[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)
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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..............
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Program and Financing (in millions of dollars)
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Identification code 75-9911-0-1-554 2001 actual 2002 est. 2003 est.
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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
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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
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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
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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
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[[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
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[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
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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)
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Identification code 75-9911-0-1-554 2001 actual 2002 est. 2003 est.
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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
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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
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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)
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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
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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
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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
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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
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Personnel Summary
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Identification code 75-4309-0-3-554 2001 actual 2002 est. 2003 est.
----------------------------------------------------------------------------
2001 Total compensable workyears: Full-
time equivalent employment...... 35 38 38
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HEALTH RESOURCES AND SERVICES ADMINISTRATION
Federal Funds
General and special funds:
Health Resources and Services
For carrying out titles II, III, 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.)