    [Appendix]
    [Detailed Budget Estimates by Agency]
    [Department of Health and Human Services, except Social Security]
    [From the U.S. Government Printing Office, www.gpo.gov]

                         THE BUDGET FOR FISCAL YEAR 2003

                     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; [$1,345,386,000, of which not to exceed
    $161,716,000 to be derived from prescription drug user fees authorized
    by 21 U.S.C. 379(h), including any such fees assessed prior to the
    current fiscal year but credited during the current year, in accordance
    with section 736(g)(4), shall be credited to this appropriation and
    remain available until expended: Provided, That fees derived from
    applications received during fiscal year 2002 shall be subject to the
    fiscal year 2002 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) $312,049,000 shall be for the Center for Food Safety
    and Applied Nutrition and related field activities in the Office of
    Regulatory Affairs; (2) $352,647,000 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 $13,207,000 shall be available
    for grants and contracts awarded under section 5 of the Orphan Drug Act
    (21 U.S.C. 360ee); (3) $155,875,000 shall be for the Center for
    Biologics Evaluation and Research and for related field activities in
    the Office of Regulatory Affairs; (4) $82,967,000 shall be for the
    Center for Veterinary Medicine and for related field activities in the
    Office of Regulatory Affairs; (5) $179,521,000 shall be for the Center
    for Devices and Radiological Health and for related field activities in
    the Office of Regulatory Affairs; (6) $37,082,000 shall be for the
    National Center for Toxicological Research; (7) $29,798,000 shall be for
    Rent and Related activities, other than the amounts paid to the General
    Services Administration, of which $4,000,000 for costs related to
    occupancy of new facilities at White Oak, Maryland, shall remain
    available until September 30, 2003; (8) $105,116,000 shall be for
    payments to the General Services Administration for rent and related
    costs; and (9) $90,331,000 shall be for other activities, including the
    Office of the Commissioner; the Office of Management and Systems; 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 Committees on Appropriations of both Houses of
    Congress] $1,424,136,000.
        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 may be credited to this account, to remain available until expended.
    (Agriculture, Rural Development, Food and Drug Administration, and
    Related Agencies Appropriations Act, 2002; additional authorizing
    legislation required.)

                            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, [$34,281,000]
    $8,000,000, to remain available until expended (7 U.S.C. 2209b).
    (Agriculture, Rural Development, Food and Drug Administration, and
    Related Agencies Appropriations Act, 2002.)
        [For emergency expenses to respond to the September 11, 2001,
    terrorist attacks on the United States, for ``Salaries and Expenses'',
    $151,100,000, to remain available until expended, to be obligated from
    amounts made available in Public Law 107-38.] (Emergency Supplemental
    Act, 2002.)

                  Unavailable Collections (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9911-0-1-554      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    01.99 Balance, start of year............
        Receipts:
    02.20 Cooperative research and
            development agreements..........           2           2           2
        Appropriations:
    05.00 Salaries and expenses.............          -2          -2          -2
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9911-0-1-554      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
          Direct program:

    00.01   Foods...........................         302         422         430
    00.02   Drugs...........................         410         508         536
    00.03   Devices and radiological
              products......................         173         190         199
    00.04   National Center for
              Toxicological Research........          38          45          43
    00.05   Other activities................          72          93          81
    00.06   Other rent and rent related
              activities....................          31          30          36
    00.07   Rental payments.................          87          99          99
    00.08   Buildings and facilities........          33          34           8
    00.09   CRADAs..........................           1           2           2
    00.10   Contingency fund................           2
    09.01 Reimbursable program..............         207         212          44
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       1,356       1,635       1,478
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          91          75          75
    22.00 New budget authority (gross)......       1,337       1,635       1,478
    22.10 Resources available from
            recoveries of prior year
            obligations.....................           2
    22.22 Unobligated balance transferred
            from other accounts.............           1
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       1,431       1,710       1,553
    23.95 Total new obligations.............      -1,356      -1,635      -1,478
    24.40 Unobligated balance carried
            forward, end of year............          75          75          75
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       1,169       1,270       1,432
    40.15   Appropriation (emergency).......                     151
    40.35   Appropriation rescinded.........         -25
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       1,144       1,421       1,432
          Mandatory:

    60.20   Appropriation (special fund)....           2           2           2
          Spending authority from offsetting
              collections:

            Discretionary:
    68.00     Offsetting collections (cash).         183         212          44
    68.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........           8
                                               ---------   ---------  ----------
    68.90       Spending authority from
                  offsetting collections
                  (total discretionary).....         191         212          44
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       1,337       1,635       1,478
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         365         387         477
    73.10 Total new obligations.............       1,356       1,635       1,478
    73.20 Total outlays (gross).............      -1,318      -1,545      -1,486
    73.40 Adjustments in expired accounts
            (net)...........................         -11
    73.45 Recoveries of prior year
            obligations.....................          -2
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................          -8
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................           5
    74.40 Obligated balance, end of year....         387         477         469
    ----------------------------------------------------------------------------

    [[Page 428]]

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       1,075       1,271       1,128
    86.93 Outlays from discretionary
            balances........................         242         274         356
    86.97 Outlays from new mandatory
            authority.......................           1           2           2
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       1,318       1,545       1,486
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.40   Offsetting collections (cash)
              from: Non-Federal sources.....        -195        -212         -44
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................          -8
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............          12
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       1,146       1,423       1,434
    90.00 Outlays...........................       1,123       1,333       1,442
    ---------------------------------------------------------------------------

                            [In millions of dollars]

                                            2001         2002        2003
    Distribution of budget authority by
        account:
      Salaries and expenses.............       1,111       1,387       1,424
      Buildings and facilities..........          33          34           8
    Distribution of outlays by account:
      Salaries and expenses.............       1,108       1,316       1,425
      Buildings and facilities..........          15          17          17

      Budget Authority and Outlays Excluding Full Funding for Federal Retiree
                           CostsP (in millions of dollars)

    ----------------------------------------------------------------------------
                                             2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       1,099       1,371       1,379
    90.00 Outlays...........................       1,076       1,281       1,387
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2001 actual  2002 est.   2003 est.
    Enacted/requested:
      Budget Authority..................       1,146       1,423       1,434
      Outlays...........................       1,123       1,335       1,442
    Legislative proposal, not subject to
        PAYGO:
      Budget Authority..................
      Outlays...........................
                                        ------------------------------------
    Total:
      Budget Authority..................       1,146       1,423       1,434
      Outlays...........................       1,123       1,335       1,442
                                        ====================================

        The Food and Drug Administration assures the safety of the nation's
    foods, medicines, medical devices and other products through
    regulations, pre-market product and manufacturer reviews and post-market
    inspections. The budget includes funding for counter terrorism
    activities that specifically deal with the protection of products
    regulated by the FDA (such as drugs, vaccines, foods, and animal feed),
    and the availability of medical products for public health preparedness
    in the event of an attack. The budget also requests funding for food
    safety, Bovine Spongiform Encephalopathy (``Mad Cow'' disease)
    prevention, blood safety, and patient safety.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9911-0-1-554      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........         477         582         626
    11.3      Other than full-time permanent          35          34          35
    11.5      Other personnel compensation..          18          20          20
                                               ---------   ---------  ----------
    11.9        Total personnel compensation         530         636         681
    12.1    Civilian personnel benefits.....         175         199         213
    21.0    Travel and transportation of
              persons.......................          22          26          28
    22.0    Transportation of things........           3           5           7
    23.1    Rental payments to GSA..........          87          99          99
    23.2    Rental payments to others.......           4           6           6
    23.3    Communications, utilities, and
              miscellaneous charges.........          22          30          29
    24.0    Printing and reproduction.......           3           3           3
    25.1    Advisory and assistance services          15          17          17
    25.2    Other services..................          42          83          78
    25.3    Other purchases of goods and
              services from Government
              accounts......................          50          53          51
    25.4    Operation and maintenance of
              facilities....................          28          44          35
    25.5    Research and development
              contracts.....................          26          42          43
    25.7    Operation and maintenance of
              equipment.....................          26          29          28
    26.0    Supplies and materials..........          18          26          25
    31.0    Equipment.......................          40          70          62
    32.0    Land and structures.............          29          26
    41.0    Grants, subsidies, and
              contributions.................          27          27          27
    42.0    Insurance claims and indemnities           2           2           2
                                               ---------   ---------  ----------
    99.0      Direct obligations............       1,149       1,423       1,434
    99.0  Reimbursable obligations..........         207         212          44
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       1,356       1,635       1,478
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-9911-0-1-554      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears: Full-
            time equivalent employment......       7,795       8,779       9,116
        Reimbursable:
    2001  Total compensable workyears: Full-
            time equivalent employment......       1,233       1,254         152
        Allocation account:
    3001  Total compensable workyears: Full-
            time equivalent employment......          15
    ---------------------------------------------------------------------------

                              Salaries and Expenses

                  (Legislative proposal, not subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9911-2-1-554      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    09.01 Reimbursable program..............                                 272
                                               ---------   ---------  ----------
    10.00   Total new obligations...........                                 272
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                                 272
    23.95 Total new obligations.............                                -272
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    68.00   Spending authority from
              offsetting collections
              (gross): Offsetting
              collections (cash)............                                 272
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                                 272
    73.20 Total outlays (gross).............                                -272
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................                                 272
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.40   Offsetting collections (cash)
              from: Non-Federal sources.....                                -272
    ----------------------------------------------------------------------------

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

        The budget includes a total of $272,038,000 in prescription drug
    user fees. Authorizing language for these fees will be proposed to
    authorize the collection and spending of the fees subject to
    appropriations language.

    [[Page 429]]

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9911-2-1-554      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    99.0  Reimbursable obligations:
            Reimbursable obligations........                                 272
                                               ---------   ---------  ----------
    99.9    Total new obligations...........                                 272
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-9911-2-1-554      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    2001  Total compensable workyears: Full-
            time equivalent employment......                               1,242
    ---------------------------------------------------------------------------

    Public enterprise funds:

               Revolving Fund for Certification and Other Services

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4309-0-3-554      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    10.00 Total new obligations.............           4           5           5
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           3           4           4
    22.00 New budget authority (gross)......           5           5           5
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......           8           9           9
    23.95 Total new obligations.............          -4          -5          -5
    24.40 Unobligated balance carried
            forward, end of year............           4           4           4
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    69.00   Offsetting collections (cash)...           5           5           5
    ----------------------------------------------------------------------------

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

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................           4           5           5
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.40   Offsetting collections (cash)
              from: Non-Federal sources.....          -5          -5          -5
    ----------------------------------------------------------------------------

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

        FDA certifies color additives for use in foods, drugs, and
    cosmetics. It also lists color additives for use in foods, drugs,
    medical devices, and cosmetics (21 U.S.C. 346a, 356, 357, 376). These
    services are financed wholly by fees paid by the industries affected.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4309-0-3-554      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    11.1  Personnel compensation: Full-time
            permanent.......................           2           2           2
    12.1  Civilian personnel benefits.......           1           1           1
    25.2  Other services....................           1           2           2
                                               ---------   ---------  ----------
    99.9    Total new obligations...........           4           5           5
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-4309-0-3-554      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    2001  Total compensable workyears: Full-
            time equivalent employment......          35          38          38
    ---------------------------------------------------------------------------

                  HEALTH RESOURCES AND SERVICES ADMINISTRATION

                                  Federal Funds

    General and special funds:

                          Health Resources and Services

        For carrying out titles II, III, IV, 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 (including section 510), and
    sections 1128E and 1820 of the Social Security Act, the Health Care
    Quality Improvement Act of 1986, as amended, the Native Hawaiian Health
    Care Act of 1988, as amended, the Cardiac Arrest Survival Act of 2000,
    and the Poison Control Center Enhancement and Awareness Act,
    [$6,081,237,000, of which $311,978,000 shall be available for
    construction and renovation of health care and other facilities, and]
    $5,381,836,000, of which [$40,000,000] $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 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 fees collected
    for the full disclosure of information under the ``Health Care Fraud and
    Abuse Data Collection Program'', authorized by section 1128E(d)(2) of
    the Social Security Act, shall be sufficient to recover the full costs
    of operating the program, and shall remain available until expended to
    carry out that Act: Provided further, That no more than [$15,000,000]
    $25,000,000 is available for carrying out the provisions of Public Law
    104-73: Provided further, That of the funds made available under this
    heading, [$265,085,000] $265,877,000 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 $639,000,000 shall be for State
    AIDS Drug Assistance Programs authorized by section 2616 of the Public
    Health Service Act: [Provided further, That of the amount provided under
    this heading, $80,000 shall be for the Wausau Health Foundation in
    Wausau, Wisconsin, for a survey and analysis of local health
    professionals' career paths to better understand entry into and exit
    from health professions, $100,000 shall be for the University of San
    Diego Institute for the Advancement of Health Policy to assess through
    teaching, research and delivery of services the impact of public policy
    on families from vulnerable populations, $200,000 shall be for the Luna
    County, New Mexico and the Columbus Volunteer Fire Department to provide
    emergency medical services to immigrants, $350,000 shall be for the
    Clinical Pharmacy Training Program at the University of Hawaii at Hilo,
    $475,000 shall be for the American Federation of Negro Affairs, $500,000
    shall be for the University of Washington Center for Health Workforce
    Studies in Seattle, Washington, for a demonstration project to collect
    and analyze health workforce data, $800,000 shall be for the University
    of Iowa for the training of Certified Registered Nurse Anesthetists,
    $1,000,000 shall be for the Washington Health Foundation for a
    comprehensive demonstration project on improving nurse retention, and
    $1,100,000 shall be for the Iowa Department of Public Health to create a
    Center for Health Care Workforce Shortage: Provided further, That,
    notwithstanding section 502(a)(1) of the Social Security Act, not to
    exceed $115,236,000 is available for carrying out special projects of
    regional and national significance pursuant to section 501(a)(2) of such
    Act, of which $50,000 is for the Center for Great Expectations,
    Somerville, New Jersey to provide prenatal health care, education and
    counseling for pregnant teens, $565,000 is for the Milwaukee Health
    Department for a pilot program providing health care services to at-risk
    children in day care, and $4,000,000 is for the Columbia Hospital for
    Women Medical Center in Washington, D.C., to support community outreach
    programs for women:] Provided further, That [$10,000,000] $73,044,000 is
    available for special projects of regional and national

    [[Page 430]]

    significance under section 501(a)(2) of the Social Security Act, which
    shall not be counted toward compliance with the allocation required in
    section 502(a)(1) of such Act, and which shall be used only for making
    competitive grants to provide abstinence education (as defined in
    section 510(b)(2) of such Act) to adolescents and for evaluations
    (including longitudinal evaluations) of activities under the grants and
    for Federal costs of administering the grants: Provided further, That
    grants under the immediately preceding proviso shall be made only to
    public and private entities which agree that, with respect to an
    adolescent to whom the entities provide abstinence education under such
    grant, the entities will not provide to that adolescent any other
    education regarding sexual conduct, except that, in the case of an
    entity expressly required by law to provide health information or
    services the adolescent shall not be precluded from seeking health
    information or services from the entity in a different setting than the
    setting in which the abstinence education was provided: Provided
    further, That the funds expended for such evaluations may not exceed 3.5
    percent of such amount. (Department of Health and Human Services
    Appropriations Act, 2002; additional authorizing legislation required.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0350-0-1-550      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
          Direct program:

    00.02   Loan guarantee subsidy..........                       1           1
    00.10   Health centers..................       1,164       1,329       1,433
    00.11   National Health Service Corps...          43          49          48
    00.12   National Health Service Corps
              recruitment...................          84          99         143
    00.13   Hansen's disease center.........          19          19          19
    00.14   Payment to Hawaii for the
              treatment of Hansen's disease.           2           2           2
    00.15   Black lung clinics..............           6           6           6
    00.16   Nursing loan repayment..........           7          10          15
    00.17   Health professions..............         352         378          94
    00.18   Maternal and child health block
              grant.........................         714         732         732
    00.19   Healthy start...................          90          99          99
    00.20   Universal newborn hearing.......           8          10
    00.21   Emergency medical services for
              children......................          19          19
    00.22   Poison control centers..........          20          21
    00.23   HIV/AIDS........................       1,808       1,911       1,911
    00.24   Organ transplantation...........          15          20          25
    00.25   Health care facilities..........         250         312
    00.26   Bone marrow donor registry......          22          22          22
    00.27   Rural health policy development.          13          17           6
    00.28   Rural health outreach grants....          60          51          38
    00.29   Rural health flexibility grants.          25          40          25
    00.30   Telehealth......................          36          39           6
    00.31   Program management..............         150         161         156
    00.32   Family planning.................         255         266         266
    00.33   Abstinence education............          43          50
    00.34   State access program............          15          15
    00.35   Community access program........         125         105
    00.36   Health centers tort claim fund..          21          15          25
    00.37   Trauma EMS......................           3           3
    00.39   Childrens' GME..................         235         285         200
    00.40   Denali commission...............          10          20
    00.41   Community based abstinence
              grants........................          20          40          73
    00.42   State offices of rural health...           4           8           4
    00.43   Adoption awareness..............          10
    00.44   Rural access to emergency
              devices.......................                      13           2
    00.45   Radiation Exposure Compensation
              Act...........................                       4           4
    00.46   Traumatic brain injury..........                       7           7
    00.47   Healthy communities innovation
              initiative....................                                  20
                                               ---------   ---------  ----------
    03.00   Total direct programs...........       5,648       6,178       5,382
    09.01 Reimbursable program..............         155         162         167
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       5,803       6,340       5,549
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          49          33          31
    22.00 New budget authority (gross)......       5,793       6,338       5,548
    22.10 Resources available from
            recoveries of prior year
            obligations.....................           1
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       5,843       6,371       5,579
    23.95 Total new obligations.............      -5,803      -6,340      -5,549
    23.98 Unobligated balance expiring or
            withdrawn.......................          -8
    24.40 Unobligated balance carried
            forward, end of year............          33          31          30
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       5,567       6,098       5,381
    40.71   Reduction pursuant to P.L. Labor
              HHS 107-116...................                      -1
    40.75   Reduction pursuant to P.L. 106-
              554 (Labor/HHS)...............          -1
    42.00   Transferred from other accounts.           3
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       5,569       6,097       5,381
    55.00   Advance appropriation...........          20          30
          Mandatory:

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

    68.00   Spending authority from
              offsetting collections:
              Offsetting collections (cash).         150         156         161
          Mandatory:

    69.00   Offsetting collections
              (cash)(HIPDB).................           4           5           6
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       5,793       6,338       5,548
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       3,459       4,557       5,314
    73.10 Total new obligations.............       5,803       6,340       5,549
    73.20 Total outlays (gross).............      -4,758      -5,583      -5,765
    73.40 Adjustments in expired accounts
            (net)...........................           2
    73.45 Recoveries of prior year
            obligations.....................          -1
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................          52
    74.40 Obligated balance, end of year....       4,557       5,314       5,098
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       2,175       2,137       1,958
    86.93 Outlays from discretionary
            balances........................       2,522       3,384       3,763
    86.97 Outlays from new mandatory
            authority.......................          18          19           6
    86.98 Outlays from mandatory balances...          43          43          38
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       4,758       5,583       5,765
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............        -189        -140        -143
    88.40     Non-Federal sources...........         -17         -21         -24
                                               ---------   ---------  ----------
    88.90       Total, offsetting
                  collections (cash)........        -206        -161        -167
          Against gross budget authority only:

    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............          52
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       5,639       6,177       5,381
    90.00 Outlays...........................       4,552       5,422       5,598
    ---------------------------------------------------------------------------

      Budget Authority and Outlays Excluding Full Funding for Federal Retiree
                           CostsP (in millions of dollars)

    ----------------------------------------------------------------------------
                                             2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       5,624       6,161       5,365
    90.00 Outlays...........................       4,537       5,406       5,582
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2001 actual  2002 est.   2003 est.
    Enacted/requested:
      Budget Authority..................       5,639       6,177       5,381
      Outlays...........................       4,552       5,422       5,598
    Legislative proposal, subject to
        PAYGO:
      Budget Authority..................                                  50
      Outlays...........................                                  14
                                        ------------------------------------
    Total:
      Budget Authority..................       5,639       6,177       5,431
      Outlays...........................       4,552       5,422       5,612
                                        ====================================

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

    ----------------------------------------------------------------------------
    Identification code 75-0350-0-1-550      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
        Guaranteed loan levels supportable by subsidy
                    budget authority:
    215001Health centers: Facilities
            renovation loan guarantee levels           5          10          10

    [[Page 431]]

    215002Health centers: Managed care
            network development loan
            guarantee levels................                       1           2
    215003Health centers: Managed care plan
            loan guarantee levels...........           2          10           5
                                               ---------   ---------  ----------
    215901Total loan guarantee levels.......           7          21          17
        Guaranteed loan subsidy (in percent):
    232001Health centers: Facilities
            renovation loan guarantee levels        3.28        4.08        3.49
    232002Health centers: Managed care
            network development loan
            guarantee levels................        7.71        9.27        9.02
    232003Health centers: Managed care plan
            loan guarantee levels...........        2.34        5.00        7.65
                                               ---------   ---------  ----------
    232901Weighted average subsidy rate.....        3.01        4.76        5.88
        Guaranteed loan subsidy budget authority:
    233001Health centers: Facilities
            renovation loan guarantee levels                       1           1
    233002Health centers: Managed care
            network development loan
            guarantee levels................
    233003Health centers: Managed care plan
            loan guarantee levels...........
                                               ---------   ---------  ----------
    233901Total subsidy budget authority....                       1           1
        Guaranteed loan subsidy outlays:
    234001Health centers: Facilities
            renovation loan guarantee levels                       1           1
    234002Health centers: Managed care
            network development loan
            guarantee levels................
    234003Health centers: Managed care plan
            loan guarantee levels...........
                                               ---------   ---------  ----------
    234901Total subsidy outlays.............                       1           1
    ----------------------------------------------------------------------------

        Administrative expense data:
    351001Administrative expenses...........           1           1           1
    358001Outlays from balances.............
    359001Outlays 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. The 2003 Budget includes a Healthy Communities Innovation
    Initiative that is an innovative service demonstration program to
    prevent diabetes, asthma, and obesity at the community level.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0350-0-1-550      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........         109         116         114
    11.3      Other than full-time permanent           5           6           6
    11.5      Other personnel compensation..           4           4           4
                                               ---------   ---------  ----------
    11.9        Total personnel compensation         118         126         124
    12.1    Civilian personnel benefits.....          44          51          50
    13.0    Benefits for former personnel...           3           2           2
    21.0    Travel and transportation of
              persons.......................           5           5           3
    23.1    Rental payments to GSA..........          13          13          11
    23.3    Communications, utilities, and
              miscellaneous charges.........           4           6           5
    24.0    Printing and reproduction.......           2           3           2
    25.1    Advisory and assistance services          61          60          52
    25.2    Other services..................          74          81          83
    25.3    Other purchases of goods and
              services from Government
              accounts......................         107         123          99
    25.4    Operation and maintenance of
              facilities....................           1           1           1
    25.5    Research and development
              contracts.....................           1
    25.6    Medical care....................           1           1           1
    25.7    Operation and maintenance of
              equipment.....................           5           5           5
    26.0    Supplies and materials..........           2           2           2
    31.0    Equipment.......................           6           5           5
    41.0    Grants, subsidies, and
              contributions.................       5,183       5,679       4,912
    42.0    Insurance claims and indemnities          19          15          25
                                               ---------   ---------  ----------
    99.0      Direct obligations............       5,649       6,178       5,382
    99.0  Reimbursable obligations..........         154         162         167
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       5,803       6,340       5,549
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-0350-0-1-550      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears: Full-
            time equivalent employment......       1,709       1,783       1,712
        Reimbursable:
    2001  Total compensable workyears: Full-
            time equivalent employment......         267         277         277
        Allocation account:
    3001  Total compensable workyears: Full-
            time equivalent employment......                      15          33
    ---------------------------------------------------------------------------

                          Health Resources and Services

                    (Legislative proposal, subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0350-4-1-550      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
          Direct program:

    00.33   Abstinence education............                                  50
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................                                  50
    ----------------------------------------------------------------------------

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

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................                                  50
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                                  50
    73.20 Total outlays (gross).............                                 -14
    74.40 Obligated balance, end of year....                                  36
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                                  14
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                                  50
    90.00 Outlays...........................                                  14
    ---------------------------------------------------------------------------

                          Vaccine Injury Compensation

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0320-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    10.00 Total new obligations (object
            class 42.0).....................          33           8
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          43          11           3
    22.00 New budget authority (gross)......           1
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......          44          11           3
    23.95 Total new obligations.............         -33          -8
    24.40 Unobligated balance carried
            forward, end of year............          11           3           3
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

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

        Change in obligated balances:
    72.40 Obligated balance, start of year..           3           3
    73.10 Total new obligations.............          33           8
    73.20 Total outlays (gross).............         -33         -11
    74.40 Obligated balance, end of year....           3
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................           1
    86.98 Outlays from mandatory balances...          33          11
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........          33          11
    ----------------------------------------------------------------------------

    [[Page 432]]

        Offsets:
          Against gross budget authority and outlays:

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

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................          32          11
    ---------------------------------------------------------------------------

        The Vaccine improvement program was established pursuant to Public
    Law 99-660 and Public Law 100-203, and serves as a source of funds to
    pay claims for compensation for vaccine related injury or death. Payment
    of claims associated with vaccine related injury or death occurring
    before October 1, 1988 are financed from the General Fund and are
    reflected in this account. Given sufficient carry-over funds from prior
    years' appropriations to pay for the balance of the pre-1988 backlog of
    claims yet to be adjudicated, no appropriation is requested in 2003 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

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0355-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    10.00 Total new obligations (object
            class 92.0).....................         580
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......         580
    23.95 Total new obligations.............        -580
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................         580
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............         580
    73.20 Total outlays (gross).............        -580
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................         580
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         580
    90.00 Outlays...........................         580
    ---------------------------------------------------------------------------

        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      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........                                   3
    22.00 New financing authority (gross)...                       1           1
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......                       1           4
    24.40 Unobligated balance carried
            forward, end of year............                       3           4
    ----------------------------------------------------------------------------

        New financing authority (gross), detail:
          Discretionary:

    68.00   Spending authority from
              offsetting collections
              (gross): (Federal sources:
              From program account).........                       1           1
    87.00 Total financing disbursements
            (gross).........................                      -1          -1
    ----------------------------------------------------------------------------

        Offsets:
          Against gross financing authority and
              financing disbursements:

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

        Net financing authority and financing
            disbursements:
    89.00 Financing authority...............
    90.00 Financing disbursements...........                      -2          -2
    ---------------------------------------------------------------------------

                 Status of Guaranteed Loans (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4442-0-3-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
        Position with respect to appropriations act
                    limitation on commitments:
    2111  Limitation on guaranteed loans
            made by private lenders.........
    2121  Limitation available from carry-
            forward.........................         134         127         106
    2143  Uncommitted limitation carried
            forward.........................        -127        -106         -89
                                               ---------   ---------  ----------
    2150    Total guaranteed loan
              commitments...................           7          21          17
    2199  Guaranteed amount of guaranteed
            loan commitments................           6          17          14
    ----------------------------------------------------------------------------

        Cumulative balance of guaranteed loans
                    outstanding:
    2210  Outstanding, start of year........           5          12          33
    2231  Disbursements of new guaranteed
            loans...........................           7          21          17
    2251  Repayments and prepayments........
    2263  Adjustments: Terminations for
            default that result in claim
            payments........................
                                               ---------   ---------  ----------
    2290    Outstanding, end of year........          12          33          50
    ----------------------------------------------------------------------------

        Memorandum:
    2299  Guaranteed amount of guaranteed
            loans outstanding, end of year..           6          17          14
    ---------------------------------------------------------------------------

        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. This program has
    used $21 million of its available $160 million in loan guarantee
    authority, HRSA plans to use approximately $38 million of the remaining
    existing loan guarantee limit over 2002 and 2003. 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    2000 actual    2001 actual     2002 est.      2003 est.
    -----------------------------------------------------------------------------------------------
        ASSETS:
    1101  Federal assets: Fund balances with
            Treasury........................           4              4             1              1
                                            ------------ --------------  ------------  -------------
    1999    Total assets....................           4              4             1              1
        LIABILITIES:
    2204  Non-Federal liabilities:
            Liabilities for loan guarantees.           4              4             1              1
                                            ------------ --------------  ------------  -------------
    2999    Total liabilities...............           4              4             1              1
        NET POSITION:
    3300  Cumulative results of operations..
                                            ------------ --------------  ------------  -------------
    3999    Total net position..............
                                            ------------ --------------  ------------  -------------
    4999  Total liabilities and net position           4              4             1              1
    -----------------------------------------------------------------------------------------------

    [[Page 433]]

                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,
    [$3,792,000] $3,914,000. (Department of Health and Human Services
    Appropriations Act, 2002.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0340-0-1-552      2001 actual   2002 est.   2003 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 obligated balances:
    72.40 Obligated balance, start of year..           1           1
    73.10 Total new obligations.............           4           4           4
    73.20 Total outlays (gross).............          -4          -5          -4
    74.40 Obligated balance, end of year....           1
    ----------------------------------------------------------------------------

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

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

       Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program

                              (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0340-0-1-552      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
        Guaranteed loan levels supportable by subsidy
                    budget authority:
    215001HEAL Loan guarantee...............
                                               ---------   ---------  ----------
    215901Total loan guarantee levels.......
        Guaranteed loan subsidy (in percent):
    232001Loan guarantee....................        0.00        0.00        0.00
                                               ---------   ---------  ----------
    232901Weighted average subsidy rate.....        0.00        0.00        0.00
        Guaranteed loan subsidy budget authority:
    233001Loan guarantee....................
                                               ---------   ---------  ----------
    233901Total subsidy budget authority....
        Guaranteed loan subsidy outlays:
    234001Loan guarantee....................
                                               ---------   ---------  ----------
    234901Total subsidy outlays.............
                                               ---------   ---------  ----------
    235901Total upward reestimate budget
            authority.......................
        Guaranteed loan upward reestimate subsidy
                    outlays:
    236001Subsidy outlays--Upward
            Reestimates.....................
                                               ---------   ---------  ----------
    236901Total upward reestimate subsidy
            outlays.........................
        Guaranteed loan downward reestimate subsidy
                    budget authority:
    237001Downward Reestimate...............
                                               ---------   ---------  ----------
    237901Total downward reestimate subsidy
            budget authority................
        Guaranteed loan downward reestimate subsidy
                    outlays:
    238001Downward Reestimates..............
                                               ---------   ---------  ----------
    238901Total downward reestimate subsidy
            outlays.........................
    ----------------------------------------------------------------------------

        Administrative expense data:
    351001Budget authority..................           4           4           4
    358001Outlays from balances.............           1           1
    359001Outlays from new authority........           3           4           4
    ---------------------------------------------------------------------------

        The Health education assistance loan (HEAL) program guarantees loans
    from private lenders to health professions students to help pay for the
    costs of their training. As required by the Federal Credit Reform Act of
    1990, this account records, for the HEAL program, the subsidy costs
    associated with HEAL loan guarantees committed in 1992 and beyond
    (including modifications of HEAL loan guarantees that resulted from
    obligations or commitments in any year), as well as administrative
    expenses of the program. The administrative expenses are estimated on a
    cash basis.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0340-0-1-552      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

          Direct obligations:

    11.1    Personnel compensation: Full-
              time permanent................           2           2           2
    25.3    Other purchases of goods and
              services from Government
              accounts......................           1           1           1
                                               ---------   ---------  ----------
    99.0      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      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    1001  Total compensable workyears: Full-
            time equivalent employment......          28          22          22
    ---------------------------------------------------------------------------

               Health Education Assistance Loans Financing Account

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4304-0-3-552      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Death and disability claims.......           2           2           2
    00.02 Default claims....................          15          27          30
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          17          29          32
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         301         321         323
    22.00 New financing authority (gross)...          36          32          34
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         337         353         357
    23.95 Total new obligations.............         -17         -29         -32
    24.40 Unobligated balance carried
            forward, end of year............         321         323         324
    ----------------------------------------------------------------------------

        New financing authority (gross), detail:
          Discretionary:

    68.00   Spending authority from
              offsetting collections
              (gross): Offsetting
              collections (cash)............          36          32          34
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............          17          29          32
    73.20 Total financing disbursements
            (gross).........................         -17         -29         -32
    87.00 Total financing disbursements
            (gross).........................          17          29          32
    ----------------------------------------------------------------------------

        Offsets:
          Against gross financing authority and
              financing disbursements:

            Offsetting collections (cash)
                from:
    88.25     Interest on uninvested funds..         -32         -27         -28
    88.40     Recoveries of defaulted loans.          -4          -5          -6
                                               ---------   ---------  ----------
    88.90       Total, offsetting
                  collections (cash)........         -36         -32         -34
    ----------------------------------------------------------------------------

        Net financing authority and financing
            disbursements:
    89.00 Financing authority...............
    90.00 Financing disbursements...........         -19          -3          -2
    ---------------------------------------------------------------------------

    [[Page 434]]

                 Status of Guaranteed Loans (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4304-0-3-552      2001 actual   2002 est.   2003 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........       1,535       1,513       1,478
    2251  Repayments and prepayments........          -5          -6          -7
          Adjustments:

    2261    Terminations for default that
              result in loans receivable....         -14         -27         -30
    2263    Terminations for default that
              result in claim payments......          -3          -2          -2
                                               ---------   ---------  ----------
    2290    Outstanding, end of year........       1,513       1,478       1,439
    ----------------------------------------------------------------------------

        Memorandum:
    2299  Guaranteed amount of guaranteed
            loans outstanding, end of year..       1,513       1,478       1,439
    ----------------------------------------------------------------------------

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

    2310    Outstanding, start of year......          53          63          85
    2331    Disbursements for guaranteed
              loan claims...................          14          27          30
    2351    Repayments of loans receivable..          -4          -5          -6
                                               ---------   ---------  ----------
    2390      Outstanding, end of year......          63          85         109
    ---------------------------------------------------------------------------

        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    2000 actual    2001 actual     2002 est.      2003 est.
    -----------------------------------------------------------------------------------------------
        ASSETS:
    1101  Federal assets: Fund balances with
            Treasury........................         301            321           323            324
    1206  Non-Federal assets: Receivables,
            net.............................          42             51            51             51
                                            ------------ --------------  ------------  -------------
    1999    Total assets....................         343            372           374            375
        LIABILITIES:
    2204  Non-Federal liabilities:
            Liabilities for loan guarantees.         343            372           374            375
                                            ------------ --------------  ------------  -------------
    2999    Total liabilities...............         343            372           374            375
        NET POSITION:
    3300  Cumulative results of operations..
                                            ------------ --------------  ------------  -------------
    3999    Total net position..............
                                            ------------ --------------  ------------  -------------
    4999  Total liabilities and net position         343            372           374            375
    -----------------------------------------------------------------------------------------------

              Health Education Assistance Loans Liquidating Account

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4305-0-3-552      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Death and disability claims.......           2           6           6
    00.02 Defaulted loans...................           9          20          15
    00.03 Debt collection...................           3           4           6
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          14          30          27
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......          35          30          27
    22.40 Capital transfer to general fund..         -20
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......          15          30          27
    23.95 Total new obligations.............         -14         -30         -27
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................          10          10           7
    69.00 Offsetting collections (cash).....          25          20          20
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................          35          30          27
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          22          21          20
    73.10 Total new obligations.............          14          30          27
    73.20 Total outlays (gross).............         -16         -30         -27
    74.40 Obligated balance, end of year....          21          20          20
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................          10          30          27
    86.98 Outlays from mandatory balances...           6
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........          16          30          27
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.40   Offsetting collections (cash)
              from: Non-Federal sources.....         -25         -20         -20
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          10          10           7
    90.00 Outlays...........................          -9          10           7
    ---------------------------------------------------------------------------

                 Status of Guaranteed Loans (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4305-0-3-552      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
        Cumulative balance of guaranteed loans
                    outstanding:
    2210  Outstanding, start of year........         722         668         618
    2251  Repayments and prepayments........         -41         -39         -40
          Adjustments:

    2261    Terminations for default that
              result in loans receivable....         -12          -8          -7
    2263    Terminations for default that
              result in claim payments......          -1          -3          -3
                                               ---------   ---------  ----------
    2290    Outstanding, end of year........         668         618         568
    ----------------------------------------------------------------------------

        Memorandum:
    2299  Guaranteed amount of guaranteed
            loans outstanding, end of year..         668         618         568
    ----------------------------------------------------------------------------

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

    2310    Outstanding, start of year......         500         497         464
    2331    Disbursements for guaranteed
              loan claims...................          12           8           7
    2351    Repayments of loans receivable..         -17         -17         -17
    2361    Write-offs of loans receivable..         -24         -24         -24
    2364    Other adjustments, net..........          26
                                               ---------   ---------  ----------
    2390      Outstanding, end of year......         497         464         430
    ---------------------------------------------------------------------------
        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    2000 actual    2001 actual     2002 est.      2003 est.
    -----------------------------------------------------------------------------------------------
    0101  Revenue...........................          28             14            30             27
    0102  Expense...........................         -28            -14           -30            -27
                                            ------------ --------------  ------------  -------------
    0105  Net income or loss (-)............
    -----------------------------------------------------------------------------------------------

                                 Balance Sheet (in millions of dollars)

    -----------------------------------------------------------------------------------------------
    Identification code   75-4305-0-3-552    2000 actual    2001 actual     2002 est.      2003 est.
    -----------------------------------------------------------------------------------------------
        ASSETS:
    1101  Federal assets: Fund balances with
            Treasury........................          22             21            20             20
    1206  Non-Federal assets: Receivables,
            net.............................         381            376           376            376
                                            ------------ --------------  ------------  -------------
    1999    Total assets....................         403            397           396            396

    [[Page 435]]

        LIABILITIES:
    2204  Non-Federal liabilities:
            Liabilities for loan guarantees.         403            397           396            396
                                            ------------ --------------  ------------  -------------
    2999    Total liabilities...............         403            397           396            396
        NET POSITION:
    3300  Cumulative results of operations..
                                            ------------ --------------  ------------  -------------
    3999    Total net position..............
                                            ------------ --------------  ------------  -------------
    4999  Total liabilities and net position         403            397           396            396
    -----------------------------------------------------------------------------------------------

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4305-0-3-552      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    25.2  Other services....................           3           8           8
    42.0  Insurance claims and indemnities..          11          22          19
                                               ---------   ---------  ----------
    99.9    Total new obligations...........          14          30          27
    ---------------------------------------------------------------------------

                   Medical Facilities Guarantee and Loan Fund

                federal interest subsidies for medical facilities

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9931-0-3-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          65          67          71
    22.00 New budget authority (gross)......           3           4           4
    22.60 Portion applied to repay debt.....          -1
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......          67          71          75
    24.40 Unobligated balance carried
            forward, end of year............          67          71          75
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    69.00   Offsetting collections (cash)...           3           4           4
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..           1           1           1
    74.40 Obligated balance, end of year....           1           1           1
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

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

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

                   Status of Direct Loans (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9931-0-3-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
        Cumulative balance of direct loans
                    outstanding:
    1210  Outstanding, start of year........          11           9           5
    1251  Repayments: Repayments and
            prepayments.....................          -2          -4          -5
                                               ---------   ---------  ----------
    1290    Outstanding, end of year........           9           5
    ---------------------------------------------------------------------------

                 Status of Guaranteed Loans (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9931-0-3-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
        Cumulative balance of guaranteed loans
                    outstanding:
    2210  Outstanding, start of year........          24          19          13
    2251  Repayments and prepayments........          -5          -6          -6
                                               ---------   ---------  ----------
    2290    Outstanding, end of year........          19          13           7
    ----------------------------------------------------------------------------

        Memorandum:
    2299  Guaranteed amount of guaranteed
            loans outstanding, end of year..          19          13           7
    ---------------------------------------------------------------------------

        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 [$2,992,000]
    $2,991,000 shall be available from the Trust Fund to the Secretary of
    Health and Human Services. (Department of Health and Human Services
    Appropriations Act, 2002.)

                  Unavailable Collections (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8175-0-7-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    01.99 Balance, start of year............       1,546       1,627       1,718
        Receipts:
    02.00 Deposits..........................         112         123         125
    02.40 Interest income...................          58          60          63
                                               ---------   ---------  ----------
    02.99   Total receipts and collections..         170         183         188
                                               ---------   ---------  ----------
    04.00 Total: Balances and collections...       1,716       1,810       1,906
        Appropriations:
    05.00 Vaccine injury compensation
            program trust fund..............         -89         -92         -96
                                               ---------   ---------  ----------
    05.99   Total appropriations............         -89         -92         -96
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............       1,627       1,718       1,810
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8175-0-7-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Compensation: Claims for post--FY
            1989 injuries...................          79          83          86
          Administrative expenses:

    01.03   Claims processing (Claims Court)           3           3           3
    01.04   Claims processing (Public Health
              Service)......................           3           3           3
    01.05   Claims processing (Dept. of
              Justice)......................           4           4           4
                                               ---------   ---------  ----------
    01.91     Total, administrative expenses          10          10          10
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          89          93          96
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           1           1
    22.00 New budget authority (gross)......          89          92          96
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......          90          93          96
    23.95 Total new obligations.............         -89         -93         -96
    24.40 Unobligated balance carried
            forward, end of year............           1
    ----------------------------------------------------------------------------

    [[Page 436]]

        New budget authority (gross), detail:
          Discretionary:

    40.26   Appropriation (trust fund)......          10          10          10
          Mandatory:

    60.26   Appropriation (trust fund)......          79          82          86
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................          89          92          96
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..                       1
    73.10 Total new obligations.............          89          93          96
    73.20 Total outlays (gross).............         -89         -93         -96
    74.40 Obligated balance, end of year....           1
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................          10          10          10
    86.97 Outlays from new mandatory
            authority.......................          79          82          86
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........          89          93          96
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          89          92          96
    90.00 Outlays...........................          88          93          96
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    92.01 Total investments, start of year:
            Federal securities: Par value...                   1,628       1,693
    92.02 Total investments, end of year:
            Federal securities: Par value...       1,628       1,693       1,793
    ---------------------------------------------------------------------------

        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      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    25.2  Other services....................           3           3           3
    25.3  Other purchases of goods and
            services from Government
            accounts........................           7           7           7
    42.0  Insurance claims and indemnities..          79          83          86
                                               ---------   ---------  ----------
    99.9    Total new obligations...........          89          93          96
    ---------------------------------------------------------------------------

                        Ricky Ray Hemophilia Relief Fund

                  Unavailable Collections (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-8074-0-7-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    01.99 Balance, start of year............
        Receipts:
    02.40 Payments from the general fund....         580
    02.41 Interest on investments, Ricky....           2
                                               ---------   ---------  ----------
    02.99   Total receipts and collections..         582
        Appropriations:
    05.00 Ricky Ray hemophilia relief fund..        -582
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-8074-0-7-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Compensation--claims..............         465         139
    00.02 Administrative expenses subject to
            limitation......................           3           3           3
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         468         142           3
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          31         145           3
    22.00 New budget authority (gross)......         582
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         613         145           3
    23.95 Total new obligations.............        -468        -142          -3
    24.40 Unobligated balance carried
            forward, end of year............         145           3
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.26   Appropriation (trust fund)......         582
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          11           3
    73.10 Total new obligations.............         468         142           3
    73.20 Total outlays (gross).............        -475        -146          -3
    74.40 Obligated balance, end of year....           3
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................         442
    86.98 Outlays from mandatory balances...          31         146           3
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         475         146           3
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         582
    90.00 Outlays...........................         475         146           3
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    92.02 Total investments, end of year:
            Federal securities: Par value...         130
    ---------------------------------------------------------------------------

        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      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    11.1  Personnel compensation: Full-time
            permanent.......................           2           2           2
    25.2  Other services....................           1           1           1
                                               ---------   ---------  ----------
    99.0      Limitation acct--direct
                obligations.................           3           3           3
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-8074-0-7-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    6001  Total compensable workyears: Full-
            time equivalent employment......          18          18          17
    ---------------------------------------------------------------------------

                              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, [$2,389,614,000]
    $2,513,668,000, 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 [$15,000,000] up to
    $18,000,000 shall remain available until expended, for the Indian
    Catastrophic Health Emergency Fund: Provided further, That
    [$445,776,000] $450,130,000 for contract medical care shall remain
    available for obligation until September 30, [2003] 2004: Provided
    further, That of the funds provided,

    [[Page 437]]

    up to [$22,000,000] $25,000,000 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 2
    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, [2003] 2004:
    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 [$268,234,000] $270,734,000 shall be for payments
    to tribes and tribal organizations for contract or grant support costs
    associated with contracts, grants, self-governance compacts or annual
    funding agreements between the Indian Health Service and a tribe or
    tribal organization pursuant to the Indian Self-Determination Act of
    1975, as amended, prior to or during fiscal year [2002] 2003, of which
    not to exceed [$20,000,000] $2,500,000 may be used for contract support
    costs associated with new or expanded self-determination contracts,
    grants, self-governance compacts or annual funding agreements: 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, 2002; additional authorizing
    legislation required.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0390-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
          Direct program:

    00.01   Clinical services...............       1,822       1,940       1,994
    00.02   Preventive health...............          98         102         105
    00.03   Urban health....................          30          31          32
    00.04   Indian health professions.......          29          31          35
    00.05   Tribal management...............           2           2           2
    00.06   Direct operations...............          61          64          63
    00.07   Self-governance.................          10          10          10
    00.08   Contract support costs..........         248         268         271
    00.09   Diabetes funds..................         100         100         100
    09.01 Reimbursable program..............         709         767         767
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       3,109       3,315       3,379
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         165         185         185
    22.00 New budget authority (gross)......       3,129       3,315       3,380
    22.10 Resources available from
            recoveries of prior year
            obligations.....................           8
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       3,302       3,500       3,565
    23.95 Total new obligations.............      -3,109      -3,315      -3,379
    23.98 Unobligated balance expiring or
            withdrawn.......................          -7
    24.40 Unobligated balance carried
            forward, end of year............         185         185         185
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       2,325       2,448       2,513
    40.77   Reduction pursuant to P.L. 106-
              554 (0.22 percent)............          -5
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       2,320       2,448       2,513
          Mandatory:

    60.00   Appropriation...................          70          70         100
    62.00   Transferred from CMS for
              diabetes......................          30          30
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................         100         100         100
          Spending authority from offsetting
              collections:

            Discretionary:
    68.00     Offsetting collections (cash).         676         767         767
    68.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........          33
                                               ---------   ---------  ----------
    68.90       Spending authority from
                  offsetting collections
                  (total discretionary).....         709         767         767
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       3,129       3,315       3,380
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         465         601         605
    73.10 Total new obligations.............       3,109       3,315       3,379
    73.20 Total outlays (gross).............      -3,088      -3,311      -3,441
    73.40 Adjustments in expired accounts
            (net)...........................         117
    73.45 Recoveries of prior year
            obligations.....................          -8
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................         -33
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................          39
    74.40 Obligated balance, end of year....         601         605         545
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       2,757       2,929       2,986
    86.93 Outlays from discretionary
            balances........................         231         282         356
    86.97 Outlays from new mandatory
            authority.......................          52          52          52
    86.98 Outlays from mandatory balances...          48          48          46
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       3,088       3,311       3,441
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............        -448        -392        -403
    88.40     Non-Federal sources...........        -345        -375        -364
                                               ---------   ---------  ----------
    88.90       Total, offsetting
                  collections (cash)........        -793        -767        -767
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................         -33
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............         117
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       2,420       2,548       2,613
    90.00 Outlays...........................       2,294       2,544       2,674
    ---------------------------------------------------------------------------

      Budget Authority and Outlays Excluding Full Funding for Federal Retiree
                           Costs (in millions of dollars)

    ----------------------------------------------------------------------------
                                             2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       2,366       2,490       2,553
    90.00 Outlays...........................       2,240       2,486       2,614
    ---------------------------------------------------------------------------

        The Indian health services account provides medical care, public
    health services, and health professions training opportunities to
    American Indians and Alaska Natives. An estimated $1,642 million will be
    administered by tribal governments under self-determination contracts
    and self-governance compacts in 2003.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0390-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........         381         406         424
    11.3      Other than full-time permanent          16          18          18
    11.5      Other personnel compensation..          33          35          37
                                               ---------   ---------  ----------
    11.9        Total personnel compensation         430         459         479
    12.1    Civilian personnel benefits.....         168         181         188
    13.0    Benefits for former personnel...          12          12          13
            Travel and transportation of
                persons:
    21.0      Travel and transportation of
                persons.....................          12          12           9
    21.0      Patient Travel................          17          17          17
    22.0    Transportation of things........           8           8           8
    23.1    Rental payments to GSA..........           8           4           4
    23.2    Rental payments to others.......           3           7           7
    23.3    Communications, utilities, and
              miscellaneous charges.........          20          21          21
    24.0    Printing and reproduction.......           1           1           1
    25.1    Advisory and assistance services           7           7           7
    25.2    Other services..................          64          61          61
    25.3    Other purchases of goods and
              services from Government
              accounts......................                       2           2

    [[Page 438]]

    25.4    Operation and maintenance of
              facilities....................           9           6           6
    25.5    Research and development
              contracts.....................                       1           1
    25.6    Medical care....................         217         232         232
    25.7    Operation and maintenance of
              equipment.....................           4           5           5
    25.8    Subsistence and support of
              persons.......................                       2           2
    26.0    Supplies and materials..........         101         101         101
    31.0    Equipment.......................          19          19          19
    32.0    Land and structures.............           1           1           1
    41.0    Grants, subsidies, and
              contributions.................       1,298       1,388       1,427
    42.0    Insurance claims and indemnities           1           1           1
                                               ---------   ---------  ----------
    99.0      Direct obligations............       2,400       2,548       2,612
    99.0  Reimbursable obligations..........         709         767         767
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       3,109       3,315       3,379
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-0390-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears: Full-
            time equivalent employment......       9,656       9,782       9,839
        Reimbursable:
    2001  Total compensable workyears: Full-
            time equivalent employment......       3,710       3,710       3,710
    ---------------------------------------------------------------------------

                            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, [$369,487,000] $370,475,000, 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 from the funds appropriated herein, $5,000,000 shall be
    designated by the Indian Health Service as a contribution to the Yukon-
    Kuskokwim Health Corporation (YKHC) to continue a priority project for
    the acquisition of land, planning, design and construction of 79 staff
    quarters in the Bethel service area, pursuant to the negotiated project
    agreement between the YKHC and the Indian Health Service: Provided
    further, That this project shall not be subject to the construction
    provisions of the Indian Self-Determination and Education Assistance Act
    and shall be removed from the Indian Health Service priority list upon
    completion: Provided further, That the Federal Government shall not be
    liable for any property damages or other construction claims that may
    arise from YKHC undertaking this project: Provided further, That the
    land shall be owned or leased by the YKHC and title to quarters shall
    remain vested with the YKHC: Provided further, That $5,000,000 shall
    remain available until expended for the purpose of funding up to two
    joint venture health care facility projects authorized under the Indian
    Health Care Improvement Act, as amended: Provided further, That
    priority, by rank order, shall be given to tribes with outpatient
    projects on the existing Indian Health Services priority list that have
    Service-approved planning documents, and can demonstrate by March 1,
    2002, the financial capability necessary to provide an appropriate
    facility: Provided further, That joint venture funds unallocated after
    March 1, 2002, shall be made available for joint venture projects on a
    competitive basis giving priority to tribes that currently have no
    existing Federally-owned health care facility, have planning documents
    meeting Indian Health Service requirements prepared for approval by the
    Service and can demonstrate the financial capability needed to provide
    an appropriate facility: Provided further, That the Indian Health
    Service shall request additional staffing, operation and maintenance
    funds for these facilities in future budget requests:] 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 notwithstanding the provisions of title III, section 306,
    of the Indian Health Care Improvement Act (Public Law 94-437, as
    amended), construction contracts authorized under title I of the Indian
    Self-Determination and Education Assistance Act of 1975, as amended, may
    be used rather than grants to fund small ambulatory facility
    construction projects: Provided further, That if a contract is used, the
    IHS is authorized to improve municipal, private, or tribal lands, and
    that at no time, during construction or after completion of the project
    will the Federal Government have any rights or title to any real or
    personal property acquired as a part of the contract: Provided further,
    That notwithstanding any other provision of law or regulation, for
    purposes of acquiring sites for a new clinic and staff quarters in St.
    Paul Island, Alaska, the Secretary of Health and Human Services may
    accept land donated by the Tanadgusix Corporation]. (Department of the
    Interior and Related Agencies Appropriations Act, 2002; additional
    authorizing legislation required.)

                  Unavailable Collections (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0391-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    01.99 Balance, start of year............
        Receipts:
    02.20 Rent and charges for quarters,
            Indian health service, HHS......          11           6           6
        Appropriations:
    05.00 Indian health facilities..........         -11          -6          -6
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0391-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
          Direct program:

    00.01   Sanitation and health facilities         154         181         167
    00.02   Maintenance.....................          42          52          53
    00.03   Facilities and environmental
              health........................         123         133         140
    00.04   Equipment.......................          11          16          16
                                               ---------   ---------  ----------
    01.00     Total direct program..........         330         382         376
    09.01 Reimbursable program..............           6           4           4
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         336         386         380
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          90         138         138
    22.00 New budget authority (gross)......         384         388         383
    22.10 Resources available from
            recoveries of prior year
            obligations.....................           1
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         475         526         521
    23.95 Total new obligations.............        -336        -386        -380
    24.40 Unobligated balance carried
            forward, end of year............         138         138         139
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................         371         376         371
    40.77   Reduction pursuant to P.L. 106-
              554 (0.22 percent)............          -1
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............         370         376         371
          Mandatory:

    60.20   Appropriation (special fund)....          11           6           6
          Spending authority from offsetting
              collections:

            Discretionary:
    68.00     Offsetting collections (cash).           7           7           7

    [[Page 439]]

    68.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........          -4
                                               ---------   ---------  ----------
    68.90       Spending authority from
                  offsetting collections
                  (total discretionary).....           3           7           7
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................         384         389         384
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         321         323         375
    73.10 Total new obligations.............         336         386         380
    73.20 Total outlays (gross).............        -338        -336        -383
    73.45 Recoveries of prior year
            obligations.....................          -1
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................           4
    74.40 Obligated balance, end of year....         323         375         374
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................         105         125         124
    86.93 Outlays from discretionary
            balances........................         225         206         254
    86.97 Outlays from new mandatory
            authority.......................           7           6           6
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         338         336         383
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........          -7          -7          -7
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................           4
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         381         381         376
    90.00 Outlays...........................         330         329         376
    ---------------------------------------------------------------------------

      Budget Authority and Outlays Excluding Full Funding for Federal Retiree
                           Costs (in millions of dollars)

    ----------------------------------------------------------------------------
                                             2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         374         374         368
    90.00 Outlays...........................         323         322         368
    ---------------------------------------------------------------------------

        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      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........          52          56          59
    11.3      Other than full-time permanent           5           6           6
    11.5      Other personnel compensation..           1           2           2
                                               ---------   ---------  ----------
    11.9        Total personnel compensation          58          64          67
    12.1    Civilian personnel benefits.....          22          23          25
    21.0    Travel and transportation of
              persons.......................           3           3           3
    22.0    Transportation of things........           3           2           3
    23.1    Rental payments to GSA..........           2
    23.3    Communications, utilities, and
              miscellaneous charges.........          12          12          12
    25.1    Advisory and assistance services           1           2           2
    25.2    Other services..................         113         151         140
    25.3    Other purchases of goods and
              services from Government
              accounts......................           5           5           5
    25.4    Operation and maintenance of
              facilities....................           2           3           3
    25.7    Operation and maintenance of
              equipment.....................           1           1           1
    26.0    Supplies and materials..........           7           9           8
    31.0    Equipment.......................           6           6           6
    32.0    Land and structures.............          14          15          14
    41.0    Grants, subsidies, and
              contributions.................          75          83          84
    42.0    Insurance claims and indemnities           7
    43.0    Interest and dividends..........           1           1           1
                                               ---------   ---------  ----------
    99.0      Direct obligations............         332         380         374
    99.0  Reimbursable obligations..........           4           6           6
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         336         386         380
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-0391-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    1001  Total compensable workyears: Full-
            time equivalent employment......       1,300       1,308       1,326
    ---------------------------------------------------------------------------

                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]
    therefor 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.
        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. 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.
        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.
        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.
        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.
        [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.]
        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. 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. Such amounts shall remain available until
    expended.
        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.
        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, 2002.)

    [[Page 440]]

                   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, XXI, 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, [$4,293,151,000, of which $250,000,000 shall
    remain available until expended for equipment and construction and
    renovation of facilities, and] $3,931,742,000, of which $143,763,000 for
    international HIV/AIDS shall remain available until September 30, [2003]
    2004, 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 [$23,286,000] $46,982,000
    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 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 15 States[: Provided further, That
    notwithstanding any other provision of law, a single contract or related
    contracts for development and construction of facilities may be employed
    which collectively include the full scope of the project: Provided
    further, That the solicitation and contract shall contain the clause
    ``availability of funds'' found at 48 CFR 52.232-18]. (Department of
    Health and Human Services Appropriations Act, 2002; additional
    authorizing legislation required.)
        [For emergency expenses to respond to the September 11, 2001,
    terrorist attacks on the United States for ``Disease control, research,
    and training'' for baseline safety screening for the emergency services
    personnel and rescue and recovery personnel, $12,000,000, to remain
    available until expended to be obligated from amounts made available in
    Public Law 107-38.] (Emergency Supplemental Act, 2002.)

                  Unavailable Collections (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0943-0-1-999      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    01.99 Balance, start of year............
        Receipts:
    02.20 Cooperative research and
            development agreements, Centers
            for Disease Contr...............           1           1           1
        Appropriations:
    05.00 Disease control, research, and
            training........................          -1          -1          -1
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0943-0-1-999      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
          Direct program:

    00.01   Preventive health block grants..         176
    00.02   Prevention centers..............          23
    00.03   Sexually transmitted diseases...         148
    00.04   Immunization....................         529
    00.05   Infectious diseases.............         307
    00.06   Other chronic and environmental
              diseases......................         601
    00.07   Tobacco.........................         102
    00.08   Occupational health and safety..         119
    00.10   Epidemic services...............         175
    00.11   Health statistics...............          26
    00.12   H I V...........................         767
    00.13   Prevention research.............          14
    00.14   Buildings & Facilities..........         170
    00.17   Eliminating racial and ethnic
              disparities...................          35
    00.18   Program administration..........         715
    00.19   Birth defects/developmental
              disabilities/disability and
              health........................                      91          90
    00.20   Chronic disease prev & health
              promotion.....................                     753         697
    00.21   Environmental health............                     157         155
    00.22   Epidemic services and response..                      83          81
    00.23   Health statistics...............                     108          83
    00.24   HIV/AIDS, STD and TB prevention.                   1,143       1,143
    00.25   Immunization....................                     631         632
    00.26   Infectious disease control......                     355         344
    00.27   Injury prevention and control...                     151         146
    00.28   Occupational safety and health..                     287         258
    00.29   Preventive health and heath
              service block grant...........                     135         135
    00.30   Public health improvement.......                     150         119
    00.31   Building and facilities.........                     250
    00.32   Office of the Director..........                      52          48
    09.01 Reimbursable program..............         197         159         188
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       4,104       4,505       4,119
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          26          47          63
    22.00 New budget authority (gross)......       4,125       4,521       4,123
    22.22 Unobligated balance transferred
            from other accounts.............           2
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       4,153       4,568       4,186
    23.95 Total new obligations.............      -4,104      -4,505      -4,119
    23.98 Unobligated balance expiring or
            withdrawn.......................          -1
    24.40 Unobligated balance carried
            forward, end of year............          47          63          67
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       3,919       4,348       3,931
    40.15   Appropriation (emergency).......                      12
    40.71   Reduction pursuant to P.L. 107-
              116 (Labor/HHS)...............                      -2
    40.75   Reduction pursuant to P.L. 106-
              554 (Labor/HHS)...............          -2
    41.00   Transferred to other accounts...          -3
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       3,914       4,358       3,931
          Mandatory:

    60.00   Appropriation...................                                   3
    60.20   Appropriation (special fund)....           1           1           1
    62.00   Transferred from other accounts.          13           3
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................          14           4           4
          Spending authority from offsetting
              collections:

            Discretionary:
    68.00     Offsetting collections (cash).         121         136         141
    68.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........          76          23          47
                                               ---------   ---------  ----------
    68.90       Spending authority from
                  offsetting collections
                  (total discretionary).....         197         159         188
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       4,125       4,521       4,123
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       2,673       3,246       3,658
    73.10 Total new obligations.............       4,104       4,505       4,119
    73.20 Total outlays (gross).............      -3,517      -4,070      -4,297
    73.40 Adjustments in expired accounts
            (net)...........................         -27
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................         -76         -23         -47
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................          90
    74.40 Obligated balance, end of year....       3,246       3,658       3,433
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       1,530       1,634       1,524
    86.93 Outlays from discretionary
            balances........................       1,983       2,426       2,765
    86.97 Outlays from new mandatory
            authority.......................           4           4           4
    86.98 Outlays from mandatory balances...                       6           4
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       3,517       4,070       4,297
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............        -204        -131        -136
    88.40     Non-Federal sources...........          -5          -5          -5
                                               ---------   ---------  ----------
    88.90       Total, offsetting
                  collections (cash)........        -209        -136        -141
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................         -76         -23         -47
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............          88
    ----------------------------------------------------------------------------

    [[Page 441]]

        Net budget authority and outlays:
    89.00 Budget authority..................       3,928       4,362       3,935
    90.00 Outlays...........................       3,308       3,934       4,156
    ---------------------------------------------------------------------------

                 Comparable BA by Activity (dollars in millions)

                                            2001         2002        2003
    Birth defects/developmental/
    disabilities/disability & health....          71          91          90
    HIV/AIDS, STD, TB...................        1051        1143        1143
    HIV/AIDS (non-add)..................         855         932         933
    Immunization........................         556         631         631
    Infectious disease control..........         327         354         345
    Environmental health................         140         157         156
    Chronic disease/health promotion....         756         754         697
    Preventive health block grant.......         135         135         135
    Occupational safety and health......         270         287         258
    Injury prevention...................         144         151         146
    Health statistics BA................          54         108          83
      Program level.....................         126         131         130
    Epidemic services...................          81          83          81
    Public health improvement...........         113         150         119
    Office of the Director..............          42          52          48
    Emergency response..................                      12
                                        ------------------------------------
    Total...............................       3,739       4,108       3,932
                                        ====================================

      Budget Authority and Outlays Excluding Full Funding for Federal Retiree
                           Costs (in millions of dollars)

    ----------------------------------------------------------------------------
                                             2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       3,877       4,307       3,878
    90.00 Outlays...........................       3,257       3,879       4,099
    ---------------------------------------------------------------------------

        The Centers for Disease Control and Prevention (CDC) supports a
    number of categorical programs designed to improve the health and safety
    of all Americans. These programs include immunization, HIV prevention,
    chronic disease prevention and health promotion, infectious disease
    control, occupational safety and health, injury prevention and control,
    occupational safety and health, injury prevention and control,
    environmental health, and programs that reduce the occurrence of birth
    defects and developmental disabilities. CDC also supports bioterrorism
    and emergency response activities. Funding for these activities is
    included in the Public Health and Social Services Emergency Fund
    provided to CDC from the Office of the Secretary of Health and Human
    Services.

        In 2002, CDC modified and consolidated several budget categories to
    simplify its budget, and move towards budgeting its activities by
    organization. The new budget categories represent total costs of a
    program, including both administrative costs and CDC's centralized
    services. The comparable table above displays funding levels in 2001,
    2002, and 2003 using the new categories as if they were implemented in
    2001.

        The 2003 Budget also creates a new HHS Health Facilities
    Construction and Management Fund within the Office of the Secretary that
    will fund facilities construction for CDC and the National Institutes of
    Health centrally rather than in the individual agency accounts. Through
    this mechanism, the Department will prioritize and fund construction
    projects competitively across the two agencies.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0943-0-1-999      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........         355         404         406
    11.3      Other than full-time permanent          36          40          41
    11.5      Other personnel compensation..          20          24          25
    11.8      Special personal services
                payments....................           1
                                               ---------   ---------  ----------
    11.9        Total personnel compensation         412         468         472
    12.1    Civilian personnel benefits.....         170         190         194
    21.0    Travel and transportation of
              persons.......................          34          42          45
    22.0    Transportation of things........           6           6           7
    23.1    Rental payments to GSA..........          35          44          52
    23.2    Rental payments to others.......           2           3           3
    23.3    Communications, utilities, and
              miscellaneous charges.........          25          34          38
    24.0    Printing and reproduction.......           6           7           8
    25.1    Advisory and assistance services         123         127         132
    25.2    Other services..................          57          63          69
    25.3    Other purchases of goods and
              services from Government
              accounts......................         221         232         236
    25.4    Operation and maintenance of
              facilities....................          43          46          34
    25.5    Research and development
              contracts.....................         246         269         271
    25.6    Medical care....................           2           3           2
    25.7    Operation and maintenance of
              equipment.....................          19          24          30
    25.8    Subsistence and support of
              persons.......................           5          10           8
    26.0    Supplies and materials..........          35          38          38
    31.0    Equipment.......................          68          59          63
    32.0    Land and structures.............         144         238
    41.0    Grants, subsidies, and
              contributions.................       2,254       2,442       2,228
    42.0    Insurance claims and indemnities           1           1           1
                                               ---------   ---------  ----------
    99.0      Direct obligations............       3,908       4,346       3,931
    99.0  Reimbursable obligations..........         196         159         188
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       4,104       4,505       4,119
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-0943-0-1-999      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears: Full-
            time equivalent employment......       7,019       7,556       7,183
        Reimbursable:
    2001  Total compensable workyears: Full-
            time equivalent employment......         663         252         448
        Allocation account:
    3001  Total compensable workyears: Full-
            time equivalent employment......         174         447         497
    ---------------------------------------------------------------------------

                Agency for Toxic Substances and Disease Registry

                toxic substances and environmental public health

        For necessary expenses for the Agency for Toxic Substances and
    Disease Registry (ATSDR) in carrying out activities set forth in
    sections 104(i), 111(c)(4), and 111(c)(14) of the Comprehensive
    Environmental Response, Compensation, and Liability Act of 1980
    (CERCLA), as amended; section 118(f) of the Superfund Amendments and
    Reauthorization Act of 1986 (SARA), as amended; and section 3019 of the
    Solid Waste Disposal Act, as amended, [$78,235,000] $80,599,000, to be
    derived from the Hazardous Substance Superfund Trust Fund pursuant to
    section 517(a) of SARA (26 U.S.C. 9507): Provided, That notwithstanding
    any other provision of law, in lieu of performing a health assessment
    under section 104(i)(6) of CERCLA, the Administrator of ATSDR may
    conduct other appropriate health studies, evaluations, or activities,
    including, without limitation, biomedical testing, clinical evaluations,
    medical monitoring, and referral to accredited health care providers:
    Provided further, That in performing any such health assessment or
    health study, evaluation, or activity, the Administrator of ATSDR shall
    not be bound by the deadlines in section 104(i)(6)(A) of CERCLA:
    Provided further, That none of the funds appropriated under this heading
    shall be available for ATSDR to issue in excess of 40 toxicological
    profiles pursuant to section 104(i) of CERCLA during fiscal year [2002]
    2003, and existing profiles may be updated as necessary. (Departments of
    Veterans Affairs and Housing and Urban Development, and Independent
    Agencies Appropriations Act, 2002; additional authorizing legislation
    required.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-8252-0-7-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Direct program....................          78          81          80
    09.01 Reimbursable program..............          18          26          26
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          96         107         106
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......          97         107         106
    23.95 Total new obligations.............         -96        -107        -106
    ----------------------------------------------------------------------------

    [[Page 442]]

        New budget authority (gross), detail:
          Discretionary:

    40.26   Appropriation (trust fund)......          78          81          80
          Spending authority from offsetting
              collections:

    68.00   Offsetting collections (cash)...           7          26          26
    68.10   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................          12
                                               ---------   ---------  ----------
    68.90     Spending authority from
                offsetting collections
                (total discretionary).......          19          26          26
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................          97         107         106
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..                      30          49
    73.10 Total new obligations.............          96         107         106
    73.20 Total outlays (gross).............         -54         -88         -92
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................         -12
    74.40 Obligated balance, end of year....          30          49          65
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................          54          56          56
    86.93 Outlays from discretionary
            balances........................                      31          34
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........          54          88          92
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........          -7         -26         -26
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................         -12
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          78          81          80
    90.00 Outlays...........................          47          62          66
    ---------------------------------------------------------------------------

      Budget Authority and Outlays Excluding Full Funding for Federal Retiree
                           Costs (in millions of dollars)

    ----------------------------------------------------------------------------
                                             2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          75          78          77
    90.00 Outlays...........................          44          59          63
    ---------------------------------------------------------------------------

        The Agency for Toxic Substances and Disease Registry (ATSDR) is
    authorized under the Comprehensive Environmental Response, Compensation,
    and Liability Act of 1980 (CERCLA). ATSDR evaluates the health effects
    on humans resulting from the release of toxic substances, and works to
    prevent or reduce the health consequences through public health
    assessments at Superfund and other sites, health education,
    surveillance, and applied research activities. ATSDR is financed through
    the EPA Superfund.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-8252-0-7-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........          21          22          22
    11.3      Other than full-time permanent           1           1           1
    11.5      Other personnel compensation..           1           1           1
                                               ---------   ---------  ----------
    11.9        Total personnel compensation          23          24          24
    12.1    Civilian personnel benefits.....           9           9           9
    21.0    Travel and transportation of
              persons.......................           2           2           2
    23.3    Communications, utilities, and
              miscellaneous charges.........           1           1           1
    25.1    Advisory and assistance services           4           4           4
    25.2    Other services..................           2           2           2
    25.3    Other purchases of goods and
              services from Government
              accounts......................           8           8           8
    25.5    Research and development
              contracts.....................           6           8           8
    31.0    Equipment.......................           2           2           2
    41.0    Grants, subsidies, and
              contributions.................          21          21          20
                                               ---------   ---------  ----------
    99.0      Direct obligations............          78          81          80
    99.0  Reimbursable obligations..........          18          26          26
                                               ---------   ---------  ----------
    99.9    Total new obligations...........          96         107         106
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-8252-0-7-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears: Full-
            time equivalent employment......         353         352         344
        Reimbursable:
    2001  Total compensable workyears: Full-
            time equivalent employment......          76          77          77
    ---------------------------------------------------------------------------

                          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, [$4,190,405,000.] $5,122,111,000:
    Provided, That the Director of the National Institutes of Health may
    transfer up to $400,000,000 to other National Institutes of Health
    appropriations: Provided further, That the total amount provided for
    cancer research at the National Institutes of Health will be not less
    than $5,122,111,000. (Department of Health and Human Services
    Appropriations Act, 2002; additional authorizing legislation required.)

                    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, [$2,576,125,000] $2,746,280,000.
    (Department of Health and Human Services Appropriations Act, 2002;
    additional authorizing legislation required.)

             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, [$343,327,000] $366,550,000.
    (Department of Health and Human Services Appropriations Act, 2002;
    additional authorizing legislation required.)

        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,
    [$1,466,833,000] $1,578,913,000. (Department of Health and Human
    Services Appropriations Act, 2002; additional authorizing legislation
    required.)

             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,
    [$1,328,188,000] $1,416,780,000. (Department of Health and Human
    Services Appropriations Act, 2002; additional authorizing legislation
    required.)

              National Institute of Allergy and Infectious Diseases

                          (including transfer of funds)

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to allergy and infectious diseases,
    [$2,372,278,000] $3,959,054,000: Provided, That [the Director may
    transfer up to $25,000,000] $100,000,000 may be made available to
    International Assistance Programs, ``Global Fund to Fight HIV/AIDS,
    Malaria, and Tuberculosis'', to remain available until expended, to
    further the Institute's efforts to prevent and alleviate these diseases.
    (Department of Health and Human Services Appropriations Act, 2002;
    additional authorizing legislation required.)

                 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, [$1,725,263,000]

    [[Page 443]]

    $1,842,404,000. (Department of Health and Human Services Appropriations
    Act, 2002; additional authorizing legislation required.)

            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,
    [$1,113,605,000] $1,191,431,000. (Department of Health and Human
    Services Appropriations Act, 2002; additional authorizing legislation
    required.)

                             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,
    [$581,366,000] $620,083,000. (Department of Health and Human Services
    Appropriations Act, 2002; additional authorizing legislation required.)

               National Institute of Environmental Health Sciences

        For necessary expenses for the National Institute of Environmental
    Health Sciences in carrying out activities set forth in section 311(a)
    of the Comprehensive Environmental Response, Compensation, and Liability
    Act of 1980, as amended, [$70,228,000]  and section 126(g) of the
    Superfund Amendments and Reauthorization Act of 1986, $74,471,000.
    (Departments of Veterans Affairs and Housing and Urban Development, and
    Independent Agencies Appropriations Act, 2002.)
        For carrying out sections 301 and 311 and title IV of the Public
    Health Service Act with respect to environmental health sciences,
    [$566,639,000] $606,962,000. (Department of Health and Human Services
    Appropriations Act, 2002; additional authorizing legislation required.)
        [For emergency expenses to respond to the September 11, 2001,
    terrorist attacks on the United States for ``National Institute of
    Environmental Health Sciences'' for carrying out under current
    authorities, worker training, research, and education activities,
    $10,500,000, to remain available until expended, to be obligated from
    amounts made available in Public Law 107-38.]
        [Public Law 107-73 is amended under this heading by adding ``and
    section 126(g) of the Superfund Amendments and Reauthorization Act of
    1986,'' after the words, ``as amended,''.] (Emergency Supplemental Act,
    2002.)

                           National Institute on Aging

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to aging, [$893,443,000] $953,160,000.
    (Department of Health and Human Services Appropriations Act, 2002;
    additional authorizing legislation required.)

      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, [$448,865,000] $478,085,000. (Department of Health and Human
    Services Appropriations Act, 2002; additional authorizing legislation
    required.)

        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,
    [$342,072,000] $364,186,000. (Department of Health and Human Services
    Appropriations Act, 2002; additional authorizing legislation required.)

                     National Institute of Nursing Research

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to nursing research, [$120,451,000]
    $128,158,000. (Department of Health and Human Services Appropriations
    Act, 2002; additional authorizing legislation required.)

               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, [$384,238,000]
    $409,960,000. (Department of Health and Human Services Appropriations
    Act, 2002; additional authorizing legislation required.)

                        National Institute on Drug Abuse

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to drug abuse, [$888,105,000] $948,452,000.
    (Department of Health and Human Services Appropriations Act, 2002;
    additional authorizing legislation required.)

                       National Institute of Mental Health

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to mental health, [$1,248,626,000]
    $1,332,165,000. (Department of Health and Human Services Appropriations
    Act, 2002; additional authorizing legislation required.)

                    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, [$429,515,000]
    $457,032,000. (Department of Health and Human Services Appropriations
    Act, 2002; additional authorizing legislation required.)

           National Institute of Biomedical Imaging and Bioengineering

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to biomedical imaging and bioengineering
    research, [$111,984,000] $118,842,000. (Department of Health and Human
    Services Appropriations Act, 2002; additional authorizing legislation
    required.)

                     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, [$1,011,594,000] $1,072,581,000: 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 $110,000,000 shall be for
    extramural facilities construction grants, of which $5,000,000 shall be
    for beginning construction of facilities for a Chimp Sanctuary system as
    authorized in Public Law 106-551]. (Department of Health and Human
    Services Appropriations Act, 2002; additional authorizing legislation
    required.)

           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,
    [$104,644,000] $111,494,000. (Department of Health and Human Services
    Appropriations Act, 2002; additional authorizing legislation required.)

            National Center on Minority Health and Health Disparities

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to minority health and health disparities
    research, [$157,812,000] $178,559,000. (Department of Health and Human
    Services Appropriations Act, 2002; additional authorizing legislation
    required.)

                      John E. Fogarty International Center

        For carrying out the activities at the John E. Fogarty International
    Center, [$56,940,000] $62,933,000. (Department of Health and Human
    Services Appropriations Act, 2002; additional authorizing legislation
    required.)

                          National Library of Medicine

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to health information communications,
    [$277,658,000] $308,987,000, of which $4,000,000 shall be available
    until expended for improvement of information systems: Provided, That in
    fiscal year [2002] 2003, 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,
    2002; additional authorizing legislation required.)

                             Office of the Director

                          (including transfer of funds)

        For carrying out the responsibilities of the Office of the Director,
    National Institutes of Health, [$235,540,000] $252,642,000, of which
    [$53,540,000] $56,572,000 shall be for the Office of AIDS Research:
    Provided, That funding shall be available for the purchase of not to
    exceed 29 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

    [[Page 444]]

    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 1 fiscal year after
    the fiscal year in which they are deposited. (Department of Health and
    Human Services Appropriations Act, 2002; additional authorizing
    legislation required.)

                            buildings and facilities

                          (including transfer of funds)

        For the study of, construction of, renovation of, and acquisition of
    equipment for, facilities of or used by the National Institutes of
    Health, including the acquisition of real property, [$309,600,000]
    $632,800,000, to remain available until expended[, of which $26,000,000
    shall be for the John Edward Porter Neuroscience Research Center:
    Provided, That notwithstanding any other provision of law, single
    contracts or related contracts, which collectively include the full
    scope of the project, may be employed for the development and
    construction of the first and second phases of the John Edward Porter
    Neuroscience Research Center: Provided further, That the solicitations
    and contracts shall contain the clause ``availability of funds'' found
    at 48 CFR 52.232-18: Provided further, That the Director may transfer up
    to $75,000,000 to International Assistance Programs, ``Global Fund to
    Fight HIV/AIDS, Malaria, and Tuberculosis'', to remain available until
    expended]. (Department of Health and Human Services Appropriations Act,
    2002; additional authorizing legislation required.)

                  Unavailable Collections (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9915-0-1-552      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    01.99 Balance, start of year............
        Receipts:
    02.20 Cooperative research and
            development agreements, NIH.....          14          14          14
        Appropriations:
    05.00 National Institutes of Health.....         -14         -14         -14
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9915-0-1-552      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
          Direct program:

    00.01   National Cancer Institute.......       3,778       4,209       5,122
    00.02   National Heart, Lung, and Blood
              Institute.....................       2,304       2,581       2,747
    00.03   National Institute of Dental and
              Craniofacial Research.........         308         345         366
    00.04   National Institute of Diabetes
              and Digestive and Kidney
              Disease.......................       1,403       1,568       1,676
    00.05   National Institute of
              Neurological Disorders and
              Stroke........................       1,180       1,332       1,417
    00.06   National Institute of Allergy
              and Infectious Diseases.......       2,048       2,354       3,959
    00.07   National Institute of General
              Medical Sciences..............       1,536       1,726       1,842
    00.08   National Institute of Child
              Health and Human Development..         980       1,117       1,191
    00.09   National Eye Institute..........         512         583         620
    00.10   National Institute of
              Environmental Health Sciences.         570         652         682
    00.11   National Institute on Aging.....         788         896         953
    00.12   National Institute of Arthritis
              and Musculoskeletal and Skin
              Disease.......................         397         451         478
    00.13   National Institute on Deafness
              and Other Communication
              Disorder......................         301         343         364
    00.14   National Institute of Mental
              Health........................       1,111       1,254       1,332
    00.15   National Institute on Drug Abuse         793         891         948
    00.16   Natinal Institute on Alcohol
              Abuse and Alcoholism..........         342         386         410
    00.17   National Institute of Nursing
              Research......................         104         121         128
    00.18   National Human Genome Research
              Institute.....................         383         430         457
    00.19   National Institute of Biomedical
              Imaging and Bioengineering....                     112         119
    00.20   National Center for Research
              Resources.....................         818       1,013       1,073
    00.21   National Center for
              Complementary and Alternative
              Medicine......................          89         105         111
    00.22   National Center on Minority
              Health and Health Disparities.         130         158         178
    00.23   John E. Fogarty International
              Center........................          52          58          64
    00.24   National Library of Medicine....         243         282         309
    00.25   Office of the Director..........         216         239         253
    00.26   Buildings and facilities........         206         332         633
    00.27   Cooperative Research and
              Development Agreements........          10          10          10
    00.28   Royalities......................          41
    09.00 Reimbursable program..............       1,317       1,611       1,685
                                               ---------   ---------  ----------
    10.00   Total new obligations...........      21,960      25,159      29,127
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         173         211         117
    22.00 New budget authority (gross)......      22,001      25,065      29,131
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......      22,174      25,276      29,248
    23.95 Total new obligations.............     -21,960     -25,159     -29,127
    23.98 Unobligated balance expiring or
            withdrawn.......................          -3
    24.40 Unobligated balance carried
            forward, end of year............         211         117         121
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................      20,455      23,442      27,335
    40.15   Appropriation (emergency).......                      10
    40.71   Reduction pursuant to P.L. 107-
              116 (Labor/HHS)...............                      -9
    40.75   Reduction pursuant to P.L. 106-
              554 (Labor/HHS)...............          -9
    41.00   Transferred to other accounts...          -9        -100
    42.00   Transferred from other accounts.          10
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............      20,447      23,343      27,335
          Mandatory:

    60.00   Appropriation...................          70          70          97
    60.20   Appropriation (special fund)....          14          14          14
    62.00   Transferred from other accounts.          27          27
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................         111         111         111
          Spending authority from offsetting
              collections:

            Discretionary:
    68.00     Offsetting collections (cash).       1,518       1,611       1,685
    68.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........         -75
                                               ---------   ---------  ----------
    68.90       Spending authority from
                  offsetting collections
                  (total discretionary).....       1,443       1,611       1,685
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................      22,001      25,065      29,131
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..      16,198      19,229      22,100
    73.10 Total new obligations.............      21,960      25,159      29,127
    73.20 Total outlays (gross).............     -18,850     -22,288     -25,272
    73.40 Adjustments in expired accounts
            (net)...........................        -154
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................          75
    74.40 Obligated balance, end of year....      19,229      22,100      25,955
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       7,020       7,824       8,876
    86.93 Outlays from discretionary
            balances........................      11,818      14,365      16,312
    86.97 Outlays from new mandatory
            authority.......................          12          38          19
    86.98 Outlays from mandatory balances...                      61          65
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........      18,850      22,288      25,272
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........      -1,518      -1,611      -1,685
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................          75
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................      20,558      23,454      27,446
    90.00 Outlays...........................      17,332      20,677      23,587
    ---------------------------------------------------------------------------

       Budget Authority and Outlays Excluding Full Funding for Federal Retiree
                           Costs (in millions of dollars)

    ----------------------------------------------------------------------------
                                             2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................      20,479      23,367      27,355

    [[Page 445]]

    90.00 Outlays...........................      17,253      20,590      23,496
    ---------------------------------------------------------------------------

             DISTRIBUTION OF BUDGET AUTHORITY AND OUTLAYS BY ACCOUNT

                              [Dollars in millions]

                                            2001         2002        2003
    Distribution of budget authority by
        account:
      National Cancer Institute.........      3, 773       4,210       5,122
      National Heart, Lung, and Blood
        Institute.......................       2,304       2,582       2,746
      National Institute of Dental and
        Craniofacial Research...........         308         345         367
      National Institute of Diabetes and
        Digestive and Kidney Diseases...       1,404       1,568       1,676
      National Institute of Neurological
        Disorder and Stroke.............       1,179       1,332       1,417
      National Institute of Allergy and
        Infectious Diseases.............       2,049       2,354       3,959
      National Institute of General
        Medical Sciences................       1,537       1,726       1,842
      National Institute of Child Health
        and Human Development...........         979       1,117       1,191
      National Eye Institute............         512         583         620
      National Institute of
        Environmental Health Sciences...         570         652         682
      National Institute on Aging.......         788         896         953
      National Institute of Arthritis
        and Musculoskeletal and Skin
        Diseases........................         398         450         478
      National Institute on Deafness and
        Other Communication Disorders...         301         343         364
      National Institute of Nursing
        Research........................         105         121         128
      National Institute on Alcohol
        Abuse and Alcoholism............         342         386         410
      National Institute on Drug Abuse..         793         891         948
      National Institute of Mental
        Health..........................       1,111       1,254       1,332
      National Center for Research
        Resources.......................         818       1,012       1,073
      National Human Genome Research
        Institute.......................         383         431         457
      National Institute of Biomedical
        Imaging and Bioengineering......           0         112         119
      National Center for Complementary
        and Alternative Medicine........          89         105         111
      National Center for Minority
        Health and Health Disparities...         130         158         179
      John E. Fogarty International
        Center..........................          51          57          63
      National Library of Medicine......         243         282         309
      Office of the Director............         216         239         253
      Buildings and facilities..........         161         235         633
                                        ------------------------------------
          Subtotal......................      20,544      23,441      27,432
      Cooperative Research and
        Development Agreements..........          14          14          14
                                        ------------------------------------
          Total Budget Authority, NIH...      20,558      23,455      27,446
                                        ====================================

                              [Dollars in millions]

                                            2001         2002        2003
    Distribution of outlays by account:
      National Cancer Institute.........       3,255       3,786       4,366
      National Heart, Lung, and Blood
        Institute.......................       1,902       2,381       2,445
      National Institute of Dental and
        Craniofacial Research...........         270         309         342
      National Institute of Diabetes and
        Digestive and Kidney Diseases...       1,157       1,389       1,557
      National Institute of Neurological
        Disorders and Stroke............         989       1,178       1,318
      National Institute of Allergy and
        Infectious Diseases.............       1,769       2,050       2,704
      National Institute of General
        Medical Sciences................       1,324       1,541       1,713
      National Institute of Child Health
        and Human Development...........         817         999       1,123
      National Eye Institute............         442         519         578
      National Institute of
        Environmental Health Sciences...         434         580         645
      National Institute on Aging.......         662         780         877
      National Institute of Arthritis
        and Musculoskeletal and Skin
        Diseases........................         344         397         445
      National Institute on Deafness and
        Other Communication Disorders...         265         299         343
      National Institute of Nursing
        Research........................          83         103         117
      National Institute on Alcohol
        Abuse and Alcoholism............         282         336         378
      National Institute on Drug Abuse..         667         780         867
      National Institute of Mental
        Health..........................         951       1,116       1,234
      National Center for Research
        Resources.......................         625         811         958
      National Human Genome Research
        Institute.......................         385         405         441
      National Institute of Biomedical
        Imaging and Bioengineering......           0          17          35
      National Center for Complementary
        and Alternative Medicine........          46          80         102
      National Center for Minority
        Health and Health Disparities...          15          49          56
      John E. Fogarty International
        Center..........................          43          85         133
      National Library of Medicine......         228         252         288
      Office of the Director............         289         239         240
      Buildings and Facilities..........         203         182         269
      Service and Supply Fund/Management
        Fund............................        -125           0           0
                                        ------------------------------------
          Subtotal Outlays..............      17,322      20,663      23,573
      Cooperative Research and
        Development Agreements..........          11          14          14
                                        ------------------------------------
          Total Outlays, NIH............      17,333      20,677      23,587
                                        ====================================

        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 is working to meet the management challenges that can arise when
    an agency receives a substantial infusion of resources over a short
    period of time. NIH is in the process of identifying strategies and
    policies that would be implemented in 2003 and beyond to maximize
    budgetary and management flexibility in the future. Such strategies
    could include funding the total costs of an increasing number of new
    grants in the grant's first year and supporting some one-time activities
    such as high-priority construction and renovation projects.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9915-0-1-552      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........         585         659         706
    11.3      Other than full-time permanent         220         244         263
    11.5      Other personnel compensation..          39          33          37
    11.8      Special personal services
                payments....................         104         116         129
                                               ---------   ---------  ----------
    11.9        Total personnel compensation         948       1,052       1,135
    12.1    Civilian personnel benefits.....         269         298         320
    21.0    Travel and transportation of
              persons.......................          40          44          52
    22.0    Transportation of things........           5           6           7
    23.1    Rental payments to GSA..........           6          11          14
    23.2    Rental payments to others.......          22          29          32
    23.3    Communications, utilities, and
              miscellaneous charges.........          31          35          45
    24.0    Printing and reproduction.......          16          18          20
    25.1    Advisory and assistance services          72          70          77
    25.2    Other services..................         408         761       1,161
    25.3    Other purchases of goods and
              services from Government
              accounts......................       1,470       1,634       1,854
    25.4    Operation and maintenance of
              facilities....................         261         166         206
    25.5    Research and development
              contracts.....................       1,084       1,307       2,238
    25.6    Medical care....................          12          13          16
    25.7    Operation and maintenance of
              equipment.....................          61          55          65
    26.0    Supplies and materials..........         195         212         257
    31.0    Equipment.......................         164         183         222
    32.0    Land and structures.............                                   8
    41.0    Grants, subsidies, and
              contributions.................      15,579      17,654      19,713
                                               ---------   ---------  ----------
    99.0      Direct obligations............      20,643      23,548      27,442
    99.0  Reimbursable obligations..........       1,317       1,611       1,685
                                               ---------   ---------  ----------
    99.9    Total new obligations...........      21,960      25,159      29,127
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-9915-0-1-552      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears: Full-
            time equivalent employment......      12,049      12,875      13,085
        Reimbursable:
    2001  Total compensable workyears: Full-
            time equivalent employment......       4,469       4,589       4,604
    ---------------------------------------------------------------------------

            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, [$3,138,279,000, of which $28,721,000 shall be available for
    the projects and in the amounts specified in the statement of the
    managers on the conference report accompanying this Act] $3,197,704,000.
    (Department of Health and Human Services Appropriations Act, 2002;
    additional authorizing legislation required.)

    [[Page 446]]

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1362-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
          Direct program:

    00.01   Mental health and substance
              abuse activities..............         793         889         900
    00.02   Mental health partnership.......         420         433         433
    00.03   Substance abuse partnership.....       1,665       1,725       1,785
    00.05   Program management..............          83          95          79
    09.01 Reimbursable program..............          24          36          37
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       2,985       3,178       3,234
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........                       7           7
    22.00 New budget authority (gross)......       2,992       3,178       3,234
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       2,992       3,185       3,241
    23.95 Total new obligations.............      -2,985      -3,178      -3,234
    23.98 Unobligated balance expiring or
            withdrawn.......................          -1
    24.40 Unobligated balance carried
            forward, end of year............           7           7           7
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       2,969       3,143       3,197
    40.71   Reduction pursuant to P.L. 107-
              116 (Labor/HHS)...............                      -1
    40.75   Reduction pursuant to P.L. 106-
              554 (Labor/HHS)...............          -1
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       2,968       3,142       3,197
          Spending authority from offsetting
              collections:

    68.00   Offsetting collections (cash)...          22          36          37
    68.10   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................           2
                                               ---------   ---------  ----------
    68.90     Spending authority from
                offsetting collections
                (total discretionary).......          24          36          37
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       2,992       3,178       3,234
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       1,985       2,156       2,380
    73.10 Total new obligations.............       2,985       3,178       3,234
    73.20 Total outlays (gross).............      -2,777      -2,954      -3,121
    73.40 Adjustments in expired accounts
            (net)...........................         -48
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................          -2
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................          13
    74.40 Obligated balance, end of year....       2,156       2,380       2,493
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       1,294       1,318       1,341
    86.93 Outlays from discretionary
            balances........................       1,483       1,636       1,780
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       2,777       2,954       3,121
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........         -36         -36         -37
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................          -2
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............          14
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       2,968       3,142       3,197
    90.00 Outlays...........................       2,741       2,918       3,084
    ---------------------------------------------------------------------------

      Budget Authority and Outlays Excluding Full Funding for Federal Retiree
                                        Costs

                              (in millions of dollars)

    ----------------------------------------------------------------------------
                                             2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       2,964       3,138       3,193
    90.00 Outlays...........................       2,737       2,914       3,080
    ---------------------------------------------------------------------------

        This program provides Federal support for treatment and prevention
    in the areas of alcoholism, drug abuse, and mental health. The
    Administration has proposed to retain the language of the HHS General
    Provisions dealing with the penalty in Sec. 1926 of the Public Health
    Service Act, known as the Synar Amendment. The only penalty allowed
    under the current law is disproportionally severe, and could penalize
    those needing substance abuse services. The Administration looks forward
    to working with Congress to achieve a permanent statutory change that
    would establish a more fair and sustainable penalty structure.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1362-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........          38          41          40
    11.3      Other than full-time permanent           1           1           1
    11.5      Other personnel compensation..           1           1           1
                                               ---------   ---------  ----------
    11.9        Total personnel compensation          40          43          42
    12.1    Civilian personnel benefits.....          13          13          13
    21.0    Travel and transportation of
              persons.......................           2           2           2
    23.1    Rental payments to GSA..........           5           6           6
    23.3    Communications, utilities, and
              miscellaneous charges.........           2           2           2
    24.0    Printing and reproduction.......           5           6           6
    25.1    Advisory and assistance services          15          16          12
    25.2    Other services..................         228         230         181
    25.3    Other purchases of goods and
              services from Government
              accounts......................          96          96          72
    31.0    Equipment.......................           1           1           1
    41.0    Grants, subsidies, and
              contributions.................       2,552       2,725       2,858
    42.0    Insurance claims and indemnities           2           2           2
                                               ---------   ---------  ----------
    99.0      Direct obligations............       2,961       3,142       3,197
    99.0  Reimbursable obligations..........          24          36          37
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       2,985       3,178       3,234
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-1362-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears: Full-
            time equivalent employment......         552         560         520
        Reimbursable:
    2001  Total compensable workyears: Full-
            time equivalent employment......          66          59          59
    ---------------------------------------------------------------------------

                   AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

                                  Federal Funds

    General and special funds:

                         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, [$2,600,000; in
    addition,] amounts received from Freedom of Information Act fees,
    reimbursable and interagency agreements, and the sale of data shall be
    credited to this appropriation and shall remain available until
    expended: Provided, That the amount made available pursuant to section
    [926(b)] 927(c) of the Public Health Service Act shall not exceed
    [$296,145,000] $251,700,000. (Department of Health and Human Services
    Appropriations Act, 2002; additional authorizing legislation required.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1700-0-1-552      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
          Direct program:

    01.01   Research on health costs,
              quality, and outcomes.........         104
    01.04   Program support.................           3           3
    09.00 Reimbursable program..............         183         310         265
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         290         313         265
    ----------------------------------------------------------------------------

    [[Page 447]]

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           5           7           7
    22.00 New budget authority (gross)......         293         313         265
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         298         320         272
    23.95 Total new obligations.............        -290        -313        -265
    24.40 Unobligated balance carried
            forward, end of year............           7           7           7
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................         107           3
          Spending authority from offsetting
              collections:

    68.00   Offsetting collections (cash)...         180         310         265
    68.10   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................           6
                                               ---------   ---------  ----------
    68.90     Spending authority from
                offsetting collections
                (total discretionary).......         186         310         265
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................         293         313         265
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         212         278         187
    73.10 Total new obligations.............         290         313         265
    73.20 Total outlays (gross).............        -216        -401        -361
    73.40 Adjustments in expired accounts
            (net)...........................          -3          -3
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................          -6
    74.40 Obligated balance, end of year....         278         187          91
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................          77         310         265
    86.93 Outlays from discretionary
            balances........................         139          91          96
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         216         401         361
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........        -180        -310        -265
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................          -6
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         107           3
    90.00 Outlays...........................          35          91          96
    ---------------------------------------------------------------------------

      Budget Authority and Outlays Excluding Full Funding for Federal Retiree
                           Costs (in millions of dollars)

    ----------------------------------------------------------------------------
                                             2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         105           3
    90.00 Outlays...........................          33          91          96
    ---------------------------------------------------------------------------

        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      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........          13           2
    11.3      Other than full-time permanent           3
                                               ---------   ---------  ----------
    11.9        Total personnel compensation          16           2
    12.1    Civilian personnel benefits.....           6           1
    23.1    Rental payments to GSA..........           3
    23.3    Communications, utilities, and
              miscellaneous charges.........           1
    24.0    Printing and reproduction.......           1
    25.2    Other services..................           8
    25.3    Other purchases of goods and
              services from Government
              accounts......................           9
    25.5    Research and development
              contracts.....................          31
    31.0    Equipment.......................           1
    41.0    Grants, subsidies, and
              contributions.................          31
                                               ---------   ---------  ----------
    99.0      Direct obligations............         107           3
    99.0  Reimbursable obligations..........         183         310         265
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         290         313         265
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-1700-0-1-552      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears: Full-
            time equivalent employment......         216          22
        Reimbursable:
    2001  Total compensable workyears: Full-
            time equivalent employment......          68         272         294
    ---------------------------------------------------------------------------

                   CENTERS FOR MEDICARE AND MEDICAID SERVICES

                                  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, [$106,821,882,000] $112,090,218,000, to remain
    available until expended.
        For making, after May 31, [2002] 2003, payments to States under
    title XIX of the Social Security Act for the last quarter of fiscal year
    [2002] 2003 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 [2003, $46,601,937,000] 2004,
    $51,861,386,000, 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, 2002.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0512-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Medicaid vendor payments..........     124,848     135,604     148,726
    00.02 State and local administration....       7,040       8,293       9,142
    00.03 Vaccine purchases.................         857         990         824
    09.00 Medicare Part B premium transfer..                      65
    09.01 Reimbursable program..............       1,239
                                               ---------   ---------  ----------
    10.00   Total new obligations...........     133,984     144,952     158,692
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         110         110
    22.00 New budget authority (gross)......     130,718     144,842     158,692
    22.10 Resources available from
            recoveries of prior year
            obligations.....................       3,267
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......     134,095     144,952     158,692
    23.95 Total new obligations.............    -133,984    -144,952    -158,692
    24.40 Unobligated balance carried
            forward, end of year............         110
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

            Appropriation:
    60.00     Appropriation.................      93,586     106,822     112,090
    60.00     Appropriation.................       5,244       1,611
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................      98,830     108,433     112,090
    65.00   Advance appropriation...........      30,589      36,208      46,602
    69.00 Offsetting collections (cash).....       1,273         201
    69.10 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................          26
                                               ---------   ---------  ----------
    69.90   Spending authority from
              offsetting collections (total
              mandatory)....................       1,299         201
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................     130,718     144,842     158,692
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       5,581       5,626       5,626

    [[Page 448]]

    73.10 Total new obligations.............     133,984     144,952     158,692
    73.20 Total outlays (gross).............    -130,647    -144,952    -158,692
    73.45 Recoveries of prior year
            obligations.....................      -3,267
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................         -26
    74.40 Obligated balance, end of year....       5,626       5,626       5,626
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................     129,198     143,952     157,692
    86.98 Outlays from mandatory balances...       1,449       1,000       1,000
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........     130,647     144,952     158,692
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........      -1,273        -201
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................         -26
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................     129,419     144,641     158,692
    90.00 Outlays...........................     129,374     144,751     158,692
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2001 actual  2002 est.   2003 est.
    Enacted/requested:
      Budget Authority..................     129,419     144,641     158,692
      Outlays...........................     129,374     144,751     158,692
    Legislative proposal, not subject to
        PAYGO:
      Budget Authority..................                              -1,280
      Outlays...........................                              -1,280
    Legislative proposal, subject to
        PAYGO:
      Budget Authority..................                               1,378
      Outlays...........................                               1,378
                                        ------------------------------------
    Total:
      Budget Authority..................     129,419     144,641     158,790
      Outlays...........................     129,374     144,751     158,790
                                        ====================================

        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      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    41.0  Direct obligations: Grants,
            subsidies, and contributions....     132,745     144,887     158,692
    99.0  Reimbursable obligations:
            Reimbursable obligations........       1,239          65
                                               ---------   ---------  ----------
    99.9    Total new obligations...........     133,984     144,952     158,692
    ---------------------------------------------------------------------------

                          Grants to States for Medicaid

                  (Legislative proposal, not subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0512-2-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
              Federal sources:
    88.00       Federal sources.............                              -1,200
    88.00       Federal sources.............                                 -80
                                               ---------   ---------  ----------
    88.90       Total, offsetting
                  collections (cash)........                              -1,280
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                              -1,280
    90.00 Outlays...........................                              -1,280
    ---------------------------------------------------------------------------

                          Grants to States for Medicaid

                    (Legislative proposal, subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0512-4-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Targeted reforms..................                                  90
    00.02 Medicare low-income drug
            assistance......................                               1,200
    00.03 Medicare Part B premium transfer..                                  80
    00.04 New freedom demonstrations........                                   8
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................                               1,378
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                               1,378
    23.95 Total new obligations.............                              -1,378
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................                                  98
    69.00 Offsetting collections (cash).....                               1,280
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................                               1,378
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                               1,378
    73.20 Total outlays (gross).............                              -1,378
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                               1,378
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                               1,378
    90.00 Outlays...........................                               1,378
    ---------------------------------------------------------------------------

        This schedule reflects the Administration's Medicaid proposals, as
    well as the Administration's Transitional Medicare Low-Income Drug
    Assistance program. This program would provide comprehensive drug
    coverage for low-income Medicare beneficiaries. The budget also proposes
    to extend the subsidy of Medicare Part B premiums for certain qualified
    individuals. This schedule also reflects the Medicaid effects of the
    Administration's Supplemental Security Income and child support
    enforcement proposals.

        As part of the Administration's continuing effort to identify and
    eliminate barriers to community living for people with disabilities, the
    Administration is proposing new demonstrations to integrate people with
    disabilities into society. These proposals include a demonstration that
    will finance home- and community-based alternatives for children in
    psychiatric residential treatment facilities and two new demonstrations
    that will finance respite care services for adults, and respite care
    services for children with substantial disabilities.

                         State Grants and Demonstrations

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0516-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    10.00 Total new obligations (object
            class 41.0).....................          22         107          72
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........                      40
    22.00 New budget authority (gross)......          62          67          72
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......          62         107          72
    23.95 Total new obligations.............         -22        -107         -72
    24.40 Unobligated balance carried
            forward, end of year............          40
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................          62          67          72
    ----------------------------------------------------------------------------

    [[Page 449]]

        Change in obligated balances:
    72.40 Obligated balance, start of year..                      20         109
    73.10 Total new obligations.............          22         107          72
    73.20 Total outlays (gross).............          -2         -18         -30
    74.40 Obligated balance, end of year....          20         109         151
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................           2                       7
    86.98 Outlays from mandatory balances...                      18          23
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........           2          18          30
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          62          67          72
    90.00 Outlays...........................           2          18          30
    ---------------------------------------------------------------------------

        The Ticket to Work and Work Incentives Improvement Act of 1999 (P.L.
    106-170), Title II, established two grant programs. Section 203 provides
    funding for Medicaid infrastructure grants to support the design,
    establishment and operation of State infrastructures to help working
    people with disabilities purchase health coverage through Medicaid.
    Section 204 provides funding for States to establish Demonstrations to
    Maintain Independence and Employment, which will provides Medicaid
    benefits and services to working individuals who have a condition that,
    without medical assistance, will result in disability.

                       Payments to Health Care Trust Funds

        For payment to the Federal Hospital Insurance and the Federal
    Supplementary Medical Insurance Trust Funds, as provided under section
    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, [$81,979,200,000] $81,471,216,000. (Department
    of Health and Human Services Appropriations Act, 2002.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0580-0-1-571      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Supplementary medical insurance
            (SMI)...........................      69,777      77,295      80,905
    00.02 Hospital insurance for uninsured
            (HI)............................         321         292         225
    00.03 Federal uninsured payment (HI)....         132         150         168
    00.04 Program management (HI)...........         149         205         174
    00.05 FHI trust fund, Transfers from
            general fund (civil monetary
            penalties)......................           6           7           7
    00.06 Federal payments from taxation of
            OASDI benefits (HI).............       4,903      10,796       8,742
    00.07 Fraud and abuse control, FBI......          88         101         114
    00.08 Fraud and abuse control, criminal
            fines...........................           3           3           4
                                               ---------   ---------  ----------
    10.00   Total new obligations...........      75,379      88,849      90,339
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......      75,382      92,886      90,339
    23.95 Total new obligations.............     -75,379     -88,849     -90,339
    23.98 Unobligated balance expiring or
            withdrawn.......................          -3      -4,037
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

            Appropriation:
    60.00     Appropriation.................       4,912      10,806       8,753
    60.00     Appropriation.................      70,382      81,979      81,472
    60.00     Appropriation.................          88         101         114
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................      75,382      92,886      90,339
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          68
    73.10 Total new obligations.............      75,379      88,849      90,339
    73.20 Total outlays (gross).............     -75,447     -88,849     -90,339
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................      75,379      88,849      90,339
    86.98 Outlays from mandatory balances...          68
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........      75,447      88,849      90,339
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................      75,382      92,886      90,339
    90.00 Outlays...........................      75,447      88,849      90,339
    ---------------------------------------------------------------------------

      Budget Authority and Outlays Excluding Full Funding for Federal Retiree
                           Costs (in millions of dollars)

    ----------------------------------------------------------------------------
                                             2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................      75,382      92,886      90,330
    90.00 Outlays...........................      75,447      88,849      90,330
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2001 actual  2002 est.   2003 est.
    Enacted/requested:
      Budget Authority..................      75,382      92,886      90,339
      Outlays...........................      75,447      88,849      90,339
    Legislative proposal, not subject to
        PAYGO:
      Budget Authority..................                                 -19
      Outlays...........................                                 -19
                                        ------------------------------------
    Total:
      Budget Authority..................      75,382      92,886      90,320
      Outlays...........................      75,447      88,849      90,320
                                        ====================================

        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 CMS
    program management.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0580-0-1-571      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    41.0  Grants, subsidies, and
            contributions...................      74,777      88,202      89,772
    42.0  Insurance claims and indemnities..         453         442         393
    92.0  Undistributed.....................         149         205         174
                                               ---------   ---------  ----------
    99.9    Total new obligations...........      75,379      88,849      90,339
    ---------------------------------------------------------------------------

                       Payments to Health Care Trust Funds

                  (Legislative proposal, not subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0580-2-1-571      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Supplementary medical insurance
            (SMI)...........................                                 -19
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................                                 -19
    ----------------------------------------------------------------------------

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

        New budget authority (gross), detail:
          Mandatory:

            Appropriation:
    60.00     Appropriation.................                                 -19
    60.00     Appropriation.................
    60.00     Appropriation.................
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................                                 -19
    ----------------------------------------------------------------------------

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

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                                 -19
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                                 -19

    [[Page 450]]

    90.00 Outlays...........................                                 -19
    ---------------------------------------------------------------------------

        The budget proposes a package of immediate reforms to strengthen
    Medicare and improve beneficiary choice.

        The budget proposes new discretionary user fees paid by providers
    for submitting paper claims and duplicate or unprocessable claims. This
    account reflects the reduction in payments to HI and SMI as a result of
    this user fee proposal.

                               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 [$2,440,798,000] $2,538,330,000, 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 section
    1857(e)(2) of the Social Security 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 [$18,200,000] from amounts appropriated under this
    heading, $3,000,000 for the managed care system redesign shall remain
    available until expended[: Provided further, That $100,000 of the amount
    available for research, demonstration, and evaluation activities shall
    be awarded to the Regional Nursing Centers Consortium in Philadelphia to
    initiate a demonstration project to evaluate 15 nurse-managed health
    centers in urban and rural areas across Pennsylvania: Provided further,
    That $200,000 of the amount available for research, demonstration, and
    evaluation activities shall be awarded to the Madonna Rehabilitation
    Center in Lincoln, Nebraska to create a new standard of rehabilitation
    practice and program design for children and adults with disabilities:
    Provided further, That $250,000 of the amount available for research,
    demonstration, and evaluation activities shall be awarded to the Cook
    County, Illinois Bureau of Health for the Asthma Champion Initiative to
    reduce morbidity and mortality from asthma in high prevalence areas:
    Provided further, That $250,000 of the amount available for research,
    demonstration, and evaluation activities shall be awarded to the
    Illinois Primary Health Care Association to implement the Shared
    Integrated Management Information System providing centralized case
    management, reimbursement and administrative support services: Provided
    further, That $500,000 of the amount available for research,
    demonstration, and evaluation activities shall be awarded to Project
    Access in Muskegon, Michigan to offer affordable insurance to uninsured
    workers, primarily in small business, and low-income individuals:
    Provided further, That $590,000 of the amount available for research,
    demonstration, and evaluation activities shall be awarded to Santa Clara
    County, California, for the outreach and application assistance aspects
    of its Children's Health Initiative, to demonstrate means of expanding
    enrollment of eligible children in Medicaid, SCHIP and other available
    health care programs: Provided further, That $800,000 of the amount
    available for research, demonstration, and evaluation activities shall
    be awarded to the Fishing Partnership Health Plan, based in Boston,
    Massachusetts, for a demonstration project on the efficacy of using a
    community-based health benefit program to provide health care coverage
    for lower-income independently employed workers and their families:
    Provided further, That $800,000 of the amount available for research,
    demonstration, and evaluation activities shall be awarded to the Mind-
    Body Institute of Boston, Massachusetts to continue and expand a
    demonstration project: Provided further, That $900,000 of the amount
    available for research, demonstration, and evaluation activities shall
    be awarded to the Children's Hospice International demonstration program
    to provide a continuum of care for children with life-threatening
    conditions and their families: Provided further, That $1,500,000 of the
    amount available for research, demonstration, and evaluation activities
    shall be awarded to the Iowa Department of Public Health for the
    continuation of a prescription drug cooperative demonstration: 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 for a demonstration of residential
    and outpatient treatment facilities]: Provided further, That
    $51,000,000, to remain available until September 30, 2004, is for
    contract costs for the Healthcare Integrated General Ledger Accounting
    System: Provided further, That the Secretary of Health and Human
    Services is directed to collect fees in fiscal year [2002] 2003 from
    Medicare+Choice organizations pursuant to section 1857(e)(2) of the
    Social Security Act and from eligible organizations with risk-sharing
    contracts under section 1876 of that Act pursuant to section
    1876(k)(4)(D) of that Act. (Department of Health and Human Services
    Appropriations Act, 2002; additional authorizing legislation required.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0511-0-1-550      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
          Direct program:

    00.01   Medicare operations.............       1,344       1,534       1,675
    00.02   Federal administration..........         533         561         587
    00.03   State survey and certification..         242         254         248
    00.04   Research, demonstrations, and
              evaluation projects...........         138         117          28
                                               ---------   ---------  ----------
    01.00   Total direct program............       2,257       2,466       2,538
    09.01 CLIA..............................          36          44          44
    09.03 Other reimbursements..............           2           2           2
    09.06 Medicare+Choice...................          40          17          16
                                               ---------   ---------  ----------
    09.09   Total reimbursable program......          78          63          62
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       2,335       2,529       2,600
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          71          80          80
    22.00 New budget authority (gross)......       2,351       2,529       2,600
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       2,422       2,609       2,680
    23.95 Total new obligations.............      -2,335      -2,529      -2,600
    23.98 Unobligated balance expiring or
            withdrawn.......................          -7
    24.40 Unobligated balance carried
            forward, end of year............          80          80          80
    ----------------------------------------------------------------------------

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

            Discretionary:
              Offsetting collections (cash):
    68.00       Offsetting collections
                  (cash)....................       1,727       2,467       2,539
    68.00       Offsetting collections
                  (cash)....................          83          62          61
    68.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........         541
                                               ---------   ---------  ----------
    68.90       Spending authority from
                  offsetting collections
                  (total discretionary).....       2,351       2,529       2,600
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          52         175         175
    73.10 Total new obligations.............       2,335       2,529       2,600
    73.20 Total outlays (gross).............      -2,233      -2,529      -2,600
    73.40 Adjustments in expired accounts
            (net)...........................         -42
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................        -541
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................         604
    74.40 Obligated balance, end of year....         175         175         175
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       1,689       2,529       2,600
    86.93 Outlays from discretionary
            balances........................         543
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       2,233       2,529       2,600
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............      -2,294      -2,466      -2,538
    88.40     Non-Federal sources...........         -62         -63         -62
                                               ---------   ---------  ----------

    [[Page 451]]

    88.90       Total, offsetting
                  collections (cash)........      -2,356      -2,529      -2,600
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................        -541
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............         546
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................        -123
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2001 actual  2002 est.   2003 est.
    Enacted/requested:
      Budget Authority..................
      Outlays...........................        -124
    Legislative proposal, not subject to
        PAYGO:
      Budget Authority..................
      Outlays...........................
                                        ------------------------------------
    Total:
      Budget Authority..................
      Outlays...........................        -124
                                        ====================================

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

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0511-0-1-550      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........         295         323         329
    11.3      Other than full-time permanent           5           8           8
    11.5      Other personnel compensation..           5           5           4
                                               ---------   ---------  ----------
    11.9        Total personnel compensation         305         336         341
    12.1    Civilian personnel benefits.....          92          97         100
    21.0    Travel and transportation of
              persons.......................          10          12          12
    22.0    Transportation of things........           1
    23.1    Rental payments to GSA..........          18          16          17
    23.3    Communications, utilities, and
              miscellaneous charges.........          20           3           3
    24.0    Printing and reproduction.......           8           6           7
    25.1    Advisory and assistance services          10
    25.2    Other services..................         580         383         363
    25.3    Other purchases of goods and
              services from Government
              accounts......................          31           3           3
    25.6    Medical care....................       1,063       1,534       1,675
    26.0    Supplies and materials..........           3           1           1
    31.0    Equipment.......................          12           2
    32.0    Land and structures.............          10          10          10
    41.0    Grants, subsidies, and
              contributions.................          94          63           6
                                               ---------   ---------  ----------
    99.0      Direct obligations............       2,257       2,466       2,538
    99.0  Reimbursable obligations..........          78          63          62
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       2,335       2,529       2,600
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-0511-0-1-550      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears: Full-
            time equivalent employment......       4,501       4,552       4,396
        Reimbursable:
    2001  Total compensable workyears: Full-
            time equivalent employment......          82          80          80
    ---------------------------------------------------------------------------

                               Program Management

                  (Legislative proposal, not subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0511-2-1-550      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
          Direct program:

    00.01   Medicare operations.............                                -130
                                               ---------   ---------  ----------
    01.00   Total direct program............                                -130
    09.01 Proposed user fees................                                 130
                                               ---------   ---------  ----------
    09.09   Total reimbursable program......                                 130
                                               ---------   ---------  ----------
    10.00   Total new obligations...........
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............                                 130
    88.40     Non-Federal sources...........                                -130
                                               ---------   ---------  ----------
    88.90       Total, offsetting
                  collections (cash)........
    ----------------------------------------------------------------------------

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

        The Budget includes $130 million in new user fees to finance CMS
    activities. Proposed fees include: a duplicate or unprocessable claims
    fee and a paper claims fee. Authorizing legislation for these fees will
    be proposed to authorize the collection and spending of the fees subject
    to appropriations language. If authorizing legislation is enacted, the
    amount appropriated from the Federal hospital insurance and Federal
    supplementary medical insurance trust funds will be reduced by $130
    million.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0511-2-1-550      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    25.6  Direct obligations: Medical care..                                -130
    99.0  Reimbursable obligations:
            Reimbursable obligations........                                 130
                                               ---------   ---------  ----------
    99.9    Total new obligations...........
    ---------------------------------------------------------------------------

                     State Children's Health Insurance Fund

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0515-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Grants, subsidies, and
            contributions...................       6,283       3,115       3,175
    00.02 Advisory and assistance services..          10
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................       6,293       3,115       3,175
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......       6,283       3,115       3,175
    22.10 Resources available from
            recoveries of prior year
            obligations.....................          10
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       6,293       3,115       3,175
    23.95 Total new obligations.............      -6,293      -3,115      -3,175
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

            Appropriation:
    60.00     Appropriation, BBA............       4,309       3,150       3,150
    60.00     Appropriation, BBRA for
                territories.................                      25          25
    60.00     Appropriation, BBRA...........
    61.00   Transferred to other accounts...         -60         -60
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................       4,249       3,115       3,175
    63.00   Reappropriation.................       2,034
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       6,283       3,115       3,175
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..      10,951      11,501      10,927
    73.10 Total new obligations.............       6,293       3,115       3,175
    73.20 Total outlays (gross).............      -3,699      -3,689      -4,362
    73.40 Adjustments in expired accounts
            (net)...........................      -2,034                    -799
    73.45 Recoveries of prior year
            obligations.....................         -10
    74.40 Obligated balance, end of year....      11,501      10,927       8,942
    ----------------------------------------------------------------------------

    [[Page 452]]

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................       1,519          72          86
    86.98 Outlays from mandatory balances...       2,180       3,617       4,276
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       3,699       3,689       4,362
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       6,283       3,115       3,175
    90.00 Outlays...........................       3,699       3,689       4,362
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2001 actual  2002 est.   2003 est.
    Enacted/requested:
      Budget Authority..................       6,283       3,115       3,175
      Outlays...........................       3,699       3,689       4,362
    Legislative proposal, subject to
        PAYGO:
      Budget Authority..................
      Outlays...........................                                 -40
                                        ------------------------------------
    Total:
      Budget Authority..................       6,283       3,115       3,175
      Outlays...........................       3,699       3,689       4,322
                                        ====================================

        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.

                     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      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.20 Total outlays (gross).............                                  40
    74.40 Obligated balance, end of year....                                  40
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.98 Outlays from mandatory balances...                                 -40
    ----------------------------------------------------------------------------

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

        The Budget proposes to extend the availability of funds expiring at
    the end of 2002 and 2003 through 2006.

          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 [2002] 2003,
    no commitments for direct loans or loan guarantees shall be made.
    (Department of Health and Human Services Appropriations Act, 2002.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4420-0-3-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          10          10          10
    24.40 Unobligated balance carried
            forward, end of year............          10          10          10
    ----------------------------------------------------------------------------

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

        The last loan commitments from the HMO loan fund were made in 1983.

                                   Trust Funds

                      Federal Hospital Insurance Trust Fund

                  Unavailable Collections (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8005-0-7-571      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    01.99 Balance, start of year............     167,263     196,791     231,981
        Receipts:
    02.00 Transfers from general fund (FICA
            taxes)..........................     139,507     141,297     148,349
    02.01 Transfers from general fund (SECA
            taxes)..........................       9,722       9,974      10,541
    02.02 Receipts from Railroad Retirement
            Board...........................         422         406         420
    02.03 Civil penalties and damages.......         453         499         549
    02.20 Premiums collected for uninsured
            individuals not otherwise
            eligible........................       1,440       1,502       1,538
    02.21 Other proprietary receipts from
            the public......................           1
    02.40 Federal employer contributions
            (FICA)..........................       2,029       2,183       2,299
    02.41 Postal service employer
            contributions (FICA)............         673         711         733
    02.42 Payments from the general fund
            (uninsured and program
            management).....................         603         647         567
    02.43 Taxation on OASDI benefits........       4,903      10,796       8,742
    02.44 Interest payments by Railroad
            Retirement Board................          48          35          35
          Offsetting receipts (intragovernmental):

    02.45   Interest received by trust funds      12,290      12,707      14,892
    02.45   Interest received by trust
              funds, legislative proposal
              not subject to PAYG...........                                  -8
    02.46 Payments for military service
            credits.........................           2
    02.47 FBI, Payment from the general fund          88         101         114
    02.48 Criminal fines, transfers from the
            general fund....................           3           3           4
    02.49 Civil monetary penalties,
            transfers from the general fund.           6           7           7
    02.50 Transfers from DOD, HI............          25          16           4
    02.80 Federal hospital insurance trust
            fund, offsetting collections....           1
    02.81 Health care fraud and abuse
            control, offsetting collections.           3
                                               ---------   ---------  ----------
    02.99   Total receipts and collections..     172,219     180,884     188,786
                                               ---------   ---------  ----------
    04.00 Total: Balances and collections...     339,482     377,675     420,767
        Appropriations:
          Appropriations:

    05.00   Federal hospital insurance trust
              fund..........................    -141,749    -144,695    -148,600
    05.00   Proposed legislation not subject
              to PAYGO......................                                  25
    05.00   Proposed legislation subject to
              PAYGO.........................                                -410
    05.01 Health care fraud and abuse
            control account.................        -956      -1,010      -1,075
                                               ---------   ---------  ----------
    05.99   Total appropriations............    -142,705    -145,705    -150,060
    06.10 Unobligated balance returned to
            receipts........................          14          11
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............     196,791     231,981     270,707
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8005-0-7-571      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Benefit payments, HI..............     135,971     141,432     145,870
    00.02 Administration, HI................       1,375       1,596       1,621
    00.03 Peer review organizations, HI.....          55         306         434
    00.04 Research, HI......................         113          96          23
    00.05 HI partial transfer of home health
            to SMI..........................       3,103       1,313         652
    00.06 Quinquennial adjustment...........       1,177
                                               ---------   ---------  ----------
    01.00   Subtotal direct obligations.....     141,794     144,743     148,600
    09.01 Reimbursable program..............           1
                                               ---------   ---------  ----------
    10.00   Total new obligations...........     141,795     144,743     148,600
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......     141,795     144,743     148,600
    23.95 Total new obligations.............    -141,795    -144,743    -148,600
    ----------------------------------------------------------------------------

    [[Page 453]]

        New budget authority (gross), detail:
          Discretionary:

    40.26   Appropriation (trust fund)......       1,448       1,652       1,604
          Mandatory:

    60.26   Appropriation (trust fund)......     170,813     179,279     187,228
    60.45   Portion precluded from
              obligation....................     -30,467     -36,188     -40,232
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................     140,346     143,091     146,996
    69.00 Offsetting collections (cash).....           1
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................     141,795     144,743     148,600
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         635         408         338
    73.10 Total new obligations.............     141,795     144,743     148,600
    73.20 Total outlays (gross).............    -142,022    -144,813    -148,542
    74.40 Obligated balance, end of year....         408         338         396
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       1,448       1,361       1,371
    86.93 Outlays from discretionary
            balances........................                     264         286
    86.97 Outlays from new mandatory
            authority.......................     140,307     142,892     146,736
    86.98 Outlays from mandatory balances...         267         296         149
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........     142,022     144,813     148,542
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

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

        Net budget authority and outlays:
    89.00 Budget authority..................     141,794     144,743     148,600
    90.00 Outlays...........................     142,021     144,813     148,542
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    92.01 Total investments, start of year:
            Federal securities: Par value...     168,859     197,137     232,492
    92.02 Total investments, end of year:
            Federal securities: Par value...     197,137     232,492     271,719
    ---------------------------------------------------------------------------

      Budget Authority and Outlays Excluding Full Funding for Federal Retiree
                           Costs (in millions of dollars)

    ----------------------------------------------------------------------------
                                             2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................     141,748     144,695     148,552
    90.00 Outlays...........................     141,975     144,765     148,494
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2001 actual  2002 est.   2003 est.
    Enacted/requested:
      Budget Authority..................     141,794     144,743     148,600
      Outlays...........................     142,021     144,813     148,542
    Legislative proposal, not subject to
        PAYGO:
      Budget Authority..................                                 -25
      Outlays...........................                                 -25
    Legislative proposal, subject to
        PAYGO:
      Budget Authority..................                                 410
      Outlays...........................                                 410
                                        ------------------------------------
    Total:
      Budget Authority..................     141,794     144,743     148,985
      Outlays...........................     142,021     144,813     148,927
                                        ====================================

        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      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
        Unexpended balance, start of year:
    0100  Treasury balance..................        -789         246
    0101  U.S. Securities: Par value........     168,859     197,137     232,492
                                               ---------   ---------  ----------
    0199    Total balance, start of year....     168,070     197,383     232,492
        Cash income during the year:
          Current law:

            Receipts:
    1200      FHI trust fund, transfers from
                general fund (FICA taxes)...     139,507     141,297     148,349
    1201      FHI trust fund, transfers from
                general fund (SECA taxes)...       9,722       9,974      10,541
    1202      FHI trust fund, receipts from
                Railroad Retirement Board...         422         406         420
    1203      HCFAC: Civil penalties and
                damages.....................         453         499         549
            Offsetting receipts
                (proprietary):
    1220      FHI trust fund, premiums
                collected for uninsured
                individuals not otherwise
                eligible....................       1,440       1,502       1,538
    1221      Other proprietary receipts....           1
            Offsetting receipts
                (intragovernmental):
    1240      FHI trust fund, Federal
                employer contributions
                (FICA)......................       2,029       2,183       2,299
    1241      FHI trust fund, Postal Service
                employer contributions
                (FICA)......................         673         711         733
              Offsetting receipts
                  (intragovernmental):
    1242        FHI trust fund, Federal
                  payment for transitional
                  coverage for uninsured
                  Federal employees.........         132         150         168
    1242        FHI trust fund, Federal
                  payment for transitional
                  coverage for the uninsured         321         292         225
    1242        FHI trust fund, general fund
                  transfer, program
                  management (HI)...........         149         205         174
    1243      FHI trust fund, Federal
                payments for OASDI taxes....       4,903      10,796       8,742
    1244      FHI trust fund, interest
                payment from Railroad
                Retirement Board............          48          35          35
    1245      FHI trust fund, interest on
                investments.................      12,290      12,707      14,892
    1246      FHI trust fund, transfer from
                Department of Defense for
                military service credits....           2
    1247      HCFAC: FBI....................          88         101         114
    1248      HCFAC: Criminal fines.........           3           3           4
    1249      HCFAC: Civil monetary
                penalties...................           6           7           7
    1250      Other intragovernmental
                transactions................          25          16           4
            Offsetting collections:
    1280      FHI trust fund user fees......           1
    1281      HCFAC user fees...............           3
    1299    Income under present law........     172,219     180,884     188,794
          Proposed legislation:

            Offsetting receipts
                (intragovernmental):
    2245      Interest on investments,
                legislative proposal not
                subject to PAYGO............                                  -8
                                               ---------   ---------  ----------
    3299    Total cash income...............     172,219     180,884     188,786
        Cash outgo during year:
          Current law:

            Cash outgo during the year (-):
    4500      Benefit Payments..............    -135,979    -141,432    -145,870
    4500      Administration................      -1,399      -1,532      -1,609
    4500      Peer Review Organizations.....        -274        -403        -323
    4500      Research......................         -44         -84         -88
    4500      HI Partial Transfer of Home
                Health to SMI...............      -3,103      -1,313        -652
    4500      Quinquennial adjustment (-)...      -1,177
    4501    HCFAC...........................        -929      -1,010      -1,075
    4599    Outgo under current law (-).....    -142,905    -145,775    -149,617
          Proposed legislation:

            Cash outgo during the year (-):
    5500      Administration, legislative
                proposal not subject to
                PAYGO.......................                                  25
    5500      Benefit payments, legislative
                proposal subject to PAYGO...                                -410
    5599    Outgo under proposed legislation
              (-)...........................                                -385
                                               ---------   ---------  ----------
    6599    Total cash outgo (-)............    -142,905    -145,775    -150,002
        Unexpended balance, end of year:
    8700  Uninvested balance................         246
    8701  Federal securities: Par value.....     197,137     232,492     271,276
                                               ---------   ---------  ----------
    8799    Total balance, end of year......     197,383     232,492     271,276
    ---------------------------------------------------------------------------

        *This schedule does not include the Administration's proposal for
    Transitional Medicare Low-Income Drug Assistance.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8005-0-7-571      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    25.3  Portion of limitation on
            administrative expenses: Social
            Security........................         580         662         649
          Grants, subsidies, and contributions:

    41.0    Payment for health insurance
              experiments and demonstration
              projects......................         113          96          23
    41.0    Payment for peer review
              organization (PRO) activities.          55         306         434
    42.0  Insurance claims and indemnities..     137,148     141,432     145,870
          Undistributed:

    92.0    HI Partial Transfer of Home
              Health to SMI.................       3,103       1,313         652
    92.0    Reimbursement for administrative
              expenses for other than SSA
              LAE...........................          48          52          53
    92.0    Purchases of goods and services.         748         882         919
                                               ---------   ---------  ----------

    [[Page 454]]

    99.9    Total new obligations...........     141,795     144,743     148,600
    ---------------------------------------------------------------------------

                         Federal Hospital Insurance Fund

                  (Legislative proposal, not subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8005-2-7-571      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.02 Administration, HI................                                 -25
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 92.0)...................                                 -25
    ----------------------------------------------------------------------------

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

        New budget authority (gross), detail:
          Discretionary:

    40.26   Appropriation (trust fund)......                                 -25
          Mandatory:

    60.26   Appropriation (trust fund)......                                  25
    60.45   Portion precluded from
              obligation....................                                 -25
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................                                 -25
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                                 -25
    73.20 Total outlays (gross).............                                  25
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................                                 -25
    ----------------------------------------------------------------------------

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

        Memorandum (non-add) entries:
    92.01 Total investments, start of year:
            Federal securities: Par value...
    92.02 Total investments, end of year:
            Federal securities: Par value...                                 -25
    ---------------------------------------------------------------------------

        The budget proposes new discretionary user fees paid by providers
    for submitting paper claims and duplicate or unprocessable claims. This
    account reflects the reduction in payments to HI as a result of this
    user fee proposal.

                         Federal Hospital Insurance Fund

                    (Legislative proposal, subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8005-4-7-571      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Benefit payments, HI..............                                 410
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 42.0)...................                                 410
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                                 410
    23.95 Total new obligations.............                                -410
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.26   Appropriation (trust fund)......                                  -8
    60.45   Portion precluded from
              obligation....................                                 418
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................                                 410
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                                 410
    73.20 Total outlays (gross).............                                -410
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                                 410
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                                 410
    90.00 Outlays...........................                                 410
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    92.02 Total investments, end of year:
            Federal securities: Par value...                                -418
    ---------------------------------------------------------------------------

        The budget proposes a package of immediate reforms to strengthen
    Medicare and improve beneficiary choice.

                   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      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Medicare integrity program........         680         700         720
    00.02 FBI fraud and abuse control.......          88         101         114
    00.03 Other fraud and abuse control.....         180         209         241
    09.01 Reimbursable program..............           2
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         950       1,010       1,075
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......         956       1,010       1,075
    23.95 Total new obligations.............        -950      -1,010      -1,075
    23.98 Unobligated balance expiring or
            withdrawn.......................          -4
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.26   Appropriation (trust fund)......         953       1,010       1,075
    69.00 Offsetting collections (cash).....           3
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................         956       1,010       1,075
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         172         184         173
    73.10 Total new obligations.............         950       1,010       1,075
    73.20 Total outlays (gross).............        -929      -1,010      -1,075
    73.40 Adjustments in expired accounts
            (net)...........................         -10         -11
    74.40 Obligated balance, end of year....         184         173         173
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................         929       1,010       1,075
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

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

        Net budget authority and outlays:
    89.00 Budget authority..................         953       1,010       1,075
    90.00 Outlays...........................         926       1,010       1,075
    ---------------------------------------------------------------------------

        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      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

          Direct obligations:

    25.6    Medical care (CMS)..............         680         700         720
            Undistributed:
    92.0      Undistributed (FBI)...........          88         101         114
    92.0      Undistributed.................           2
                                               ---------   ---------  ----------
    99.0      Direct obligations............         770         801         834

    [[Page 455]]

          Allocation Account:

            Travel and transportation of
                persons:
    21.0      Travel and transportation of
                persons (OIG)...............           6           7           7
    21.0      Travel and transportation of
                persons (DoJ)...............           1           1           1
    22.0    Transportation of things (OIG)..           2           1           1
            Rental payments to GSA:
    23.1      Rental payments to GSA (OIG)..           9           9          10
    23.1      Rental payments to GSA (DoJ)..           3           3           3
    23.1      Rental payments to GSA (OGC)..           2           1
    23.3    Communications, utilities, and
              miscellaneous charges (OIG)...           2           2           3
    24.0    Printing and reproduction [DOJ].           1           1           1
            Advisory and assistance
                services:
    25.1      Advisory and assistance
                services [DOJ]..............           2           1           1
    25.1      Advisory and assistance
                services (OGC)..............           1
    25.1      Advisory and assistance
                services (CMS)..............                       1          12
            Other services:
    25.2      Other services (DoJ)..........          12          25          18
    25.2      Other services [OIG]..........           2           2           2
    25.2      Other services (CMS)..........           1
    25.2      Other services (OGC)..........                                   1
    25.2      Other services (AOA)..........                                   1
            Other purchases of goods and
                services from Government
                accounts:
    25.3      Purchases of goods and
                services from Government
                accounts (DoJ)..............           2           2           2
    25.3      Purchases of goods and
                services from Government
                accounts [OIG]..............          11          10          11
    25.7    Operation and maintenance of
              equipment (OIG)...............                       1           1
    26.0    Supplies and materials (OIG)....           2           2           2
            Equipment:
    31.0      Equipment (OIG)...............           4           4           4
    31.0      Equipment [DOJ]...............                       1           1
            Grants, subsidies, and
                contributions:
    41.0      Grants, subsidies, and
                contributions (AoA).........                       1           1
    41.0      Grants, subsidies, and
                contributions (CMS).........           2           2           5
            Undistributed:
    92.0      Undistributed (OIG full-time
                permanent)..................          70          81          90
    92.0      Undistributed (DoJ full-Time
                permanent)..................          15          15          17
    92.0      Undistributed (OGC full-time
                permanent)..................           2           2           5
    92.0      Undistributed (AoA full-time
                permanent)..................                       1           1
    92.0      Undistributed (CMS full-time
                permanent)..................                                   4
    92.0      Undistributed (DoJ other than
                full-time permanent)........                       1           1
    92.0      Undistributed (OIG other than
                full-time permanent)........           1           1           1
    92.0      Undistributed (OIG other
                personnel compensation).....           1           2           2
    92.0      Undistributed (DoJ special
                personal services payments).           2           1           1
    92.0      Undistributed (OIG personnel
                benefits)...................          20          23          26
    92.0      Undistributed (DoJ personnel
                benefits)...................           4           4           4
    92.0      Undistributed (OGC personnel
                benefits)...................                       1
    92.0      Undistributed (CMS personnel
                benefits)...................                                   1
                                               ---------   ---------  ----------
    99.0      Allocation account............         180         209         241
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         950       1,010       1,075
    ---------------------------------------------------------------------------

        This schedule reflects the estimated distribution of the allocation
    account for 2003. Actual 2003 distributions will be determined by the
    Secretary of HHS and the Attorney General consistent with the
    Administration's priorities, including augmenting existing Medicaid
    program integrity activities.

                                         2001 actual  2002 est.   2003 est.
    Department of Justice, DOJ..........          42          55          50
    Office of the Inspector General, HHS         130         145         160
    Centers for Medicare and Medicaid
    Services, Medicaid Program
    Integrity, HHS......................           0           0          10
    Centers for Medicare and Medicaid
    Services, Other HHS.................           3           3          12
    Office of the General Counsel, HHS..           5           4           6
    Other HHS...........................           0           2           3
                                        ------------------------------------
          Total.........................         180         209         241
                                        ====================================

               Federal Supplementary Medical Insurance Trust Fund

                  Unavailable Collections (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8004-0-7-571      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    01.99 Balance, start of year............      45,730      41,663      39,823
        Receipts:
    02.20 Premiums collected for the aged...      19,447      20,872      22,259
    02.21 Premiums collected for the
            disabled........................       2,861       3,248       3,550
    02.22 Other proprietary receipts from
            the public......................           4
          Offsetting receipts (intragovernmental):

    02.40   Federal contributions...........      69,838      77,295      80,905
    02.40   Federal contributions,
              legislative proposal not
              subject to PAYGO..............                                 -19
          Offsetting receipts (intragovernmental):

    02.41   Interest received by trust fund.       3,187       2,897       2,704
    02.41   Interest received by trust fund,
              legislative proposal not
              subject to PAYGO..............                                  -1
    02.42 Transfers from DOD, SMI...........          25          15           4
    02.80 Federal supplementary medical
            insurance trust fund, offsetting
            collections.....................       3,103       1,313         652
                                               ---------   ---------  ----------
    02.99   Total receipts and collections..      98,465     105,640     110,054
                                               ---------   ---------  ----------
    04.00 Total: Balances and collections...     144,195     147,303     149,877
        Appropriations:
          Appropriations:

    05.00   Federal supplementary medical
              insurance trust fund..........    -102,532    -107,480    -111,249
    05.00   Legislative proposal not subject
              to PAYGO......................                                  25
    05.00   Legislative proposal subject to
              PAYGO.........................                                  10
                                               ---------   ---------  ----------
    05.99   Total appropriations............    -102,532    -107,480    -111,214
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............      41,663      39,823      38,663
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8004-0-7-571      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Benefit payments, SMI.............      97,411     103,976     108,255
    00.02 Administration, SMI...............       1,935       2,062       2,228
    00.03 Peer review organizations, SMI....          32          77         109
    00.04 Research, SMI.....................          25          21           5
    00.06 Transfer to Medicaid for payment
            of SMI premiums.................          60          65
    09.01 HI partial transfer of home health       3,103       1,313         652
                                               ---------   ---------  ----------
    10.00   Total new obligations...........     102,566     107,514     111,249
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......     102,566     107,514     111,249
    23.95 Total new obligations.............    -102,566    -107,514    -111,249
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.26   Appropriation (trust fund)......       1,959       2,082       2,228
    40.71   Reduction pursuant to P.L. 107-
              116...........................                      -4
    40.75   Reduction pursuant to P.L. 106-
              554 (Labor/HHS)...............          -4
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       1,955       2,078       2,228
          Mandatory:

    60.26   Appropriation (trust fund)......      93,441     102,283     107,229
    60.28   Appropriation (unavailable
              balances).....................       4,067       1,840       1,140
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................      97,508     104,123     108,369
    69.00 Offsetting collections (cash).....       3,103       1,313         652
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................     102,566     107,514     111,249
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         167         144         120
    73.10 Total new obligations.............     102,566     107,514     111,249
    73.20 Total outlays (gross).............    -102,589    -107,538    -111,201
    74.40 Obligated balance, end of year....         144         120         168
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       1,955       2,047       2,203
    86.97 Outlays from new mandatory
            authority.......................     100,583     105,386     108,956
    86.98 Outlays from mandatory balances...          51         105          42
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........     102,589     107,538     111,201
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........      -3,103      -1,313        -652
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................      99,463     106,201     110,597
    90.00 Outlays...........................      99,486     106,225     110,549
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    92.01 Total investments, start of year:
            Federal securities: Par value...      45,075      41,944      39,908

    [[Page 456]]

    92.02 Total investments, end of year:
            Federal securities: Par value...      41,944      39,908      38,815
    ---------------------------------------------------------------------------

      Budget Authority and Outlays Excluding Full Funding for Federal Retiree
                           Costs (in millions of dollars)

    ----------------------------------------------------------------------------
                                             2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................      99,429     106,167     110,562
    90.00 Outlays...........................      99,452     106,191     110,514
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2001 actual  2002 est.   2003 est.
    Enacted/requested:
      Budget Authority..................      99,463     106,201     110,597
      Outlays...........................      99,486     106,225     110,549
    Legislative proposal, not subject to
        PAYGO:
      Budget Authority..................                                 -25
      Outlays...........................                                 -25
    Legislative proposal, subject to
        PAYGO:
      Budget Authority..................                                 -10
      Outlays...........................                                 -10
                                        ------------------------------------
    Total:
      Budget Authority..................      99,463     106,201     110,562
      Outlays...........................      99,486     106,225     110,514
                                        ====================================

        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      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
        Unexpended balance, start of year:
    0100  Treasury balance..................         821        -172
    0101  U.S. Securities: Par value........      45,075      41,978      39,942
                                               ---------   ---------  ----------
    0199    Total balance, start of year....      45,897      41,807      39,943
        Cash income during the year:
          Current law:

            Offsetting receipts
                (proprietary):
    1220      Premiums collected for the
                aged, FSMI fund.............      19,447      20,872      22,259
    1221      Premiums collected for the
                disabled, FSMI fund.........       2,861       3,248       3,550
    1222      Other proprietary receipts....           4
            Offsetting receipts
                (intragovernmental):
    1240      Federal contributions, FSMI
                fund........................      69,838      77,295      80,905
    1241      Interest received by trust
                fund, FSMI fund.............       3,187       2,897       2,704
    1242      Intragovernmental transactions          25          15           4
            Offsetting collections:
    1280      HI partial transfer of home
                health......................       3,103       1,313         652
    1299    Income under present law........      98,465     105,640     110,074
          Proposed legislation:

            Offsetting receipts
                (intragovernmental):
    2240      Federal contributions,
                legislative proposal not
                subject to PAYGO............                                 -19
    2241      Interest received by trust
                fund, legislative proposal
                not subject to PAYGO........                                  -1
    2299    Income under proposed
              legislation...................                                 -20
                                               ---------   ---------  ----------
    3299    Total cash income...............      98,465     105,640     110,054
        Cash outgo during year:
          Current law:

            Cash outgo during the year (-):
    4500      Benefit payments & ESRD.......     -97,411    -103,976    -108,255
    4500      Administration................      -1,917      -2,000      -2,189
    4500      Peer review organizations.....         -55        -132         -86
    4500      Research......................          -9         -18         -19
    4500      HI partial transfer of home
                health......................      -3,103      -1,313        -652
    4500      Transfer to Medicaid for
                payment of SMI premiums.....         -60         -65
    4599    Outgo under current law (-).....    -102,555    -107,504    -111,201
          Proposed legislation:

            Cash outgo during the year (-):
    5500      Administration, legislative
                proposal not subject to
                PAYGO.......................                                  25
    5500      Benefit payments & ESRD,
                legislative proposal subject
                to PAYGO....................                                  10
    5599    Outgo under proposed legislation
              (-)...........................                                  35
                                               ---------   ---------  ----------
    6599    Total cash outgo (-)............    -102,555    -107,504    -111,166
        Unexpended balance, end of year:
    8700  Uninvested balance................        -172
    8701  Federal securities: Par value.....      41,978      39,942      38,830
                                               ---------   ---------  ----------
    8799    Total balance, end of year......      41,807      39,943      38,831
    ---------------------------------------------------------------------------

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8004-0-7-571      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

          Direct obligations:

    25.3    Portion of limitation on
              administrative expenses:
              Social Security...............         516         585         627
            Grants, subsidies, and
                contributions:
    41.0      Payment for peer review
                organization (PRO) activity.          32          77         109
    41.0      Payment for health insurance
                experiments and
                demonstration projects......          25          21           5
    42.0    Insurance claims and indemnities      97,471     104,041     108,255
    92.0    Undistributed...................       1,419       1,477       1,601
                                               ---------   ---------  ----------
    99.0      Direct obligations............      99,463     106,201     110,597
    99.0  Reimbursable obligations..........       3,103       1,313         652
                                               ---------   ---------  ----------
    99.9    Total new obligations...........     102,566     107,514     111,249
    ---------------------------------------------------------------------------
        * This schedule does not include the Administration's proposal for
    Transitional Medicare Low-Income Drug Assistance.

               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      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.02 Administration, SMI...............                                 -25
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 92.0)...................                                 -25
    ----------------------------------------------------------------------------

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

        New budget authority (gross), detail:
          Discretionary:

    40.26   Appropriation (trust fund)......                                -105
          Mandatory:

    60.26   Appropriation (trust fund)......                                 105
    60.28   Appropriation (unavailable
              balances).....................                                 -25
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................                                  80
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................                                 -25
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                                 -25
    73.20 Total outlays (gross).............                                  25
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................                                -105
    86.97 Outlays from new mandatory
            authority.......................                                  80
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........                                 -25
    ----------------------------------------------------------------------------

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

        Memorandum (non-add) entries:
    92.02 Total investments, end of year:
            Federal securities: Par value...                                  25
    ---------------------------------------------------------------------------

    [[Page 457]]

        The budget proposes new discretionary user fees paid by providers
    for submitting paper claims and duplicate or unprocessable claims. This
    account reflects the reduction in payments to SMI as a result of this
    user fee proposal.

        The budget proposes to extend the subsidy of Medicare cost sharing
    for certain qualified individuals.

               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      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Benefit payments, SMI.............                                 -10
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 42.0)...................                                 -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:

    60.26   Appropriation (trust fund)......                                 -20
    60.28   Appropriation (unavailable
              balances).....................                                  10
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................                                 -10
    ----------------------------------------------------------------------------

        Change in obligated balances:
    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
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    92.02 Total investments, end of year:
            Federal securities: Par value...                                 -10
    ---------------------------------------------------------------------------

        The budget proposes a package of immediate reforms to strengthen
    Medicare and improve beneficiary choice.

                     Allocation Received From Other Accounts

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

                    ADMINISTRATION FOR CHILDREN AND FAMILIES

                                  Federal Funds

    General and special funds:

                     Temporary Assistance for Needy Families

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1552-0-1-609      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 State family assistance grant.....      16,489      16,489      16,489
    00.03 Territories--family assistance
            grants..........................          73          78          78
    00.04 Matching grants to territories....           6          15          15
    00.05 Bonus to reward decrease in
            illegitimacy....................          75         100         100
    00.06 Supplemental grants for population
            increases.......................         319
    00.07 Bonus to reward high performance
            States..........................         200         200         400
    00.08 Tribal work programs..............           8           7           7
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................      17,170      16,889      17,089
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........       1,122         600         400
    22.00 New budget authority (gross)......      16,689      16,689      16,689
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......      17,811      17,289      17,089
    23.95 Total new obligations.............     -17,170     -16,889     -17,089
    23.98 Unobligated balance expiring or
            withdrawn.......................         -42
    24.40 Unobligated balance carried
            forward, end of year............         600         400
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................      16,689      16,689      16,689
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..      11,803      10,543       9,098
    73.10 Total new obligations.............      17,170      16,889      17,089
    73.20 Total outlays (gross).............     -18,583     -18,334     -19,353
    73.40 Adjustments in expired accounts
            (net)...........................         152
    74.40 Obligated balance, end of year....      10,543       9,098       6,834
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................      10,536      11,655      12,586
    86.98 Outlays from mandatory balances...       8,047       6,679       6,767
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........      18,583      18,334      19,353
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................      16,689      16,689      16,689
    90.00 Outlays...........................      18,583      18,334      19,353
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2001 actual  2002 est.   2003 est.
    Enacted/requested:
      Budget Authority..................      16,689      16,689      16,689
      Outlays...........................      18,583      18,334      19,353
    Legislative proposal, subject to
        PAYGO:
      Budget Authority..................                                 319
      Outlays...........................                                   1
                                        ------------------------------------
    Total:
      Budget Authority..................      16,689      16,689      17,008
      Outlays...........................      18,583      18,334      19,354
                                        ====================================

        This account provides continued 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.

                     Temporary Assistance for Needy Families

                    (Legislative proposal, subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1552-4-1-609      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.05 Bonus to reward decrease in
            illegitimacy....................                                -100
    00.06 Illegitimacy reduction and family
            formation activities............                                 100
    00.07 Supplemental grants for population
            increases.......................                                 319
                                               ---------   ---------  ----------
    10.00   Total new obligations...........                                 319
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                                 319
    23.95 Total new obligations.............                                -319
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................                                 319
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                                 319
    73.20 Total outlays (gross).............                                  -1
    74.40 Obligated balance, end of year....                                 318
    ----------------------------------------------------------------------------

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

        Net budget authority and outlays:
    89.00 Budget authority..................                                 319

    [[Page 458]]

    90.00 Outlays...........................                                   1
    ---------------------------------------------------------------------------

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1552-4-1-609      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    25.1  Advisory and assistance services..                                  15
    41.0  Grants, subsidies, and
            contributions...................                                 304
                                               ---------   ---------  ----------
    99.9    Total new obligations...........                                 319
    ---------------------------------------------------------------------------

        This schedule reflects additional proposals to be included in the
    reauthorization of the Temporary Assistance for Needy Families program.
    These include funding for Supplemental Grants and initiatives to reduce
    out-of-wedlock births and to promote family formation.

                                Contingency Fund

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1522-0-1-609      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........       1,958
    23.98 Unobligated balance expiring or
            withdrawn.......................      -1,958
    ----------------------------------------------------------------------------

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

                                Contingency Fund

                    (Legislative proposal, subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1522-4-1-609      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 TANF Contingency Fund.............                                  45
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................                                  45
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                               2,000
    23.95 Total new obligations.............                                 -45
    24.40 Unobligated balance carried
            forward, end of year............                               1,955
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................                               2,000
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                                  45
    73.20 Total outlays (gross).............                                 -45
    ----------------------------------------------------------------------------

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

        Net budget authority and outlays:
    89.00 Budget authority..................                               2,000
    90.00 Outlays...........................                                  45
    ---------------------------------------------------------------------------

        This schedule reflects a proposal to authorize a more accessible
    Contingency Fund.

      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), [$2,447,800,000] $2,475,800,000,
    to remain available until expended; and for such purposes for the first
    quarter of fiscal year [2003] 2004, $1,100,000,000, 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 fiscal year for
    unanticipated costs, incurred for the current fiscal year, such sums as
    may be necessary. (Department of Health and Human Services
    Appropriations Act, 2002.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1501-0-1-609      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

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

            Benefit payments:
    00.01     State child support
                administrative costs........       2,945       3,452       3,542
    00.03     Access and visitation grants..          10          10          10
                                               ---------   ---------  ----------
    00.91   Subtotal, child support
              enforcement...................       2,955       3,462       3,552
    01.02 Payments to territories...........          23          23          23
    01.03 Repatriation......................           1           1           1
                                               ---------   ---------  ----------
    01.91   Subtotal, other payments........          24          24          24
          Aid to families with dependent children (AFDC)
              payments:

    02.01   AFDC benefit payments...........          29          45
    02.03   State and local welfare
              administration................                       5
    02.04   AFDC/JOBS child care............           2
                                               ---------   ---------  ----------
    02.91     Subtotal, AFDC programs.......          31          50
    09.01 Federal Incentive/hold harmless
            pmts to States..................         425         460         461
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       3,435       3,996       4,037
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           1          89
    22.00 New budget authority (gross)......       3,517       3,908       4,037
    22.10 Resources available from
            recoveries of prior year
            obligations.....................           6
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       3,524       3,997       4,037
    23.95 Total new obligations.............      -3,435      -3,996      -4,037
    24.40 Unobligated balance carried
            forward, end of year............          89
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................       2,442       2,448       2,476
    65.00   Advance appropriation...........         650       1,000       1,100
    69.00 Offsetting collections (cash).....         425         460         461
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       3,517       3,908       4,037
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       1,080         803         781
    73.10 Total new obligations.............       3,435       3,996       4,037
    73.20 Total outlays (gross).............      -3,706      -4,018      -4,133
    73.45 Recoveries of prior year
            obligations.....................          -6
    74.40 Obligated balance, end of year....         803         781         685
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................       3,068       3,535       3,626
    86.98 Outlays from mandatory balances...         638         483         507
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       3,706       4,018       4,133
    ----------------------------------------------------------------------------

    [[Page 459]]

        Offsets:
          Against gross budget authority and outlays:

    88.45   Offsetting collections (cash)
              from: Offsetting governmental
              collections (from non-Federal
              sources)......................        -425        -460        -461
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       3,092       3,448       3,576
    90.00 Outlays...........................       3,281       3,558       3,672
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2001 actual  2002 est.   2003 est.
    Enacted/requested:
      Budget Authority..................       3,092       3,448       3,576
      Outlays...........................       3,281       3,558       3,672
    Legislative proposal, subject to
        PAYGO:
      Budget Authority..................                                 -59
      Outlays...........................                                 -59
                                        ------------------------------------
    Total:
      Budget Authority..................       3,092       3,448       3,517
      Outlays...........................       3,281       3,558       3,613
                                        ====================================

        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.
    The remaining net Federal share of collections is returned to the
    Treasury in a receipt account. The text table below shows the net
    Federal costs of child support enforcement:

                 Net Federal Costs of Child Support Enforcement

                            (In millions of dollars)

                                            2001         2002        2003
    Gross Federal share of collections..     (1,281)     (1,225)     (1,250)
    Federal incentive payments to States         415         450         461
    Hold harmless payments..............          10          10           0
    State child support administrative
    costs...............................       2,945       3,452       3,542
    Access and visitation grants........          10          10          10
                                        ------------------------------------
        Total...........................       2,099       2,697       2,763
                                        ====================================

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1501-0-1-609      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

          Direct obligations:

    25.2    Other services..................           3
    41.0    Grants, subsidies, and
              contributions.................       3,007       3,536       3,576
                                               ---------   ---------  ----------
    99.0      Direct obligations............       3,010       3,536       3,576
    99.0  Reimbursable obligations..........         425         460         461
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       3,435       3,996       4,037
    ---------------------------------------------------------------------------

      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      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

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

            Benefit payments:
    00.01     State child support
                administrative costs........                                 -59
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................                                 -59
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                                 -59
    23.95 Total new obligations.............                                  59
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................                                 -59
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                                 -59
    73.20 Total outlays (gross).............                                  59
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                                 -59
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                                 -59
    90.00 Outlays...........................                                 -59
    ---------------------------------------------------------------------------

        This legislative proposal includes provisions to increase child
    support collections and to direct more of these payments to families.
    This also includes a user fee proposal for families that have never
    relied on public assistance and for whom State child support collection
    efforts have been successful.

                        Low Income Home Energy Assistance

        For making payments under title XXVI of the Omnibus Budget
    Reconciliation Act of 1981, [$1,700,000,000] $1,400,000,000.
        For making payments under title XXVI of the Omnibus Budget
    Reconciliation Act of 1981, $300,000,000: Provided, That these funds are
    for the unanticipated home energy assistance needs of one or more
    States, as authorized by section 2604(e) of the Act[: Provided further,
    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 an
    official 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], and
    notwithstanding the designation requirement of section 2602(e).
    (Department of Health and Human Services Appropriations Act, 2002.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1502-0-1-609      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    10.00 Total new obligations (object
            class 41.0).....................       1,856       1,919       1,619
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         156         300         300
    22.00 New budget authority (gross)......       2,000       2,000       1,700
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       2,156       2,300       2,000
    23.95 Total new obligations.............      -1,856      -1,919      -1,619
    23.98 Unobligated balance expiring or
            withdrawn.......................                     -81         -81
    24.40 Unobligated balance carried
            forward, end of year............         300         300         300
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

            Appropriation:
    40.00     Appropriation.................       1,400       1,700       1,400
    40.00     Appropriation (contingent)....                                 300
    40.15   Appropriation (emergency).......         600         300
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       2,000       2,000       1,700
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         822         513         602
    73.10 Total new obligations.............       1,856       1,919       1,619
    73.20 Total outlays (gross).............      -2,161      -1,830      -1,692
    73.40 Adjustments in expired accounts
            (net)...........................          -4                      -3
    74.40 Obligated balance, end of year....         513         602         526
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       1,306       1,382       1,166
    86.93 Outlays from discretionary
            balances........................         855         449         526
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       2,161       1,830       1,692
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       2,000       2,000       1,700
    90.00 Outlays...........................       2,161       1,830       1,692
    ---------------------------------------------------------------------------

        This program makes grants to States and Indian tribes to aid low-
    income households with high energy costs through

    [[Page 460]]

    payments to eligible households, energy suppliers, and weatherization
    providers. Obligation estimates for the contingency fund are based on
    average historical obligation rates.

                         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), [$450,203,000] $442,724,000: Provided, That funds appropriated
    pursuant to section 414(a) of the Immigration and Nationality Act for
    fiscal year [2002] 2003 shall be available for the costs of assistance
    provided and other activities through September 30, [2004] 2005:
    Provided further, That up to $10,000,000 is available to carry out the
    Trafficking Victims Protection Act of 2000.
        For carrying out section 5 of the Torture Victims Relief Act of 1998
    (Public Law 105-320), $10,000,000. (Department of Health and Human
    Services Appropriations Act, 2002.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1503-0-1-609      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Refugee and entrant assistance....         463         460         455
    00.02 Assistance for treatment of
            torture victims.................          10          10          10
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         473         470         465
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          48          22          12
    22.00 New budget authority (gross)......         433         460         453
    22.10 Resources available from
            recoveries of prior year
            obligations.....................          14
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         495         482         465
    23.95 Total new obligations.............        -473        -470        -465
    24.40 Unobligated balance carried
            forward, end of year............          22          12
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................         433         460         453
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         597         556         563
    73.10 Total new obligations.............         473         470         465
    73.20 Total outlays (gross).............        -456        -463        -467
    73.40 Adjustments in expired accounts
            (net)...........................         -44
    73.45 Recoveries of prior year
            obligations.....................         -14
    74.40 Obligated balance, end of year....         556         563         563
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................         148         138         136
    86.93 Outlays from discretionary
            balances........................         308         325         331
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         456         463         467
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         433         460         453
    90.00 Outlays...........................         456         463         467
    ---------------------------------------------------------------------------

        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      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    25.1  Advisory and assistance services..           1           1           1
    25.2  Other services....................           1           1           1
    25.3  Other purchases of goods and
            services from Government
            accounts........................           1           1           1
    41.0  Grants, subsidies, and
            contributions...................         470         467         462
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         473         470         465
    ---------------------------------------------------------------------------

                       Promoting Safe and Stable Families

        For carrying out [subpart 2 of part B of title IV] section 436 of
    the Social Security Act, $305,000,000[. In addition, for such purposes,
    $70,000,000 to carry out such subpart.]; for section 437, $200,000,000;
    and for section 439, $25,000,000. (Department of Health and Human
    Services Appropriations Act, 2002.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1512-0-1-506      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Grants to States and Tribes.......         268         353         475
    00.02 Research, training and technical
            assistance......................           6           9          13
    00.03 State court assessment activities.          10          13          17
    00.04 Mentoring children of prisoners...                                  25
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         284         375         530
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......         305         375         530
    23.95 Total new obligations.............        -284        -375        -530
    23.98 Unobligated balance expiring or
            withdrawn.......................         -21
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

            Appropriation:
    40.00     Appropriation.................                      70         200
    40.00     Appropriation.................                                  25
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............                      70         225
          Mandatory:

    60.00   Appropriation...................         305         305         305
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................         305         375         530
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         345         339         413
    73.10 Total new obligations.............         284         375         530
    73.20 Total outlays (gross).............        -258        -300        -372
    73.40 Adjustments in expired accounts
            (net)...........................         -32
    74.40 Obligated balance, end of year....         339         413         571
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................                      11          34
    86.93 Outlays from discretionary
            balances........................                                  46
    86.97 Outlays from new mandatory
            authority.......................          42          46          46
    86.98 Outlays from mandatory balances...         216         243         246
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         258         300         372
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         305         375         530
    90.00 Outlays...........................         258         300         372
    ---------------------------------------------------------------------------

        This program provides funds for a broad range of child welfare
    services, including family preservation and family support services.
    Includes funding for competitive grants to mentor the children of
    prisoners.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1512-0-1-506      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    25.1  Advisory and assistance services..           4           5           6
    25.2  Other services....................           2           3           8
    41.0  Grants, subsidies, and
            contributions...................         278         367         516
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         284         375         530
    ---------------------------------------------------------------------------

               Job Opportunities and Basic Skills Training Program

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1509-0-1-504      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          43           8           3
    73.20 Total outlays (gross).............          -4          -4          -3
    73.40 Adjustments in expired accounts
            (net)...........................         -31          -1
    74.40 Obligated balance, end of year....           8           3
    ----------------------------------------------------------------------------

    [[Page 461]]

        Outlays (gross), detail:
    86.98 Outlays from mandatory balances...           4           4           3
    ----------------------------------------------------------------------------

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

        This activity was replaced by Temporary Assistance for Needy
    Families.

                        Child Care Entitlement to States

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1550-0-1-609      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Mandatory child care..............       1,177       1,178       1,178
    00.02 Matching child care...............       1,332       1,478       1,478
    00.03 Training and technical assistance.           6           7           7
    00.04 Child care tribal grants..........          56          54          54
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       2,571       2,717       2,717
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......       2,571       2,717       2,717
    23.95 Total new obligations.............      -2,571      -2,717      -2,717
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................       2,567       2,717       2,717
    63.00   Reappropriation.................           4
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       2,571       2,717       2,717
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         641         814         995
    73.10 Total new obligations.............       2,571       2,717       2,717
    73.20 Total outlays (gross).............      -2,342      -2,536      -2,737
    73.40 Adjustments in expired accounts
            (net)...........................         -56
    74.40 Obligated balance, end of year....         814         995         975
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................       1,893       2,019       2,051
    86.98 Outlays from mandatory balances...         448         516         686
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       2,342       2,536       2,737
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       2,571       2,717       2,717
    90.00 Outlays...........................       2,342       2,536       2,737
    ---------------------------------------------------------------------------

        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      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    25.1  Advisory and assistance services..           6           7           7
    41.0  Grants, subsidies, and
            contributions...................       2,565       2,710       2,710
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       2,571       2,717       2,717
    ---------------------------------------------------------------------------

        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), $2,099,994,000 shall be used to supplement, not supplant
    state general revenue funds for child care assistance for low-income
    families: Provided, That $19,120,000 shall be available for child care
    resource and referral and school-aged child care activities, of which
    $1,000,000 shall be for the Child Care Aware toll free hotline: Provided
    further, That, in addition to the amounts required to be reserved by the
    States under section 658G, $272,672,000 shall be reserved by the States
    for activities authorized under section 658G, of which $100,000,000
    shall be for activities that improve the quality of infant and toddler
    care: Provided further, That $10,000,000 shall be for use by the
    Secretary for child care research, demonstration, and evaluation
    activities. (Department of Health and Human Services Appropriations Act,
    2002.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1515-0-1-609      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Block grant payments to States....       1,990       2,090       2,090
    00.04 Research and evaluation fund......          10          10          10
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       2,000       2,100       2,100
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......       2,000       2,100       2,100
    23.95 Total new obligations.............      -2,000      -2,100      -2,100
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................         817       2,100       2,100
    55.00   Advance appropriation...........       1,183
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       2,000       2,100       2,100
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         499       1,121       1,304
    73.10 Total new obligations.............       2,000       2,100       2,100
    73.20 Total outlays (gross).............      -1,376      -1,917      -2,062
    73.40 Adjustments in expired accounts
            (net)...........................          -2
    74.40 Obligated balance, end of year....       1,121       1,304       1,342
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       1,050       1,092       1,092
    86.93 Outlays from discretionary
            balances........................         326         825         970
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       1,376       1,917       2,062
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       2,000       2,100       2,100
    90.00 Outlays...........................       1,376       1,917       2,062
    ---------------------------------------------------------------------------

        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      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    25.1  Advisory and assistance services..           6           6           6
    25.2  Other services....................           1           1           1
    41.0  Grants, subsidies, and
            contributions...................       1,993       2,093       2,093
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       2,000       2,100       2,100
    ---------------------------------------------------------------------------

                           Social Services Block Grant

        For making grants to States pursuant to section 2002 of the Social
    Security Act, $1,700,000,000[: Provided, That notwithstanding
    subparagraph (B) of section 404(d)(2) of such Act, the applicable
    percent specified under such subparagraph for a State to carry out State
    programs pursuant to title XX of such Act shall be 10 percent].
    (Department of Health and Human Services Appropriations Act, 2002.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1534-0-1-506      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    10.00 Total new obligations (object
            class 41.0).....................       1,725       1,700       1,700
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           1           1           1
    22.00 New budget authority (gross)......       1,725       1,700       1,700
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       1,726       1,701       1,701
    23.95 Total new obligations.............      -1,725      -1,700      -1,700

    [[Page 462]]

    24.40 Unobligated balance carried
            forward, end of year............           1           1           1
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................       1,725       1,700       1,700
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         873         745         642
    73.10 Total new obligations.............       1,725       1,700       1,700
    73.20 Total outlays (gross).............      -1,852      -1,803      -1,792
    73.40 Adjustments in expired accounts
            (net)...........................          -1                      -1
    74.40 Obligated balance, end of year....         745         642         548
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................       1,472       1,445       1,445
    86.98 Outlays from mandatory balances...         379         358         348
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       1,852       1,803       1,792
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       1,725       1,700       1,700
    90.00 Outlays...........................       1,852       1,803       1,792
    ---------------------------------------------------------------------------

                     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, sections 310 and 316 of the Family Violence Prevention
    and Services Act, as amended, 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), sections 1201 and 1211 of
    the Children's Health Act of 2000, the Abandoned Infants Assistance Act
    of 1988, [the Early Learning Opportunities Act, part B(1) of title IV
    and] sections 413, 429A, 1110, and 1115 of the Social Security Act, and
    sections 40155, 40211, and 40241 of Public Law 103-322; 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, sections 310 and 316 of the Family
    Violence Prevention and Services Act, as amended, and section 126 and
    titles IV and V of Public Law 100-485, [$8,429,183,000] $8,489,632,000,
    of which $43,000,000, to remain available until September 30, [2003]
    2004, 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) and may be made for adoptions completed in fiscal years
    [2000 and] 2001 and 2002; of which [$738,821,000] $640,325,000 shall be
    for making payments under the Community Services Block Grant Act; and of
    which [$6,537,906,000] $6,667,553,000 shall be for making payments under
    the Head Start Act, of which $1,400,000,000 shall become available
    October 1, [2002] 2003 and remain available through September 30, [2003]
    2004: 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 all eligible entities currently in good standing
    in the Community Services Block Grant program shall receive an increase
    in funding proportionate to the increase provided in this Act for the
    Community Services Block Grant: Provided further, That $88,133,000 shall
    be for activities authorized by the Runaway and Homeless Youth Act,
    notwithstanding the allocation requirements of section 388(a) of such
    Act, of which $39,739,900 is for the transitional living program:
    Provided further, That [$30,000,000] $100,000,000 is for a compassion
    capital fund to provide grants to charitable organizations to emulate
    model social service programs and to encourage research on the best
    practices of social service organizations: 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 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 funds appropriated for section 680(a)(2) of the
    Community Services Block Grant Act, as amended, shall be available for
    financing construction and rehabilitation and loans or investments in
    private business enterprises owned by community development
    corporations.
        [Funds appropriated for fiscal year 2002 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 2002 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, 2002; additional
    authorizing legislation required.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1536-0-1-506      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Head start........................       6,194       6,538       6,667
          Social services programs:

            Runaway and homeless youth:
    01.03     Runaway and homeless youth....          48          48          48
    01.04     Transitional living...........          21          40          40
    01.06   Education grants to reduce
              sexual abuse of runaway youth.          15          15          15
            Child abuse:
    01.07     Child abuse State grants......          21          22          22
    01.08     Child abuse discretionary
                grants......................          33          26          26
    01.09     Community based resource
                centers.....................          33          33          33
            Child welfare programs:
    01.11     Child welfare services........         292         292         292
    01.12     Child welfare training........           7           8           8
    01.15     Abandoned infants.............          12          12          12
    01.16     Adoption incentives...........          43          43          43
    01.17     Adoption opportunities........          27          27          27
    01.18   Children's health act programs..                      13          13
    01.19   Social services and income
              maintenance research..........          38          31           6
    01.20   Native American programs........          46          46          45
    01.21   Compassion capital fund.........                      30         100
    01.23   Early learning fund.............          20          25
            Developmental disabilities
                program:
    01.24     Protection and advocacy.......          33          35          35
    01.25     Projects of national
                significance................          11          12          12
    01.26     Centers for excellence........          21          24          24
    01.27     State grants..................          68          70          70
    01.28   Federal administration..........         173         183         182
    01.29   Faith-based center..............                       2           2
                                               ---------   ---------  ----------
    01.91     Subtotal......................         962       1,037       1,055
                                               ---------   ---------  ----------
    02.00   Subtotal, ACYF programs.........       7,156       7,575       7,722
          Community services programs:

    03.01   Community services block grants.         600         650         570
    03.03   Community food and nutrition....           6           7           7
    03.04   Community services discretionary          36          39          39
    03.05   National youth sports...........          16          17
    03.06 Individual development accounts...          25          25          25
    03.08 Domestic violence hotline.........           2           2           2
    03.09 Grants for battered women's
            shelters........................         117         125         125
                                               ---------   ---------  ----------
    03.91   Subtotal........................         802         865         768
                                               ---------   ---------  ----------
    04.00   Total, direct program...........       7,958       8,440       8,490
    09.01 Reimbursable program..............          16          15          15
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       7,974       8,455       8,505
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           3           3           3
    22.00 New budget authority (gross)......       7,982       8,455       8,505
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       7,985       8,458       8,508
    23.95 Total new obligations.............      -7,974      -8,455      -8,505
    23.98 Unobligated balance expiring or
            withdrawn.......................          -7

    [[Page 463]]

    24.40 Unobligated balance carried
            forward, end of year............           3           3           3
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       6,567       7,041       7,090
    40.71   Reduction pursuant to P.L. 107-
              116...........................                      -1
    40.75   Reduction pursuant to P.L. 106-
              554 (Labor/HHS)...............          -1
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       6,566       7,040       7,090
    55.00   Advance appropriation...........       1,400       1,400       1,400
          Spending authority from offsetting
              collections:

    68.00   Offsetting collections (cash)...          15          15          15
    68.10   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................           1
                                               ---------   ---------  ----------
    68.90     Spending authority from
                offsetting collections
                (total discretionary).......          16          15          15
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       7,982       8,455       8,505
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       3,394       4,375       5,084
    73.10 Total new obligations.............       7,974       8,455       8,505
    73.20 Total outlays (gross).............      -6,956      -7,746      -8,310
    73.40 Adjustments in expired accounts
            (net)...........................         -36
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................          -1
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................           2
    74.40 Obligated balance, end of year....       4,375       5,084       5,279
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       4,180       4,055       4,037
    86.93 Outlays from discretionary
            balances........................       2,776       3,691       4,273
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       6,956       7,746       8,310
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........         -15         -15         -15
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................          -1
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       7,966       8,440       8,490
    90.00 Outlays...........................       6,940       7,731       8,295
    ---------------------------------------------------------------------------

      Budget Authority and Outlays Excluding Full Funding for Federal Retiree
                           Costs (in millions of dollars)

    ----------------------------------------------------------------------------
                                             2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       7,956       8,429       8,479
    90.00 Outlays...........................       6,930       7,720       8,284
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2001 actual  2002 est.   2003 est.
    Enacted/requested:
      Budget Authority..................       7,966       8,440       8,490
      Outlays...........................       6,941       7,731       8,295
    Legislative proposal, not subject to
        PAYGO:
      Budget Authority..................                                  30
      Outlays...........................                                   4
                                        ------------------------------------
    Total:
      Budget Authority..................       7,966       8,440       8,520
      Outlays...........................       6,941       7,731       8,299
                                        ====================================

        Provides funding for a Compassion Capital Fund to support public and
    private partnerships in funding community and faith-based charitable
    organizations that expand upon or emulate model social service programs.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1536-0-1-506      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........         104         113         113
    11.3      Other than full-time permanent           1           1           1
    11.5      Other personnel compensation..           1           1           1
                                               ---------   ---------  ----------
    11.9        Total personnel compensation         106         115         115
    12.1    Civilian personnel benefits.....          30          33          33
    21.0    Travel and transportation of
              persons.......................           9           5           5
    23.1    Rental payments to GSA..........          15          16          16
    23.3    Communications, utilities, and
              miscellaneous charges.........           2           2           2
    24.0    Printing and reproduction.......           2           3           3
    25.1    Advisory and assistance services          93         124         124
    25.2    Other services..................           4          41          41
    25.3    Other purchases of goods and
              services from Government
              accounts......................          38          30          30
    25.7    Operation and maintenance of
              equipment.....................           1           1           1
    26.0    Supplies and materials..........           1           2           2
    31.0    Equipment.......................           1           1           1
    41.0    Grants, subsidies, and
              contributions.................       7,657       8,067       8,117
                                               ---------   ---------  ----------
    99.0      Direct obligations............       7,959       8,440       8,490
    99.0  Reimbursable obligations..........          15          15          15
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       7,974       8,455       8,505
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-1536-0-1-506      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    1001  Total compensable workyears: Full-
            time equivalent employment......       1,430       1,547       1,492
    ---------------------------------------------------------------------------

                      Children and Family Services Programs

                  (Legislative proposal, not subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1536-2-1-506      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    01.19 Maternity group homes.............                                  10
    01.20 Strengthening fatherhood and
            healthy marriages...............                                  20
                                               ---------   ---------  ----------
    04.00   Total, direct program...........                                  30
                                               ---------   ---------  ----------
    10.00   Total new obligations...........                                  30
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                                  30
    23.95 Total new obligations.............                                 -30
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................                                  30
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                                  30
    73.20 Total outlays (gross).............                                  -4
    74.40 Obligated balance, end of year....                                  26
    ----------------------------------------------------------------------------

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

        Net budget authority and outlays:
    89.00 Budget authority..................                                  30
    90.00 Outlays...........................                                   4
    ---------------------------------------------------------------------------

        This legislative proposal establishes the Responsible Fatherhood and
    Healthy Marriages Program. The budget provides grants to faith-based and
    community organizations to assist non-custodial fathers in becoming more
    involved in the lives of their children. In addition, the Administration
    includes funding for grants to provide young, pregnant and parenting
    women with access to maternity group homes.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1536-2-1-506      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    25.3  Other purchases of goods and
            services from Government
            accounts........................                                   7
    41.0  Grants, subsidies, and
            contributions...................                                  23
                                               ---------   ---------  ----------
    99.9    Total new obligations...........                                  30
    ---------------------------------------------------------------------------

    [[Page 464]]

                        Violent Crime Reduction Programs

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-8605-0-1-754      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         117          29           4
    73.20 Total outlays (gross).............         -88         -25          -4
    74.40 Obligated balance, end of year....          29           4
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.93 Outlays from discretionary
            balances........................          88          25           4
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................          88          25           4
    ---------------------------------------------------------------------------

                  Children's Research and Technical Assistance

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1553-0-1-609      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Training and technical assistance.          13          13          13
    00.02 Federal parent locator service....          26          25          25
    00.04 Welfare research..................                                  15
    09.01 Reimbursable program..............           8          10          11
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          47          48          64
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           1           1
    22.00 New budget authority (gross)......          47          47          64
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......          48          48          64
    23.95 Total new obligations.............         -47         -48         -64
    24.40 Unobligated balance carried
            forward, end of year............           1
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................          39          37          53
    69.00 Offsetting collections (cash).....           8          10          11
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................          47          47          64
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          36          33          33
    73.10 Total new obligations.............          47          48          64
    73.20 Total outlays (gross).............         -48         -49         -52
    73.40 Adjustments in expired accounts
            (net)...........................          -1
    74.40 Obligated balance, end of year....          33          33          45
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................          47          25          26
    86.98 Outlays from mandatory balances...           1          24          26
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........          48          49          52
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.40   Offsetting collections (cash)
              from: Non-Federal sources.....          -8         -10         -11
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          39          37          53
    90.00 Outlays...........................          40          39          41
    ---------------------------------------------------------------------------

        This account provides funding for research and technical assistance
    activities established in P.L. 104-193. Amounts for welfare research are
    in addition to research amounts in the Children and families services
    program account and the Temporary Assistance to Needy Families account
    under Illegitimacy Reduction and Family Formation activities.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1553-0-1-609      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

          Direct obligations:

    21.0    Travel and transportation of
              persons.......................           1           1           1
    23.1    Rental payments to GSA..........           1           1           1
    23.3    Communications, utilities, and
              miscellaneous charges.........           1           1           1
    25.1    Advisory and assistance services          15          14          22
    25.2    Other services..................           4           5           5
    25.3    Other purchases of goods and
              services from Government
              accounts......................          15          13          13
    41.0    Grants, subsidies, and
              contributions.................           2           2          10
                                               ---------   ---------  ----------
    99.0      Direct obligations............          39          37          53
    99.0  Reimbursable obligations..........           8          11          11
                                               ---------   ---------  ----------
    99.9    Total new obligations...........          47          48          64
    ---------------------------------------------------------------------------

           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, [$4,885,600,000] $4,855,000,000.
    In addition, for carrying out section 477(i), $60,000,000.
        For making payments to States or other non-Federal entities under
    title IV-E of the [Social Security] Act, for the first quarter of fiscal
    year [2003, $1,754,000,000] 2004, $1,745,600,000.
        For making, after May 31 of the current fiscal year, payments to
    States or other non-Federal entities under section 474 of title IV-E,
    for the last 3 months of the current fiscal year for unanticipated
    costs, incurred for the current fiscal year, such sums as may be
    necessary. (Department of Health and Human Services Appropriations Act,
    2002.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1545-0-1-609      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Foster care.......................       4,297       4,601       4,885
    00.02 Independent living................         140         140         140
    00.03 Education and training vouchers...                                  60
    00.04 Adoption assistance...............       1,149       1,426       1,585
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       5,586       6,167       6,669
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......       6,401       6,622       6,669
    23.95 Total new obligations.............      -5,586      -6,167      -6,669
    23.98 Unobligated balance expiring or
            withdrawn.......................        -815        -455
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................                                  60
          Mandatory:

    60.00   Appropriation...................       4,863       4,886       4,855
    65.00   Advance appropriation...........       1,538       1,736       1,754
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       6,401       6,622       6,669
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       1,071         934       1,003
    73.10 Total new obligations.............       5,586       6,167       6,669
    73.20 Total outlays (gross).............      -5,711      -6,098      -6,431
    73.40 Adjustments in expired accounts
            (net)...........................         -12
    74.40 Obligated balance, end of year....         934       1,003       1,241
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................                                   9
    86.97 Outlays from new mandatory
            authority.......................       4,854       5,306       5,656
    86.98 Outlays from mandatory balances...         857         792         765
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       5,711       6,098       6,431
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       6,401       6,622       6,669
    90.00 Outlays...........................       5,711       6,098       6,431
    ---------------------------------------------------------------------------

        Foster care.--The proposed level will support eligible low-income
    children who must be placed outside the home. An average of 249,400
    children per month will be served in 2003.

    [[Page 465]]

        Adoption assistance.--The proposed funding level will support
    subsidies for families adopting eligible low-income children with
    special needs. An average of 327,900 children per month will be served
    in 2003.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1545-0-1-609      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    25.1  Advisory and assistance services..           6           7          11
    25.2  Other services....................           2           2           3
    41.0  Grants, subsidies, and
            contributions...................       5,578       6,158       6,655
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       5,586       6,167       6,669
    ---------------------------------------------------------------------------

                             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, [$1,199,814,000] $1,342,357,000, of which $5,000,000 shall
    be available for activities regarding medication management, screening,
    and education to prevent incorrect medication and adverse drug
    reactions; and of which $149,670,000 shall be allocated to States
    consistent with the formula in section 311 of the Older Americans Act of
    1965. (Department of Health and Human Services Appropriations Act, 2002;
    additional authorizing legislation required.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0142-0-1-506      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    01.01 Supportive services and centers...         325         357         357
    01.02 Preventive health.................          21          21          21
    01.03 National family caregiver support
            program.........................         125         142         142
    01.05 Congregate meals..................         378         390         492
    01.06 Home-delivered meals..............         152         177         225
    01.08 Grants to Indian tribes...........          23          26          28
    01.09 Training, research, and
            discretionary projects..........          36          38          28
    01.10 Aging network support activities..           2           2           2
    01.11 Federal administration............          18          19          19
    01.13 Alzheimer's disease demonstration
            grants to States................           9          11          11
    01.14 Grants to States for the
            protection of vulnerable older
            Americans.......................          14          18          18
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       1,104       1,201       1,342
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           2           2           2
    22.00 New budget authority (gross)......       1,104       1,201       1,342
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       1,106       1,203       1,344
    23.95 Total new obligations.............      -1,104      -1,201      -1,342
    24.40 Unobligated balance carried
            forward, end of year............           2           2           1
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       1,104       1,201       1,342
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         303         456         516
    73.10 Total new obligations.............       1,104       1,201       1,342
    73.20 Total outlays (gross).............        -953      -1,137      -1,295
    73.40 Adjustments in expired accounts
            (net)...........................           1          -4
    74.40 Obligated balance, end of year....         456         516         563
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................         680         728         829
    86.93 Outlays from discretionary
            balances........................         273         409         466
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         953       1,137       1,295
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       1,104       1,201       1,342
    90.00 Outlays...........................         953       1,137       1,295
    ---------------------------------------------------------------------------

      Budget Authority and Outlays Excluding Full Funding for Federal Retiree
                           Costs (in millions of dollars)

    ----------------------------------------------------------------------------
                                             2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       1,103       1,200       1,341
    90.00 Outlays...........................         952       1,136       1,294
    ---------------------------------------------------------------------------

        Administration on Aging.--The proposed level will provide continued
    funding for core formula grant programs that provide nutrition,
    supportive services and caregiver support services through the aging
    network. AoA programs are part of a comprehensive system of support for
    older people and their families.

        In order to improve program management, the budget proposes to merge
    funding from the smaller Department of Agriculture nutrition program for
    the elderly with AOA's nutrition programs. Although both Departments
    currently fund these services, HHS is the lead agency and has greater
    interaction with service providers. This merger will improve program
    oversight and streamline reporting requirements.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0142-0-1-506      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    11.1  Personnel compensation: Full-time
            permanent.......................           9          10          10
    12.1  Civilian personnel benefits.......           3           3           3
    23.1  Rental payments to GSA............           2           2           2
    25.1  Advisory and assistance services..           2           3           2
    25.2  Other services....................           3           2           3
    25.3  Other purchases of goods and
            services from Government
            accounts........................           3           3           3
    41.0  Grants, subsidies, and
            contributions...................       1,082       1,178       1,319
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       1,104       1,201       1,342
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-0142-0-1-506      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears: Full-
            time equivalent employment......         115         119         115
        Allocation account:
    3001  Total compensable workyears: Full-
            time equivalent employment......           5           5           5
    ---------------------------------------------------------------------------

                             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, [$341,703,000]
    $387,880,000, 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; and $52,951,000 to be transferred from the accounts of the
    National Institutes of Health and $1,610,000 to be transferred from
    ``Healthcare Research and Quality'' for carrying out public affairs and
    legislative affairs activities of the National Institutes of Health and
    the Agency for Healthcare Research and Quality, respectively: Provided,
    That of the funds made available under this heading for carrying out
    title XX of the Public Health Service Act, $11,885,000 shall be for
    activities specified under section 2003(b)(2), of which $10,157,000
    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 of this amount, $50,000,000 is for minority AIDS
    prevention and treatment activities; and [$21,998,000] $19,938,000 shall
    be for an Information Technology Security and Innovation Fund for
    Department-wide activities

    [[Page 466]]

    involving cybersecurity, information technology security, and related
    innovation projects. (Department of Health and Human Services
    Appropriations Act, 2002; additional authorizing legislation required.)

                             office for civil rights

        For expenses necessary for the Office for Civil Rights,
    [$28,691,000] $32,260,000, 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, 2002; additional authorizing
    legislation required.)

                                 policy research

        For carrying out, to the extent not otherwise provided, research
    studies under section 1110 of the Social Security Act and title III of
    the Public Health Service Act, [$2,500,000] $2,499,000: Provided, That
    in addition to amounts provided herein, [funds] $18,000,000 shall be
    available from amounts available under section 241 of the Public Health
    Service Act [may be used] to carry out national health or human services
    research and evaluation activities: Provided further, That the
    expenditure of any funds available under section 241 of the Public
    Health Service Act are subject to the requirements of section 205 of
    this Act. (Department of Health and Human Services Appropriations Act,
    2002; additional authorizing legislation required.)

                public health and social services emergency fund

        For expenses necessary to support activities related to countering
    potential biological, disease and chemical threats to civilian
    populations, [$242,949,000: Provided, That this amount is distributed as
    follows: Centers for Disease Control and Prevention, $181,919,000, of
    which $52,000,000 shall remain available until expended for the National
    Pharmaceutical Stockpile; and Office of Emergency Preparedness,
    $61,030,000] $2,295,184,000. (Department of Health and Human Services
    Appropriations Act, 2002; additional authorizing legislation required.)

               health facilities construction and management fund

        For the study of, construction of, renovation of, and acquisition of
    equipment for, facilities of the Centers for Disease Control and
    Prevention and the National Institutes of Health, including the
    acquisition of real property, as well as extramural facilities
    construction grants and security improvements for Federal and non-
    Federal laboratories, $1,056,980,000, to remain available until
    expended, of which $632,800,000 shall be derived by transfer from the
    NIH Buildings and Facilities account, $150,000,000 shall be derived by
    transfer from the National Institutes of Allergy and Infectious Diseases
    account and is for extramural bioterrorism and infectious disease
    research facility construction and renovation; $5,000,000 shall be
    derived by transfer from the National Cancer Institute account;
    $8,180,000 shall be derived by transfer from the National Center for
    Minority Health and Health Disparities account; and $77,000,000 shall be
    derived by transfer from the National Center for Research Resources
    account; Provided, That after notice thereof is transmitted to Congress,
    the Secretary of HHS may transfer funds in this account among the
    purposes and activities of the account.

               [Public health and social services emergency fund]

        [For emergency expenses to respond to the September 11, 2001,
    terrorist attacks on the United States, to provide grants to public
    entities, not-for-profit entities, and Medicare and Medicaid enrolled
    suppliers and institutional providers to reimburse for health care
    related expenses or lost revenues directly attributable to the public
    health emergency resulting from the September 11, 2001, terrorist acts,
    for ``Public Health and Social Services Emergency Fund'', $140,000,000,
    to remain available until expended, to be obligated from amounts made
    available in Public Law 107-38: Provided, That none of the costs have
    been reimbursed or are eligible for reimbursement from other sources.]
        [For emergency expenses necessary to support activities related to
    countering potential biological, disease, and chemical threats to
    civilian populations, for ``Public Health and Social Services Emergency
    Fund'', $2,504,314,000, to remain available in Public Law 107-38. Of
    this amount, $865,000,000 shall be for the Centers for Disease Control
    and Prevention for improving State and local capacity; $135,000,000
    shall be for grants to improve hospital capacity to respond to
    bioterrorism; $100,000,000 shall be for upgrading capacity at the
    Centers for Disease Control and Prevention, including research:
    Provided, That up to $10,000,000 of this amount shall be for the
    tracking and control of biological pathogens; $85,000,000 shall be for
    the National Institute of Allergy and Infectious Diseases for
    bioterrorism-related research and development and other related needs;
    $70,000,000 shall be for the National Institute of Allergy and
    Infectious Diseases for the construction of a biosafety laboratory and
    related infrastructure costs; $593,000,000 shall be for the National
    Pharmaceutical Stockpile; $512,000,000 shall be for the purchase of
    smallpox vaccine; $71,000,000 shall be for improving laboratory security
    at the National Institutes of Health and the Centers for Disease Control
    and Prevention; $7,500,000 shall be for environmental hazard control
    activities conducted by the Centers for Disease Control and Prevention;
    $10,000,000 shall be for the Substance Abuse and Mental Health Services
    Administration; and $55,814,000 shall be for bioterrorism preparedness
    and disaster response activities in the Office of the Secretary. At the
    discretion of the Secretary, these amounts may be transferred between
    categories subject to normal reprogramming procedures.] (Emergency
    Supplemental Act, 2002.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9912-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
          Direct activities:

    00.01   General departmental management.         309         357         393
    00.02   Office for Civil Rights.........          29          34          36
    00.03   Policy research.................          16           3           2
    00.04   Public health and social
              services emergency fund.......         291       2,887       2,295
    00.05   Health Facilities, Construction
              and Management Fund...........                                 184
    09.01 Reimbursable program..............         119         144         141
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         764       3,425       3,051
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          55         111         108
    22.00 New budget authority (gross)......         852       3,422       3,051
    22.10 Resources available from
            recoveries of prior year
            obligations.....................           3
    22.21 Unobligated balance transferred to
            other accounts..................         -32
    22.22 Unobligated balance transferred
            from other accounts.............           4
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         882       3,533       3,159
    23.95 Total new obligations.............        -764      -3,425      -3,051
    23.98 Unobligated balance expiring or
            withdrawn.......................          -5
    24.40 Unobligated balance carried
            forward, end of year............         111         108         108
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................         577         626       2,901
    40.15   Appropriation (emergency).......                   2,644
    40.71   Reduction pursuant to P.L. 107-
              116...........................                      -1
    40.75   Reduction pursuant to P.L. 106-
              554 (Labor/HHS)...............          -1
    42.00   Transferred from other accounts.         145
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............         721       3,269       2,901
          Spending authority from offsetting
              collections:

    68.00   Offsetting collections (cash)...          82         153         150
    68.10   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................          49
                                               ---------   ---------  ----------
    68.90     Spending authority from
                offsetting collections
                (total discretionary).......         131         153         150
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................         852       3,422       3,051
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         528         607       2,270
    73.10 Total new obligations.............         764       3,425       3,051
    73.20 Total outlays (gross).............        -680      -1,762      -2,514
    73.40 Adjustments in expired accounts
            (net)...........................           3
    73.45 Recoveries of prior year
            obligations.....................          -3
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................         -49
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................          44
    74.40 Obligated balance, end of year....         607       2,270       2,807
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................         386       1,334       1,170
    86.93 Outlays from discretionary
            balances........................         294         429       1,344
                                               ---------   ---------  ----------

    [[Page 467]]

    87.00   Total outlays (gross)...........         680       1,762       2,514
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........        -128        -153        -150
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................         -49
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............          46
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         721       3,269       2,901
    90.00 Outlays...........................         553       1,609       2,364
    ---------------------------------------------------------------------------

                              (Dollars in millions)

                                         2001 actual  2002 est.   2003 est.
    Distribution of budget authority by
        account:
      General Departmental Management...         302         340         379
      Legislative/Public Affairs
        Consolidation: non-add..........        (--)        (--)        (28)
      Office for Civil Rights...........          25          29          30
      Policy Research...................          17           2           2
      Public Health and Social Services
        Emergency Fund..................         367       2,887       2,295
      Health Facilities Construction and
        Management Fund.................                                 184
    Distribution of outlays by account:
      General Departmental Management...         195         289         342
      Legislative/Public Affairs
        Consolidation: non-add..........        (--)        (--)        (25)
      Office for Civil Rights...........          22          28          30
      Policy research...................           7          22          17
      Public Health and Social Services
        Emergency Fund..................         318       1,259       1,936
      Health Facilities Construction and
        Management Fund.................                                  28

      Budget Authority and Outlays Excluding Full Funding for Federal Retiree
                           Costs (in millions of dollars)

    ----------------------------------------------------------------------------
                                             2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         711       3,258       2,890
    90.00 Outlays...........................         542       1,598       2,353
    ---------------------------------------------------------------------------

        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, emergency preparedness, as well as programs
    to counter bioterrorist threats.

        The 2003 Budget creates a new HHS Health Facilities Construction and
    Management Fund within the Office of the Secretary. Through this
    mechanism, the Department will prioritize and fund health facility
    construction projects competitively across the National Institutes of
    Health and the Centers for Disease Control and Prevention. In addition,
    HHS will establish a process to include the Indian Health Service (IHS)
    and the Food and Drug Administration (FDA) facility projects in its
    Department-wide priority-setting process, with the goal of including
    funding for IHS and FDA facilities in this Fund in the 2004 Budget.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9912-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........          95         118         142
    11.3      Other than full-time permanent           5           5           4
    11.5      Other personnel compensation..           2           4           4
                                               ---------   ---------  ----------
    11.9        Total personnel compensation         102         127         150
    12.1    Civilian personnel benefits.....          30          37          43
    21.0    Travel and transportation of
              persons.......................           5           9          10
    22.0    Transportation of things........                       1           1
    23.1    Rental payments to GSA..........          14          13          14
    23.2    Rental payments to others.......                       3           3
    23.3    Communications, utilities, and
              miscellaneous charges.........           6           4           4
    24.0    Printing and reproduction.......           2           4           4
    25.1    Advisory and assistance services          15          26          30
    25.2    Other services..................          37          91          95
    25.3    Other purchases of goods and
              services from Government
              accounts......................          73          35          46
    25.4    Operation and maintenance of
              facilities....................           5          77          46
    25.5    Research and development
              contracts.....................          11          10          16
    25.7    Operation and maintenance of
              equipment.....................           5           8           8
    26.0    Supplies and materials..........           6          11          12
    31.0    Equipment.......................           8          28          23
    41.0    Grants, subsidies, and
              contributions.................          76          98          84
                                               ---------   ---------  ----------
    99.0      Direct obligations............         395         582         589
    99.0  Reimbursable obligations..........         119         144         141
          Allocation Account:

            Personnel compensation:
    11.1      Full-time permanent...........          16          26          19
    11.3      Other than full-time permanent           2           2
              Other personnel compensation:
    11.5        Other personnel compensation           1           1
    11.5        Other personnel compensation
                                               ---------   ---------  ----------
    11.9        Total personnel compensation          19          29          19
    12.1    Civilian personnel benefits.....           6           8           5
    21.0    Travel and transportation of
              persons.......................           2           6           5
    22.0    Transportation of things........                       2           2
    23.2    Rental payments to others.......                                   1
    23.3    Communications, utilities, and
              miscellaneous charges.........           3           5           2
    24.0    Printing and reproduction.......                       2
    25.1    Advisory and assistance services          12          41          49
    25.2    Other services..................           6         582         126
    25.3    Other purchases of goods and
              services from Government
              accounts......................          62         520         237
    25.4    Operation and maintenance of
              facilities....................                       4
    25.5    Research and development
              contracts.....................          25          53
    25.7    Operation and maintenance of
              equipment.....................           1           1
    26.0    Supplies and materials..........           3          21          17
    31.0    Equipment.......................          11          46          37
    41.0    Grants, subsidies, and
              contributions.................         100       1,379       1,821
                                               ---------   ---------  ----------
    99.0      Allocation account............         250       2,699       2,321
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         764       3,425       3,051
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-9912-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears: Full-
            time equivalent employment......       1,359       1,494       1,746
        Reimbursable:
    2001  Total compensable workyears: Full-
            time equivalent employment......         173         235         234
        Allocation account:
    3001  Total compensable workyears: Full-
            time equivalent employment......          61          75          75
    ---------------------------------------------------------------------------

                    Allocations Received From Other Accounts

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

                             PROGRAM SUPPORT CENTER

    General and special funds:

         [Retirement Pay and] Medical Benefits for Commissioned Officers

        For [retirement pay and] medical benefits of Public Health Service
    Commissioned Officers as authorized by law, [for payments under the
    Retired Serviceman's Family Protection Plan and Survivor Benefit Plan,]
    and for medical care of dependents and retired personnel under the
    Dependents' Medical Care Act (10 U.S.C. ch. 55), [and for payments
    pursuant to section 229(b) of the Social Security Act (42 U.S.C.
    429(b)),] such amounts as may be required during the current fiscal
    year. (Department of Health and Human Services Appropriations Act, 2002;
    additional authorizing legislation required.)

    [[Page 468]]

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0379-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Retirement payments...............         194         208
    00.02 Survivors' benefits...............          11          12
    00.03 Medical care......................          40          41          15
    00.04 Military service credits..........           1           1           1
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         246         262          16
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......         250         262          16
    23.95 Total new obligations.............        -246        -262         -16
    23.98 Unobligated balance expiring or
            withdrawn.......................          -4
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................         250         262          16
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..           6          20          26
    73.10 Total new obligations.............         246         262          16
    73.20 Total outlays (gross).............        -241        -256         -17
    73.40 Adjustments in expired accounts
            (net)...........................           8
    74.40 Obligated balance, end of year....          20          26          25
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................         223         237          14
    86.98 Outlays from mandatory balances...          18          19           3
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         241         256          17
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         250         262          16
    90.00 Outlays...........................         241         256          17
    ---------------------------------------------------------------------------

      Budget Authority and Outlays Excluding Full Funding for Federal Retiree
                           Costs (in millions of dollars)

    ----------------------------------------------------------------------------
                                             2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         250         262         251
    90.00 Outlays...........................         241         256         252
    ---------------------------------------------------------------------------

        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.

        As part of the Administration's initiative to reflect full accrual
    of retirement costs, legislation is proposed to establish a new
    retirement fund to be known as the ``Public Health Service Commissioned
    Corps Retirement Fund.'' Budget year data are presented in that new
    account.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0379-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    13.0  Benefits for former personnel.....         205         220
    25.3  Other purchases of goods and
            services from Government
            accounts........................           1           1           1
    25.6  Medical care......................          40          41          15
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         246         262          16
    ---------------------------------------------------------------------------

      Payment to Public Health Service Commissioned Corps Retirement System

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0367-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    10.00 Total new obligations (object
            class 92.0).....................                                 132
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                                 132
    23.95 Total new obligations.............                                -132
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................                                 132
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                                 132
    73.20 Total outlays (gross).............                                -132
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                                 132
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                                 132
    90.00 Outlays...........................                                 132
    ---------------------------------------------------------------------------

            Public Health Service Commissioned Corps Retirement Fund

                  Unavailable Collections (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-5371-0-2-602      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    01.99 Balance, start of year............
        Receipts:
    02.40 Agency contributions..............                                 104
    02.42 General fund payment..............                                 132
                                               ---------   ---------  ----------
    02.99   Total receipts and collections..                                 236
        Appropriations:
    05.00 Public Health Service commissioned
            officers corps retirement fund..                                -235
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-5371-0-2-602      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Direct Program Activity...........                                 222
    00.02 Direct Program Activity...........                                  13
                                               ---------   ---------  ----------
    10.00   Total new obligations...........                                 235
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                                 235
    23.95 Total new obligations.............                                -235
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.20   Appropriation (special fund)....                                 235
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                                 235
    73.20 Total outlays (gross).............                                -235
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                                 213
    86.98 Outlays from mandatory balances...                                  22
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........                                 235
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                                 235
    90.00 Outlays...........................                                 235
    ---------------------------------------------------------------------------

    [[Page 469]]

                             Health Activities Funds

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9913-0-1-552      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           7           7           7
    24.40 Unobligated balance carried
            forward, end of year............           7           7           7
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..           2           2           2
    74.40 Obligated balance, end of year....           2           2           2
    ----------------------------------------------------------------------------

        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      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    09.01 Program support center............         273         297         325
    09.02 Federal employee occupational
            health..........................          99         121         131
    09.03 OS activities.....................           7           7           8
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         379         425         464
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          56          69          69
    22.00 New budget authority (gross)......         381         425         464
    22.10 Resources available from
            recoveries of prior year
            obligations.....................          11
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         448         494         533
    23.95 Total new obligations.............        -379        -425        -464
    24.40 Unobligated balance carried
            forward, end of year............          69          69          69
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    69.00   Offsetting collections (cash)...         367         425         464
    69.10   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................          14
                                               ---------   ---------  ----------
    69.90     Spending authority from
                offsetting collections
                (total mandatory)...........         381         425         464
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          -3         -15         -15
    73.10 Total new obligations.............         379         425         464
    73.20 Total outlays (gross).............        -366        -425        -464
    73.45 Recoveries of prior year
            obligations.....................         -11
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................         -14
    74.40 Obligated balance, end of year....         -15         -15         -15
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................         366         425         464
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........        -367        -425        -464
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................         -14
    ----------------------------------------------------------------------------

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

        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 Federal occupational health (FOH)
    program is also funded through the SSF. FOH includes clinical services,
    environmental health services and employee assistance programs. The
    Office of the Secretary (OS) activities line includes the fund manager,
    departmental contracts and grants, audit resolution, and the regional
    health administrators.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9941-0-4-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

          Personnel compensation:

    11.1    Full-time permanent.............          70          81          79
    11.3    Other than full-time permanent..           2           2           2
    11.5    Other personnel compensation....           2           3           4
                                               ---------   ---------  ----------
    11.9      Total personnel compensation..          74          86          85
    12.1  Civilian personnel benefits.......          27          28          28
    21.0  Travel and transportation of
            persons.........................           2           3           4
    22.0  Transportation of things..........           2           2           2
    23.1  Rental payments to GSA............          12          13          13
    23.3  Communications, utilities, and
            miscellaneous charges...........           7           9           9
    24.0  Printing and reproduction.........           1           1           1
    25.1  Advisory and assistance services..          11          13          14
    25.2  Other services....................          95         101         119
    25.3  Other purchases of goods and
            services from Government
            accounts........................          27          29          33
    25.4  Operation and maintenance of
            facilities......................          13          14          16
    25.6  Medical care......................          33          40          44
    26.0  Supplies and materials............          66          77          85
    31.0  Equipment.........................           9           9          11
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         379         425         464
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-9941-0-4-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    2001  Total compensable workyears: Full-
            time equivalent employment......       1,195       1,318       1,267
    ---------------------------------------------------------------------------

                                   Trust Funds

                            Miscellaneous Trust Funds

                  Unavailable Collections (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9971-0-7-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    01.99 Balance, start of year............
        Receipts:
    02.00 Gifts and contributions,
            miscellaneous trust funds.......          37          37          37
    02.20 Contributions, Indian health
            facilities, Health Services
            Administration..................          32          32          32
    02.40 Interest, Miscellaneous trust
            funds...........................           1           1           1
                                               ---------   ---------  ----------
    02.99   Total receipts and collections..          70          70          70
        Appropriations:
    05.00 Miscellaneous trust funds.........         -70         -70         -70
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9971-0-7-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.02 Gifts.............................          26          38          38
    00.03 Contributions, Indian health
            facilities......................          27          32          32
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          53          70          70
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          49          69          69
    22.00 New budget authority (gross)......          70          70          70

    [[Page 470]]

    22.10 Resources available from
            recoveries of prior year
            obligations.....................           3
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         122         139         139
    23.95 Total new obligations.............         -53         -70         -70
    24.40 Unobligated balance carried
            forward, end of year............          69          69          69
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.26   Appropriation (trust fund)......          70          70          70
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          83          80          72
    73.10 Total new obligations.............          53          70          70
    73.20 Total outlays (gross).............         -53         -78         -72
    73.45 Recoveries of prior year
            obligations.....................          -3
    74.40 Obligated balance, end of year....          80          72          70
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................          26          28          28
    86.98 Outlays from mandatory balances...          27          50          44
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........          53          78          72
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          70          70          70
    90.00 Outlays...........................          53          78          72
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    92.01 Total investments, start of year:
            Federal securities: Par value...          20          25          25
    92.02 Total investments, end of year:
            Federal securities: Par value...          25          25          25
    ---------------------------------------------------------------------------

                              [Dollars in millions]

                                            2001         2002        2003
    Distribution of budget authority by
        account:
      Gifts.............................          38          38          38
      Contributions, Indian health
        facilities......................          32          32          32
    Distribution of outlays by account:
      Gifts.............................          23          41          38
      Contributions, Indian health
        facilities......................          30          37          34

        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      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    11.1  Personnel compensation: Full-time
            permanent.......................           1           1           1
    21.0  Travel and transportation of
            persons.........................           1           1           1
    22.0  Transportation of things..........                       1           1
    25.1  Advisory and assistance services..                       1           1
    25.2  Other services....................          14          15          15
    25.3  Other purchases of goods and
            services from Government
            accounts........................           1           1           1
    25.4  Operation and maintenance of
            facilities......................           1           1           1
    25.5  Research and development contracts           3           5           5
    25.7  Operation and maintenance of
            equipment.......................           8          10          10
    26.0  Supplies and materials............           1           2           2
    31.0  Equipment.........................           1           2           2
    32.0  Land and structures...............           2           2           2
    41.0  Grants, subsidies, and
            contributions...................          20          28          28
                                               ---------   ---------  ----------
    99.9    Total new obligations...........          53          70          70
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-9971-0-7-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    1001  Total compensable workyears: Full-
            time equivalent employment......          12          12          12
    ---------------------------------------------------------------------------

                         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, [$35,786,000] $49,972,000: Provided, That, of such amount,
    necessary sums are available for providing protective services to the
    Secretary and investigating non-payment of child support cases for which
    non-payment is a Federal offense under 18 U.S.C. 228. (Department of
    Health and Human Services Appropriations Act, 2002; additional
    authorizing legislation required.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0128-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Direct program....................          42          45          50
    09.01 Reimbursable program..............          16          17          12
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          58          62          62
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           1           1           1
    22.00 New budget authority (gross)......          58          62          62
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......          59          63          63
    23.95 Total new obligations.............         -58         -62         -62
    24.40 Unobligated balance carried
            forward, end of year............           1           1           1
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................          42          45          50
          Spending authority from offsetting
              collections:

    68.00   Offsetting collections (cash)...           5          17          12
    68.10   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................          11
                                               ---------   ---------  ----------
    68.90     Spending authority from
                offsetting collections
                (total discretionary).......          16          17          12
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................          58          62          62
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          -6           1           4
    73.10 Total new obligations.............          58          62          62
    73.20 Total outlays (gross).............         -57         -59         -62
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................         -11
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................          18
    74.40 Obligated balance, end of year....           1           4           4
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................          55          58          58
    86.93 Outlays from discretionary
            balances........................           3           1           4
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........          57          59          62
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........         -24         -17         -12
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................         -11
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............          19
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          42          45          50
    90.00 Outlays...........................          34          42          50
    ---------------------------------------------------------------------------

      Budget Authority and Outlays Excluding Full Funding for Federal Retiree
                           Costs (in millions of dollars)

    ----------------------------------------------------------------------------
                                             2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          34          36          40
    90.00 Outlays...........................          26          33          40
    ---------------------------------------------------------------------------

    [[Page 471]]

        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 and
    Medicaid 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)

                                             2001 actual   2002 est.   2003 est.
    Budget Authority:
      Discretionary appropriations..........          42          45          50
      Mandatory (HCFAC Account).............         130         145         160
                                               ---------   ---------  ----------
          Total.............................         172         190         210
    Outlays:
      Discretionary appropriations..........          34          42          50
      Mandatory (HCFAC Account).............         126         145         160
                                               ---------   ---------  ----------
          Total.............................         160         187         210

        This schedule reflects distribution of mandatory funds from the
    HCFAC account in 2002. Actual 2003 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      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------

          Direct obligations:

    11.1    Personnel compensation: Full-
              time permanent................          19          22          24
    12.1    Civilian personnel benefits.....          13          15          16
    21.0    Travel and transportation of
              persons.......................           2           1           2
    23.1    Rental payments to GSA..........           3           3           3
    25.3    Other purchases of goods and
              services from Government
              accounts......................           3           3           4
    26.0    Supplies and materials..........           1
    31.0    Equipment.......................           1           1           1
                                               ---------   ---------  ----------
    99.0      Direct obligations............          42          45          50
    99.0  Reimbursable obligations..........          16          17          12
                                               ---------   ---------  ----------
    99.9    Total new obligations...........          58          62          62
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-0128-0-1-551      2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears: Full-
            time equivalent employment......         285         309         320
        Reimbursable:
    2001  Total compensable workyears: Full-
            time equivalent employment......          59          56          16
        Allocation account:
    3001  Total compensable workyears: Full-
            time equivalent employment......       1,099       1,223       1,305
    ---------------------------------------------------------------------------

                    Allocations Received From Other Accounts

        Note.--Obligations incurred under allocations from other accounts
    are included in the schedules of the parent appropriations as follows:
    Centers for Medicare and Medicaid Services ``Health Care Fraud and Abuse
    Control Account.''

                          GENERAL FUND RECEIPT ACCOUNTS

                               (in millions of dollars)

    ----------------------------------------------------------------------------
                                             2001 actual   2002 est.   2003 est.
    ----------------------------------------------------------------------------
    Offsetting receipts from the public:
      75-310700  Federal share of child
        support collections.................         856         765         789
        Legislative proposal, subject to
          PAYGO.............................                                   7
                                               ---------   ---------  ----------
    General Fund Offsetting receipts from
     the public.............................         856         765         796
    ----------------------------------------------------------------------------
    Intragovernmental payments:
      20-310530  Quinquennial adjustment for
        military service credits, Federal
        hospital insurance..................       1,177
                                               ---------   ---------  ----------
    General Fund Intragovernmental payments.       1,177
    ---------------------------------------------------------------------------

                               GENERAL PROVISIONS

        Sec. 201. Funds appropriated in this title shall be available for
    not to exceed $37,000 for official reception and representation expenses
    when specifically approved by the Secretary.
        Sec. 202. The Secretary shall make available through assignment not
    more than 60 employees of the Public Health Service to assist in child
    survival activities and to work in AIDS programs through and with funds
    provided by the Agency for International Development, the United Nations
    International Children's Emergency Fund or the World Health
    Organization.
        Sec. 203. None of the funds appropriated under this Act may be used
    to implement section [399L(b)] 399F(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, the Agency for Healthcare Research and
    Quality, 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 [I] 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.]
        Sec. [206] 205. Notwithstanding section 241(a) of the Public Health
    Service Act, such portion as the Secretary shall determine, but not more
    than 1.25 percent, of any amounts appropriated for programs authorized
    under said 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. [207] 206. Not to exceed [1] 3 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 or any other Act
    may be transferred between appropriations, but no such appropriation
    shall be increased by more than [3] 10 percent by any such transfer:
    Provided, [That an appropriation may be increased by up to an additional
    2 percent subject to approval by the House and Senate Committees on
    Appropriations: Provided further,] That the Appropriations Committees of
    both Houses of Congress are notified at least 15 days in advance of any
    transfer.
        Sec. [208] 207. The Director of the National Institutes of Health,
    jointly with the Director of the Office of AIDS Research, may transfer
    up to 3 percent among institutes, centers, and divisions from the total
    amounts identified by these two Directors as funding for research
    pertaining to the human immunodeficiency virus: Provided, That the
    Congress is promptly notified of the transfer.
        Sec. [209] 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. [210] 209. 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. [211] 210. None of the funds appropriated by this Act
    (including funds appropriated to any trust fund) may be used to carry

    [[Page 472]]

    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] 211. Notwithstanding any other provision of law, no
    provider of services under title X of the Public Health Service Act
    shall be exempt from any State law requiring notification or the
    reporting of child abuse, child molestation, sexual abuse, rape, or
    incest.
        [Sec. 213. 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,
                1999, 2000, and 2001'' and inserting ``1997, 1998, 1999,
                2000, 2001, and 2002''; and
                    (B) in subsection (e), by striking ``October 1, 2001''
                each place it appears and inserting ``October 1, 2002''; and
            (2) in section 599E (8 U.S.C. 1255 note) in subsection (b)(2),
        by striking ``September 30, 2001'' and inserting ``September 30,
        2002''.]
        Sec. [214] 212. (a) Except as provided by subsection (e) 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 by May 1, [2002] 2003 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) 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.
        (c) The State is to maintain State expenditures in fiscal year
    [2002] 2003 for tobacco prevention programs and for compliance
    activities at a level that is not less than the level of such
    expenditures maintained by the State for fiscal year [2001] 2002, and
    adding to that level the additional funds for tobacco compliance
    activities required under subsection (a). The State is to submit a
    report to the Secretary on all fiscal year [2001] 2002 State
    expenditures and all fiscal year [2002] 2003 obligations for tobacco
    prevention and compliance activities by program activity by July 31,
    [2002] 2003.
        (d) The Secretary shall exercise discretion in enforcing the timing
    of the State obligation of the additional funds required by the
    certification described in subsection (a) as late as July 31, [2002]
    2003.
        (e) None of the funds appropriated by this Act may be used to
    withhold substance abuse funding pursuant to section 1926 from a
    territory that receives less than $1,000,000.
        Sec. [215] 213. In order for the Centers for Disease Control and
    Prevention to carry out international health activities, including HIV/
    AIDS and other infectious disease, chronic and environmental disease,
    and other health activities abroad during fiscal year [2002] 2003, the
    Secretary of Health and Human Services is authorized to--
            (1) utilize the authorities contained in subsection 2(c) of the
        State Department Basic Authorities Act of 1956, as amended; and
            (2) utilize the authorities contained in 22 U.S.C. 291 and 292
        and directly or through contract or cooperative agreement to lease,
        alter or renovate facilities in foreign countries, to carry out
        programs supported by this appropriation notwithstanding PHS Act
        section 307.
    In exercising the authority set forth in paragraphs (1) and (2), the
    Secretary of Health and Human Services shall consult with the Department
    of State to assure that planned activities are within the legal
    strictures of the State Department Basic Authorities Act of 1956, as
    amended, and other applicable parts of title 22, United States Code.
        Sec. [216] 214. The Division of Federal Occupational Health may
    utilize personal services contracting to employ professional management/
    administrative and occupational health professionals.
        [Sec. 217. Notwithstanding any other provision of law relating to
    vacancies in offices for which appointments must be made by the
    President, including any time limitation on serving in an acting
    capacity, the Acting Director of the National Institutes of Health as of
    January 12, 2000, may serve in that position until a new Director of the
    National Institutes of Health is confirmed by the Senate.]
        [Sec. 218. Section 582 of the Public Health Service Act (42 U.S.C.
    290hh-1(f)) is amended by adding at the end the following:
        ``(g) Short Title.--This section may be cited as the `Donald J.
    Cohen National Child Traumatic Stress Initiative'.''.]
        Sec. 215. Of funds appropriated in this Act and awarded to a State
    under the Public Health Service Act and Title V of the Social Security
    Act, each State may transfer up to 20 percent of such funds between such
    grants: Provided, That funds for a single grant shall not be increased
    by more than 50 percent above the original grant award amount: Provided
    further, That a State exercising this transfer authority must notify the
    Secretary of Health and Human Services in writing at least 30 days prior
    to implementing such a transfer: Provided further, That the Secretary of
    Health and Human Services shall issue guidance to implement this
    transfer authority.
        Sec. 216. With the funds appropriated to the National Institutes of
    Health in this Act, NIH is authorized to obligate in fiscal year 2003
    the full multi-year cost of a grant or contract that is awarded in that
    year, and any funds which may be deobligated subsequently shall remain
    available until expended for the same purposes. (Department of Health
    and Human Services Appropriations Act, 2002.)