and assistance services           7           1           1
25.2    Other services..................          36          34          51
25.3    Purchases of goods and services 
          from Government accounts......          28          23          27
25.4    Operation and maintenance of 
          facilities....................           4           3           3
25.5    Research and development 
          contracts.....................           2          35          34
25.7    Operation and maintenance of 
          equipment.....................           3           5           5
26.0    Supplies and materials..........           3           4           4
31.0    Equipment.......................           4           6           7
41.0    Grants, subsidies, and 
          contributions.................          49         101          41
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..         261         357         331
99.0  Reimbursable obligations..........          98          98         103
      Allocation Account:

        Personnel compensation:
11.1      Full-time permanent...........          17          17           9
11.3      Other than full-time permanent                       2
11.5      Other personnel compensation..                       1
                                           ---------   ---------  ----------
11.9        Total personnel compensation          17          20           9
12.1    Civilian personnel benefits.....           7           6           2
21.0    Travel and transportation of 
          persons.......................           3           5           1
22.0    Transportation of things........                       1
23.1    Rental payments to GSA..........                       2           2
23.3    Communications, utilities, and 
          miscellaneous charges.........           4          12
24.0    Printing and reproduction.......           1           4
25.1    Advisory and assistance services          12           1
25.2    Other services..................         125         220          65
25.3    Purchases of goods and services 
          from Government accounts......           4
25.5    Research and development 
          contracts.....................           7           2           2
25.6    Medical care....................          54         154
25.7    Operation and maintenance of 
          equipment.....................          18
26.0    Supplies and materials..........           1           2           1
31.0    Equipment.......................          49          10           8
41.0    Grants, subsidies, and 
          contributions.................         133         136         115
                                           ---------   ---------  ----------
99.0      Subtotal, allocation account..         435         575         205
                                           ---------   ---------  ----------
99.9    Total new obligations...........         794       1,030         639
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-9912-0-1-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: Full-
        time equivalent employment......       1,250       1,412       1,498
    Reimbursable:
2001  Total compensable workyears: Full-
        time equivalent employment......         177         184         201
    Allocation account:
3001  Total compensable workyears: Full-
        time equivalent employment......          56          63          66
---------------------------------------------------------------------------

                                

                Allocations Received From Other Accounts

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

[[Page 474]]

                                


 
                         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, 2000, as 
enacted by section 1000(a)(4) of the Consolidated Appropriations Act, 
2000 (P.L. 106-113).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0379-0-1-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Retirement payments...............         159         172         176
00.02 Survivors' benefits...............          12          12          12
00.03 Medical care......................          29          30          31
00.04 Military service credits..........           2           1           1
                                           ---------   ---------  ----------
10.00   Total new obligations...........         202         215         220
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
22.00 New budget authority (gross)......         202         215         220
23.95 Total new obligations.............        -202        -215        -220
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.05   Appropriation (indefinite)......         202         215         220
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year          23          23          23
73.10 Total new obligations.............         202         215         220
73.20 Total outlays (gross).............        -202        -213        -219
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..          23          23          24
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................         184         197         201
86.98 Outlays from mandatory balances...          18          18          18
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........         202         213         219
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................         202         215         220
90.00 Outlays...........................         202         213         219
---------------------------------------------------------------------------

    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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
13.0  Benefits for former personnel.....         171         184         188
25.2  Other services....................          29          30          31
25.3  Purchases of goods and services 
        from Government accounts........           2           1           1
                                           ---------   ---------  ----------
99.9    Total new obligations...........         202         215         220
---------------------------------------------------------------------------

                                

                         Health Activities Funds

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9913-0-1-552      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year          10          10          10
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..          10          10          10
----------------------------------------------------------------------------

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

    This display shows activities in support of St. Elizabeths Hospital 
and scientific activities overseas that were supported by foreign 
currencies by the United States abroad.

                                

Intragovernmental funds:

                      HHS Service and Supply Fund 

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9941-0-4-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
09.01 Program support center............         307         311         326
09.02 Federal employee occupational 
        health..........................          85          93         101
09.03 OS activities.....................           7           7           7
                                           ---------   ---------  ----------
10.00   Total new obligations...........         399         411         434
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          35          57          57
22.00 New budget authority (gross)......         421         411         434
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         456         468         491
23.95 Total new obligations.............        -399        -411        -434
24.40 Unobligated balance available, end 
        of year.........................          57          57          57
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

69.00   Offsetting collections (cash)...         376         411         434
69.10   From Federal sources: Change in 
          receivables and unpaid, 
          unfilled orders...............          45
                                           ---------   ---------  ----------
69.90     Spending authority from 
            offsetting collections 
            (total mandatory)...........         421         411         434
----------------------------------------------------------------------------

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

72.40   Obligated balance, start of year         -41        -108        -108
72.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............         218         263         263
                                           ---------   ---------  ----------
72.99     Total unpaid obligations, 
            start of year...............         177         155         155
73.10 Total new obligations.............         399         411         434
73.20 Total outlays (gross).............        -421        -411        -434
      Unpaid obligations, end of year:

74.40   Obligated balance, end of year..        -108        -108        -108
74.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............         263         263         263
                                           ---------   ---------  ----------
74.99     Total unpaid obligations, end 
            of year.....................         155         155         155
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................         421         411         434
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........        -376        -411        -434
      Against gross budget authority only:

88.95   From Federal sources: Change in 
          receivables and unpaid, 
          unfilled orders...............         -45
----------------------------------------------------------------------------

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

    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

[[Page 475]]

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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

      Personnel compensation:

11.1    Full-time permanent.............          56          60          64
11.3    Other than full-time permanent..           9          10          10
11.5    Other personnel compensation....           3           3           3
                                           ---------   ---------  ----------
11.9      Total personnel compensation..          68          73          77
12.1  Civilian personnel benefits.......          12          14          15
21.0  Travel and transportation of 
        persons.........................           2           2           3
22.0  Transportation of things..........           2           2           2
23.1  Rental payments to GSA............           9          10          10
23.3  Communications, utilities, and 
        miscellaneous charges...........          38          43          44
24.0  Printing and reproduction.........           2           2           2
25.1  Advisory and assistance services..           2           3           3
25.2  Other services....................          86          93          98
25.3  Purchases of goods and services 
        from Government accounts........          57          36          36
26.0  Supplies and materials............         113         128         138
31.0  Equipment.........................           8           5           6
                                           ---------   ---------  ----------
99.9    Total new obligations...........         399         411         434
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-9941-0-4-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Reimbursable:
2001  Total compensable workyears: Full-
        time equivalent employment......       1,179       1,284       1,290
    Allocation account:
3001  Total compensable workyears: Full-
        time equivalent employment......          29
---------------------------------------------------------------------------

                                

                               Trust Funds

                        Miscellaneous Trust Funds

              Unavailable Collections (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9971-0-7-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Balance, start of year:
01.99 Balance, start of year............
    Receipts:
02.01 Contributions, Indian health 
        facilities, Health Services 
        Administration..................          25          25          25
02.02 Gifts and contributions, 
        miscellaneous trust funds.......          26          26          26
02.03 Interest, miscellaneous trust 
        funds...........................           1           1           1
                                           ---------   ---------  ----------
02.99   Total receipts..................          52          52          52
    Appropriation:
05.01 Miscellaneous trust funds.........         -52         -52         -52
                                           ---------   ---------  ----------
07.99 Total balance, end of year........
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9971-0-7-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.02 Gifts.............................          23          27          27
00.03 Contributions, Indian health 
        facilities......................          12          25          25
                                           ---------   ---------  ----------
10.00   Total new obligations...........          35          52          52
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................          27          47          47
22.00 New budget authority (gross)......          52          52          52
22.10 Resources available from 
        recoveries of prior year 
        obligations.....................           3
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......          82          99          99
23.95 Total new obligations.............         -35         -52         -52
24.40 Unobligated balance available, end 
        of year.........................          47          47          47
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.27   Appropriation (trust fund, 
          indefinite)...................          52          52          52
----------------------------------------------------------------------------

    Change in unpaid obligations:
72.40 Unpaid obligations, start of year: 
        Obligated balance, start of year          96          68          65
73.10 Total new obligations.............          35          52          52
73.20 Total outlays (gross).............         -60         -55         -53
73.45 Adjustments in unexpired accounts.          -3
74.40 Unpaid obligations, end of year: 
        Obligated balance, end of year..          68          65          64
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................           8          13          13
86.98 Outlays from mandatory balances...          52          42          40
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........          60          55          53
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................          52          52          52
90.00 Outlays...........................          60          55          53
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.01 Total investments, start of year: 
        U.S. securities: Par value......          13          15          15
92.02 Total investments, end of year: 
        U.S. securities: Par value......          15          15          15
---------------------------------------------------------------------------

                          [Dollars in millions]

                                        1999         2000        2001
Distribution of budget authority by 
    account:
  Gifts.............................          27          27          27
  Contributions, Indian health 
    facilities......................          25          25          25
Distribution of outlays by account:
  Gifts.............................          24          20          24
  Contributions, Indian health 
    facilities......................          36          35          29

    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      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
11.3  Personnel compensation: Other than 
        full-time permanent.............           2           2           2
12.1  Civilian personnel benefits.......           1           1           1
21.0  Travel and transportation of 
        persons.........................           1           2           2
22.0  Transportation of things..........           1           2           2
25.2  Other services....................           2           3           3
25.3  Purchases of goods and services 
        from Government accounts........           1           2           2
25.4  Operation and maintenance of 
        facilities......................           2           3           3
25.5  Research and development contracts           5           8           8
25.7  Operation and maintenance of 
        equipment.......................           4           6           6
26.0  Supplies and materials............           2           3           3
31.0  Equipment.........................           1           1           1
32.0  Land and structures...............           4           5           5
41.0  Grants, subsidies, and 
        contributions...................           9          14          14
                                           ---------   ---------  ----------
99.9    Total new obligations...........          35          52          52
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-9971-0-7-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
1001  Total compensable workyears: Full-
        time equivalent employment......          61          61          61
---------------------------------------------------------------------------

                                


 
                     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, [$31,500,000] $33,849,000. (Department of Health and Human 
Services Appropriations Act, 2000, as enacted by section

[[Page 476]]

1000(a)(4) of the Consolidated Appropriations Act, 2000 (P.L. 106-113).)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0128-0-1-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Direct program....................          29          31          34
09.01 Reimbursable program..............          14          22          23
                                           ---------   ---------  ----------
10.00   Total new obligations...........          43          53          57
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance available, 
        start of year...................           1           1           1
22.00 New budget authority (gross)......          43          53          57
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......          44          54          58
23.95 Total new obligations.............         -43         -53         -57
24.40 Unobligated balance available, end 
        of year.........................           1           1           1
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................          29          31          34
      Spending authority from offsetting 
          collections:

68.00   Offsetting collections (cash)...          24          22          23
68.10   From Federal sources: Change in 
          receivables and unpaid, 
          unfilled orders...............         -10
                                           ---------   ---------  ----------
68.90     Spending authority from 
            offsetting collections 
            (total discretionary).......          14          22          23
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................          43          53          57
----------------------------------------------------------------------------

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

72.40   Obligated balance, start of year           3          -3           5
72.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............          14           4           4
                                           ---------   ---------  ----------
72.99     Total unpaid obligations, 
            start of year...............          17           1           9
73.10 Total new obligations.............          43          53          57
73.20 Total outlays (gross).............         -58         -45         -58
      Unpaid obligations, end of year:

74.40   Obligated balance, end of year..          -3           5           4
74.95   From Federal sources: 
          Receivables and unpaid, 
          unfilled orders...............           4           4           4
                                           ---------   ---------  ----------
74.99     Total unpaid obligations, end 
            of year.....................           1           9           8
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................          40          49          54
86.93 Outlays from discretionary 
        balances........................          18          -4           4
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........          58          45          58
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........         -24         -22         -23
      Against gross budget authority only:

88.95   From Federal sources: Change in 
          receivables and unpaid, 
          unfilled orders...............          10
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................          29          31          34
90.00 Outlays...........................          34          23          35
---------------------------------------------------------------------------

    The Office of Inspector General (OIG) 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 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)

                                         1999 actual   2000 est.   2001 est.
Budget Authority:
  Discretionary appropriations..........          29          31          34
  Mandatory (HCFAC Account).............         100         124         124
                                           ---------   ---------  ----------
      Total.............................         129         155         158
Outlays:
  Discretionary appropriations..........          34          23          35
  Mandatory (HCFAC Account).............          84         124         124
                                           ---------   ---------  ----------
      Total.............................         118         147         159

    This schedule reflects estimated distribution of mandatory funds 
from the HCFAC account in FY 2001. Actual FY 2001 distribution will be 
determined by the Secretary of HHS and the Attorney General.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0128-0-1-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------

      Direct obligations:

11.1    Personnel compensation: Full-
          time permanent................          16          18          20
12.1    Civilian personnel benefits.....           4           4           5
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           4           4
31.0    Equipment.......................           1           1           1
                                           ---------   ---------  ----------
99.0      Subtotal, direct obligations..          29          31          34
99.0  Reimbursable obligations..........          14          22          23
                                           ---------   ---------  ----------
99.9    Total new obligations...........          43          53          57
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0128-0-1-551      1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: Full-
        time equivalent employment......         275         285         306
    Reimbursable:
2001  Total compensable workyears: Full-
        time equivalent employment......          56          93          90
    Allocation account:
      Total compensable workyears:

        Full-time equivalent employment:
3001      Full-time equivalent 
            employment..................         882       1,054       1,143
3001      Full-time equivalent 
            employment..................          60
---------------------------------------------------------------------------

                                

                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)

----------------------------------------------------------------------------
                                         1999 actual   2000 est.   2001 est.
----------------------------------------------------------------------------
Offsetting receipts from the public:
  75-310700  Federal share of child 
    support collections.................         868         851         850
    Legislative proposal, subject to 
      PAYGO.............................                                  22
                                           ---------   ---------  ----------
General Fund Offsetting receipts from 
 the public.............................         868         851         872
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                           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 Develop

[[Page 477]]

ment, 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 II.
    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 1.6 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.

                           (transfer of funds)

    Sec. 206. Not to exceed 1 percent of any discretionary funds 
(pursuant to the Balanced Budget and Emergency Deficit Control Act of 
1985, as amended) which are appropriated for the current fiscal year for 
the Department of Health and Human Services in this Act may be 
transferred between appropriations, but no such appropriation shall be 
increased by more than 3 percent by any such transfer: Provided, That 
the Appropriations Committees of both Houses of Congress are notified at 
least 15 days in advance of any transfer.
    Sec. 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. 208. 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 
the National Institutes of Health 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. [209] 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. 210. The final rule entitled ``Organ Procurement and 
Transplantation Network'', promulgated by the Secretary of Health and 
Human Services on April 2, 1998 (63 Fed. Reg. 16295 et seq.) (relating 
to part 121 of title 42, Code of Federal Regulations), together with the 
amendments to such rules promulgated on October 20, 1999 (64 Fed. Reg. 
56649 et seq.) shall not become effective before the expiration of the 
42 day period beginning on the date of the enactment of this Act.]
    Sec. [211] 209. 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. 212. (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.--With respect to fiscal year 
2000, 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.--Each State's allotment for 
fiscal year 2000 for programs under this subpart shall be equal to such 
State's allotment for such programs for fiscal year 1999, except that, 
if the amount appropriated in fiscal year 2000 is less than the amount 
appropriated in fiscal year 1999, then the amount of a State's allotment 
under section 1921 shall be equal to the amount that the State received 
under section 1921 in fiscal year 1999 decreased by the percentage by 
which the amount appropriated for fiscal year 2000 is less than the 
amount appropriated for such section for fiscal year 1999.''.]
    Sec. [213] 210. 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.
    [Sec. 214. Extension of Certain Adjudication Provisions.--The 
Foreign Operations, Export Financing, and Related Programs 
Appropriations Act, 1990 (Public Law 101-167) is amended--
            (1) in section 599D (8 U.S.C. 1157 note)--
                    (A) in subsection (b)(3), by striking ``1997, 1998, 
            and 1999'' and inserting ``1997, 1998, 1999, and 2000''; and
                    (B) in subsection (e), by striking ``October 1, 
            1999'' each place it appears and inserting ``October 1, 
            2000''; and
            (2) in section 599E (8 U.S.C. 1255 note) in subsection 
    (b)(2), by striking ``September 30, 1999'' and inserting ``September 
    30, 2000''.]
    [Sec. 215. None of the funds provided in this Act or in any other 
Act making appropriations for fiscal year 2000 may be used to administer 
or implement in Arizona or in the Kansas City, Missouri or in the Kansas 
City, Kansas area the Medicare Competitive Pricing Demonstration Project 
(operated by the Secretary of Health and Human Services under authority 
granted in section 4011 of the Balanced Budget Act of 1997 (Public Law 
105-33)).]
    [Sec. 216. Of the funds appropriated for the National Institutes of 
Health for fiscal year 2000, $3,000,000,000 shall not be available for 
obligation until September 29, 2000. Of the funds appropriated for the 
Health Resources and Services Administration for fiscal year 2000, 
$450,000,000 shall not be available for obligation until September 29, 
2000. Of the funds appropriated for the Centers for Disease Control and 
Prevention for fiscal year 2000, $500,000,000 shall not be available for 
obligation until September 29, 2000. Of the funds appropriated for the 
Children and Families Services Programs for fiscal year 2000, 
$400,000,000 shall not be available for obligation until September 29, 
2000. Of the funds appropriated for the Social Services Block Grant for 
fiscal year 2000, $425,000,000 shall not be available for obligation 
until September 29, 2000. Of the funds appropriated for the Substance 
Abuse and Mental Health Services Administration for fiscal year 2000, 
$200,000,000 shall not be available for obligation until September 29, 
2000. Such funds delayed by this section shall be available for 
obligation until October 15, 2000.]
    [Sec. 217. Study and Report on the Geographic Adjustment Factors 
Under the Medicare Program. (a) Study.--The Secretary of Health and 
Human Services shall conduct a study on--
            (1) the reasons why, and the appropriateness of the fact 
    that, the geographic adjustment factor (determined under paragraph 
    (2) of section 1848(e) (42 U.S.C. 1395w-4(e)) used in determining 
    the amount of payment for physicians' services under the Medicare 
    program is less for physicians' services provided in New Mexico than 
    for physicians' services provided in Arizona, Colorado, and Texas; 
    and
            (2) the effect that the level of the geographic cost-of-
    practice adjustment factor (determined under paragraph (3) of such 
    section) has on the recruitment and retention of physicians in small 
    rural States, including New Mexico, Iowa, Louisiana, and Arkansas.
    (b) Report.--Not later than 3 months after the date of the enactment 
of this Act, the Secretary of Health and Human Services shall submit a 
report to Congress on the study conducted under subsection

[[Page 478]]

(a), together with any recommendations for legislation that the 
Secretary determines to be appropriate as a result of such study.]
    [Sec. 218. Withholding of Substance Abuse Funds. (a) In General.--
None of the funds appropriated by this Act may be used to withhold 
substance abuse funding from a State pursuant to section 1926 of the 
Public Health Service Act (42 U.S.C. 300x-26) if such State certifies to 
the Secretary of Health and Human Services that the State will commit 
additional State funds, in accordance with subsection (b), to ensure 
compliance with State laws prohibiting the sale of tobacco products to 
individuals under 18 years of age.
    (b) Amount of State Funds.--The amount of funds to be committed by a 
State under subsection (a) shall be equal to 1 percent of such State's 
substance abuse block grant allocation for each percentage point by 
which the State misses the retailer compliance rate goal established by 
the Secretary of Health and Human Services under section 1926 of such 
Act, except that the Secretary may agree to a smaller commitment of 
additional funds by the State.
    (c) Supplement not Supplant.--Amounts expended by a State pursuant 
to a certification under subsection (a) shall be used to supplement and 
not supplant State funds used for tobacco prevention programs and for 
compliance activities described in such subsection in the fiscal year 
preceding the fiscal year to which this section applies.
    (d) Enforcement of State Expenditure.--The Secretary shall exercise 
discretion in enforcing the timing of the State expenditure required by 
the certification described in subsection (a) as late as July 31, 2000.] 
\1\
    \1\ The Administration proposes to delete this provision and will 
work with the Congress to address this issue.
    [Sec. 219. None of the funds made available under this title may be 
used to carry out the transmittal of August 13, 1997 (relating to self-
administered drugs) of the Deputy Director of the Division of Acute Care 
of the Health Care Financing Administration to regional offices of such 
Administration or to promulgate any regulation or other transmittal or 
policy directive that has the effect of imposing (or clarifying the 
imposition of ) a restriction on the coverage of injectable drugs under 
section 1861(s)(2) of the Social Security Act beyond the restrictions 
applied before the date of such transmittal.]
    [Sec. 220. In accordance with section 1557 of title 31, United 
States Code, funds obligated and awarded in fiscal years 1994 and 1995 
under the heading ``National Cancer Institute'' for the Cancer Therapy 
and Research Center in San Antonio, Texas, grant numbers 1 C06 CA58690-
01 and 3 C06 CA58690-01S1, shall be exempt from subchapter IV of chapter 
15 of such title and the obligated unexpended dollars shall remain 
available to the grantee for expenditure without fiscal year limitation 
to fulfill the purpose of the award.]
    [Sec. 221. Not later than January 15, 2000, the Secretary of Health 
and Human Services shall transfer $20,000,000 from the appropriation in 
this Act for ``National Institutes of Health--National Institute of 
Allergy and Infectious Diseases'' to the appropriation in this Act for 
``Centers for Disease Control and Prevention--Disease Control, Research, 
and Training''.]
    Sec. 211. Funds provided in Public Law 106-31 under the heading, 
``Refugee and Entrant Assistance,'' shall be available until expended, 
remain subject to the first and second provisos under that heading, and 
are available for costs of assisting in the resettlement of refugees and 
entrants--
        (1)(A) under section 412(b)(3) of the Immigration and 
    Nationality Act, and 45 CFR 400.205 and 45 CFR 400.207;
        (B) under 45 CFR 400.203(b) and 45 CFR 400.204(b), to maintain 
    the period of time-eligibility in effect under 45 CFR 400.211 as of 
    the end of the preceding fiscal year; and
        (C) under section 412(c)(1) of the Immigration and Nationality 
    Act and section 7 of Public Law 99-605 (8 USC 1522 note) in the 
    event of refugee arrivals in excess of those anticipated in the 
    annual consultation under section 207(d) of the Immigration and 
    Nationality Act; and
        (2) under section 501(a)(1) of the Refugee Education Assistance 
    Act of 1980 for costs comparable to costs specified in paragraph 
    (1): Provided, That an unanticipated mass migration of eligible 
    populations may be considered for purposes of paragraph 1(C) to be 
    comparable to refugee arrivals in excess of those anticipated in the 
    annual consultation under section 207(d) of the Immigration and 
    Nationality Act. (Department of Health and Human Services 
    Appropriations Act, 2000, as enacted by section 1000(a)(4) of the 
    Consolidated Appropriations Act, 2000 (P.L. 106-113).)