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


                     THE BUDGET FOR FISCAL YEAR 2003


 
                 DEPARTMENT OF HEALTH AND HUMAN SERVICES



                      FOOD AND DRUG ADMINISTRATION

                              Federal Funds

General and special funds:

                          Salaries and Expenses

    For necessary expenses of the Food and Drug Administration, 
including hire and purchase of passenger motor vehicles; for payment of 
space rental and related costs pursuant to Public Law 92-313 for 
programs and activities of the Food and Drug Administration which are 
included in this Act; for rental of special purpose space in the 
District of Columbia or elsewhere; and for miscellaneous and emergency 
expenses of enforcement activities, authorized and approved by the 
Secretary and to be accounted for solely on the Secretary's certificate, 
not to exceed $25,000; [$1,345,386,000, of which not to exceed 
$161,716,000 to be derived from prescription drug user fees authorized 
by 21 U.S.C. 379(h), including any such fees assessed prior to the 
current fiscal year but credited during the current year, in accordance 
with section 736(g)(4), shall be credited to this appropriation and 
remain available until expended: Provided, That fees derived from 
applications received during fiscal year 2002 shall be subject to the 
fiscal year 2002 limitation: Provided further, That none of these funds 
shall be used to develop, establish, or operate any program of user fees 
authorized by 31 U.S.C. 9701: Provided further, That of the total amount 
appropriated: (1) $312,049,000 shall be for the Center for Food Safety 
and Applied Nutrition and related field activities in the Office of 
Regulatory Affairs; (2) $352,647,000 shall be for the Center for Drug 
Evaluation and Research and related field activities in the Office of 
Regulatory Affairs, of which no less than $13,207,000 shall be available 
for grants and contracts awarded under section 5 of the Orphan Drug Act 
(21 U.S.C. 360ee); (3) $155,875,000 shall be for the Center for 
Biologics Evaluation and Research and for related field activities in 
the Office of Regulatory Affairs; (4) $82,967,000 shall be for the 
Center for Veterinary Medicine and for related field activities in the 
Office of Regulatory Affairs; (5) $179,521,000 shall be for the Center 
for Devices and Radiological Health and for related field activities in 
the Office of Regulatory Affairs; (6) $37,082,000 shall be for the 
National Center for Toxicological Research; (7) $29,798,000 shall be for 
Rent and Related activities, other than the amounts paid to the General 
Services Administration, of which $4,000,000 for costs related to 
occupancy of new facilities at White Oak, Maryland, shall remain 
available until September 30, 2003; (8) $105,116,000 shall be for 
payments to the General Services Administration for rent and related 
costs; and (9) $90,331,000 shall be for other activities, including the 
Office of the Commissioner; the Office of Management and Systems; the 
Office of the Senior Associate Commissioner; the Office of International 
and Constituent Relations; the Office of Policy, Legislation, and 
Planning; and central services for these offices: Provided further, That 
funds may be transferred from one specified activity to another with the 
prior approval of the Committees on Appropriations of both Houses of 
Congress] $1,424,136,000.
    In addition, mammography user fees authorized by 42 U.S.C. 263(b) 
may be credited to this account, to remain available until expended.
    In addition, export certification user fees authorized by 21 U.S.C. 
381 may be credited to this account, to remain available until expended. 
(Agriculture, Rural Development, Food and Drug Administration, and 
Related Agencies Appropriations Act, 2002; additional authorizing 
legislation required.)

                        Buildings and Facilities

    For plans, construction, repair, improvement, extension, alteration, 
and purchase of fixed equipment or facilities of or used by the Food and 
Drug Administration, where not otherwise provided, [$34,281,000] 
$8,000,000, to remain available until expended (7 U.S.C. 2209b). 
(Agriculture, Rural Development, Food and Drug Administration, and 
Related Agencies Appropriations Act, 2002.)
    [For emergency expenses to respond to the September 11, 2001, 
terrorist attacks on the United States, for ``Salaries and Expenses'', 
$151,100,000, to remain available until expended, to be obligated from 
amounts made available in Public Law 107-38.] (Emergency Supplemental 
Act, 2002.)

              Unavailable Collections (in millions of dollars)

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

               Program and Financing (in millions of dollars)

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

    Obligations by program activity:
      Direct program:

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

[[Page 428]]



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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

                        [In millions of dollars]

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

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

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

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

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

               Object Classification (in millions of dollars)

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

      Direct obligations:

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

                              Personnel Summary

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

                                

                          Salaries and Expenses

              (Legislative proposal, not subject to PAYGO)

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

[[Page 429]]

               Object Classification (in millions of dollars)

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

                              Personnel Summary

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

                                

Public enterprise funds:

           Revolving Fund for Certification and Other Services

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

               Object Classification (in millions of dollars)

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

                              Personnel Summary

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

                                


 
              HEALTH RESOURCES AND SERVICES ADMINISTRATION

                              Federal Funds

General and special funds:

                      Health Resources and Services

    For carrying out titles II, III, IV, VII, VIII, X, XII, XIX, and 
XXVI of the Public Health Service Act, section 427(a) of the Federal 
Coal Mine Health and Safety Act, title V (including section 510), and 
sections 1128E and 1820 of the Social Security Act, the Health Care 
Quality Improvement Act of 1986, as amended, the Native Hawaiian Health 
Care Act of 1988, as amended, the Cardiac Arrest Survival Act of 2000, 
and the Poison Control Center Enhancement and Awareness Act, 
[$6,081,237,000, of which $311,978,000 shall be available for 
construction and renovation of health care and other facilities, and] 
$5,381,836,000, of which [$40,000,000] $25,000,000 from general 
revenues, notwithstanding section 1820(j) of the Social Security Act, 
shall be available for carrying out the Medicare rural hospital 
flexibility grants program under section 1820 of such Act: Provided, 
That of the funds made available under this heading, $250,000 shall be 
available until expended for facilities renovations at the Gillis W. 
Long Hansen's Disease Center: Provided further, That in addition to fees 
authorized by section 427(b) of the Health Care Quality Improvement Act 
of 1986, fees shall be collected for the full disclosure of information 
under the Act sufficient to recover the full costs of operating the 
National Practitioner Data Bank, and shall remain available until 
expended to carry out that Act: Provided further, That fees collected 
for the full disclosure of information under the ``Health Care Fraud and 
Abuse Data Collection Program'', authorized by section 1128E(d)(2) of 
the Social Security Act, shall be sufficient to recover the full costs 
of operating the program, and shall remain available until expended to 
carry out that Act: Provided further, That no more than [$15,000,000] 
$25,000,000 is available for carrying out the provisions of Public Law 
104-73: Provided further, That of the funds made available under this 
heading, [$265,085,000] $265,877,000 shall be for the program under 
title X of the Public Health Service Act to provide for voluntary family 
planning projects: Provided further, That amounts provided to said 
projects under such title shall not be expended for abortions, that all 
pregnancy counseling shall be nondirective, and that such amounts shall 
not be expended for any activity (including the publication or 
distribution of literature) that in any way tends to promote public 
support or opposition to any legislative proposal or candidate for 
public office: Provided further, That $639,000,000 shall be for State 
AIDS Drug Assistance Programs authorized by section 2616 of the Public 
Health Service Act: [Provided further, That of the amount provided under 
this heading, $80,000 shall be for the Wausau Health Foundation in 
Wausau, Wisconsin, for a survey and analysis of local health 
professionals' career paths to better understand entry into and exit 
from health professions, $100,000 shall be for the University of San 
Diego Institute for the Advancement of Health Policy to assess through 
teaching, research and delivery of services the impact of public policy 
on families from vulnerable populations, $200,000 shall be for the Luna 
County, New Mexico and the Columbus Volunteer Fire Department to provide 
emergency medical services to immigrants, $350,000 shall be for the 
Clinical Pharmacy Training Program at the University of Hawaii at Hilo, 
$475,000 shall be for the American Federation of Negro Affairs, $500,000 
shall be for the University of Washington Center for Health Workforce 
Studies in Seattle, Washington, for a demonstration project to collect 
and analyze health workforce data, $800,000 shall be for the University 
of Iowa for the training of Certified Registered Nurse Anesthetists, 
$1,000,000 shall be for the Washington Health Foundation for a 
comprehensive demonstration project on improving nurse retention, and 
$1,100,000 shall be for the Iowa Department of Public Health to create a 
Center for Health Care Workforce Shortage: Provided further, That, 
notwithstanding section 502(a)(1) of the Social Security Act, not to 
exceed $115,236,000 is available for carrying out special projects of 
regional and national significance pursuant to section 501(a)(2) of such 
Act, of which $50,000 is for the Center for Great Expectations, 
Somerville, New Jersey to provide prenatal health care, education and 
counseling for pregnant teens, $565,000 is for the Milwaukee Health 
Department for a pilot program providing health care services to at-risk 
children in day care, and $4,000,000 is for the Columbia Hospital for 
Women Medical Center in Washington, D.C., to support community outreach 
programs for women:] Provided further, That [$10,000,000] $73,044,000 is 
available for special projects of regional and national

[[Page 430]]

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

               Program and Financing (in millions of dollars)

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

    Obligations by program activity:
      Direct program:

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

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

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

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

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

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

[[Page 431]]

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

    Administrative expense data:
351001Administrative expenses...........           1           1           1
358001Outlays from balances.............
359001Outlays for administrative 
        expenses........................           1           1           1
---------------------------------------------------------------------------

    Activities displayed here support categorical health resources and 
services grants and the Medical malpractice claims fund, which pays 
malpractice claims filed against employees of federally-supported health 
centers. The 2003 Budget includes a Healthy Communities Innovation 
Initiative that is an innovative service demonstration program to 
prevent diabetes, asthma, and obesity at the community level.

               Object Classification (in millions of dollars)

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

      Direct obligations:

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

                              Personnel Summary

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

                                

                      Health Resources and Services

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

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

    Obligations by program activity:
      Direct program:

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

                                

                      Vaccine Injury Compensation 

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

[[Page 432]]



    Offsets:
      Against gross budget authority and outlays:

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

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

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

                                

             Payment to the Ricky Ray Hemophilia Relief Fund

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

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

                                

Credit accounts:

             Health Center Guaranteed Loan Financing Account

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4442-0-3-551      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------

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

    New financing authority (gross), detail:
      Discretionary:

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

    Offsets:
      Against gross financing authority and 
          financing disbursements:

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

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

             Status of Guaranteed Loans (in millions of dollars)

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

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

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

    P.L. 104-299 and P.L. 104-208 authorize HRSA to guarantee up to $80 
million in private loans to health centers for the costs of developing 
and operating managed care networks or plans and for the construction, 
renovation and modernization of medical facilities. This program has 
used $21 million of its available $160 million in loan guarantee 
authority, HRSA plans to use approximately $38 million of the remaining 
existing loan guarantee limit over 2002 and 2003. As required by the 
Federal Credit Reform Act of 1990, this financing account records all 
cash flows to and from the Government resulting from the Health center 
loan guarantee program. The program account for this activity is 
displayed in the Health resources and services account (75-0350) as a 
line in the program and financing schedule.

                             Balance Sheet (in millions of dollars)

-----------------------------------------------------------------------------------------------
Identification code   75-4442-0-3-551    2000 actual    2001 actual     2002 est.      2003 est.
-----------------------------------------------------------------------------------------------
    ASSETS:
1101  Federal assets: Fund balances with 
        Treasury........................           4              4             1              1
                                        ------------ --------------  ------------  -------------
1999    Total assets....................           4              4             1              1
    LIABILITIES:
2204  Non-Federal liabilities: 
        Liabilities for loan guarantees.           4              4             1              1
                                        ------------ --------------  ------------  -------------
2999    Total liabilities...............           4              4             1              1
    NET POSITION:
3300  Cumulative results of operations..
                                        ------------ --------------  ------------  -------------
3999    Total net position..............
                                        ------------ --------------  ------------  -------------
4999  Total liabilities and net position           4              4             1              1
-----------------------------------------------------------------------------------------------

[[Page 433]]



                                

            Health Education Assistance Loans Program Account

    Such sums as may be necessary to carry out the purpose of the 
program, as authorized by title VII of the Public Health Service Act, as 
amended. For administrative expenses to carry out the guaranteed loan 
program, including section 709 of the Public Health Service Act, 
[$3,792,000] $3,914,000. (Department of Health and Human Services 
Appropriations Act, 2002.)

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

                          (in millions of dollars)

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

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

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

               Object Classification (in millions of dollars)

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

      Direct obligations:

11.1    Personnel compensation: Full-
          time permanent................           2           2           2
25.3    Other purchases of goods and 
          services from Government 
          accounts......................           1           1           1
                                           ---------   ---------  ----------
99.0      Direct obligations............           3           3           3
99.5  Below reporting threshold.........           1           1           1
                                           ---------   ---------  ----------
99.9    Total new obligations...........           4           4           4
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0340-0-1-552      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------
1001  Total compensable workyears: Full-
        time equivalent employment......          28          22          22
---------------------------------------------------------------------------

                                

           Health Education Assistance Loans Financing Account

               Program and Financing (in millions of dollars)

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

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

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

    New financing authority (gross), detail:
      Discretionary:

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

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

    Offsets:
      Against gross financing authority and 
          financing disbursements:

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

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

[[Page 434]]



             Status of Guaranteed Loans (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-4304-0-3-552      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------
    Position with respect to appropriations act 
                limitation on commitments:
2111  Limitation on guaranteed loans 
        made by private lenders.........
                                           ---------   ---------  ----------
2150    Total guaranteed loan 
          commitments...................
----------------------------------------------------------------------------

    Cumulative balance of guaranteed loans 
                outstanding:
2210  Outstanding, start of year........       1,535       1,513       1,478
2251  Repayments and prepayments........          -5          -6          -7
      Adjustments:

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

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

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

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

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

                             Balance Sheet (in millions of dollars)

-----------------------------------------------------------------------------------------------
Identification code   75-4304-0-3-552    2000 actual    2001 actual     2002 est.      2003 est.
-----------------------------------------------------------------------------------------------
    ASSETS:
1101  Federal assets: Fund balances with 
        Treasury........................         301            321           323            324
1206  Non-Federal assets: Receivables, 
        net.............................          42             51            51             51
                                        ------------ --------------  ------------  -------------
1999    Total assets....................         343            372           374            375
    LIABILITIES:
2204  Non-Federal liabilities: 
        Liabilities for loan guarantees.         343            372           374            375
                                        ------------ --------------  ------------  -------------
2999    Total liabilities...............         343            372           374            375
    NET POSITION:
3300  Cumulative results of operations..
                                        ------------ --------------  ------------  -------------
3999    Total net position..............
                                        ------------ --------------  ------------  -------------
4999  Total liabilities and net position         343            372           374            375
-----------------------------------------------------------------------------------------------

                                

          Health Education Assistance Loans Liquidating Account

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

             Status of Guaranteed Loans (in millions of dollars)

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

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

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

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

2310    Outstanding, start of year......         500         497         464
2331    Disbursements for guaranteed 
          loan claims...................          12           8           7
2351    Repayments of loans receivable..         -17         -17         -17
2361    Write-offs of loans receivable..         -24         -24         -24
2364    Other adjustments, net..........          26
                                           ---------   ---------  ----------
2390      Outstanding, end of year......         497         464         430
---------------------------------------------------------------------------
    Note.--Includes carryover commitments from prior years.
    Note.--The adjustment to loans receivable represents interest, which 
had not previously been reflected in cumulative outstanding balances.

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

                        Statement of Operations (in millions of dollars)

-----------------------------------------------------------------------------------------------
Identification code   75-4305-0-3-552    2000 actual    2001 actual     2002 est.      2003 est.
-----------------------------------------------------------------------------------------------
0101  Revenue...........................          28             14            30             27
0102  Expense...........................         -28            -14           -30            -27
                                        ------------ --------------  ------------  -------------
0105  Net income or loss (-)............
-----------------------------------------------------------------------------------------------

                             Balance Sheet (in millions of dollars)

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

[[Page 435]]

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

               Object Classification (in millions of dollars)

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

                                

               Medical Facilities Guarantee and Loan Fund

            federal interest subsidies for medical facilities

               Program and Financing (in millions of dollars)

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

               Status of Direct Loans (in millions of dollars)

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

             Status of Guaranteed Loans (in millions of dollars)

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

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

    Title VII, part C of the Public Health Service Act established a 
revolving fund from which health professions schools could borrow in 
order to provide loans to their students.

    Public Law 89-751, the Allied Health Professions Personnel Training 
Act of 1966, amended the Public Health Service Act to authorize the 
Federal Government to pay the difference between the interest paid by 
students to the schools and the interest payable by the schools to the 
Government National Mortgage Association (GNMA) and the Treasury.

    Title VI and subsequently title XVI of the Public Health Service Act 
established a loan and loan guarantee fund for medical facilities with a 
maximum amount allowable for the Government's liability. Direct loans 
were made available for public facilities and guaranteed loans for 
private, nonprofit facilities. Funds under this authority were 
established in the amount of $50 million for use in fulfilling 
guarantees in event of default, $30 million as a revolving fund for 
direct loans and an amount for interest subsidy payments on guaranteed 
loans. Unobligated balances will be used to pay defaults and interest 
subsidy payments.

                                

  

                               Trust Funds

             Vaccine Injury Compensation Program Trust Fund

    For payments from the Vaccine Injury Compensation Program Trust 
Fund, such sums as may be necessary for claims associated with vaccine-
related injury or death with respect to vaccines administered after 
September 30, 1988, pursuant to subtitle 2 of title XXI of the Public 
Health Service Act, to remain available until expended: Provided, That 
for necessary administrative expenses, not to exceed [$2,992,000] 
$2,991,000 shall be available from the Trust Fund to the Secretary of 
Health and Human Services. (Department of Health and Human Services 
Appropriations Act, 2002.)

              Unavailable Collections (in millions of dollars)

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

               Program and Financing (in millions of dollars)

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

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

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

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

[[Page 436]]



    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

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

    The Vaccine improvement program was established pursuant to Public 
Law 99-660 and Public Law 100-203, and serves as a source of funds to 
pay claims for compensation for vaccine related injury or death. This 
account reflects payments for claims for vaccine related injury or death 
occurring after October 1, 1988.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8175-0-7-551      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------
25.2  Other services....................           3           3           3
25.3  Other purchases of goods and 
        services from Government 
        accounts........................           7           7           7
42.0  Insurance claims and indemnities..          79          83          86
                                           ---------   ---------  ----------
99.9    Total new obligations...........          89          93          96
---------------------------------------------------------------------------

                                

                    Ricky Ray Hemophilia Relief Fund

              Unavailable Collections (in millions of dollars)

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

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

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

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

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8074-0-7-551      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------
11.1  Personnel compensation: Full-time 
        permanent.......................           2           2           2
25.2  Other services....................           1           1           1
                                           ---------   ---------  ----------
99.0      Limitation acct--direct 
            obligations.................           3           3           3
---------------------------------------------------------------------------

                              Personnel Summary

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

                                


 
                          INDIAN HEALTH SERVICE

                              Federal Funds

General and special funds:

                         Indian Health Services

    For expenses necessary to carry out the Act of August 5, 1954 (68 
Stat. 674), the Indian Self-Determination Act, the Indian Health Care 
Improvement Act, and titles II and III of the Public Health Service Act 
with respect to the Indian Health Service, [$2,389,614,000] 
$2,513,668,000, together with payments received during the fiscal year 
pursuant to 42 U.S.C. 238(b) for services furnished by the Indian Health 
Service: Provided, That funds made available to tribes and tribal 
organizations through contracts, grant agreements, or any other 
agreements or compacts authorized by the Indian Self-Determination and 
Education Assistance Act of 1975 (25 U.S.C. 450), shall be deemed to be 
obligated at the time of the grant or contract award and thereafter 
shall remain available to the tribe or tribal organization without 
fiscal year limitation: Provided further, That [$15,000,000] up to 
$18,000,000 shall remain available until expended, for the Indian 
Catastrophic Health Emergency Fund: Provided further, That 
[$445,776,000] $450,130,000 for contract medical care shall remain 
available for obligation until September 30, [2003] 2004: Provided 
further, That of the funds provided,

[[Page 437]]

up to [$22,000,000] $25,000,000 shall be used to carry out the loan 
repayment program under section 108 of the Indian Health Care 
Improvement Act: Provided further, That funds provided in this Act may 
be used for 1-year contracts and grants which are to be performed in 2 
fiscal years, so long as the total obligation is recorded in the year 
for which the funds are appropriated: Provided further, That the amounts 
collected by the Secretary of Health and Human Services under the 
authority of title IV of the Indian Health Care Improvement Act shall 
remain available until expended for the purpose of achieving compliance 
with the applicable conditions and requirements of titles XVIII and XIX 
of the Social Security Act (exclusive of planning, design, or 
construction of new facilities): Provided further, That funding 
contained herein, and in any earlier appropriations Acts for scholarship 
programs under the Indian Health Care Improvement Act (25 U.S.C. 1613) 
shall remain available for obligation until September 30, [2003] 2004: 
Provided further, That amounts received by tribes and tribal 
organizations under title IV of the Indian Health Care Improvement Act 
shall be reported and accounted for and available to the receiving 
tribes and tribal organizations until expended: Provided further, That, 
notwithstanding any other provision of law, of the amounts provided 
herein, not to exceed [$268,234,000] $270,734,000 shall be for payments 
to tribes and tribal organizations for contract or grant support costs 
associated with contracts, grants, self-governance compacts or annual 
funding agreements between the Indian Health Service and a tribe or 
tribal organization pursuant to the Indian Self-Determination Act of 
1975, as amended, prior to or during fiscal year [2002] 2003, of which 
not to exceed [$20,000,000] $2,500,000 may be used for contract support 
costs associated with new or expanded self-determination contracts, 
grants, self-governance compacts or annual funding agreements: Provided 
further, That funds available for the Indian Health Care Improvement 
Fund may be used, as needed, to carry out activities typically funded 
under the Indian Health Facilities account. (Department of the Interior 
and Related Agencies Appropriations Act, 2002; additional authorizing 
legislation required.)

               Program and Financing (in millions of dollars)

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

    Obligations by program activity:
      Direct program:

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

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

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

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

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

               Object Classification (in millions of dollars)

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

      Direct obligations:

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

[[Page 438]]

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

                              Personnel Summary

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

                                

                        Indian Health Facilities

    For construction, repair, maintenance, improvement, and equipment of 
health and related auxiliary facilities, including quarters for 
personnel; preparation of plans, specifications, and drawings; 
acquisition of sites, purchase and erection of modular buildings, and 
purchases of trailers; and for provision of domestic and community 
sanitation facilities for Indians, as authorized by section 7 of the Act 
of August 5, 1954 (42 U.S.C. 2004a), the Indian Self-Determination Act, 
and the Indian Health Care Improvement Act, and for expenses necessary 
to carry out such Acts and titles II and III of the Public Health 
Service Act with respect to environmental health and facilities support 
activities of the Indian Health Service, [$369,487,000] $370,475,000, to 
remain available until expended: Provided, That notwithstanding any 
other provision of law, funds appropriated for the planning, design, 
construction or renovation of health facilities for the benefit of an 
Indian tribe or tribes may be used to purchase land for sites to 
construct, improve, or enlarge health or related facilities: [Provided 
further, That from the funds appropriated herein, $5,000,000 shall be 
designated by the Indian Health Service as a contribution to the Yukon-
Kuskokwim Health Corporation (YKHC) to continue a priority project for 
the acquisition of land, planning, design and construction of 79 staff 
quarters in the Bethel service area, pursuant to the negotiated project 
agreement between the YKHC and the Indian Health Service: Provided 
further, That this project shall not be subject to the construction 
provisions of the Indian Self-Determination and Education Assistance Act 
and shall be removed from the Indian Health Service priority list upon 
completion: Provided further, That the Federal Government shall not be 
liable for any property damages or other construction claims that may 
arise from YKHC undertaking this project: Provided further, That the 
land shall be owned or leased by the YKHC and title to quarters shall 
remain vested with the YKHC: Provided further, That $5,000,000 shall 
remain available until expended for the purpose of funding up to two 
joint venture health care facility projects authorized under the Indian 
Health Care Improvement Act, as amended: Provided further, That 
priority, by rank order, shall be given to tribes with outpatient 
projects on the existing Indian Health Services priority list that have 
Service-approved planning documents, and can demonstrate by March 1, 
2002, the financial capability necessary to provide an appropriate 
facility: Provided further, That joint venture funds unallocated after 
March 1, 2002, shall be made available for joint venture projects on a 
competitive basis giving priority to tribes that currently have no 
existing Federally-owned health care facility, have planning documents 
meeting Indian Health Service requirements prepared for approval by the 
Service and can demonstrate the financial capability needed to provide 
an appropriate facility: Provided further, That the Indian Health 
Service shall request additional staffing, operation and maintenance 
funds for these facilities in future budget requests:] Provided further, 
That not to exceed $500,000 shall be used by the Indian Health Service 
to purchase TRANSAM equipment from the Department of Defense for 
distribution to the Indian Health Service and tribal facilities: 
Provided further, That not to exceed $500,000 shall be used by the 
Indian Health Service to obtain ambulances for the Indian Health Service 
and tribal facilities in conjunction with an existing interagency 
agreement between the Indian Health Service and the General Services 
Administration: Provided further, That not to exceed $500,000 shall be 
placed in a Demolition Fund, available until expended, to be used by the 
Indian Health Service for demolition of Federal buildings[: Provided 
further, That notwithstanding the provisions of title III, section 306, 
of the Indian Health Care Improvement Act (Public Law 94-437, as 
amended), construction contracts authorized under title I of the Indian 
Self-Determination and Education Assistance Act of 1975, as amended, may 
be used rather than grants to fund small ambulatory facility 
construction projects: Provided further, That if a contract is used, the 
IHS is authorized to improve municipal, private, or tribal lands, and 
that at no time, during construction or after completion of the project 
will the Federal Government have any rights or title to any real or 
personal property acquired as a part of the contract: Provided further, 
That notwithstanding any other provision of law or regulation, for 
purposes of acquiring sites for a new clinic and staff quarters in St. 
Paul Island, Alaska, the Secretary of Health and Human Services may 
accept land donated by the Tanadgusix Corporation]. (Department of the 
Interior and Related Agencies Appropriations Act, 2002; additional 
authorizing legislation required.)

              Unavailable Collections (in millions of dollars)

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

               Program and Financing (in millions of dollars)

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

    Obligations by program activity:
      Direct program:

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

[[Page 439]]

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

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

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

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

    The Indian health facilities account supports construction, repair 
and improvement, equipment, and environmental health and facilities 
support for the Indian health services.

               Object Classification (in millions of dollars)

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

      Direct obligations:

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

                              Personnel Summary

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

                                

            Administrative Provisions, Indian Health Service

    Appropriations in this Act to the Indian Health Service shall be 
available for services as authorized by 5 U.S.C. 3109 but at rates not 
to exceed the per diem rate equivalent to the maximum rate payable for 
senior-level positions under 5 U.S.C. 5376; hire of passenger motor 
vehicles and aircraft; purchase of medical equipment; purchase of 
reprints; purchase, renovation and erection of modular buildings and 
renovation of existing facilities; payments for telephone service in 
private residences in the field, when authorized under regulations 
approved by the Secretary; and for uniforms or allowances [therefore] 
therefor as authorized by 5 U.S.C. 5901-5902; and for expenses of 
attendance at meetings which are concerned with the functions or 
activities for which the appropriation is made or which will contribute 
to improved conduct, supervision, or management of those functions or 
activities.
    In accordance with the provisions of the Indian Health Care 
Improvement Act, non-Indian patients may be extended health care at all 
tribally administered or Indian Health Service facilities, subject to 
charges, and the proceeds along with funds recovered under the Federal 
Medical Care Recovery Act (42 U.S.C. 2651-2653) shall be credited to the 
account of the facility providing the service and shall be available 
without fiscal year limitation. Notwithstanding any other law or 
regulation, funds transferred from the Department of Housing and Urban 
Development to the Indian Health Service shall be administered under 
Public Law 86-121 (the Indian Sanitation Facilities Act) and Public Law 
93-638, as amended.
    Funds appropriated to the Indian Health Service in this Act, except 
those used for administrative and program direction purposes, shall not 
be subject to limitations directed at curtailing Federal travel and 
transportation.
    Notwithstanding any other provision of law, funds previously or 
herein made available to a tribe or tribal organization through a 
contract, grant, or agreement authorized by title I or title III of the 
Indian Self-Determination and Education Assistance Act of 1975 (25 
U.S.C. 450), may be deobligated and reobligated to a self-determination 
contract under title I, or a self-governance agreement under title III 
of such Act and thereafter shall remain available to the tribe or tribal 
organization without fiscal year limitation.
    None of the funds made available to the Indian Health Service in 
this Act shall be used to implement the final rule published in the 
Federal Register on September 16, 1987, by the Department of Health and 
Human Services, relating to the eligibility for the health care services 
of the Indian Health Service until the Indian Health Service has 
submitted a budget request reflecting the increased costs associated 
with the proposed final rule, and such request has been included in an 
appropriations Act and enacted into law.
    [Funds made available in this Act are to be apportioned to the 
Indian Health Service as appropriated in this Act, and accounted for in 
the appropriation structure set forth in this Act.]
    With respect to functions transferred by the Indian Health Service 
to tribes or tribal organizations, the Indian Health Service is 
authorized to provide goods and services to those entities, on a 
reimbursable basis, including payment in advance with subsequent 
adjustment. The reimbursements received therefrom, along with the funds 
received from those entities pursuant to the Indian Self-Determination 
Act, may be credited to the same or subsequent appropriation account 
which provided the funding. Such amounts shall remain available until 
expended.
    Reimbursements for training, technical assistance, or services 
provided by the Indian Health Service will contain total costs, 
including direct, administrative, and overhead associated with the 
provision of goods, services, or technical assistance.
    The appropriation structure for the Indian Health Service may not be 
altered without advance [approval of] notice submitted to the House and 
Senate Committees on Appropriations. (Department of the Interior and 
Related Agencies Appropriations Act, 2002.)

[[Page 440]]

                                


 
               CENTERS FOR DISEASE CONTROL AND PREVENTION

                              Federal Funds

General and special funds:

                 Disease Control, Research, and Training

    To carry out titles II, III, VII, XI, XV, XVII, XIX, XXI, and XXVI 
of the Public Health Service Act, sections 101, 102, 103, 201, 202, 203, 
301, and 501 of the Federal Mine Safety and Health Act of 1977, sections 
20, 21, and 22 of the Occupational Safety and Health Act of 1970, title 
IV of the Immigration and Nationality Act, and section 501 of the 
Refugee Education Assistance Act of 1980; including insurance of 
official motor vehicles in foreign countries; and hire, maintenance, and 
operation of aircraft, [$4,293,151,000, of which $250,000,000 shall 
remain available until expended for equipment and construction and 
renovation of facilities, and] $3,931,742,000, of which $143,763,000 for 
international HIV/AIDS shall remain available until September 30, [2003] 
2004, and in addition, such sums as may be derived from authorized user 
fees, which shall be credited to this account: Provided, That in 
addition to amounts provided herein, up to [$23,286,000] $46,982,000 
shall be available from amounts available under section 241 of the 
Public Health Service Act to carry out the National Center for Health 
Statistics surveys: Provided further, That none of the funds made 
available for injury prevention and control at the Centers for Disease 
Control and Prevention may be used to advocate or promote gun control: 
Provided further, That the Director may redirect the total amount made 
available under authority of Public Law 101-502, section 3, dated 
November 3, 1990, to activities the Director may so designate: Provided 
further, That the Congress is to be notified promptly of any such 
transfer: Provided further, That not to exceed $10,000,000 may be 
available for making grants under section 1509 of the Public Health 
Service Act to not more than 15 States[: Provided further, That 
notwithstanding any other provision of law, a single contract or related 
contracts for development and construction of facilities may be employed 
which collectively include the full scope of the project: Provided 
further, That the solicitation and contract shall contain the clause 
``availability of funds'' found at 48 CFR 52.232-18]. (Department of 
Health and Human Services Appropriations Act, 2002; additional 
authorizing legislation required.)
    [For emergency expenses to respond to the September 11, 2001, 
terrorist attacks on the United States for ``Disease control, research, 
and training'' for baseline safety screening for the emergency services 
personnel and rescue and recovery personnel, $12,000,000, to remain 
available until expended to be obligated from amounts made available in 
Public Law 107-38.] (Emergency Supplemental Act, 2002.)

              Unavailable Collections (in millions of dollars)

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

               Program and Financing (in millions of dollars)

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

    Obligations by program activity:
      Direct program:

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

[[Page 441]]



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

             Comparable BA by Activity (dollars in millions)

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

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

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

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

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

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

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

               Object Classification (in millions of dollars)

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

      Direct obligations:

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

                              Personnel Summary

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

                                

            Agency for Toxic Substances and Disease Registry

            toxic substances and environmental public health

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

               Program and Financing (in millions of dollars)

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

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

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

[[Page 442]]



    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

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

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

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

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

               Object Classification (in millions of dollars)

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

      Direct obligations:

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

                              Personnel Summary

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

                                


 
                      NATIONAL INSTITUTES OF HEALTH

                              Federal Funds

General and special funds:

                        National Cancer Institute

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to cancer, [$4,190,405,000.] $5,122,111,000: 
Provided, That the Director of the National Institutes of Health may 
transfer up to $400,000,000 to other National Institutes of Health 
appropriations: Provided further, That the total amount provided for 
cancer research at the National Institutes of Health will be not less 
than $5,122,111,000. (Department of Health and Human Services 
Appropriations Act, 2002; additional authorizing legislation required.)

                National Heart, Lung, and Blood Institute

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to cardiovascular, lung, and blood diseases, 
and blood and blood products, [$2,576,125,000] $2,746,280,000. 
(Department of Health and Human Services Appropriations Act, 2002; 
additional authorizing legislation required.)

         National Institute of Dental and Craniofacial Research

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to dental disease, [$343,327,000] $366,550,000. 
(Department of Health and Human Services Appropriations Act, 2002; 
additional authorizing legislation required.)

    National Institute of Diabetes and Digestive and Kidney Diseases

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to diabetes and digestive and kidney disease, 
[$1,466,833,000] $1,578,913,000. (Department of Health and Human 
Services Appropriations Act, 2002; additional authorizing legislation 
required.)

         National Institute of Neurological Disorders and Stroke

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to neurological disorders and stroke, 
[$1,328,188,000] $1,416,780,000. (Department of Health and Human 
Services Appropriations Act, 2002; additional authorizing legislation 
required.)

          National Institute of Allergy and Infectious Diseases

                      (including transfer of funds)

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

             National Institute of General Medical Sciences

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to general medical sciences, [$1,725,263,000]

[[Page 443]]

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

        National Institute of Child Health and Human Development

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to child health and human development, 
[$1,113,605,000] $1,191,431,000. (Department of Health and Human 
Services Appropriations Act, 2002; additional authorizing legislation 
required.)

                         National Eye Institute

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to eye diseases and visual disorders, 
[$581,366,000] $620,083,000. (Department of Health and Human Services 
Appropriations Act, 2002; additional authorizing legislation required.)

           National Institute of Environmental Health Sciences

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

                       National Institute on Aging

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

  National Institute of Arthritis and Musculoskeletal and Skin Diseases

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to arthritis and musculoskeletal and skin 
diseases, [$448,865,000] $478,085,000. (Department of Health and Human 
Services Appropriations Act, 2002; additional authorizing legislation 
required.)

    National Institute on Deafness and Other Communication Disorders

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to deafness and other communication disorders, 
[$342,072,000] $364,186,000. (Department of Health and Human Services 
Appropriations Act, 2002; additional authorizing legislation required.)

                 National Institute of Nursing Research

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

           National Institute on Alcohol Abuse and Alcoholism

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to alcohol abuse and alcoholism, [$384,238,000] 
$409,960,000. (Department of Health and Human Services Appropriations 
Act, 2002; additional authorizing legislation required.)

                    National Institute on Drug Abuse

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

                   National Institute of Mental Health

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

                National Human Genome Research Institute

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to human genome research, [$429,515,000] 
$457,032,000. (Department of Health and Human Services Appropriations 
Act, 2002; additional authorizing legislation required.)

       National Institute of Biomedical Imaging and Bioengineering

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

                 National Center for Research Resources

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to research resources and general research 
support grants, [$1,011,594,000] $1,072,581,000: Provided, That none of 
these funds shall be used to pay recipients of the general research 
support grants program any amount for indirect expenses in connection 
with such grants[: Provided further, That $110,000,000 shall be for 
extramural facilities construction grants, of which $5,000,000 shall be 
for beginning construction of facilities for a Chimp Sanctuary system as 
authorized in Public Law 106-551]. (Department of Health and Human 
Services Appropriations Act, 2002; additional authorizing legislation 
required.)

       National Center for Complementary and Alternative Medicine

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to complementary and alternative medicine, 
[$104,644,000] $111,494,000. (Department of Health and Human Services 
Appropriations Act, 2002; additional authorizing legislation required.)

        National Center on Minority Health and Health Disparities

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

                  John E. Fogarty International Center

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

                      National Library of Medicine

    For carrying out section 301 and title IV of the Public Health 
Service Act with respect to health information communications, 
[$277,658,000] $308,987,000, of which $4,000,000 shall be available 
until expended for improvement of information systems: Provided, That in 
fiscal year [2002] 2003, the Library may enter into personal services 
contracts for the provision of services in facilities owned, operated, 
or constructed under the jurisdiction of the National Institutes of 
Health. (Department of Health and Human Services Appropriations Act, 
2002; additional authorizing legislation required.)

                         Office of the Director

                      (including transfer of funds)

    For carrying out the responsibilities of the Office of the Director, 
National Institutes of Health, [$235,540,000] $252,642,000, of which 
[$53,540,000] $56,572,000 shall be for the Office of AIDS Research: 
Provided, That funding shall be available for the purchase of not to 
exceed 29 passenger motor vehicles for replacement only: Provided 
further, That the Director may direct up to 1 percent of the total 
amount made available in this or any other Act to all National 
Institutes of Health appropriations to activities the Director may so 
designate: Provided further, That no such appropriation shall be 
decreased by more than 1 percent by any such transfers and that

[[Page 444]]

the Congress is promptly notified of the transfer: Provided further, 
That the National Institutes of Health is authorized to collect third 
party payments for the cost of clinical services that are incurred in 
National Institutes of Health research facilities and that such payments 
shall be credited to the National Institutes of Health Management Fund: 
Provided further, That all funds credited to the National Institutes of 
Health Management Fund shall remain available for 1 fiscal year after 
the fiscal year in which they are deposited. (Department of Health and 
Human Services Appropriations Act, 2002; additional authorizing 
legislation required.)

                        buildings and facilities

                      (including transfer of funds)

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

              Unavailable Collections (in millions of dollars)

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

               Program and Financing (in millions of dollars)

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

    Obligations by program activity:
      Direct program:

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

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

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

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

[[Page 445]]

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

         DISTRIBUTION OF BUDGET AUTHORITY AND OUTLAYS BY ACCOUNT

                          [Dollars in millions]

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

                          [Dollars in millions]

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

    This program funds biomedical research and research training. These 
accounts will continue to be appropriated separately, and are displayed 
in a consolidated format to improve the readability of the presentation. 
Detailed information is available through the Department of Health and 
Human Services.

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

               Object Classification (in millions of dollars)

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

      Direct obligations:

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

                              Personnel Summary

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

                                


 
        SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

                              Federal Funds

General and special funds:

               Substance Abuse and Mental Health Services

    For carrying out titles V and XIX of the Public Health Service Act 
with respect to substance abuse and mental health services, the 
Protection and Advocacy for Mentally Ill Individuals Act of 1986, and 
section 301 of the Public Health Service Act with respect to program 
management, [$3,138,279,000, of which $28,721,000 shall be available for 
the projects and in the amounts specified in the statement of the 
managers on the conference report accompanying this Act] $3,197,704,000. 
(Department of Health and Human Services Appropriations Act, 2002; 
additional authorizing legislation required.)

[[Page 446]]

               Program and Financing (in millions of dollars)

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

    Obligations by program activity:
      Direct program:

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

  Budget Authority and Outlays Excluding Full Funding for Federal Retiree 
                                    Costs

                          (in millions of dollars)

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

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

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

               Object Classification (in millions of dollars)

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

      Direct obligations:

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

                              Personnel Summary

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

                                


 
               AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

                              Federal Funds

General and special funds:

                     Healthcare Research and Quality

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

               Program and Financing (in millions of dollars)

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

    Obligations by program activity:
      Direct program:

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

[[Page 447]]



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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

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

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

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

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

               Object Classification (in millions of dollars)

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

      Direct obligations:

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

                              Personnel Summary

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

                                


 
               CENTERS FOR MEDICARE AND MEDICAID SERVICES

                              Federal Funds

General and special funds:

                      Grants to States for Medicaid

    For carrying out, except as otherwise provided, titles XI and XIX of 
the Social Security Act, [$106,821,882,000] $112,090,218,000, to remain 
available until expended.
    For making, after May 31, [2002] 2003, payments to States under 
title XIX of the Social Security Act for the last quarter of fiscal year 
[2002] 2003 for unanticipated costs, incurred for the current fiscal 
year, such sums as may be necessary.
    For making payments to States or in the case of section 1928 on 
behalf of States under title XIX of the Social Security Act for the 
first quarter of fiscal year [2003, $46,601,937,000] 2004, 
$51,861,386,000, to remain available until expended.
    Payment under title XIX may be made for any quarter with respect to 
a State plan or plan amendment in effect during such quarter, if 
submitted in or prior to such quarter and approved in that or any 
subsequent quarter. (Department of Health and Human Services 
Appropriations Act, 2002.)

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

[[Page 448]]

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

    Medicaid assists States in providing medical care to their low-
income population by granting Federal matching payments under title XIX 
of the Social Security Act to States with approved plans.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0512-0-1-551      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------
41.0  Direct obligations: Grants, 
        subsidies, and contributions....     132,745     144,887     158,692
99.0  Reimbursable obligations: 
        Reimbursable obligations........       1,239          65
                                           ---------   ---------  ----------
99.9    Total new obligations...........     133,984     144,952     158,692
---------------------------------------------------------------------------

                                

                      Grants to States for Medicaid

              (Legislative proposal, not subject to PAYGO)

               Program and Financing (in millions of dollars)

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

    Offsets:
      Against gross budget authority and outlays:

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

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

                      Grants to States for Medicaid

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

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

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

                                

                     State Grants and Demonstrations

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

[[Page 449]]



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

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

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

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

                                

                   Payments to Health Care Trust Funds

    For payment to the Federal Hospital Insurance and the Federal 
Supplementary Medical Insurance Trust Funds, as provided under section 
1844 of the Social Security Act, sections 103(c) and 111(d) of the 
Social Security Amendments of 1965, section 278(d) of Public Law 97-248, 
and for administrative expenses incurred pursuant to section 201(g) of 
the Social Security Act, [$81,979,200,000] $81,471,216,000. (Department 
of Health and Human Services Appropriations Act, 2002.)

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

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

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

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

    Payments are made (1) to the Federal Supplementary Medical Insurance 
trust fund; and (2) to the Federal Hospital Insurance trust fund for 
individuals aged 65 and over who meet certain transitional insured 
status requirements, and for civil service employees and annuitants who 
worked before 1983 and who were employed during January 1983. Since 
1992, amounts have been included for non-Medicare activities of CMS 
program management.

               Object Classification (in millions of dollars)

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

                                

                   Payments to Health Care Trust Funds

              (Legislative proposal, not subject to PAYGO)

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

[[Page 450]]

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

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

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

                                

                           Program Management

    For carrying out, except as otherwise provided, titles XI, XVIII, 
XIX, and XXI of the Social Security Act, titles XIII and XXVII of the 
Public Health Service Act, and the Clinical Laboratory Improvement 
Amendments of 1988, not to exceed [$2,440,798,000] $2,538,330,000, to be 
transferred from the Federal Hospital Insurance and the Federal 
Supplementary Medical Insurance Trust Funds, as authorized by section 
201(g) of the Social Security Act; together with all funds collected in 
accordance with section 353 of the Public Health Service Act and section 
1857(e)(2) of the Social Security Act, and such sums as may be collected 
from authorized user fees and the sale of data, which shall remain 
available until expended, and together with administrative fees 
collected relative to Medicare overpayment recovery activities, which 
shall remain available until expended: Provided, That all funds derived 
in accordance with 31 U.S.C. 9701 from organizations established under 
title XIII of the Public Health Service Act shall be credited to and 
available for carrying out the purposes of this appropriation: Provided 
further, That [$18,200,000] from amounts appropriated under this 
heading, $3,000,000 for the managed care system redesign shall remain 
available until expended[: Provided further, That $100,000 of the amount 
available for research, demonstration, and evaluation activities shall 
be awarded to the Regional Nursing Centers Consortium in Philadelphia to 
initiate a demonstration project to evaluate 15 nurse-managed health 
centers in urban and rural areas across Pennsylvania: Provided further, 
That $200,000 of the amount available for research, demonstration, and 
evaluation activities shall be awarded to the Madonna Rehabilitation 
Center in Lincoln, Nebraska to create a new standard of rehabilitation 
practice and program design for children and adults with disabilities: 
Provided further, That $250,000 of the amount available for research, 
demonstration, and evaluation activities shall be awarded to the Cook 
County, Illinois Bureau of Health for the Asthma Champion Initiative to 
reduce morbidity and mortality from asthma in high prevalence areas: 
Provided further, That $250,000 of the amount available for research, 
demonstration, and evaluation activities shall be awarded to the 
Illinois Primary Health Care Association to implement the Shared 
Integrated Management Information System providing centralized case 
management, reimbursement and administrative support services: Provided 
further, That $500,000 of the amount available for research, 
demonstration, and evaluation activities shall be awarded to Project 
Access in Muskegon, Michigan to offer affordable insurance to uninsured 
workers, primarily in small business, and low-income individuals: 
Provided further, That $590,000 of the amount available for research, 
demonstration, and evaluation activities shall be awarded to Santa Clara 
County, California, for the outreach and application assistance aspects 
of its Children's Health Initiative, to demonstrate means of expanding 
enrollment of eligible children in Medicaid, SCHIP and other available 
health care programs: Provided further, That $800,000 of the amount 
available for research, demonstration, and evaluation activities shall 
be awarded to the Fishing Partnership Health Plan, based in Boston, 
Massachusetts, for a demonstration project on the efficacy of using a 
community-based health benefit program to provide health care coverage 
for lower-income independently employed workers and their families: 
Provided further, That $800,000 of the amount available for research, 
demonstration, and evaluation activities shall be awarded to the Mind-
Body Institute of Boston, Massachusetts to continue and expand a 
demonstration project: Provided further, That $900,000 of the amount 
available for research, demonstration, and evaluation activities shall 
be awarded to the Children's Hospice International demonstration program 
to provide a continuum of care for children with life-threatening 
conditions and their families: Provided further, That $1,500,000 of the 
amount available for research, demonstration, and evaluation activities 
shall be awarded to the Iowa Department of Public Health for the 
continuation of a prescription drug cooperative demonstration: Provided 
further, That $2,000,000 of the amount available for research, 
demonstration, and evaluation activities shall be awarded to the AIDS 
Healthcare Foundation in Los Angeles for a demonstration of residential 
and outpatient treatment facilities]: Provided further, That 
$51,000,000, to remain available until September 30, 2004, is for 
contract costs for the Healthcare Integrated General Ledger Accounting 
System: Provided further, That the Secretary of Health and Human 
Services is directed to collect fees in fiscal year [2002] 2003 from 
Medicare+Choice organizations pursuant to section 1857(e)(2) of the 
Social Security Act and from eligible organizations with risk-sharing 
contracts under section 1876 of that Act pursuant to section 
1876(k)(4)(D) of that Act. (Department of Health and Human Services 
Appropriations Act, 2002; additional authorizing legislation required.)

               Program and Financing (in millions of dollars)

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

    Obligations by program activity:
      Direct program:

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

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

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

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

[[Page 451]]


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

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

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

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

               Object Classification (in millions of dollars)

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

      Direct obligations:

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

                              Personnel Summary

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

                                

                           Program Management

              (Legislative proposal, not subject to PAYGO)

               Program and Financing (in millions of dollars)

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

    Obligations by program activity:
      Direct program:

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

               Object Classification (in millions of dollars)

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

                                

                 State Children's Health Insurance Fund 

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

[[Page 452]]



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

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

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

                                

                 State Children's Health Insurance Fund

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0515-4-1-551      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------

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

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

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

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

                                

      Health Maintenance Organization Loan and Loan Guarantee Fund

    For carrying out subsections (d) and (e) of section 1308 of the 
Public Health Service Act, any amounts received by the Secretary in 
connection with loans and loan guarantees under title XIII of the Public 
Health Service Act, to be available without fiscal year limitation for 
the payment of outstanding obligations. During fiscal year [2002] 2003, 
no commitments for direct loans or loan guarantees shall be made. 
(Department of Health and Human Services Appropriations Act, 2002.)

               Program and Financing (in millions of dollars)

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

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

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

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

                                

  

                               Trust Funds

                  Federal Hospital Insurance Trust Fund

              Unavailable Collections (in millions of dollars)

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

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

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

               Program and Financing (in millions of dollars)

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

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

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

[[Page 453]]



    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

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

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

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

    The Hospital Insurance (HI) program funds the costs of hospital and 
related care for individuals age 65 or older and for eligible disabled 
people.

    The status of the trust fund is as follows:

                  Status of Funds (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8005-0-7-571      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------
    Unexpended balance, start of year:
0100  Treasury balance..................        -789         246
0101  U.S. Securities: Par value........     168,859     197,137     232,492
                                           ---------   ---------  ----------
0199    Total balance, start of year....     168,070     197,383     232,492
    Cash income during the year:
      Current law:

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

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

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

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

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

               Object Classification (in millions of dollars)

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

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

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

[[Page 454]]


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

                     Federal Hospital Insurance Fund

              (Legislative proposal, not subject to PAYGO)

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

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

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

                                

                     Federal Hospital Insurance Fund

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

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

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

                                

               Health Care Fraud and Abuse Control Account

                 (federal hospital insurance trust fund)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8393-0-7-571      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

    P.L. 104-191 established the Health Care Fraud and Abuse Control 
(HCFAC) account within the Federal hospital insurance trust fund and 
appropriated funds, to be available without further appropriation, from 
the trust fund to the HCFAC account for specified health care fraud and 
abuse control activities of the Department of Health and Human Services 
(HHS), the Department of Justice, and other agencies.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-8393-0-7-571      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------

      Direct obligations:

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

[[Page 455]]

      Allocation Account:

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

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

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

                                

           Federal Supplementary Medical Insurance Trust Fund

              Unavailable Collections (in millions of dollars)

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

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

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

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

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

[[Page 456]]

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

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

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

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

    The Supplementary Medical Insurance (SMI) program is a voluntary 
program which affords protection against the costs of physician and 
certain other medical services. The program also covers treatment of 
end-stage renal disease for eligible enrollees. SMI costs are financed 
by premium payments from enrollees and contributions from the general 
revenues.

    The status of the trust fund is as follows:

                  Status of Funds (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8004-0-7-571      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------
    Unexpended balance, start of year:
0100  Treasury balance..................         821        -172
0101  U.S. Securities: Par value........      45,075      41,978      39,942
                                           ---------   ---------  ----------
0199    Total balance, start of year....      45,897      41,807      39,943
    Cash income during the year:
      Current law:

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

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

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

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

               Object Classification (in millions of dollars)

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

      Direct obligations:

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

           Federal Supplementary Medical Insurance Trust Fund

              (Legislative proposal, not subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8004-2-7-571      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

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



[[Page 457]]



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

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

                                

           Federal Supplementary Medical Insurance Trust Fund

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 20-8004-4-7-571      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

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

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

                                

                 Allocation Received From Other Accounts

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

                                


 
                ADMINISTRATION FOR CHILDREN AND FAMILIES

                              Federal Funds

General and special funds:

                 Temporary Assistance for Needy Families

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

    This account provides continued funding for activities established 
by the Personal Responsibility and Work Opportunity Reconciliation Act 
of 1996 (P.L. 104-193). The Temporary Assistance for Needy Families 
block grant provides funding to States for aid to low-income families 
with children.

      

                                

                 Temporary Assistance for Needy Families

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

[[Page 458]]

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

               Object Classification (in millions of dollars)

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

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

                                

                            Contingency Fund

               Program and Financing (in millions of dollars)

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

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

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

                                

                            Contingency Fund

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

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

                                

  Payments to States for Child Support Enforcement and Family Support 
                                Programs

    For making payments to States or other non-Federal entities under 
titles I, IV-D, X, XI, XIV, and XVI of the Social Security Act and the 
Act of July 5, 1960 (24 U.S.C. ch. 9), [$2,447,800,000] $2,475,800,000, 
to remain available until expended; and for such purposes for the first 
quarter of fiscal year [2003] 2004, $1,100,000,000, to remain available 
until expended.
    For making payments to each State for carrying out the program of 
Aid to Families with Dependent Children under title IV-A of the Social 
Security Act before the effective date of the program of Temporary 
Assistance to Needy Families (TANF) with respect to such State, such 
sums as may be necessary: Provided, That the sum of the amounts 
available to a State with respect to expenditures under such title IV-A 
in fiscal year 1997 under this appropriation and under such title IV-A 
as amended by the Personal Responsibility and Work Opportunity 
Reconciliation Act of 1996 shall not exceed the limitations under 
section 116(b) of such Act.
    For making, after May 31 of the current fiscal year, payments to 
States or other non-Federal entities under titles I, IV-D, X, XI, XIV, 
and XVI of the Social Security Act and the Act of July 5, 1960 (24 
U.S.C. ch. 9), for the last 3 months of the current fiscal year for 
unanticipated costs, incurred for the current fiscal year, such sums as 
may be necessary. (Department of Health and Human Services 
Appropriations Act, 2002.)

               Program and Financing (in millions of dollars)

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

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

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

[[Page 459]]



    Offsets:
      Against gross budget authority and outlays:

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

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

    This account provides for payments to States for child support 
enforcement and other family support programs, including access and 
visitation programs for families. Spending authority from the Federal 
share of child support collections is used to pay incentive payments. 
The remaining net Federal share of collections is returned to the 
Treasury in a receipt account. The text table below shows the net 
Federal costs of child support enforcement:

             Net Federal Costs of Child Support Enforcement

                        (In millions of dollars)

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

               Object Classification (in millions of dollars)

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

      Direct obligations:

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

                                

  Payments to States for Child Support Enforcement and Family Support 
                                Programs

                (Legislative proposal, subject to PAYGO)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1501-4-1-609      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

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

                                

                    Low Income Home Energy Assistance

    For making payments under title XXVI of the Omnibus Budget 
Reconciliation Act of 1981, [$1,700,000,000] $1,400,000,000.
    For making payments under title XXVI of the Omnibus Budget 
Reconciliation Act of 1981, $300,000,000: Provided, That these funds are 
for the unanticipated home energy assistance needs of one or more 
States, as authorized by section 2604(e) of the Act[: Provided further, 
That these funds are hereby designated by Congress to be emergency 
requirements pursuant to section 251(b)(2)(A) of the Balanced Budget and 
Emergency Deficit Control Act of 1985: Provided further, That these 
funds shall be made available only after submission to Congress of an 
official budget request by the President that includes designation of 
the entire amount of the request as an emergency requirement as defined 
in the Balanced Budget and Emergency Deficit Control Act of 1985], and 
notwithstanding the designation requirement of section 2602(e). 
(Department of Health and Human Services Appropriations Act, 2002.)

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

[[Page 460]]

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

                                

                     Refugee and Entrant Assistance

    For making payments for refugee and entrant assistance activities 
authorized by title IV of the Immigration and Nationality Act and 
section 501 of the Refugee Education Assistance Act of 1980 (Public Law 
96-422), [$450,203,000] $442,724,000: Provided, That funds appropriated 
pursuant to section 414(a) of the Immigration and Nationality Act for 
fiscal year [2002] 2003 shall be available for the costs of assistance 
provided and other activities through September 30, [2004] 2005: 
Provided further, That up to $10,000,000 is available to carry out the 
Trafficking Victims Protection Act of 2000.
    For carrying out section 5 of the Torture Victims Relief Act of 1998 
(Public Law 105-320), $10,000,000. (Department of Health and Human 
Services Appropriations Act, 2002.)

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1503-0-1-609      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------
25.1  Advisory and assistance services..           1           1           1
25.2  Other services....................           1           1           1
25.3  Other purchases of goods and 
        services from Government 
        accounts........................           1           1           1
41.0  Grants, subsidies, and 
        contributions...................         470         467         462
                                           ---------   ---------  ----------
99.9    Total new obligations...........         473         470         465
---------------------------------------------------------------------------

                                

                   Promoting Safe and Stable Families

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

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

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

               Object Classification (in millions of dollars)

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

                                

           Job Opportunities and Basic Skills Training Program

               Program and Financing (in millions of dollars)

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

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

[[Page 461]]



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

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

    This activity was replaced by Temporary Assistance for Needy 
Families.

                                

                    Child Care Entitlement to States

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

    This account provides child care funding for welfare recipients and 
low-income working families and was established by the Personal 
Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 
104-193).

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1550-0-1-609      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------
25.1  Advisory and assistance services..           6           7           7
41.0  Grants, subsidies, and 
        contributions...................       2,565       2,710       2,710
                                           ---------   ---------  ----------
99.9    Total new obligations...........       2,571       2,717       2,717
---------------------------------------------------------------------------

                                

    Payments to States for the Child Care and Development Block Grant

    For carrying out sections 658A through 658R of the Omnibus Budget 
Reconciliation Act of 1981 (The Child Care and Development Block Grant 
Act of 1990), $2,099,994,000 shall be used to supplement, not supplant 
state general revenue funds for child care assistance for low-income 
families: Provided, That $19,120,000 shall be available for child care 
resource and referral and school-aged child care activities, of which 
$1,000,000 shall be for the Child Care Aware toll free hotline: Provided 
further, That, in addition to the amounts required to be reserved by the 
States under section 658G, $272,672,000 shall be reserved by the States 
for activities authorized under section 658G, of which $100,000,000 
shall be for activities that improve the quality of infant and toddler 
care: Provided further, That $10,000,000 shall be for use by the 
Secretary for child care research, demonstration, and evaluation 
activities. (Department of Health and Human Services Appropriations Act, 
2002.)

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-1515-0-1-609      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------
25.1  Advisory and assistance services..           6           6           6
25.2  Other services....................           1           1           1
41.0  Grants, subsidies, and 
        contributions...................       1,993       2,093       2,093
                                           ---------   ---------  ----------
99.9    Total new obligations...........       2,000       2,100       2,100
---------------------------------------------------------------------------

                                

                       Social Services Block Grant

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

               Program and Financing (in millions of dollars)

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

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

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

[[Page 462]]

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

                                

                 Children and Families Services Programs

                        [(including rescissions)]

    For carrying out, except as otherwise provided, the Runaway and 
Homeless Youth Act, the Developmental Disabilities Assistance and Bill 
of Rights Act, the Head Start Act, the Child Abuse Prevention and 
Treatment Act, sections 310 and 316 of the Family Violence Prevention 
and Services Act, as amended, the Native American Programs Act of 1974, 
title II of Public Law 95-266 (adoption opportunities), the Adoption and 
Safe Families Act of 1997 (Public Law 105-89), sections 1201 and 1211 of 
the Children's Health Act of 2000, the Abandoned Infants Assistance Act 
of 1988, [the Early Learning Opportunities Act, part B(1) of title IV 
and] sections 413, 429A, 1110, and 1115 of the Social Security Act, and 
sections 40155, 40211, and 40241 of Public Law 103-322; for making 
payments under the Community Services Block Grant Act, section 473A of 
the Social Security Act, and title IV of Public Law 105-285, and for 
necessary administrative expenses to carry out said Acts and titles I, 
IV, X, XI, XIV, XVI, and XX of the Social Security Act, the Act of July 
5, 1960 (24 U.S.C. ch. 9), the Omnibus Budget Reconciliation Act of 
1981, title IV of the Immigration and Nationality Act, section 501 of 
the Refugee Education Assistance Act of 1980, section 5 of the Torture 
Victims Relief Act of 1998 (Public Law 105-320), sections 40155, 40211, 
and 40241 of Public Law 103-322, sections 310 and 316 of the Family 
Violence Prevention and Services Act, as amended, and section 126 and 
titles IV and V of Public Law 100-485, [$8,429,183,000] $8,489,632,000, 
of which $43,000,000, to remain available until September 30, [2003] 
2004, shall be for grants to States for adoption incentive payments, as 
authorized by section 473A of title IV of the Social Security Act (42 
U.S.C. 670-679) and may be made for adoptions completed in fiscal years 
[2000 and] 2001 and 2002; of which [$738,821,000] $640,325,000 shall be 
for making payments under the Community Services Block Grant Act; and of 
which [$6,537,906,000] $6,667,553,000 shall be for making payments under 
the Head Start Act, of which $1,400,000,000 shall become available 
October 1, [2002] 2003 and remain available through September 30, [2003] 
2004: Provided, That to the extent Community Services Block Grant funds 
are distributed as grant funds by a State to an eligible entity as 
provided under the Act, and have not been expended by such entity, they 
shall remain with such entity for carryover into the next fiscal year 
for expenditure by such entity consistent with program purposes: 
Provided further, That all eligible entities currently in good standing 
in the Community Services Block Grant program shall receive an increase 
in funding proportionate to the increase provided in this Act for the 
Community Services Block Grant: Provided further, That $88,133,000 shall 
be for activities authorized by the Runaway and Homeless Youth Act, 
notwithstanding the allocation requirements of section 388(a) of such 
Act, of which $39,739,900 is for the transitional living program: 
Provided further, That [$30,000,000] $100,000,000 is for a compassion 
capital fund to provide grants to charitable organizations to emulate 
model social service programs and to encourage research on the best 
practices of social service organizations: Provided further, That the 
Secretary shall establish procedures regarding the disposition of 
intangible property which permits grant funds, or intangible assets 
acquired with funds authorized under section 680 of the Community 
Services Block Grant Act, as amended, to become the sole property of 
such grantees after a period of not more than 12 years after the end of 
the grant for purposes and uses consistent with the original grant: 
Provided further, That funds appropriated for section 680(a)(2) of the 
Community Services Block Grant Act, as amended, shall be available for 
financing construction and rehabilitation and loans or investments in 
private business enterprises owned by community development 
corporations.
    [Funds appropriated for fiscal year 2002 under section 429A(e), part 
B of title IV of the Social Security Act shall be reduced by $6,000,000.
    Funds appropriated for fiscal year 2002 under section 413(h)(1) of 
the Social Security Act shall be reduced by $15,000,000.] (Department of 
Health and Human Services Appropriations Act, 2002; additional 
authorizing legislation required.)

               Program and Financing (in millions of dollars)

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

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

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

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

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

[[Page 463]]

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

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

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

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

                 Summary of Budget Authority and Outlays

                        (in millions of dollars)

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

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


               Object Classification (in millions of dollars)

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

      Direct obligations:

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

                              Personnel Summary

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

                                

                  Children and Family Services Programs

              (Legislative proposal, not subject to PAYGO)

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

               Object Classification (in millions of dollars)

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

[[Page 464]]



                                

                    Violent Crime Reduction Programs

               Program and Financing (in millions of dollars)

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

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

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

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

                                

              Children's Research and Technical Assistance 

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

               Object Classification (in millions of dollars)

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

      Direct obligations:

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

                                

       Payments to States for Foster Care and Adoption Assistance

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

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

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

[[Page 465]]

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

               Object Classification (in millions of dollars)

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

                                


 
                         ADMINISTRATION ON AGING

                              Federal Funds

General and special funds:

                         Aging Services Programs

    For carrying out, to the extent not otherwise provided, the Older 
Americans Act of 1965, as amended, and section 398 of the Public Health 
Service Act, [$1,199,814,000] $1,342,357,000, of which $5,000,000 shall 
be available for activities regarding medication management, screening, 
and education to prevent incorrect medication and adverse drug 
reactions; and of which $149,670,000 shall be allocated to States 
consistent with the formula in section 311 of the Older Americans Act of 
1965. (Department of Health and Human Services Appropriations Act, 2002; 
additional authorizing legislation required.)

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

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

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

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

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

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

               Object Classification (in millions of dollars)

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

                              Personnel Summary

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

                                


 
                         DEPARTMENTAL MANAGEMENT

                              Federal Funds

General and special funds:

                     General Departmental Management

    For necessary expenses, not otherwise provided, for general 
departmental management, including hire of six sedans, and for carrying 
out titles III, XVII, and XX of the Public Health Service Act, and the 
United States-Mexico Border Health Commission Act, [$341,703,000] 
$387,880,000, together with $5,851,000 to be transferred and expended as 
authorized by section 201(g)(1) of the Social Security Act from the 
Hospital Insurance Trust Fund and the Supplemental Medical Insurance 
Trust Fund; and $52,951,000 to be transferred from the accounts of the 
National Institutes of Health and $1,610,000 to be transferred from 
``Healthcare Research and Quality'' for carrying out public affairs and 
legislative affairs activities of the National Institutes of Health and 
the Agency for Healthcare Research and Quality, respectively: Provided, 
That of the funds made available under this heading for carrying out 
title XX of the Public Health Service Act, $11,885,000 shall be for 
activities specified under section 2003(b)(2), of which $10,157,000 
shall be for prevention service demonstration grants under section 
510(b)(2) of title V of the Social Security Act, as amended, without 
application of the limitation of section 2010(c) of said title XX: 
Provided further, That of this amount, $50,000,000 is for minority AIDS 
prevention and treatment activities; and [$21,998,000] $19,938,000 shall 
be for an Information Technology Security and Innovation Fund for 
Department-wide activities

[[Page 466]]

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

                         office for civil rights

    For expenses necessary for the Office for Civil Rights, 
[$28,691,000] $32,260,000, together with not to exceed $3,314,000 to be 
transferred and expended as authorized by section 201(g)(1) of the 
Social Security Act from the Hospital Insurance Trust Fund and the 
Supplemental Medical Insurance Trust Fund. (Department of Health and 
Human Services Appropriations Act, 2002; additional authorizing 
legislation required.)

                             policy research

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

            public health and social services emergency fund

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

           health facilities construction and management fund

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

           [Public health and social services emergency fund]

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

               Program and Financing (in millions of dollars)

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

    Obligations by program activity:
      Direct activities:

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

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

    New budget authority (gross), detail:
      Discretionary:

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

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

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

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

[[Page 467]]


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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

                          (Dollars in millions)

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

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

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

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

    Departmental management (DM) is a consolidated display of accounts 
that fund activities which provide leadership, policy, legal, and 
administrative guidance to HHS components; carry out the Department's 
civil rights and nondiscrimination enforcement programs; and support 
research to develop policy initiatives and improve existing HHS 
programs. DM also includes the activities of the Office of Public Health 
and Science, including adolescent family life, disease prevention and 
health promotion, physical fitness and sports, minority health, research 
integrity, women's health, emergency preparedness, as well as programs 
to counter bioterrorist threats.

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

               Object Classification (in millions of dollars)

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

      Direct obligations:

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

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

                              Personnel Summary

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

                                

                Allocations Received From Other Accounts

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

                                


 
                         PROGRAM SUPPORT CENTER

General and special funds:

     [Retirement Pay and] Medical Benefits for Commissioned Officers

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

[[Page 468]]

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

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

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

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

    This activity funds annuities of retired Public Health Service (PHS) 
commissioned officers and survivors of retirees, and medical care to 
active duty PHS commissioned officers, retirees, and dependents of 
members and retirees of the PHS Commissioned Corps.

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

               Object Classification (in millions of dollars)

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

                                

  Payment to Public Health Service Commissioned Corps Retirement System

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

                                

        Public Health Service Commissioned Corps Retirement Fund

              Unavailable Collections (in millions of dollars)

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

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

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

[[Page 469]]



                                

                         Health Activities Funds

               Program and Financing (in millions of dollars)

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

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

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

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

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

                                

Intragovernmental funds:

                      HHS Service and Supply Fund 

               Program and Financing (in millions of dollars)

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

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

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

    New budget authority (gross), detail:
      Mandatory:

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

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

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

    Offsets:
      Against gross budget authority and outlays:

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

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

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

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

               Object Classification (in millions of dollars)

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

      Personnel compensation:

11.1    Full-time permanent.............          70          81          79
11.3    Other than full-time permanent..           2           2           2
11.5    Other personnel compensation....           2           3           4
                                           ---------   ---------  ----------
11.9      Total personnel compensation..          74          86          85
12.1  Civilian personnel benefits.......          27          28          28
21.0  Travel and transportation of 
        persons.........................           2           3           4
22.0  Transportation of things..........           2           2           2
23.1  Rental payments to GSA............          12          13          13
23.3  Communications, utilities, and 
        miscellaneous charges...........           7           9           9
24.0  Printing and reproduction.........           1           1           1
25.1  Advisory and assistance services..          11          13          14
25.2  Other services....................          95         101         119
25.3  Other purchases of goods and 
        services from Government 
        accounts........................          27          29          33
25.4  Operation and maintenance of 
        facilities......................          13          14          16
25.6  Medical care......................          33          40          44
26.0  Supplies and materials............          66          77          85
31.0  Equipment.........................           9           9          11
                                           ---------   ---------  ----------
99.9    Total new obligations...........         379         425         464
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-9941-0-4-551      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------
2001  Total compensable workyears: Full-
        time equivalent employment......       1,195       1,318       1,267
---------------------------------------------------------------------------
  

                                

                               Trust Funds

                        Miscellaneous Trust Funds

              Unavailable Collections (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9971-0-7-551      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------
01.99 Balance, start of year............
    Receipts:
02.00 Gifts and contributions, 
        miscellaneous trust funds.......          37          37          37
02.20 Contributions, Indian health 
        facilities, Health Services 
        Administration..................          32          32          32
02.40 Interest, Miscellaneous trust 
        funds...........................           1           1           1
                                           ---------   ---------  ----------
02.99   Total receipts and collections..          70          70          70
    Appropriations:
05.00 Miscellaneous trust funds.........         -70         -70         -70
                                           ---------   ---------  ----------
07.99 Balance, end of year..............
---------------------------------------------------------------------------

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9971-0-7-551      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.02 Gifts.............................          26          38          38
00.03 Contributions, Indian health 
        facilities......................          27          32          32
                                           ---------   ---------  ----------
10.00   Total new obligations...........          53          70          70
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........          49          69          69
22.00 New budget authority (gross)......          70          70          70

[[Page 470]]

22.10 Resources available from 
        recoveries of prior year 
        obligations.....................           3
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......         122         139         139
23.95 Total new obligations.............         -53         -70         -70
24.40 Unobligated balance carried 
        forward, end of year............          69          69          69
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Mandatory:

60.26   Appropriation (trust fund)......          70          70          70
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..          83          80          72
73.10 Total new obligations.............          53          70          70
73.20 Total outlays (gross).............         -53         -78         -72
73.45 Recoveries of prior year 
        obligations.....................          -3
74.40 Obligated balance, end of year....          80          72          70
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.97 Outlays from new mandatory 
        authority.......................          26          28          28
86.98 Outlays from mandatory balances...          27          50          44
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........          53          78          72
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................          70          70          70
90.00 Outlays...........................          53          78          72
----------------------------------------------------------------------------

    Memorandum (non-add) entries:
92.01 Total investments, start of year: 
        Federal securities: Par value...          20          25          25
92.02 Total investments, end of year: 
        Federal securities: Par value...          25          25          25
---------------------------------------------------------------------------

                          [Dollars in millions]

                                        2001         2002        2003
Distribution of budget authority by 
    account:
  Gifts.............................          38          38          38
  Contributions, Indian health 
    facilities......................          32          32          32
Distribution of outlays by account:
  Gifts.............................          23          41          38
  Contributions, Indian health 
    facilities......................          30          37          34

    Gifts to the Public health service are for the benefit of patients 
and for research. Contributions are made for the construction, 
improvement, extension, and provision of sanitation facilities.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-9971-0-7-551      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------
11.1  Personnel compensation: Full-time 
        permanent.......................           1           1           1
21.0  Travel and transportation of 
        persons.........................           1           1           1
22.0  Transportation of things..........                       1           1
25.1  Advisory and assistance services..                       1           1
25.2  Other services....................          14          15          15
25.3  Other purchases of goods and 
        services from Government 
        accounts........................           1           1           1
25.4  Operation and maintenance of 
        facilities......................           1           1           1
25.5  Research and development contracts           3           5           5
25.7  Operation and maintenance of 
        equipment.......................           8          10          10
26.0  Supplies and materials............           1           2           2
31.0  Equipment.........................           1           2           2
32.0  Land and structures...............           2           2           2
41.0  Grants, subsidies, and 
        contributions...................          20          28          28
                                           ---------   ---------  ----------
99.9    Total new obligations...........          53          70          70
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-9971-0-7-551      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------
1001  Total compensable workyears: Full-
        time equivalent employment......          12          12          12
---------------------------------------------------------------------------

                                


 
                     OFFICE OF THE INSPECTOR GENERAL

General and special funds:

                       Office of Inspector General

    For expenses necessary for the Office of Inspector General in 
carrying out the provisions of the Inspector General Act of 1978, as 
amended, [$35,786,000] $49,972,000: Provided, That, of such amount, 
necessary sums are available for providing protective services to the 
Secretary and investigating non-payment of child support cases for which 
non-payment is a Federal offense under 18 U.S.C. 228. (Department of 
Health and Human Services Appropriations Act, 2002; additional 
authorizing legislation required.)

               Program and Financing (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0128-0-1-551      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------

    Obligations by program activity:
00.01 Direct program....................          42          45          50
09.01 Reimbursable program..............          16          17          12
                                           ---------   ---------  ----------
10.00   Total new obligations...........          58          62          62
----------------------------------------------------------------------------

    Budgetary resources available for obligation:
21.40 Unobligated balance carried 
        forward, start of year..........           1           1           1
22.00 New budget authority (gross)......          58          62          62
                                           ---------   ---------  ----------
23.90   Total budgetary resources 
          available for obligation......          59          63          63
23.95 Total new obligations.............         -58         -62         -62
24.40 Unobligated balance carried 
        forward, end of year............           1           1           1
----------------------------------------------------------------------------

    New budget authority (gross), detail:
      Discretionary:

40.00   Appropriation...................          42          45          50
      Spending authority from offsetting 
          collections:

68.00   Offsetting collections (cash)...           5          17          12
68.10   Change in uncollected customer 
          payments from Federal sources 
          (unexpired)...................          11
                                           ---------   ---------  ----------
68.90     Spending authority from 
            offsetting collections 
            (total discretionary).......          16          17          12
                                           ---------   ---------  ----------
70.00   Total new budget authority 
          (gross).......................          58          62          62
----------------------------------------------------------------------------

    Change in obligated balances:
72.40 Obligated balance, start of year..          -6           1           4
73.10 Total new obligations.............          58          62          62
73.20 Total outlays (gross).............         -57         -59         -62
74.00 Change in uncollected customer 
        payments from Federal sources 
        (unexpired).....................         -11
74.10 Change in uncollected customer 
        payments from Federal sources 
        (expired).......................          18
74.40 Obligated balance, end of year....           1           4           4
----------------------------------------------------------------------------

    Outlays (gross), detail:
86.90 Outlays from new discretionary 
        authority.......................          55          58          58
86.93 Outlays from discretionary 
        balances........................           3           1           4
                                           ---------   ---------  ----------
87.00   Total outlays (gross)...........          57          59          62
----------------------------------------------------------------------------

    Offsets:
      Against gross budget authority and outlays:

88.00   Offsetting collections (cash) 
          from: Federal sources.........         -24         -17         -12
      Against gross budget authority only:

88.95   Change in uncollected customer 
          payments from Federal sources 
          (unexpired)...................         -11
88.96   Portion of offsetting 
          collections (cash) credited to 
          expired accounts..............          19
----------------------------------------------------------------------------

    Net budget authority and outlays:
89.00 Budget authority..................          42          45          50
90.00 Outlays...........................          34          42          50
---------------------------------------------------------------------------

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

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

    Net budget authority and outlays:
89.00 Budget authority..................          34          36          40
90.00 Outlays...........................          26          33          40
---------------------------------------------------------------------------



[[Page 471]]



    The Office of Inspector General (OIG) identifies and recommends 
actions to correct fraud, waste, and abuse in HHS administered and 
assisted programs and operations through audits and investigations.

    In addition to the discretionary resources appropriated to the OIG, 
the Health Insurance Portability and Accountability Act of 1996 makes 
available mandatory funding for use by the OIG to combat Medicare and 
Medicaid fraud and abuse through a coordinated Health care fraud and 
abuse control (HCFAC) program with the Department of Justice. The 
following table shows total funding resources for the OIG:

                          (In millions of dollars)

                                         2001 actual   2002 est.   2003 est.
Budget Authority:
  Discretionary appropriations..........          42          45          50
  Mandatory (HCFAC Account).............         130         145         160
                                           ---------   ---------  ----------
      Total.............................         172         190         210
Outlays:
  Discretionary appropriations..........          34          42          50
  Mandatory (HCFAC Account).............         126         145         160
                                           ---------   ---------  ----------
      Total.............................         160         187         210

    This schedule reflects distribution of mandatory funds from the 
HCFAC account in 2002. Actual 2003 distribution will be determined by 
the Secretary of HHS and the Attorney General.

               Object Classification (in millions of dollars)

----------------------------------------------------------------------------
Identification code 75-0128-0-1-551      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------

      Direct obligations:

11.1    Personnel compensation: Full-
          time permanent................          19          22          24
12.1    Civilian personnel benefits.....          13          15          16
21.0    Travel and transportation of 
          persons.......................           2           1           2
23.1    Rental payments to GSA..........           3           3           3
25.3    Other purchases of goods and 
          services from Government 
          accounts......................           3           3           4
26.0    Supplies and materials..........           1
31.0    Equipment.......................           1           1           1
                                           ---------   ---------  ----------
99.0      Direct obligations............          42          45          50
99.0  Reimbursable obligations..........          16          17          12
                                           ---------   ---------  ----------
99.9    Total new obligations...........          58          62          62
---------------------------------------------------------------------------

                              Personnel Summary

----------------------------------------------------------------------------
Identification code 75-0128-0-1-551      2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------
    Direct:
1001  Total compensable workyears: Full-
        time equivalent employment......         285         309         320
    Reimbursable:
2001  Total compensable workyears: Full-
        time equivalent employment......          59          56          16
    Allocation account:
3001  Total compensable workyears: Full-
        time equivalent employment......       1,099       1,223       1,305
---------------------------------------------------------------------------

                                

                Allocations Received From Other Accounts

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

                                


 
                      GENERAL FUND RECEIPT ACCOUNTS

                           (in millions of dollars)

----------------------------------------------------------------------------
                                         2001 actual   2002 est.   2003 est.
----------------------------------------------------------------------------
Offsetting receipts from the public:
  75-310700  Federal share of child 
    support collections.................         856         765         789
    Legislative proposal, subject to 
      PAYGO.............................                                   7
                                           ---------   ---------  ----------
General Fund Offsetting receipts from 
 the public.............................         856         765         796
----------------------------------------------------------------------------
Intragovernmental payments:
  20-310530  Quinquennial adjustment for 
    military service credits, Federal 
    hospital insurance..................       1,177
                                           ---------   ---------  ----------
General Fund Intragovernmental payments.       1,177
---------------------------------------------------------------------------

                                


 
                           GENERAL PROVISIONS

    Sec. 201. Funds appropriated in this title shall be available for 
not to exceed $37,000 for official reception and representation expenses 
when specifically approved by the Secretary.
    Sec. 202. The Secretary shall make available through assignment not 
more than 60 employees of the Public Health Service to assist in child 
survival activities and to work in AIDS programs through and with funds 
provided by the Agency for International Development, the United Nations 
International Children's Emergency Fund or the World Health 
Organization.
    Sec. 203. None of the funds appropriated under this Act may be used 
to implement section [399L(b)] 399F(b) of the Public Health Service Act 
or section 1503 of the National Institutes of Health Revitalization Act 
of 1993, Public Law 103-43.
    Sec. 204. None of the funds appropriated in this Act for the 
National Institutes of Health, the Agency for Healthcare Research and 
Quality, and the Substance Abuse and Mental Health Services 
Administration shall be used to pay the salary of an individual, through 
a grant or other extramural mechanism, at a rate in excess of Executive 
Level [I] II.
    [Sec. 205. None of the funds appropriated in this Act may be 
expended pursuant to section 241 of the Public Health Service Act, 
except for funds specifically provided for in this Act, or for other 
taps and assessments made by any office located in the Department of 
Health and Human Services, prior to the Secretary's preparation and 
submission of a report to the Committee on Appropriations of the Senate 
and of the House detailing the planned uses of such funds.]
    Sec. [206] 205. Notwithstanding section 241(a) of the Public Health 
Service Act, such portion as the Secretary shall determine, but not more 
than 1.25 percent, of any amounts appropriated for programs authorized 
under said Act shall be made available for the evaluation (directly, or 
by grants or contracts) of the implementation and effectiveness of such 
programs.

                           (transfer of funds)

    Sec. [207] 206. Not to exceed [1] 3 percent of any discretionary 
funds (pursuant to the Balanced Budget and Emergency Deficit Control Act 
of 1985, as amended) which are appropriated for the current fiscal year 
for the Department of Health and Human Services in this or any other Act 
may be transferred between appropriations, but no such appropriation 
shall be increased by more than [3] 10 percent by any such transfer: 
Provided, [That an appropriation may be increased by up to an additional 
2 percent subject to approval by the House and Senate Committees on 
Appropriations: Provided further,] That the Appropriations Committees of 
both Houses of Congress are notified at least 15 days in advance of any 
transfer.
    Sec. [208] 207. The Director of the National Institutes of Health, 
jointly with the Director of the Office of AIDS Research, may transfer 
up to 3 percent among institutes, centers, and divisions from the total 
amounts identified by these two Directors as funding for research 
pertaining to the human immunodeficiency virus: Provided, That the 
Congress is promptly notified of the transfer.
    Sec. [209] 208. Of the amounts made available in this Act for the 
National Institutes of Health, the amount for research related to the 
human immunodeficiency virus, as jointly determined by the Director of 
the National Institutes of Health and the Director of the Office of AIDS 
Research, shall be made available to the ``Office of AIDS Research'' 
account. The Director of the Office of AIDS Research shall transfer from 
such account amounts necessary to carry out section 2353(d)(3) of the 
Public Health Service Act.
    Sec. [210] 209. None of the funds appropriated in this Act may be 
made available to any entity under title X of the Public Health Service 
Act unless the applicant for the award certifies to the Secretary that 
it encourages family participation in the decision of minors to seek 
family planning services and that it provides counseling to minors on 
how to resist attempts to coerce minors into engaging in sexual 
activities.
    Sec. [211] 210. None of the funds appropriated by this Act 
(including funds appropriated to any trust fund) may be used to carry

[[Page 472]]

out the Medicare+Choice program if the Secretary denies participation in 
such program to an otherwise eligible entity (including a Provider 
Sponsored Organization) because the entity informs the Secretary that it 
will not provide, pay for, provide coverage of, or provide referrals for 
abortions: Provided, That the Secretary shall make appropriate 
prospective adjustments to the capitation payment to such an entity 
(based on an actuarially sound estimate of the expected costs of 
providing the service to such entity's enrollees): Provided further, 
That nothing in this section shall be construed to change the Medicare 
program's coverage for such services and a Medicare+Choice organization 
described in this section shall be responsible for informing enrollees 
where to obtain information about all Medicare covered services.
    Sec. [212] 211. Notwithstanding any other provision of law, no 
provider of services under title X of the Public Health Service Act 
shall be exempt from any State law requiring notification or the 
reporting of child abuse, child molestation, sexual abuse, rape, or 
incest.
    [Sec. 213. The Foreign Operations, Export Financing, and Related 
Programs Appropriations Act, 1990 (Public Law 101-167) is amended--
        (1) in section 599D (8 U.S.C. 1157 note)--
                (A) in subsection (b)(3), by striking ``1997, 1998, 
            1999, 2000, and 2001'' and inserting ``1997, 1998, 1999, 
            2000, 2001, and 2002''; and
                (B) in subsection (e), by striking ``October 1, 2001'' 
            each place it appears and inserting ``October 1, 2002''; and
        (2) in section 599E (8 U.S.C. 1255 note) in subsection (b)(2), 
    by striking ``September 30, 2001'' and inserting ``September 30, 
    2002''.]
    Sec. [214] 212. (a) Except as provided by subsection (e) none of the 
funds appropriated by this Act may be used to withhold substance abuse 
funding from a State pursuant to section 1926 of the Public Health 
Service Act (42 U.S.C. 300x-26) if such State certifies to the Secretary 
of Health and Human Services by May 1, [2002] 2003 that the State will 
commit additional State funds, in accordance with subsection (b), to 
ensure compliance with State laws prohibiting the sale of tobacco 
products to individuals under 18 years of age.
    (b) The amount of funds to be committed by a State under subsection 
(a) shall be equal to 1 percent of such State's substance abuse block 
grant allocation for each percentage point by which the State misses the 
retailer compliance rate goal established by the Secretary of Health and 
Human Services under section 1926 of such Act.
    (c) The State is to maintain State expenditures in fiscal year 
[2002] 2003 for tobacco prevention programs and for compliance 
activities at a level that is not less than the level of such 
expenditures maintained by the State for fiscal year [2001] 2002, and 
adding to that level the additional funds for tobacco compliance 
activities required under subsection (a). The State is to submit a 
report to the Secretary on all fiscal year [2001] 2002 State 
expenditures and all fiscal year [2002] 2003 obligations for tobacco 
prevention and compliance activities by program activity by July 31, 
[2002] 2003.
    (d) The Secretary shall exercise discretion in enforcing the timing 
of the State obligation of the additional funds required by the 
certification described in subsection (a) as late as July 31, [2002] 
2003.
    (e) None of the funds appropriated by this Act may be used to 
withhold substance abuse funding pursuant to section 1926 from a 
territory that receives less than $1,000,000.
    Sec. [215] 213. In order for the Centers for Disease Control and 
Prevention to carry out international health activities, including HIV/
AIDS and other infectious disease, chronic and environmental disease, 
and other health activities abroad during fiscal year [2002] 2003, the 
Secretary of Health and Human Services is authorized to--
        (1) utilize the authorities contained in subsection 2(c) of the 
    State Department Basic Authorities Act of 1956, as amended; and
        (2) utilize the authorities contained in 22 U.S.C. 291 and 292 
    and directly or through contract or cooperative agreement to lease, 
    alter or renovate facilities in foreign countries, to carry out 
    programs supported by this appropriation notwithstanding PHS Act 
    section 307.
In exercising the authority set forth in paragraphs (1) and (2), the 
Secretary of Health and Human Services shall consult with the Department 
of State to assure that planned activities are within the legal 
strictures of the State Department Basic Authorities Act of 1956, as 
amended, and other applicable parts of title 22, United States Code.
    Sec. [216] 214. The Division of Federal Occupational Health may 
utilize personal services contracting to employ professional management/
administrative and occupational health professionals.
    [Sec. 217. Notwithstanding any other provision of law relating to 
vacancies in offices for which appointments must be made by the 
President, including any time limitation on serving in an acting 
capacity, the Acting Director of the National Institutes of Health as of 
January 12, 2000, may serve in that position until a new Director of the 
National Institutes of Health is confirmed by the Senate.]
    [Sec. 218. Section 582 of the Public Health Service Act (42 U.S.C. 
290hh-1(f)) is amended by adding at the end the following:
    ``(g) Short Title.--This section may be cited as the `Donald J. 
Cohen National Child Traumatic Stress Initiative'.''.]
    Sec. 215. Of funds appropriated in this Act and awarded to a State 
under the Public Health Service Act and Title V of the Social Security 
Act, each State may transfer up to 20 percent of such funds between such 
grants: Provided, That funds for a single grant shall not be increased 
by more than 50 percent above the original grant award amount: Provided 
further, That a State exercising this transfer authority must notify the 
Secretary of Health and Human Services in writing at least 30 days prior 
to implementing such a transfer: Provided further, That the Secretary of 
Health and Human Services shall issue guidance to implement this 
transfer authority.
    Sec. 216. With the funds appropriated to the National Institutes of 
Health in this Act, NIH is authorized to obligate in fiscal year 2003 
the full multi-year cost of a grant or contract that is awarded in that 
year, and any funds which may be deobligated subsequently shall remain 
available until expended for the same purposes. (Department of Health 
and Human Services Appropriations Act, 2002.)
