[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 2004
[[Page 401]]
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; 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; and notwithstanding section 521 of P.L. 107-188;
$1,673,632,000, of which not to exceed $249,825,000 shall be derived
from prescription drug user fees authorized by 21 U.S.C. 379h and shall
be credited to this account and remain available until expended:
Provided, That of the amount provided under this heading, $29,190,000
shall be derived from medical device user fees authorized by 21 U.S.C.
379j and shall be credited to this account and remain available until
expended: Provided further, That fees derived from prescription drug and
medical device applications received during fiscal year 2004 shall be
subject to the fiscal year 2004 limitation: Provided further, That any
prescription drug or medical device user fee collected in fiscal year
2004 that exceed this limitation shall be credited to this account and
remain available until expended, in accordance with 21 U.S.C. 379h(g)(4)
and 379j(h)(4).
In addition, mammography user fees authorized by 42 U.S.C. 263b 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.
Buildings and Facilities
For plans, construction, repair, improvement, extension, alteration,
and purchase of fixed equipment or facilities of or used by the Food and
Drug Administration, where not otherwise provided, $11,500,000, to
remain available until expended (7 U.S.C. 2209b).
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Unavailable Collections (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9911-0-1-554 2002 actual 2003 est. 2004 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 -1
--------- --------- ----------
07.99 Balance, end of year..............
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Program and Financing (in millions of dollars)
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Identification code 75-9911-0-1-554 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Foods............................. 393 412 413
00.02 Drugs............................. 479 513 513
00.03 Devices and radiological products. 180 191 185
00.04 National Center for Toxicological
Research........................ 39 41 40
00.05 Other activities.................. 82 85 92
00.06 Other rent and rent related
activities...................... 38 36 42
00.07 Rental payments................... 99 99 109
00.08 Buildings and facilities.......... 44 8 12
00.09 CRADAs............................ 1 2 2
09.01 Reimbursable program.............. 214 291 334
--------- --------- ----------
10.00 Total new obligations........... 1,569 1,678 1,742
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Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 69 203 203
22.00 New budget authority (gross)...... 1,698 1,678 1,741
22.10 Resources available from
recoveries of prior year
obligations..................... 5
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 1,772 1,881 1,944
23.95 Total new obligations............. -1,569 -1,678 -1,742
24.40 Unobligated balance carried
forward, end of year............ 203 203 203
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New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 1,369 1,385 1,406
40.73 Reduction pursuant to P.L. 107-
206........................... -1
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 1,368 1,385 1,406
Mandatory:
60.20 Appropriation (special fund).... 2 2 1
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 306 291 334
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 22
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 328 291 334
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 1,698 1,678 1,741
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Change in obligated balances:
72.40 Obligated balance, start of year.. 393 488 503
73.10 Total new obligations............. 1,569 1,678 1,742
73.20 Total outlays (gross)............. -1,450 -1,663 -1,735
73.40 Adjustments in expired accounts
(net)........................... -5
73.45 Recoveries of prior year
obligations..................... -5
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -22
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 7
74.40 Obligated balance, end of year.... 488 503 510
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1,182 1,326 1,384
86.93 Outlays from discretionary
balances........................ 267 335 350
86.97 Outlays from new mandatory
authority....................... 1 2 1
--------- --------- ----------
87.00 Total outlays (gross)........... 1,450 1,663 1,735
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Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -32 -25 -37
88.40 Non-Federal sources........... -291 -266 -297
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -323 -291 -334
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -22
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 17
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 1,370 1,387 1,407
90.00 Outlays........................... 1,127 1,372 1,401
----------------------------------------------------------------------------
Additional net budget authority and outlays to cover cost of fully accruing
retirement:
99.00 Budget authority.................. 56 60 67
99.01 Outlays........................... 56 60 67
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[In millions of dollars]
2002 2003 2004
Distribution of budget authority by
account:
Salaries and expenses............. 1,336 1,379 1,395
Buildings and facilities.......... 34 8 12
Distribution of outlays by account:
Salaries and expenses............. 1,085 1,356 1,388
Buildings and facilities.......... 42 16 13
[[Page 402]]
Summary of Budget Authority and Outlays
(in millions of dollars)
2002 actual 2003 est. 2004 est.
Enacted/requested:
Budget Authority.................. 1,370 1,387 1,407
Outlays........................... 1,127 1,372 1,401
Legislative proposal, not subject to
PAYGO:
Budget Authority..................
Outlays...........................
------------------------------------
Total:
Budget Authority.................. 1,370 1,387 1,407
Outlays........................... 1,127 1,372 1,401
====================================
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, improved access to generic drugs, and implementation of the Best
Pharmaceuticals for Children Act.
Object Classification (in millions of dollars)
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Identification code 75-9911-0-1-554 2002 actual 2003 est. 2004 est.
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Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 497 584 612
11.3 Other than full-time permanent 41 35 37
11.5 Other personnel compensation.. 18 20 21
11.7 Military personnel............ 33 32 36
--------- --------- ----------
11.9 Total personnel compensation 589 671 706
12.1 Civilian personnel benefits..... 134 142 147
12.2 Military personnel benefits..... 17 15 18
21.0 Travel and transportation of
persons....................... 26 28 27
22.0 Transportation of things........ 4 7 7
23.1 Rental payments to GSA.......... 99 99 109
23.2 Rental payments to others....... 5 6 6
23.3 Communications, utilities, and
miscellaneous charges......... 20 29 29
24.0 Printing and reproduction....... 3 3 3
25.1 Advisory and assistance services 41 19 16
25.2 Other services.................. 67 85 76
25.3 Other purchases of goods and
services from Government
accounts...................... 61 55 48
25.4 Operation and maintenance of
facilities.................... 52 38 33
25.5 Research and development
contracts..................... 28 43 43
25.7 Operation and maintenance of
equipment..................... 37 31 27
26.0 Supplies and materials.......... 22 25 24
31.0 Equipment....................... 80 62 59
32.0 Land and structures............. 38 2
41.0 Grants, subsidies, and
contributions................. 30 27 26
42.0 Insurance claims and indemnities 2 2 2
--------- --------- ----------
99.0 Direct obligations............ 1,355 1,387 1,408
99.0 Reimbursable obligations.......... 214 291 334
--------- --------- ----------
99.9 Total new obligations........... 1,569 1,678 1,742
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Personnel Summary
----------------------------------------------------------------------------
Identification code 75-9911-0-1-554 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 7,748 8,402 8,485
1101 Military full-time equivalent
employment.................... 564 577 587
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 1,107 1,378 1,588
2101 Military full-time equivalent
employment.................... 76 84 103
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Salaries and Expenses
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9911-2-1-554 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
09.01 Reimbursable program.............. 5
--------- --------- ----------
10.00 Total new obligations........... 5
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Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 5
23.95 Total new obligations............. -5
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
68.00 Spending authority from
offsetting collections
(gross): Offsetting
collections (cash)............ 5
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. 5
73.20 Total outlays (gross)............. -5
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 5
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.40 Offsetting collections (cash)
from: Non-Federal sources..... -5
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................
---------------------------------------------------------------------------
The budget includes a total of $5,000,000 in animal drug user fees.
Authorizing language for these fees will be proposed to authorize the
collection and spending of the fees subject to appropriations language.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9911-2-1-554 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
99.0 Reimbursable obligations:
Reimbursable obligations........ 5
--------- --------- ----------
99.9 Total new obligations........... 5
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Personnel Summary
----------------------------------------------------------------------------
Identification code 75-9911-2-1-554 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 40
---------------------------------------------------------------------------
Public enterprise funds:
Revolving Fund for Certification and Other Services
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4309-0-3-554 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
09.01 Reimbursable program.............. 5 8 6
--------- --------- ----------
10.00 Total new obligations........... 5 8 6
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 4 4 1
22.00 New budget authority (gross)...... 5 5 6
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 9 9 7
23.95 Total new obligations............. -5 -8 -6
24.40 Unobligated balance carried
forward, end of year............ 4 1 1
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[[Page 403]]
New budget authority (gross), detail:
Mandatory:
69.00 Offsetting collections (cash)... 5 5 6
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 1 1 1
73.10 Total new obligations............. 5 8 6
73.20 Total outlays (gross)............. -5 -8 -6
74.40 Obligated balance, end of year.... 1 1 1
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 5 5 6
86.98 Outlays from mandatory balances... 3
--------- --------- ----------
87.00 Total outlays (gross)........... 5 8 6
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.40 Offsetting collections (cash)
from: Non-Federal sources..... -5 -5 -6
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... 3
---------------------------------------------------------------------------
FDA certifies color additives for use in foods, drugs, and
cosmetics. It also lists color additives for use in foods, drugs,
medical devices, and cosmetics (21 U.S.C. 346a, 356, 357, 376). These
services are financed wholly by fees paid by the industries affected.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4309-0-3-554 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
11.1 Personnel compensation: Full-time
permanent....................... 2 2 2
12.1 Civilian personnel benefits....... 1 1 1
23.3 Communications, utilities, and
miscellaneous charges........... 2 2
25.2 Other services.................... 1 3 1
31.0 Equipment......................... 1
--------- --------- ----------
99.9 Total new obligations........... 5 8 6
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Personnel Summary
----------------------------------------------------------------------------
Identification code 75-4309-0-3-554 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 33 38 38
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HEALTH RESOURCES AND SERVICES ADMINISTRATION
Federal Funds
General and special funds:
Health Resources and Services
For carrying out titles II, III, IV, VII, VIII, X, XII, XIX, and
XXVI of the Public Health Service Act, section 427(a) of the Federal
Coal Mine Health and Safety Act, title V (including section 510), and
sections 711, 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,
$5,665,996,000, of which $25,000,000 from general revenues,
notwithstanding section 1820(j) of the Social Security Act, shall be
available for carrying out the Medicare rural hospital flexibility
grants program under section 1820 of such Act: Provided, That 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 $45,000,000 is available for
carrying out the provisions of Public Law 104-73: Provided further, That
an award for compensation under said provisions for actual and projected
pain and suffering and emotional distress shall not exceed $250,000:
Provided further, That of the funds made available under this heading,
$264,808,000 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 $739,000,000 shall be for State AIDS Drug Assistance Programs
authorized by section 2616 of the Public Health Service Act: Provided
further, That, notwithstanding section 502(a)(1) of the Social Security
Act, not to exceed $109,132,000 is for carrying out special projects of
regional and national significance pursuant to section 501(a)(2):
Provided further, That $73,044,000 is available for special projects of
regional and national 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.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0350-0-1-550 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.02 Loan guarantee subsidy............ 1 1 1
00.10 Health centers.................... 1,328 1,433 1,582
00.11 National Health Service Corps..... 46 46 45
00.12 National Health Service Corps
recruitment..................... 99 143 167
00.13 Hansen's disease center........... 18 18 18
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............ 10 15 27
00.17 Health professions................ 377 94 81
00.18 Maternal and child health block
grant........................... 731 732 751
00.19 Healthy start..................... 99 99 99
00.20 Universal newborn hearing......... 10
00.21 Emergency medical services for
children........................ 19
00.22 Poison control centers............ 21
00.23 HIV/AIDS.......................... 1,911 1,911 2,010
00.24 Organ transplantation............. 20 25 25
00.25 Health care facilities............ 315
00.26 Bone marrow donor registry........ 22 22 22
00.27 Rural health policy development... 15 6 6
00.28 Rural health outreach grants...... 52 38 38
00.29 Rural health flexibility grants... 40 25 30
00.30 Telehealth........................ 37 6 6
00.31 Program management................ 149 147 151
00.32 Family planning................... 265 265 265
00.33 Abstinence education.............. 44 25
00.34 State access program.............. 15
00.35 Community access program.......... 105
00.36 Health centers tort claim fund.... 16 25 45
00.37 Trauma EMS........................ 3
[[Page 404]]
00.39 Childrens' GME.................... 285 200 199
00.40 Denali commission................. 20
00.41 Community based abstinence grants. 40 73 73
00.42 State offices of rural health..... 8 4 4
00.44 Rural access to emergency devices. 12 2 2
00.45 Radiation Exposure Compensation
Act............................. 4 4 4
00.46 Traumatic brain injury............ 7 7 7
00.47 Healthy communities innovation
initiative...................... 20
00.48 Buildings and facilities.......... 1
--------- --------- ----------
03.00 Total direct programs........... 6,153 5,394 5,666
09.01 Reimbursable program.............. 140 156 160
--------- --------- ----------
10.00 Total new obligations........... 6,293 5,550 5,826
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 33 39 43
22.00 New budget authority (gross)...... 6,304 5,555 5,831
22.10 Resources available from
recoveries of prior year
obligations..................... 1
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 6,338 5,594 5,874
23.95 Total new obligations............. -6,293 -5,550 -5,826
23.98 Unobligated balance expiring or
withdrawn....................... -7
24.40 Unobligated balance carried
forward, end of year............ 39 43 48
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 6,081 5,369 5,666
40.71 Reduction pursuant to P.L. Labor
HHS 107-116................... -1
40.73 Reduction pursuant to P.L. 107-
206........................... -2
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 6,078 5,369 5,666
55.00 Advance appropriation........... 30
Mandatory:
60.00 Appropriation................... 50 25
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 122 130 130
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 1
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 123 130 130
Mandatory:
69.00 Offsetting collections
(cash)(HPSL&NSL).............. 23 31 35
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 6,304 5,555 5,831
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 4,557 5,054 4,697
73.10 Total new obligations............. 6,293 5,550 5,826
73.20 Total outlays (gross)............. -5,753 -5,907 -5,953
73.40 Adjustments in expired accounts
(net)........................... -41
73.45 Recoveries of prior year
obligations..................... -1
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -1
74.40 Obligated balance, end of year.... 5,054 4,697 4,570
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 2,328 2,072 2,201
86.93 Outlays from discretionary
balances........................ 3,354 3,760 3,691
86.97 Outlays from new mandatory
authority....................... 35 38 35
86.98 Outlays from mandatory balances... 36 37 26
--------- --------- ----------
87.00 Total outlays (gross)........... 5,753 5,907 5,953
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -102 -110 -110
88.40 Non-Federal sources........... -20 -20 -20
88.45 Offsetting governmental
collections (from non-
Federal sources)............ -23 -31 -35
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -145 -161 -165
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.................. 6,158 5,394 5,666
90.00 Outlays........................... 5,608 5,746 5,788
----------------------------------------------------------------------------
Additional net budget authority and outlays to cover cost of fully accruing
retirement:
99.00 Budget authority.................. 14 15 17
99.01 Outlays........................... 14 15 17
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2002 actual 2003 est. 2004 est.
Enacted/requested:
Budget Authority.................. 6,158 5,394 5,666
Outlays........................... 5,608 5,746 5,788
Legislative proposal, subject to
PAYGO:
Budget Authority.................. 25 50
Outlays........................... 7 37
------------------------------------
Total:
Budget Authority.................. 6,158 5,419 5,716
Outlays........................... 5,608 5,753 5,825
====================================
Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in
millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0350-0-1-550 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Guaranteed loan levels supportable by subsidy
budget authority:
215001Health centers: Facilities
renovation loan guarantee levels 1 10 10
215002Health centers: Managed care
network development loan
guarantee levels................ 2 2
215003Health centers: Managed care plan
loan guarantee levels........... 5 5
--------- --------- ----------
215901Total loan guarantee levels....... 1 17 17
Guaranteed loan subsidy (in percent):
232001Health centers: Facilities
renovation loan guarantee levels 8.71 3.49 3.52
232002Health centers: Managed care
network development loan
guarantee levels................ 9.27 9.02 9.28
232003Health centers: Managed care plan
loan guarantee levels........... 5.00 7.65 7.77
--------- --------- ----------
232901Weighted average subsidy rate..... 8.71 5.88 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, treatment and care for those living with HIV/AIDS, and
the Medical malpractice claims fund, which pays malpractice claims filed
against employees of federally-supported health centers.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0350-0-1-550 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 95 103 107
11.3 Other than full-time permanent 4 4 4
11.5 Other personnel compensation.. 3 3 3
[[Page 405]]
11.7 Military personnel............ 21 22 23
--------- --------- ----------
11.9 Total personnel compensation 123 132 137
12.1 Civilian personnel benefits..... 22 24 25
12.2 Military personnel benefits..... 11 14 17
13.0 Benefits for former personnel... 3 3 3
21.0 Travel and transportation of
persons....................... 4 4 4
23.1 Rental payments to GSA.......... 12 13 13
23.3 Communications, utilities, and
miscellaneous charges......... 4 5 5
24.0 Printing and reproduction....... 1 2 2
25.1 Advisory and assistance services 52 48 48
25.2 Other services.................. 80 87 96
25.3 Other purchases of goods and
services from Government
accounts...................... 118 94 97
25.4 Operation and maintenance of
facilities.................... 1 1 1
25.6 Medical care.................... 1 1 1
25.7 Operation and maintenance of
equipment..................... 4 5 5
26.0 Supplies and materials.......... 2 2 2
31.0 Equipment....................... 5 5 5
41.0 Grants, subsidies, and
contributions................. 5,694 4,929 5,158
42.0 Insurance claims and indemnities 16 25 46
--------- --------- ----------
99.0 Direct obligations............ 6,153 5,394 5,665
99.0 Reimbursable obligations.......... 140 156 161
--------- --------- ----------
99.9 Total new obligations........... 6,293 5,550 5,826
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0350-0-1-550 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 1,438 1,472 1,445
1101 Military full-time equivalent
employment.................... 267 270 278
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 85 128 128
2101 Military full-time equivalent
employment.................... 5 5 5
Allocation account:
Total compensable workyears:
3001 Civilian full-time equivalent
employment.................... 12 12
3101 Military full-time equivalent
employment.................... 8 21 21
---------------------------------------------------------------------------
Health Resources and Services
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0350-4-1-550 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.33 Abstinence education.............. 25 50
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 25 50
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 25 50
23.95 Total new obligations............. -25 -50
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 25 50
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 18
73.10 Total new obligations............. 25 50
73.20 Total outlays (gross)............. -7 -37
74.40 Obligated balance, end of year.... 18 31
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 7 14
86.98 Outlays from mandatory balances... 23
--------- --------- ----------
87.00 Total outlays (gross)........... 7 37
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 25 50
90.00 Outlays........................... 7 37
---------------------------------------------------------------------------
The budget extends funding for state-based abstinence education
activities for five years.
Vaccine Injury Compensation
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0320-0-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Direct program activity........... 4 8
--------- --------- ----------
10.00 Total new obligations........... 4 8
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 11 8
22.00 New budget authority (gross)...... 1
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 12 8
23.95 Total new obligations............. -4 -8
24.40 Unobligated balance carried
forward, end of year............ 8
----------------------------------------------------------------------------
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............. 4 8
73.20 Total outlays (gross)............. -5 -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... 4 11
--------- --------- ----------
87.00 Total outlays (gross)........... 5 11
----------------------------------------------------------------------------
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........................... 3 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 2004 to
cover payment of pre-1988 claims. By statute, no new claims are accepted
for this account. Payment of claims associated with vaccine related
injury or death occurring after October 1, 1988 are reflected in the
Vaccine improvement trust fund account.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0320-0-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
42.0 Direct obligations: Insurance
claims and indemnities.......... 3 8
99.0 Reimbursable obligations:
Reimbursable obligations........ 1
--------- --------- ----------
99.9 Total new obligations........... 4 8
---------------------------------------------------------------------------
Credit accounts:
Health Center Guaranteed Loan Financing Account
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4442-0-3-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 1 1
22.00 New financing authority (gross)... 1 1
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 2 2
[[Page 406]]
24.40 Unobligated balance carried
forward, end of year............ 1 1 1
----------------------------------------------------------------------------
New financing authority (gross), detail:
Discretionary:
68.00 Spending authority from
offsetting collections
(gross): (Federal sources:
From program account)......... 1 1
----------------------------------------------------------------------------
Change in obligated balances:
73.20 Total financing disbursements
(gross)......................... 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 2002 actual 2003 est. 2004 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......................... 139 138 121
2143 Uncommitted limitation carried
forward......................... -138 -121 -99
--------- --------- ----------
2150 Total guaranteed loan
commitments................... 1 17 22
2199 Guaranteed amount of guaranteed
loan commitments................ 1 14 18
----------------------------------------------------------------------------
Cumulative balance of guaranteed loans
outstanding:
2210 Outstanding, start of year........ 12 13 30
2231 Disbursements of new guaranteed
loans........................... 1 17 22
2251 Repayments and prepayments........
2263 Adjustments: Terminations for
default that result in claim
payments........................
--------- --------- ----------
2290 Outstanding, end of year........ 13 30 52
----------------------------------------------------------------------------
Memorandum:
2299 Guaranteed amount of guaranteed
loans outstanding, end of year.. 10 24 42
---------------------------------------------------------------------------
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 $0.5 million of its available $139 million in loan guarantee
authority, HRSA plans to use approximately $39 million of the remaining
existing loan guarantee limit over 2003 and 2004. 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 2001 actual 2002 actual 2003 est. 2004 est.
-----------------------------------------------------------------------------------------------
ASSETS:
1101 Federal assets: Fund balances with
Treasury........................ 4 1 1 1
------------ -------------- ------------ -------------
1999 Total assets.................... 4 1 1 1
LIABILITIES:
2204 Non-Federal liabilities:
Liabilities for loan guarantees. 4 1 1 1
------------ -------------- ------------ -------------
2999 Total liabilities............... 4 1 1 1
NET POSITION:
3300 Cumulative results of operations..
------------ -------------- ------------ -------------
3999 Total net position..............
------------ -------------- ------------ -------------
4999 Total liabilities and net position 4 1 1 1
-----------------------------------------------------------------------------------------------
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,
$3,389,000.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0340-0-1-552 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.02 Guarantee loan subsidy............ 18 20 18
00.09 Administrative expenses........... 4 4 3
--------- --------- ----------
10.00 Total new obligations........... 22 24 21
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 22 24 21
23.95 Total new obligations............. -22 -24 -21
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 4 4 3
Mandatory:
60.00 Appropriation................... 18 20 18
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 22 24 21
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 1 1
73.10 Total new obligations............. 22 24 21
73.20 Total outlays (gross)............. -22 -24 -21
74.40 Obligated balance, end of year.... 1
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 4 4 3
86.97 Outlays from new mandatory
authority....................... 18 20 18
--------- --------- ----------
87.00 Total outlays (gross)........... 22 24 21
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 22 24 21
90.00 Outlays........................... 23 24 21
---------------------------------------------------------------------------
Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in
millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0340-0-1-552 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Guaranteed loan levels supportable by subsidy
budget authority:
215001HEAL Loan guarantee............... 165 160 150
--------- --------- ----------
215901Total loan guarantee levels....... 165 160 150
Guaranteed loan subsidy (in percent):
232001HEAL Loan guarantee............... 12.43 12.43 12.19
--------- --------- ----------
232901Weighted average subsidy rate..... 12.43 12.43 12.19
Guaranteed loan subsidy budget authority:
233001HEAL Loan guarantee............... 21 20 18
--------- --------- ----------
233901Total subsidy budget authority.... 21 20 18
Guaranteed loan subsidy outlays:
234001HEAL Loan guarantee............... 18 20 18
--------- --------- ----------
234901Total subsidy outlays............. 18 20 18
----------------------------------------------------------------------------
[[Page 407]]
Administrative expense data:
351001Budget authority.................. 4 4 3
359001Outlays from new authority........ 4 4 3
---------------------------------------------------------------------------
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
11.1 Personnel compensation: Full-time
permanent....................... 2 2 1
25.3 Other purchases of goods and
services from Government
accounts........................ 2 2 2
41.0 Grants, subsidies, and
contributions................... 18 20 18
--------- --------- ----------
99.9 Total new obligations........... 22 24 21
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0340-0-1-552 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 22 22 17
---------------------------------------------------------------------------
Health Education Assistance Loans Financing Account
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4304-0-3-552 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Death and disability claims....... 4 2 2
00.02 Default claims.................... 24 37 41
--------- --------- ----------
10.00 Total new obligations........... 28 39 43
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 321 345 334
22.00 New financing authority (gross)... 52 28 27
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 373 373 361
23.95 Total new obligations............. -28 -39 -43
24.40 Unobligated balance carried
forward, end of year............ 345 334 318
----------------------------------------------------------------------------
New financing authority (gross), detail:
Discretionary:
68.00 Spending authority from
offsetting collections
(gross): Offsetting
collections (cash)............ 52 28 27
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. 28 39 43
73.20 Total financing disbursements
(gross)......................... -28 -39 -43
87.00 Total financing disbursements
(gross)......................... 28 39 43
----------------------------------------------------------------------------
Offsets:
Against gross financing authority and
financing disbursements:
Offsetting collections (cash)
from:
88.00 Federal sources............... -18 -20 -18
88.25 Interest on uninvested funds.. -2 -3
88.40 Recoveries of defaulted loans. -34 -6 -6
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -52 -28 -27
----------------------------------------------------------------------------
Net financing authority and financing
disbursements:
89.00 Financing authority...............
90.00 Financing disbursements........... -24 11 16
---------------------------------------------------------------------------
Status of Guaranteed Loans (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4304-0-3-552 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Position with respect to appropriations act
limitation on commitments:
2111 Limitation on guaranteed loans
made by private lenders......... 165 160 150
--------- --------- ----------
2150 Total guaranteed loan
commitments................... 165 160 150
2199 Guaranteed amount of guaranteed
loan commitments................ 165 160 150
----------------------------------------------------------------------------
Cumulative balance of guaranteed loans
outstanding:
2210 Outstanding, start of year........ 1,513 1,646 1,760
2231 Disbursements of new guaranteed
loans........................... 165 160 150
2251 Repayments and prepayments........ -5 -6 -6
Adjustments:
2261 Terminations for default that
result in loans receivable.... -23 -38 -41
2263 Terminations for default that
result in claim payments...... -4 -2 -2
--------- --------- ----------
2290 Outstanding, end of year........ 1,646 1,760 1,861
----------------------------------------------------------------------------
Memorandum:
2299 Guaranteed amount of guaranteed
loans outstanding, end of year.. 1,646 1,760 1,861
----------------------------------------------------------------------------
Addendum:
Cumulative balance of defaulted guaranteed
loans that result in loans receivable:
2310 Outstanding, start of year...... 373 391 423
2331 Disbursements for guaranteed
loan claims................... 23 38 41
2351 Repayments of loans receivable.. -5 -6 -6
--------- --------- ----------
2390 Outstanding, end of year...... 391 423 458
---------------------------------------------------------------------------
This account records all cash flows to and from the Government
resulting from HEAL loan guarantees committed between 1992 and 2004.
Balance Sheet (in millions of dollars)
-----------------------------------------------------------------------------------------------
Identification code 75-4304-0-3-552 2001 actual 2002 actual 2003 est. 2004 est.
-----------------------------------------------------------------------------------------------
ASSETS:
1101 Federal assets: Fund balances with
Treasury........................ 321 345 340 331
1206 Non-Federal assets: Receivables,
net............................. 51 67 67 67
------------ -------------- ------------ -------------
1999 Total assets.................... 372 412 407 398
LIABILITIES:
2204 Non-Federal liabilities:
Liabilities for loan guarantees. 372 412 407 398
------------ -------------- ------------ -------------
2999 Total liabilities............... 372 412 407 398
NET POSITION:
3300 Cumulative results of operations..
------------ -------------- ------------ -------------
3999 Total net position..............
------------ -------------- ------------ -------------
4999 Total liabilities and net position 372 412 407 398
-----------------------------------------------------------------------------------------------
Health Education Assistance Loans Liquidating Account
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4305-0-3-552 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Death and disability claims....... 3 3 3
00.02 Defaulted loans................... 17 19 15
00.03 Debt collection................... 5 6 6
--------- --------- ----------
10.00 Total new obligations........... 25 28 24
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 31 28 24
22.10 Resources available from
recoveries of prior year
obligations..................... 17
22.40 Capital transfer to general fund.. -23
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 25 28 24
23.95 Total new obligations............. -25 -28 -24
----------------------------------------------------------------------------
[[Page 408]]
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 10 7 4
69.00 Offsetting collections (cash)..... 21 21 20
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 31 28 24
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 21 4 3
73.10 Total new obligations............. 25 28 24
73.20 Total outlays (gross)............. -25 -28 -24
73.45 Recoveries of prior year
obligations..................... -17
74.40 Obligated balance, end of year.... 4 3 3
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 25 28 24
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.40 Offsetting collections (cash)
from: Non-Federal sources..... -21 -21 -20
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 10 7 4
90.00 Outlays........................... 4 7 4
---------------------------------------------------------------------------
Status of Guaranteed Loans (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4305-0-3-552 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Cumulative balance of guaranteed loans
outstanding:
2210 Outstanding, start of year........ 668 619 566
2251 Repayments and prepayments........ -39 -42 -35
Adjustments:
2261 Terminations for default that
result in loans receivable.... -8 -9 -7
2263 Terminations for default that
result in claim payments...... -2 -2 -2
--------- --------- ----------
2290 Outstanding, end of year........ 619 566 522
----------------------------------------------------------------------------
Memorandum:
2299 Guaranteed amount of guaranteed
loans outstanding, end of year.. 619 566 522
----------------------------------------------------------------------------
Addendum:
Cumulative balance of defaulted guaranteed
loans that result in loans receivable:
2310 Outstanding, start of year...... 497 488 458
2331 Disbursements for guaranteed
loan claims................... 8 9 7
2351 Repayments of loans receivable.. -15 -15 -15
2361 Write-offs of loans receivable.. -24 -24 -24
2364 Other adjustments, net.......... 22
--------- --------- ----------
2390 Outstanding, end of year...... 488 458 426
---------------------------------------------------------------------------
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 2001 actual 2002 actual 2003 est. 2004 est.
-----------------------------------------------------------------------------------------------
0101 Revenue........................... 14 25 28 24
0102 Expense........................... -14 -25 -28 -24
------------ -------------- ------------ -------------
0105 Net income or loss (-)............
-----------------------------------------------------------------------------------------------
Balance Sheet (in millions of dollars)
-----------------------------------------------------------------------------------------------
Identification code 75-4305-0-3-552 2001 actual 2002 actual 2003 est. 2004 est.
-----------------------------------------------------------------------------------------------
ASSETS:
1101 Federal assets: Fund balances with
Treasury........................ 21 4 4 4
1206 Non-Federal assets: Receivables,
net............................. 376 303 376 376
------------ -------------- ------------ -------------
1999 Total assets.................... 397 307 380 380
LIABILITIES:
2204 Non-Federal liabilities:
Liabilities for loan guarantees. 397 307 380 380
------------ -------------- ------------ -------------
2999 Total liabilities............... 397 307 380 380
NET POSITION:
3300 Cumulative results of operations..
------------ -------------- ------------ -------------
3999 Total net position..............
------------ -------------- ------------ -------------
4999 Total liabilities and net position 397 307 380 380
-----------------------------------------------------------------------------------------------
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4305-0-3-552 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
25.2 Other services.................... 5 6 6
42.0 Insurance claims and indemnities.. 20 22 18
--------- --------- ----------
99.9 Total new obligations........... 25 28 24
---------------------------------------------------------------------------
Medical Facilities Guarantee and Loan Fund
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9931-0-3-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 67 68 69
22.00 New budget authority (gross)...... 1 1 1
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 68 69 70
24.40 Unobligated balance carried
forward, end of year............ 68 69 70
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
69.00 Offsetting collections (cash)... 1 1 1
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 1 1 1
73.20 Total outlays (gross)............. 1
74.40 Obligated balance, end of year.... 1 1 1
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... -1
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.40 Offsetting collections (cash)
from: Non-Federal sources..... -1 -1 -1
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... -1 -1 -1
---------------------------------------------------------------------------
Status of Direct Loans (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9931-0-3-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Cumulative balance of direct loans
outstanding:
1210 Outstanding, start of year........ 9 8 7
1251 Repayments: Repayments and
prepayments..................... -1 -1 -1
--------- --------- ----------
1290 Outstanding, end of year........ 8 7 6
---------------------------------------------------------------------------
Status of Guaranteed Loans (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9931-0-3-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Cumulative balance of guaranteed loans
outstanding:
2210 Outstanding, start of year........ 19 16 13
2251 Repayments and prepayments........ -3 -3 -3
--------- --------- ----------
2290 Outstanding, end of year........ 16 13 10
----------------------------------------------------------------------------
[[Page 409]]
Memorandum:
2299 Guaranteed amount of guaranteed
loans outstanding, end of year.. 16 13 10
---------------------------------------------------------------------------
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 $2,991,000 shall be
available from the Trust Fund to the Secretary of Health and Human
Services.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Unavailable Collections (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8175-0-7-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
01.99 Balance, start of year............ 1,627 1,759 1,907
Receipts:
02.00 Deposits.......................... 109 124 124
02.40 Interest income................... 90 97 105
--------- --------- ----------
02.99 Total receipts and collections.. 199 221 229
--------- --------- ----------
04.00 Total: Balances and collections... 1,826 1,980 2,136
Appropriations:
05.00 Vaccine injury compensation
program trust fund.............. -67 -73 -76
--------- --------- ----------
05.99 Total appropriations............ -67 -73 -76
--------- --------- ----------
07.99 Balance, end of year.............. 1,759 1,907 2,060
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8175-0-7-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Compensation: Claims for post-FY
1989 injuries................... 57 63 66
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........... 67 73 76
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 1 1
22.00 New budget authority (gross)...... 67 73 76
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 68 74 76
23.95 Total new obligations............. -67 -73 -76
24.40 Unobligated balance carried
forward, end of year............ 1
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.26 Appropriation (trust fund)...... 10 10 10
Mandatory:
60.26 Appropriation (trust fund)...... 57 63 66
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 67 73 76
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. 67 73 76
73.20 Total outlays (gross)............. -67 -73 -76
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 10 10 10
86.97 Outlays from new mandatory
authority....................... 57 63 66
--------- --------- ----------
87.00 Total outlays (gross)........... 67 73 76
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 67 73 76
90.00 Outlays........................... 66 73 76
----------------------------------------------------------------------------
Memorandum (non-add) entries:
92.01 Total investments, start of year:
Federal securities: Par value... 1,628 1,758 1,980
92.02 Total investments, end of year:
Federal securities: Par value... 1,758 1,980 2,060
---------------------------------------------------------------------------
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 2002 actual 2003 est. 2004 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.. 57 63 66
--------- --------- ----------
99.9 Total new obligations........... 67 73 76
---------------------------------------------------------------------------
Ricky Ray Hemophilia Relief Fund
Unavailable Collections (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8074-0-7-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
01.99 Balance, start of year............
Receipts:
02.41 Interest on investments, Ricky.... 2 2
Appropriations:
05.00 Ricky Ray hemophilia relief fund.. -2 -2
--------- --------- ----------
07.99 Balance, end of year..............
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8074-0-7-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Compensation--claims.............. 48 4 1
00.02 Administrative expenses subject to
limitation...................... 2 3 2
--------- --------- ----------
10.00 Total new obligations........... 50 7 3
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 145 97 92
22.00 New budget authority (gross)...... 2 2
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 147 99 92
23.95 Total new obligations............. -50 -7 -3
[[Page 410]]
24.40 Unobligated balance carried
forward, end of year............ 97 92 89
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.26 Appropriation (trust fund)...... 2 2
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 3 1
73.10 Total new obligations............. 50 7 3
73.20 Total outlays (gross)............. -53 -8 -3
74.40 Obligated balance, end of year.... 1
----------------------------------------------------------------------------
Outlays (gross), detail:
86.98 Outlays from mandatory balances... 53 8 3
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 2 2
90.00 Outlays........................... 53 8 3
----------------------------------------------------------------------------
Memorandum (non-add) entries:
92.01 Total investments, start of year:
Federal securities: Par value... 130 91
92.02 Total investments, end of year:
Federal securities: Par value... 91
---------------------------------------------------------------------------
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
11.1 Personnel compensation: Full-time
permanent....................... 2 1 1
25.2 Other services.................... 2 1
--------- --------- ----------
99.0 Limitation acct--direct
obligations................. 2 3 2
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-8074-0-7-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Total compensable workyears:
6001 Civilian full-time equivalent
employment...................... 19 12 6
---------------------------------------------------------------------------
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, $2,502,393,000, 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 up to $18,000,000 shall remain available until expended,
for the Indian Catastrophic Health Emergency Fund: Provided further,
That $493,046,000 for contract medical care shall remain available for
obligation until September 30, 2005: Provided further, That of the funds
provided, up to $27,000,000 to remain available until expended, 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 until expended: 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 $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 2004, of which not to exceed $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.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0390-0-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.01 Clinical services............... 1,802 1,945 1,987
00.02 Preventive health............... 100 103 108
00.03 Urban health.................... 31 32 32
00.04 Indian health professions....... 34 35 35
00.05 Tribal management............... 2 2 2
00.06 Direct operations............... 54 55 57
00.07 Self-governance................. 9 10 10
00.08 Contract support costs.......... 268 271 271
00.09 Diabetes funds.................. 100 100 150
09.01 Reimbursable program.............. 767 805 812
--------- --------- ----------
10.00 Total new obligations........... 3,167 3,358 3,464
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 185 241 243
22.00 New budget authority (gross)...... 3,214 3,359 3,464
22.10 Resources available from
recoveries of prior year
obligations..................... 11
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 3,410 3,600 3,707
23.95 Total new obligations............. -3,167 -3,358 -3,464
23.98 Unobligated balance expiring or
withdrawn....................... -2
24.40 Unobligated balance carried
forward, end of year............ 241 243 243
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 2,390 2,454 2,502
40.73 Reduction pursuant to P.L. 107-
206........................... -1
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 2,389 2,454 2,502
Mandatory:
60.00 Appropriation................... 70 100 150
62.00 Transferred from CMS for
diabetes...................... 30
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 100 100 150
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 692 805 812
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 33
--------- --------- ----------
[[Page 411]]
68.90 Spending authority from
offsetting collections
(total discretionary)..... 725 805 812
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 3,214 3,359 3,464
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 604 605 728
73.10 Total new obligations............. 3,167 3,358 3,464
73.20 Total outlays (gross)............. -3,212 -3,325 -3,463
73.40 Adjustments in expired accounts
(net)........................... 9 9
73.45 Recoveries of prior year
obligations..................... -11
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -33
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 81 81
74.40 Obligated balance, end of year.... 605 728 729
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 2,869 2,964 3,013
86.93 Outlays from discretionary
balances........................ 243 281 341
86.97 Outlays from new mandatory
authority....................... 20 20 30
86.98 Outlays from mandatory balances... 80 60 79
--------- --------- ----------
87.00 Total outlays (gross)........... 3,212 3,325 3,463
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -381 -410 -448
88.40 Non-Federal sources........... -386 -395 -364
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -767 -805 -812
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.............. 75
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 2,489 2,554 2,652
90.00 Outlays........................... 2,445 2,520 2,651
----------------------------------------------------------------------------
Additional net budget authority and outlays to cover cost of fully accruing
retirement:
99.00 Budget authority.................. 59 62 67
99.01 Outlays........................... 59 62 67
---------------------------------------------------------------------------
The Indian health services account provides medical care, public
health services, and health professions training opportunities to
American Indians and Alaska Natives. An estimated $1,445 million will be
administered by tribal governments under self-determination contracts
and self-governance compacts in 2004.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0390-0-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 312 333 346
11.3 Other than full-time permanent 17 18 19
11.5 Other personnel compensation.. 29 22 35
11.7 Military personnel............ 72 77 81
--------- --------- ----------
11.9 Total personnel compensation 430 450 481
12.1 Civilian personnel benefits..... 86 91 97
12.2 Military personnel benefits..... 30 33 38
13.0 Benefits for former personnel... 7 8 10
Travel and transportation of
persons:
21.0 Travel and transportation of
persons..................... 29 27 29
21.0 Patient Travel................ 8 8 10
22.0 Transportation of things........ 8 8 10
23.1 Rental payments to GSA.......... 11 11 13
23.2 Rental payments to others....... 2 2 4
23.3 Communications, utilities, and
miscellaneous charges......... 18 19 21
24.0 Printing and reproduction....... 1 1 3
25.1 Advisory and assistance services 5 5 7
25.2 Other services.................. 91 87 89
25.4 Operation and maintenance of
facilities.................... 6 6 8
25.6 Medical care.................... 215 215 251
25.7 Operation and maintenance of
equipment..................... 4 4 6
25.8 Subsistence and support of
persons....................... 1 2 4
26.0 Supplies and materials.......... 126 126 128
31.0 Equipment....................... 9 9 11
32.0 Land and structures............. 3 3 5
41.0 Grants, subsidies, and
contributions................. 1,310 1,438 1,427
--------- --------- ----------
99.0 Direct obligations............ 2,400 2,553 2,652
99.0 Reimbursable obligations.......... 767 805 812
--------- --------- ----------
99.9 Total new obligations........... 3,167 3,358 3,464
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0390-0-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 7,454 7,498 7,528
1101 Military full-time equivalent
employment.................... 1,071 1,071 1,073
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 4,415 4,416 4,420
2101 Military full-time equivalent
employment.................... 619 618 614
---------------------------------------------------------------------------
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, $387,269,000, 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 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.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Unavailable Collections (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0391-0-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
01.99 Balance, start of year............
Receipts:
02.20 Rent and charges for quarters,
Indian health service, HHS...... 6 6 6
Appropriations:
05.00 Indian health facilities.......... -6 -6 -6
--------- --------- ----------
07.99 Balance, end of year..............
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0391-0-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.01 Sanitation and health facilities 190 166 184
00.02 Maintenance..................... 48 53 53
00.03 Facilities and environmental
health........................ 127 134 140
00.04 Equipment....................... 13 16 16
--------- --------- ----------
01.00 Total direct program.......... 378 369 393
09.01 Reimbursable program.............. 2 2 2
--------- --------- ----------
[[Page 412]]
10.00 Total new obligations........... 380 371 395
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 138 142 145
22.00 New budget authority (gross)...... 382 376 400
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 520 518 545
23.95 Total new obligations............. -380 -371 -395
24.40 Unobligated balance carried
forward, end of year............ 142 145 150
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 369 363 387
Mandatory:
60.20 Appropriation (special fund).... 6 6 6
Discretionary:
68.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 7 7 7
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 382 376 400
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 323 323 354
73.10 Total new obligations............. 380 371 395
73.20 Total outlays (gross)............. -379 -339 -385
74.40 Obligated balance, end of year.... 323 354 364
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 155 116 123
86.93 Outlays from discretionary
balances........................ 218 217 256
86.97 Outlays from new mandatory
authority....................... 6 6 6
--------- --------- ----------
87.00 Total outlays (gross)........... 379 339 385
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -7 -7 -7
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 375 369 393
90.00 Outlays........................... 372 332 378
----------------------------------------------------------------------------
Additional net budget authority and outlays to cover cost of fully accruing
retirement:
99.00 Budget authority.................. 9 9 10
99.01 Outlays........................... 9 9 10
---------------------------------------------------------------------------
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 35 38 40
11.3 Other than full-time permanent 6 6 7
11.5 Other personnel compensation.. 1 1 1
11.7 Military personnel............ 17 18 20
--------- --------- ----------
11.9 Total personnel compensation 59 63 68
12.1 Civilian personnel benefits..... 9 10 11
12.2 Military personnel benefits..... 6 6 7
21.0 Travel and transportation of
persons....................... 3 3 3
22.0 Transportation of things........ 2 3 3
23.1 Rental payments to GSA.......... 1 1 1
23.3 Communications, utilities, and
miscellaneous charges......... 11 11 12
25.1 Advisory and assistance services 2 2 4
25.2 Other services.................. 150 134 151
25.3 Other purchases of goods and
services from Government
accounts...................... 1 1 1
25.4 Operation and maintenance of
facilities.................... 9 8 3
25.7 Operation and maintenance of
equipment..................... 1 1 1
26.0 Supplies and materials.......... 10 10 11
31.0 Equipment....................... 3 3 3
32.0 Land and structures............. 15 15 15
41.0 Grants, subsidies, and
contributions................. 96 98 99
--------- --------- ----------
99.0 Direct obligations............ 378 369 393
99.0 Reimbursable obligations.......... 2 2 2
--------- --------- ----------
99.9 Total new obligations........... 380 371 395
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0391-0-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 1,162 1,179 1,205
1101 Military full-time equivalent
employment.................... 168 169 171
---------------------------------------------------------------------------
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 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.
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.
[[Page 413]]
The appropriation structure for the Indian Health Service may not be
altered without advance notice submitted to the House and Senate
Committees on Appropriations.
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, $4,267,330,000, of which $114,000,000 shall
remain available until expended for equipment and construction and
renovation of facilities; of which $293,763,000 for international HIV/
AIDS shall remain available until September 30, 2005, including not less
than $150,000,000, to remain available until expended, for the
``International Mother and Child HIV Prevention Initiative.'' 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 $51,982,000 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.
Note.--A regular 2003 appropriations for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Unavailable Collections (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0943-0-1-999 2002 actual 2003 est. 2004 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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.19 Birth defects/developmental
disabilities/disability and
health........................ 90 89 87
00.20 Chronic disease prev & health
promotion..................... 747 690 834
00.21 Environmental health............ 157 152 150
00.22 Epidemic services and response.. 81 78 76
00.23 Health statistics............... 103 79 73
00.24 HIV/AIDS, STD and TB prevention. 1,148 1,235 1,281
00.25 Immunization.................... 627 628 621
00.26 Infectious disease control...... 348 335 331
00.27 Injury prevention and control... 149 145 145
00.28 Occupational safety and health.. 281 248 246
00.29 Preventive health and heath
service block grant........... 135 135 135
00.30 Public health improvement....... 148 117 114
00.31 Building and facilities......... 236 184 114
00.32 Office of the Director.......... 49 51 60
00.33 Response and recovery........... 12
09.01 Reimbursable program.............. 224 207 212
--------- --------- ----------
10.00 Total new obligations........... 4,535 4,373 4,479
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 47 66 67
22.00 New budget authority (gross)...... 4,554 4,374 4,480
22.10 Resources available from
recoveries of prior year
obligations..................... 1
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 4,602 4,440 4,547
23.95 Total new obligations............. -4,535 -4,373 -4,479
23.98 Unobligated balance expiring or
withdrawn....................... -1
24.40 Unobligated balance carried
forward, end of year............ 66 67 68
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 4,306 4,166 4,267
40.71 Reduction pursuant to P.L. 107-
116 (Labor/HHS)............... -2
40.73 Reduction pursuant to P.L. 107-
206........................... -3
42.00 Transferred from other accounts. 25
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 4,326 4,166 4,267
Mandatory:
60.20 Appropriation (special fund).... 1 1 1
62.00 Transferred from other accounts. 3
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 4 1 1
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 71 207 212
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 153
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 224 207 212
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 4,554 4,374 4,480
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 3,246 3,972 4,032
73.10 Total new obligations............. 4,535 4,373 4,479
73.20 Total outlays (gross)............. -3,708 -4,313 -4,396
73.40 Adjustments in expired accounts
(net)........................... -20
73.45 Recoveries of prior year
obligations..................... -1
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -153
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 75
74.40 Obligated balance, end of year.... 3,972 4,032 4,115
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1,597 1,582 1,620
86.93 Outlays from discretionary
balances........................ 2,110 2,730 2,775
86.97 Outlays from new mandatory
authority....................... 1 1 1
--------- --------- ----------
87.00 Total outlays (gross)........... 3,708 4,313 4,396
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -145 -205 -210
88.40 Non-Federal sources........... -2 -2
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -145 -207 -212
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -153
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 74
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 4,330 4,167 4,268
90.00 Outlays........................... 3,565 4,106 4,184
----------------------------------------------------------------------------
Additional net budget authority and outlays to cover cost of fully accruing
retirement:
99.00 Budget authority.................. 52 55 63
99.01 Outlays........................... 52 55 63
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2002 actual 2003 est. 2004 est.
Enacted/requested:
Budget Authority.................. 4,330 4,167 4,268
Outlays........................... 3,563 4,106 4,184
Legislative proposal, not subject to
PAYGO:
Budget Authority.................. -110
Outlays........................... -48
------------------------------------
[[Page 414]]
Total:
Budget Authority.................. 4,330 4,167 4,158
Outlays........................... 3,563 4,106 4,136
====================================
The Centers for Disease Control and Prevention (CDC) supports a
number of categorical programs designed to improve the health, safety,
and protection 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, 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. The budget request for the 317 immunization
program assumes enactment of a legislative proposal that reduces the
discretionary request by $110 million.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0943-0-1-999 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 354 372 379
11.3 Other than full-time permanent 41 41 42
11.5 Other personnel compensation.. 23 23 24
11.7 Military personnel............ 50 59 60
11.8 Special personal services
payments.................... 1 1 1
--------- --------- ----------
11.9 Total personnel compensation 469 496 506
12.1 Civilian personnel benefits..... 106 115 117
12.2 Military personnel benefits..... 31 37 38
21.0 Travel and transportation of
persons....................... 35 35 36
22.0 Transportation of things........ 8 6 6
23.1 Rental payments to GSA.......... 38 40 42
23.2 Rental payments to others....... 2 2 2
23.3 Communications, utilities, and
miscellaneous charges......... 21 28 28
24.0 Printing and reproduction....... 7 7 7
25.1 Advisory and assistance services 104 93 95
25.2 Other services.................. 79 44 22
25.3 Other purchases of goods and
services from Government
accounts...................... 265 125 129
25.4 Operation and maintenance of
facilities.................... 47 43 44
25.5 Research and development
contracts..................... 270 241 261
25.6 Medical care.................... 2 2 2
25.7 Operation and maintenance of
equipment..................... 19 17 19
26.0 Supplies and materials.......... 32 21 21
31.0 Equipment....................... 64 43 39
32.0 Land and structures............. 221 180 110
41.0 Grants, subsidies, and
contributions................. 2,491 2,591 2,743
--------- --------- ----------
99.0 Direct obligations............ 4,311 4,166 4,267
99.0 Reimbursable obligations.......... 224 207 212
--------- --------- ----------
99.9 Total new obligations........... 4,535 4,373 4,479
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0943-0-1-999 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 6,599 6,559 6,558
1101 Military full-time equivalent
employment.................... 796 797 796
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 352 347 356
2101 Military full-time equivalent
employment.................... 32 31 32
Allocation account:
Total compensable workyears:
3001 Civilian full-time equivalent
employment.................... 420 497 497
---------------------------------------------------------------------------
Disease Control, Research, and Training
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0943-2-1-999 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.25 Immunization.................... -110
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... -110
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... -110
23.95 Total new obligations............. 110
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... -110
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. -110
73.20 Total outlays (gross)............. 48
74.40 Obligated balance, end of year.... -62
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... -48
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. -110
90.00 Outlays........................... -48
---------------------------------------------------------------------------
The budget includes legislative proposals for the Vaccines for
Children (VFC) program to expand access to immunizations for VFC-
eligible children. Legislation amending the Vaccines for Children
program will be proposed to allow underinsured children to receive
immunizations at state and local public health clinics and to lift the
price cap on the tetanus-diphtheria booster. These proposals will result
in approximately $110 million in savings from the CDC discretionary 317
immunization program. The budget request for the 317 program assumes
enactment of this proposal.
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, $73,467,000, 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 2004, and
existing profiles may be updated as necessary.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
[[Page 415]]
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8252-0-7-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Direct program.................... 78 77 73
09.01 Reimbursable program.............. 31 25 25
--------- --------- ----------
10.00 Total new obligations........... 109 102 98
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 109 102 98
23.95 Total new obligations............. -109 -102 -98
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.26 Appropriation (trust fund)...... 78 77 73
Spending authority from offsetting
collections:
68.00 Offsetting collections (cash)... 7 25 25
68.10 Change in uncollected customer
payments from Federal sources
(unexpired)................... 24
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)....... 31 25 25
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 109 102 98
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 30 44 32
73.10 Total new obligations............. 109 102 98
73.20 Total outlays (gross)............. -77 -114 -100
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -24
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 6
74.40 Obligated balance, end of year.... 44 32 30
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 60 77 75
86.93 Outlays from discretionary
balances........................ 17 37 25
--------- --------- ----------
87.00 Total outlays (gross)........... 77 114 100
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -13 -25 -25
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -24
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 6
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 78 77 73
90.00 Outlays........................... 65 89 75
----------------------------------------------------------------------------
Additional net budget authority and outlays to cover cost of fully accruing
retirement:
99.00 Budget authority.................. 3 3 4
99.01 Outlays........................... 3 3 4
---------------------------------------------------------------------------
The Agency for Toxic Substances and Disease Registry (ATSDR) is
authorized under the Comprehensive Environmental Response, Compensation,
and Liability Act of 1980 (CERCLA). ATSDR assesses health hazards at
specific hazardous waste sites helping to prevent or reduce exposure and
illnesses that result, and increasing knowledge and understanding of the
health effects that may result from exposure to hazardous substances.
ATSDR is financed through the EPA Superfund.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8252-0-7-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 20 20 21
11.3 Other than full-time permanent 1 1 1
11.5 Other personnel compensation.. 1 1 1
11.7 Military personnel............ 4 4 4
--------- --------- ----------
11.9 Total personnel compensation 26 26 27
12.1 Civilian personnel benefits..... 5 6 5
12.2 Military personnel benefits..... 2 2 2
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 5 4 4
25.2 Other services.................. 2 2 1
25.3 Other purchases of goods and
services from Government
accounts...................... 9 7 5
25.5 Research and development
contracts..................... 3 7 6
31.0 Equipment....................... 3 2 2
41.0 Grants, subsidies, and
contributions................. 20 18 18
--------- --------- ----------
99.0 Direct obligations............ 78 77 73
99.0 Reimbursable obligations.......... 31 25 25
--------- --------- ----------
99.9 Total new obligations........... 109 102 98
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-8252-0-7-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 308 301 301
1101 Military full-time equivalent
employment.................... 63 63 63
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 57 57 57
2101 Military full-time equivalent
employment.................... 8 8 8
---------------------------------------------------------------------------
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, $4,770,519,000.
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, $2,867,995,000.
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, $382,396,000.
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,
$1,670,007,000.
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,
$1,468,926,000.
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,
$4,335,255,000: Provided, That $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.
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, $1,923,133,000.
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,
$1,245,371,000.
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,
$648,299,000.
[[Page 416]]
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, and section 126(g) of the Superfund Amendments
and Reauthorization Act of 1986, $78,774,000.
For carrying out sections 301 and 311 and title IV of the Public
Health Service Act with respect to environmental health sciences,
$630,774,000.
National Institute on Aging
For carrying out section 301 and title IV of the Public Health
Service Act with respect to aging, $994,411,000.
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, $502,778,000.
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,
$380,377,000.
National Institute of Nursing Research
For carrying out section 301 and title IV of the Public Health
Service Act with respect to nursing research, $134,579,000.
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, $430,121,000.
National Institute on Drug Abuse
For carrying out section 301 and title IV of the Public Health
Service Act with respect to drug abuse, $995,614,000.
National Institute of Mental Health
For carrying out section 301 and title IV of the Public Health
Service Act with respect to mental health, $1,382,114,000.
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, $478,072,000.
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, $282,109,000.
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, $1,053,926,000: 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.
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,
$116,202,000.
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, $192,724,000.
John E. Fogarty International Center
For carrying out the activities at the John E. Fogarty International
Center, $64,266,000.
National Library of Medicine
For carrying out section 301 and title IV of the Public Health
Service Act with respect to health information communications,
$316,040,000, of which $4,000,000 shall be available until expended for
improvement of information systems: Provided, That in fiscal year 2004,
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.
Office of the Director
(including transfer of funds)
For carrying out the responsibilities of the Office of the Director,
National Institutes of Health, $317,983,000, of which $60,942,000 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
the Congress is promptly notified of the transfer: Provided further,
That the National Institutes of Health is authorized to collect third
party payments for the cost of clinical services that are incurred in
National Institutes of Health research facilities and that such payments
shall be credited to the National Institutes of Health Management Fund:
Provided further, That all funds credited to the National Institutes of
Health Management Fund shall remain available for one fiscal year after
the fiscal year in which they are deposited.
buildings and facilities
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, $80,000,000, to
remain available until expended.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Unavailable Collections (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9915-0-1-552 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
01.99 Balance, start of year............
Receipts:
02.20 Cooperative research and
development agreements, NIH..... 15 15 15
Appropriations:
05.00 National Institutes of Health..... -15 -15 -15
--------- --------- ----------
07.99 Balance, end of year..............
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9915-0-1-552 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.01 National Cancer Institute....... 4,178 4,673 4,771
00.02 National Heart, Lung, and Blood
Institute..................... 2,570 2,779 2,868
00.03 National Institute of Dental and
Craniofacial Research......... 342 370 382
00.04 National Institute of Diabetes
and Digestive and Kidney
Disease....................... 1,560 1,704 1,820
00.05 National Institute of
Neurological Disorders and
Stroke........................ 1,325 1,432 1,469
00.06 National Institute of Allergy
and Infectious Diseases....... 2,340 3,984 4,335
00.07 National Institute of General
Medical Sciences.............. 1,723 1,874 1,923
00.08 National Institute of Child
Health and Human Development.. 1,111 1,196 1,245
00.09 National Eye Institute.......... 580 626 648
00.10 National Institute of
Environmental Health Sciences. 645 685 710
00.11 National Institute on Aging..... 891 958 994
00.12 National Institute of Arthritis
and Musculoskeletal and Skin
Disease....................... 448 486 503
00.13 National Institute on Deafness
and Other Communication
Disorder...................... 341 366 380
00.14 National Institute of Mental
Health........................ 1,245 1,344 1,382
00.15 National Institute on Drug Abuse 892 961 996
00.16 Natinal Institute on Alcohol
Abuse and Alcoholism.......... 383 415 430
00.17 National Institute of Nursing
Research...................... 120 130 135
00.18 National Human Genome Research
Institute..................... 428 458 478
00.19 National Institute of Biomedical
Imaging and Bioengineering.... 111 120 282
[[Page 417]]
00.20 National Center for Research
Resources..................... 1,010 1,090 1,054
00.21 National Center for
Complementary and Alternative
Medicine...................... 104 113 116
00.22 National Center on Minority
Health and Health Disparities. 158 186 193
00.23 John E. Fogarty International
Center........................ 57 63 64
00.24 National Library of Medicine.... 276 308 316
00.25 Office of the Director.......... 235 254 318
00.26 Buildings and facilities........ 115 769 80
00.27 Cooperative Research and
Development Agreements........ 9 15 15
00.28 Royalities...................... 28
09.00 Reimbursable program.............. 1,628 1,855 1,887
--------- --------- ----------
10.00 Total new obligations........... 24,853 29,214 29,794
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 209 466 464
22.00 New budget authority (gross)...... 25,119 29,214 29,794
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 25,328 29,680 30,258
23.95 Total new obligations............. -24,853 -29,214 -29,794
23.98 Unobligated balance expiring or
withdrawn....................... -8
24.40 Unobligated balance carried
forward, end of year............ 466 464 464
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 23,366 27,244 27,742
40.35 Appropriation rescinded......... -30
40.71 Reduction pursuant to P.L. 107-
116 (Labor/HHS)............... -9
40.73 Reduction pursuant to P.L. 107-
206........................... -27
41.00 Transferred to other accounts... -125
42.00 Transferred from other accounts. 7
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 23,182 27,244 27,742
Mandatory:
60.00 Appropriation................... 70 100 150
60.20 Appropriation (special fund).... 15 15 15
62.00 Transferred from other accounts. 27
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 112 115 165
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 1,533 1,855 1,887
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 292
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 1,825 1,855 1,887
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 25,119 29,214 29,794
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 19,238 21,692 25,810
73.10 Total new obligations............. 24,853 29,214 29,794
73.20 Total outlays (gross)............. -22,201 -25,098 -28,386
73.40 Adjustments in expired accounts
(net)........................... -134
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -292
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 228
74.40 Obligated balance, end of year.... 21,692 25,810 27,218
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 7,095 8,829 8,989
86.93 Outlays from discretionary
balances........................ 15,022 16,166 19,267
86.97 Outlays from new mandatory
authority....................... 33 34 51
86.98 Outlays from mandatory balances... 51 69 79
--------- --------- ----------
87.00 Total outlays (gross)........... 22,201 25,098 28,386
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -1,688 -1,855 -1,887
88.40 Non-Federal sources........... -63
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -1,751 -1,855 -1,887
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -292
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 218
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 23,294 27,359 27,907
90.00 Outlays........................... 20,450 23,243 26,499
----------------------------------------------------------------------------
Additional net budget authority and outlays to cover cost of fully accruing
retirement:
99.00 Budget authority.................. 86 92 104
99.01 Outlays........................... 86 92 104
---------------------------------------------------------------------------
DISTRIBUTION OF BUDGET AUTHORITY AND OUTLAYS BY ACCOUNT
[Dollars in millions]
2002 2003 2004
Distribution of budget authority by
account:
National Cancer Institute......... 4,177 4,673 4,771
National Heart, Lung, and Blood
Institute....................... 2,570 2,779 2,868
National Institute of Dental and
Craniofacial Research........... 342 370 382
National Institute of Diabetes and
Digestive and Kidney Diseases... 1,561 1,704 1,820
National Institute of Neurological
Disorder and Stroke............. 1,325 1,432 1,469
National Institute of Allergy and
Infectious Diseases............. 2,340 3,984 4,335
National Institute of General
Medical Sciences................ 1,723 1,874 1,923
National Institute of Child Health
and Human Development........... 1,111 1,196 1,245
National Eye Institute............ 580 626 648
National Institute of
Environmental Health Sciences... 645 685 710
National Institute on Aging....... 891 958 994
National Institute of Arthritis
and Musculoskeletal and Skin
Diseases........................ 448 486 503
National Institute on Deafness and
Other Communication Disorders... 341 366 380
National Institute of Nursing
Research........................ 120 130 135
National Institute on Alcohol
Abuse and Alcoholism............ 383 415 430
National Institute on Drug Abuse.. 893 961 996
National Institute of Mental
Health.......................... 1,245 1,344 1,382
National Center for Research
Resources....................... 1,010 1,090 1,054
National Human Genome Research
Institute....................... 428 458 478
National Institute of Biomedical
Imaging and Bioengineering...... 112 120 282
National Center for Complementary
and Alternative Medicine........ 104 113 116
National Center for Minority
Health and Health Disparities... 158 186 193
John E. Fogarty International
Center.......................... 57 63 64
National Library of Medicine...... 276 308 316
Office of the Director............ 235 254 318
Buildings and facilities.......... 204 769 80
------------------------------------
Subtotal...................... 23,279 27,344 27,892
Cooperative Research and
Development Agreements.......... 15 15 15
------------------------------------
Total Budget Authority, NIH... 23,294 27,359 27,907
====================================
[Dollars in millions]
2002 2003 2004
Distribution of outlays by account:
National Cancer Institute......... 3,934 4,089 4,615
National Heart, Lung, and Blood
Institute....................... 2,341 2,513 2,744
National Institute of Dental and
Craniofacial Research........... 296 340 367
National Institute of Diabetes and
Digestive and Kidney Diseases... 1,327 1,544 1,697
National Institute of Neurological
Disorders and Stroke............ 1,145 1.297 1,415
National Institute of Allergy and
Infectious Diseases............. 2,075 2,680 3,766
National Institute of General
Medical Sciences................ 1,544 1,710 1,861
National Institute of Child Health
and Human Development........... 974 1,099 1,192
National Eye Institute............ 509 572 623
National Institute of
Environmental Health Sciences... 551 635 685
National Institute on Aging....... 782 869 948
National Institute of Arthritis
and Musculoskeletal and Skin
Diseases........................ 394 440 481
National Institute on Deafness and
Other Communication Disorders... 298 336 364
National Institute of Nursing
Research........................ 99 114 127
National Institute on Alcohol
Abuse and Alcoholism............ 331 377 410
National Institute on Drug Abuse.. 765 864 942
National Institute of Mental
Health.......................... 1,101 1,222 1,326
National Center for Research
Resources....................... 781 962 1,041
National Human Genome Research
Institute....................... 360 433 465
National Institute of Biomedical
Imaging and Bioengineering...... 20 66 135
National Center for Complementary
and Alternative Medicine........ 82 99 112
National Center for Minority
Health and Health Disparities... 86 136 165
John E. Fogarty International
Center.......................... 51 54 61
National Library of Medicine...... 252 282 307
Office of the Director............ 263 232 272
Buildings and Facilities.......... 231 268 368
Service and Supply Fund/Management
Fund............................ -152 0 0
------------------------------------
Subtotal Outlays.............. 20,440 23,233 26,489
Cooperative Research and
Development Agreements.......... 10 10 10
------------------------------------
Total Outlays, NIH............ 20,450 23,243 26,499
====================================
[[Page 418]]
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.
The National Institutes of Health (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 could be
implemented in 2004 and beyond to maximize budgetary and management
flexibility in the future. Such strategies include funding the total
costs of an increasing number of new grants in the grant's first year
and managing grant average cost increases.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9915-0-1-552 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 600 636 657
11.3 Other than full-time permanent 267 285 294
11.5 Other personnel compensation.. 37 31 32
11.7 Military personnel............ 24 25 26
11.8 Special personal services
payments.................... 117 130 133
--------- --------- ----------
11.9 Total personnel compensation 1,045 1,107 1,142
12.1 Civilian personnel benefits..... 227 241 250
12.2 Military personnel benefits..... 13 14 15
21.0 Travel and transportation of
persons....................... 44 51 53
22.0 Transportation of things........ 6 7 7
23.1 Rental payments to GSA.......... 5 6 7
23.2 Rental payments to others....... 18 23 30
23.3 Communications, utilities, and
miscellaneous charges......... 31 38 39
24.0 Printing and reproduction....... 16 19 19
25.1 Advisory and assistance services 93 90 92
25.2 Other services.................. 432 527 550
25.3 Other purchases of goods and
services from Government
accounts...................... 1,698 1,906 1,989
25.4 Operation and maintenance of
facilities.................... 294 989 306
25.5 Research and development
contracts..................... 1,245 2,190 2,329
25.6 Medical care.................... 14 16 17
25.7 Operation and maintenance of
equipment..................... 57 59 61
26.0 Supplies and materials.......... 203 239 247
31.0 Equipment....................... 177 206 209
41.0 Grants, subsidies, and
contributions................. 17,606 19,631 20,545
42.0 Insurance claims and indemnities 1
--------- --------- ----------
99.0 Direct obligations............ 23,225 27,359 27,907
99.0 Reimbursable obligations.......... 1,628 1,855 1,887
--------- --------- ----------
99.9 Total new obligations........... 24,853 29,214 29,794
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-9915-0-1-552 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 12,259 12,528 12,352
1101 Military full-time equivalent
employment.................... 379 387 382
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 4,465 4,626 4,640
2101 Military full-time equivalent
employment.................... 138 143 143
---------------------------------------------------------------------------
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, $3,393,315,000: Provided, That in addition to amounts
provided herein, $16,000,000 shall be available from amounts available
under section 241 of the Public Health Service Act to carry out national
surveys on drug abuse.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1362-0-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.01 Mental health and substance
abuse activities.............. 884 900 1,106
00.02 Mental health partnership....... 433 433 433
00.03 Substance abuse partnership..... 1,725 1,785 1,785
00.05 Program management.............. 91 77 69
09.01 Reimbursable program.............. 73 75 75
--------- --------- ----------
10.00 Total new obligations........... 3,206 3,270 3,468
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 7 6 6
22.00 New budget authority (gross)...... 3,209 3,270 3,468
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 3,215 3,276 3,474
23.95 Total new obligations............. -3,206 -3,270 -3,468
23.98 Unobligated balance expiring or
withdrawn....................... -3
24.40 Unobligated balance carried
forward, end of year............ 6 6 6
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 3,139 3,195 3,393
40.71 Reduction pursuant to P.L. 107-
116........................... -1
40.73 Reduction pursuant to P.L. 107-
206........................... -2
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 3,136 3,195 3,393
Spending authority from offsetting
collections:
68.00 Offsetting collections (cash)... 70 75 75
68.10 Change in uncollected customer
payments from Federal sources
(unexpired)................... 3
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)....... 73 75 75
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 3,209 3,270 3,468
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 2,156 2,385 2,524
73.10 Total new obligations............. 3,206 3,270 3,468
73.20 Total outlays (gross)............. -2,957 -3,131 -3,349
73.40 Adjustments in expired accounts
(net)........................... -19
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -3
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 2
74.40 Obligated balance, end of year.... 2,385 2,524 2,643
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1,314 1,327 1,405
86.93 Outlays from discretionary
balances........................ 1,643 1,803 1,944
--------- --------- ----------
87.00 Total outlays (gross)........... 2,957 3,131 3,349
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -72 -75 -75
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -3
[[Page 419]]
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 2
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 3,136 3,195 3,393
90.00 Outlays........................... 2,885 3,056 3,274
----------------------------------------------------------------------------
Additional net budget authority and outlays to cover cost of fully accruing
retirement:
99.00 Budget authority.................. 5 5 6
99.01 Outlays........................... 5 5 6
---------------------------------------------------------------------------
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 36 37 38
11.3 Other than full-time permanent 2 2 2
11.5 Other personnel compensation.. 1 1 1
11.7 Military personnel............ 2 2 2
--------- --------- ----------
11.9 Total personnel compensation 41 42 43
12.1 Civilian personnel benefits..... 9 9 9
12.2 Military personnel benefits..... 1 1 1
21.0 Travel and transportation of
persons....................... 2 2 2
23.1 Rental payments to GSA.......... 4 6 7
23.3 Communications, utilities, and
miscellaneous charges......... 2 2 2
24.0 Printing and reproduction....... 4 6 6
25.1 Advisory and assistance services 19 19 18
25.2 Other services.................. 221 221 204
25.3 Other purchases of goods and
services from Government
accounts...................... 124 124 122
31.0 Equipment....................... 1 1 1
41.0 Grants, subsidies, and
contributions................. 2,703 2,760 2,976
42.0 Insurance claims and indemnities 2 2 2
--------- --------- ----------
99.0 Direct obligations............ 3,133 3,195 3,393
99.0 Reimbursable obligations.......... 73 75 75
--------- --------- ----------
99.9 Total new obligations........... 3,206 3,270 3,468
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-1362-0-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 490 499 483
1101 Military full-time equivalent
employment.................... 36 33 33
Reimbursable:
Total compensable workyears:
2101 Military full-time equivalent
employment.................... 56 56 56
---------------------------------------------------------------------------
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, 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 927(c) of the Public Health Service
Act shall not exceed $279,000,000.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1700-0-1-552 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
01.04 Program support................. 3
09.00 Reimbursable program.............. 320 275 304
--------- --------- ----------
10.00 Total new obligations........... 323 275 304
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 7 15 15
22.00 New budget authority (gross)...... 333 275 304
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 340 290 319
23.95 Total new obligations............. -323 -275 -304
23.98 Unobligated balance expiring or
withdrawn....................... -1
24.40 Unobligated balance carried
forward, end of year............ 15 15 15
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 3
Spending authority from offsetting
collections:
68.00 Offsetting collections (cash)... 329 275 304
68.10 Change in uncollected customer
payments from Federal sources
(unexpired)................... 1
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)....... 330 275 304
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 333 275 304
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 278 337 337
73.10 Total new obligations............. 323 275 304
73.20 Total outlays (gross)............. -263 -275 -304
73.40 Adjustments in expired accounts
(net)........................... -1
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -1
74.40 Obligated balance, end of year.... 337 337 337
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 87 275 304
86.93 Outlays from discretionary
balances........................ 176
--------- --------- ----------
87.00 Total outlays (gross)........... 263 275 304
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -329 -275 -304
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.................. 3
90.00 Outlays........................... -66
---------------------------------------------------------------------------
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct obligations:
11.1 Personnel compensation: Full-
time permanent................ 2
12.1 Civilian personnel benefits..... 1
--------- --------- ----------
99.0 Direct obligations............ 3
99.0 Reimbursable obligations.......... 320 275 304
--------- --------- ----------
99.9 Total new obligations........... 323 275 304
---------------------------------------------------------------------------
[[Page 420]]
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-1700-0-1-552 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 22
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 246 284 284
2101 Military full-time equivalent
employment.................... 10 10 10
---------------------------------------------------------------------------
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, $124,892,197,000, to remain available until
expended.
For making, after May 31, 2004, payments to States under title XIX
of the Social Security Act for the last quarter of fiscal year 2004 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 2005, $58,416,275,000, 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.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0512-0-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Medicaid vendor payments.......... 142,585 152,485 166,706
00.02 State and local administration.... 8,076 8,902 9,067
00.03 Vaccine purchases................. 983 1,056 980
09.01 Medicare Part B premiums.......... 50
--------- --------- ----------
10.00 Total new obligations........... 151,644 162,493 176,754
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 110 7
22.00 New budget authority (gross)...... 147,342 162,486 176,754
22.10 Resources available from
recoveries of prior year
obligations..................... 4,198
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 151,650 162,493 176,754
23.95 Total new obligations............. -151,644 -162,493 -176,754
24.40 Unobligated balance carried
forward, end of year............ 7
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
Appropriation:
60.00 Appropriation................. 106,822 112,090 124,892
60.00 Appropriation................. 4,311 3,667
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 111,133 115,757 124,892
65.00 Advance appropriation........... 36,208 46,602 51,861
69.00 Offsetting collections (cash)..... 138 127
69.10 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -136
--------- --------- ----------
69.90 Spending authority from
offsetting collections (total
mandatory).................... 2 127
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 147,343 162,486 176,754
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 5,626 5,557 5,557
73.10 Total new obligations............. 151,644 162,493 176,754
73.20 Total outlays (gross)............. -147,650 -162,493 -176,754
73.45 Recoveries of prior year
obligations..................... -4,198
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... 136
74.40 Obligated balance, end of year.... 5,557 5,557 5,557
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 146,652 161,493 175,754
86.98 Outlays from mandatory balances... 998 1,000 1,000
--------- --------- ----------
87.00 Total outlays (gross)........... 147,650 162,493 176,754
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -138 -127
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... 136
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 147,340 162,359 176,754
90.00 Outlays........................... 147,512 162,366 176,754
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2002 actual 2003 est. 2004 est.
Enacted/requested:
Budget Authority.................. 147,341 162,359 176,753
Outlays........................... 147,512 162,366 176,754
Legislative proposal, not subject to
PAYGO:
Budget Authority.................. -50 -55
Outlays........................... -50 -55
Legislative proposal, subject to
PAYGO:
Budget Authority.................. 225 5,844
Outlays........................... 225 5,844
------------------------------------
Total:
Budget Authority.................. 147,341 162,534 182,542
Outlays........................... 147,512 162,541 182,543
====================================
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
41.0 Direct obligations: Grants,
subsidies, and contributions.... 151,642 162,443 176,754
99.0 Reimbursable obligations:
Reimbursable obligations........ 2 50
--------- --------- ----------
99.9 Total new obligations........... 151,644 162,493 176,754
---------------------------------------------------------------------------
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -50 -55
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. -50 -55
90.00 Outlays........................... -50 -55
---------------------------------------------------------------------------
This schedule reflects the Administration's Medicaid proposals.
[[Page 421]]
Grants to States for Medicaid
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0512-4-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Targeted reforms.................. 175 3,356
09.00 Reimbursable program--Medicare
Part B premium.................. 50 55
09.21 Reimbursable program from SCHIP... 2,433
--------- --------- ----------
10.00 Total new obligations........... 225 5,844
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 225 5,844
23.95 Total new obligations............. -225 -5,844
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 175 3,356
62.00 Transferred from other accounts. 2,433
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 175 5,789
69.00 Offsetting collections (cash)..... 50 55
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 225 5,844
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. 225 5,844
73.20 Total outlays (gross)............. -225 -5,844
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 225 5,844
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 225 5,844
90.00 Outlays........................... 225 5,844
---------------------------------------------------------------------------
This schedule reflects the Administration's Medicaid proposals.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0512-4-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
41.0 Direct obligations: Grants,
subsidies, and contributions.... 175 3,356
99.0 Reimbursable obligations:
Reimbursable obligations........ 50 2,488
--------- --------- ----------
99.9 Total new obligations........... 225 5,844
---------------------------------------------------------------------------
State Grants and Demonstrations
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0516-0-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 TWWIIA--infrastructure grants..... 21 24 27
00.02 TWWIIA--demo grants............... 4 9 18
00.03 High Risk Pools--seed grants...... 10 10
00.04 High Risk Pools--operations grants 30 40
--------- --------- ----------
10.00 Total new obligations........... 25 73 95
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 40 83 142
22.00 New budget authority (gross)...... 67 132 117
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 107 215 259
23.95 Total new obligations............. -25 -73 -95
24.40 Unobligated balance carried
forward, end of year............ 83 142 164
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
Appropriation:
60.00 Appropriation................. 67 72 77
60.00 Appropriation................. 60 40
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 67 132 117
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 20 35 71
73.10 Total new obligations............. 25 73 95
73.20 Total outlays (gross)............. -10 -37 -65
74.40 Obligated balance, end of year.... 35 71 101
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 2 14 29
86.98 Outlays from mandatory balances... 8 23 36
--------- --------- ----------
87.00 Total outlays (gross)........... 10 37 65
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 67 132 117
90.00 Outlays........................... 10 37 65
---------------------------------------------------------------------------
State Grants and Demonstrations provides funding for grant programs
established under the Ticket to Work and Work Incentives Improvement Act
and Title II of the Trade Act of 2002. 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 provide Medicaid benefits and services to working
individuals who have a condition that, without medical assistance, will
result in disability. Part of Title II of the Trade Act of 2002 (P.L.
107-210) amends the Public Health Service Act by adding section 2745,
which addresses promotion of qualified high-risk pools for assisting
``high-risk'' individuals who may find private health insurance
unavailable, unaffordable, or undesirable. This section establishes: (1)
seed grants to states for the creation and initial operation of a
qualified high-risk pool for those states that do not have one as of the
legislative enactment, and (2) grants to states for operation of
qualified high-risk pools.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0516-0-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Grants, subsidies, and contributions:
41.0 Grants, subsidies, and
contributions................. 25 33 45
41.0 Grants, subsidies, and
contributions................. 40 50
--------- --------- ----------
99.9 Total new obligations........... 25 73 95
---------------------------------------------------------------------------
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, $95,084,100,000.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0580-0-1-571 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Supplementary medical insurance
(SMI)........................... 78,318 80,905 94,518
00.02 Hospital insurance for uninsured
(HI)............................ 292 225 197
00.03 Federal uninsured payment (HI).... 150 168 168
00.04 Program management (HI)........... 202 173 201
00.05 FHI trust fund, Transfers from
general fund (civil monetary
penalties)...................... 7 7
00.06 Federal payments from taxation of
OASDI benefits (HI)............. 10,946 7,780 8,348
00.07 Fraud and abuse control, FBI...... 101 114 114
00.08 Fraud and abuse control, criminal
fines........................... 440 4 4
--------- --------- ----------
10.00 Total new obligations........... 90,449 89,376 103,557
----------------------------------------------------------------------------
[[Page 422]]
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 93,467 89,376 103,557
23.95 Total new obligations............. -90,449 -89,376 -103,557
23.98 Unobligated balance expiring or
withdrawn....................... -3,017
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
Appropriation:
60.00 Appropriation................. 10,946 7,780 8,348
60.00 Appropriation................. 440 11 11
60.00 Appropriation................. 81,980 81,471 95,084
60.00 Appropriation................. 101 114 114
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 93,467 89,376 103,557
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. 90,449 89,376 103,557
73.20 Total outlays (gross)............. -90,450 -89,376 -103,557
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 90,450 89,376 103,557
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 93,467 89,376 103,557
90.00 Outlays........................... 90,450 89,376 103,557
----------------------------------------------------------------------------
Additional net budget authority and outlays to cover cost of fully accruing
retirement:
99.00 Budget authority.................. 7 7 8
99.01 Outlays........................... 7 7 8
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2002 actual 2003 est. 2004 est.
Enacted/requested:
Budget Authority.................. 93,467 89,376 103,557
Outlays........................... 90,450 89,376 103,557
Legislative proposal, not subject to
PAYGO:
Budget Authority.................. 150
Outlays........................... 150
------------------------------------
Total:
Budget Authority.................. 93,467 89,376 103,707
Outlays........................... 90,450 89,376 103,707
====================================
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
41.0 Grants, subsidies, and
contributions................... 89,805 88,810 102,991
42.0 Insurance claims and indemnities.. 442 393 365
94.0 Financial transfers............... 202 173 201
--------- --------- ----------
99.0 Direct obligations............ 90,449 89,376 103,557
--------- --------- ----------
99.9 Total new obligations........... 90,449 89,376 103,557
---------------------------------------------------------------------------
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.09 Military Service Credits (HI)..... 150
--------- --------- ----------
10.00 Total new obligations (object
class 42.0)................... 150
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 150
23.95 Total new obligations............. -150
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 150
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. 150
73.20 Total outlays (gross)............. -150
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 150
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 150
90.00 Outlays........................... 150
---------------------------------------------------------------------------
The budget proposes to compensate HI for the equivalent of payroll
taxes on deemed wages posted to the Social Security earnings records of
uniformed services personnel in 2000 and 2001.
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 $2,733,507,000, 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
$65,000,000, to remain available until September 30, 2005, is for
contract costs for CMS' Systems Revitalization Plan: Provided further,
That $56,991,000, to remain available until September 30, 2005, is for
contract costs for the Healthcare Integrated General Ledger Accounting
System: Provided further, That not less than $129,000,000 shall be for
processing Medicare appeals: Provided further, That the Secretary of
Health and Human Services may use alternate mechanisms in lieu of
Administrative Law Judge review: Provided further, That the Secretaryis
directed to collect fees in fiscal year 2004 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.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0511-0-1-550 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.01 Medicare operations............. 1,521 1,709 1,777
[[Page 423]]
00.02 Federal administration.......... 530 562 581
00.03 State survey and certification.. 253 248 248
00.04 Research, demonstrations, and
evaluation projects........... 117 28 63
00.05 Revitalization plan............. 65
--------- --------- ----------
01.00 Total direct program............ 2,421 2,547 2,734
09.01 CLIA.............................. 35 43 43
09.03 Other reimbursements.............. 28 2 2
09.06 Medicare+Choice................... 21 16 14
--------- --------- ----------
09.09 Total reimbursable program...... 84 61 59
--------- --------- ----------
10.00 Total new obligations........... 2,505 2,608 2,793
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 80 99 99
22.00 New budget authority (gross)...... 2,498 2,608 2,793
22.10 Resources available from
recoveries of prior year
obligations..................... 31
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 2,609 2,707 2,892
23.95 Total new obligations............. -2,505 -2,608 -2,793
23.98 Unobligated balance expiring or
withdrawn....................... -5
24.40 Unobligated balance carried
forward, end of year............ 99 99 99
----------------------------------------------------------------------------
New budget authority (gross), detail:
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 1,748 2,608 2,793
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 758
68.73 Reduction pursuant to P.L.
107-116..................... -4
68.76 Reduction pursuant to P.L.
107-206..................... -4
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 2,498 2,608 2,793
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 175 -219 -219
73.10 Total new obligations............. 2,505 2,608 2,793
73.20 Total outlays (gross)............. -2,403 -2,608 -2,793
73.40 Adjustments in expired accounts
(net)........................... -33
73.45 Recoveries of prior year
obligations..................... -31
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -758
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 326
74.40 Obligated balance, end of year.... -219 -219 -219
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1,818 2,608 2,793
86.93 Outlays from discretionary
balances........................ 585
--------- --------- ----------
87.00 Total outlays (gross)........... 2,403 2,608 2,793
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -1,959 -2,547 -2,734
88.40 Non-Federal sources........... -60 -61 -59
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -2,019 -2,608 -2,793
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -758
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 271
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. -8
90.00 Outlays........................... 384
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2002 actual 2003 est. 2004 est.
Enacted/requested:
Budget Authority.................. -8
Outlays........................... 384
Legislative proposal, not subject to
PAYGO:
Budget Authority..................
Outlays...........................
------------------------------------
Total:
Budget Authority.................. -8
Outlays........................... 384
====================================
Program management activities include funding for research, Medicare
operations, survey and certification, CLIA, Medicare+Choice, the CMS
systems revitalization plan, and administrative costs.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0511-0-1-550 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 302 332 333
11.3 Other than full-time permanent 6 10 10
11.5 Other personnel compensation.. 6 5 4
11.7 Military personnel............ 7 7 8
--------- --------- ----------
11.9 Total personnel compensation 321 354 355
12.1 Civilian personnel benefits..... 68 71 72
12.2 Military personnel benefits..... 2 2 3
21.0 Travel and transportation of
persons....................... 10 9 10
22.0 Transportation of things........ 1
23.1 Rental payments to GSA.......... 28 16 16
23.3 Communications, utilities, and
miscellaneous charges......... 26 3 3
24.0 Printing and reproduction....... 19 4 3
25.1 Advisory and assistance services 3
25.2 Other services.................. 707 359 384
25.3 Other purchases of goods and
services from Government
accounts...................... 8 2 2
25.6 Medical care.................... 1,134 1,709 1,834
26.0 Supplies and materials.......... 3 2 2
31.0 Equipment....................... 6
32.0 Land and structures............. 10 10
41.0 Grants, subsidies, and
contributions................. 85 6 40
--------- --------- ----------
99.0 Direct obligations............ 2,421 2,547 2,734
99.0 Reimbursable obligations.......... 84 61 59
--------- --------- ----------
99.9 Total new obligations........... 2,505 2,608 2,793
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0511-0-1-550 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 4,333 4,498 4,325
1101 Military full-time equivalent
employment.................... 84 83 83
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 80 80 78
---------------------------------------------------------------------------
Program Management
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0511-2-1-550 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Medicare operations............... -130 -201
09.01 Proposed user fees................ 130 201
--------- --------- ----------
10.00 Total new obligations...........
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... 130 201
88.40 Non-Federal sources........... -130 -201
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................
---------------------------------------------------------------------------
The budget includes $201 million in new user fees to finance CMS
activities. Proposed fees include: a duplicate or unprocessable claims
fee and a Medicare appeals filing fee. Authorizing legislation for these
fees will be proposed to au
[[Page 424]]
thorize 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 $201
million.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0511-2-1-550 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
25.6 Direct obligations: Medical care.. -130 -201
99.0 Reimbursable obligations:
Reimbursable obligations........ 130 201
--------- --------- ----------
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Grants, subsidies, and
contributions................... 5,934 5,382 3,175
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 5,934 5,382 3,175
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 5,934 5,382 3,175
23.95 Total new obligations............. -5,934 -5,382 -3,175
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
Appropriation:
60.00 Appropriation, BBA............ 3,150 3,150 3,150
60.00 Appropriation, BBRA for
territories................. 25 25 25
61.00 Transferred to other accounts... -60
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 3,115 3,175 3,175
63.00 Reappropriation................. 2,819 2,207
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 5,934 5,382 3,175
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 11,501 10,934 8,099
73.10 Total new obligations............. 5,934 5,382 3,175
73.20 Total outlays (gross)............. -3,682 -4,751 -5,090
73.40 Adjustments in expired accounts
(net)........................... -2,819 -3,466 -831
74.40 Obligated balance, end of year.... 10,934 8,099 5,353
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 413 12 381
86.98 Outlays from mandatory balances... 3,269 4,739 4,709
--------- --------- ----------
87.00 Total outlays (gross)........... 3,682 4,751 5,090
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 5,934 5,382 3,175
90.00 Outlays........................... 3,682 4,751 5,090
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2002 actual 2003 est. 2004 est.
Enacted/requested:
Budget Authority.................. 5,934 5,382 3,175
Outlays........................... 3,682 4,751 5,090
Legislative proposal, subject to
PAYGO:
Budget Authority.................. -2,433
Outlays........................... -2,433
------------------------------------
Total:
Budget Authority.................. 5,934 5,382 742
Outlays........................... 3,682 4,751 2,657
====================================
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Grants, subsidies, and
contributions................... -2,433
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... -2,433
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... -2,433
23.95 Total new obligations............. 2,433
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
61.00 Transferred to other accounts... -2,433
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. -2,433
73.20 Total outlays (gross)............. 2,433
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... -2,433
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. -2,433
90.00 Outlays........................... -2,433
---------------------------------------------------------------------------
This schedule reflects SCHIP legislative proposals, including
Medicaid/SCHIP reform.
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 2004, no
commitments for direct loans or loan guarantees shall be made.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included in 2003 in this budget reflect the Administration's
2003 policy proposals.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4420-0-3-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 10 10 10
23.98 Unobligated balance expiring or
withdrawn....................... -10
24.40 Unobligated balance carried
forward, end of year............ 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.
[[Page 425]]
Trust Funds
Federal Hospital Insurance Trust Fund
Unavailable Collections (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8005-0-7-571 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
01.99 Balance, start of year............ 196,791 227,932 254,489
Receipts:
02.00 Transfers from general fund (FICA
taxes).......................... 138,876 141,866 148,900
02.01 Transfers from general fund (SECA
taxes).......................... 9,785 10,011 10,487
02.02 Receipts from Railroad Retirement
Board........................... 388 398 397
02.03 Civil penalties and damages....... 330 363 363
02.20 Premiums collected for uninsured
individuals not otherwise
eligible........................ 1,525 1,568 1,681
02.21 Other proprietary receipts from
the public...................... 1
02.40 Federal employer contributions
(FICA).......................... 2,191 2,333 2,402
02.41 Postal service employer
contributions (FICA)............ 722 684 683
02.42 Payments from the general fund
(uninsured and program
management)..................... 646 566 566
02.43 Taxation on OASDI benefits........ 10,946 7,780 8,348
02.44 Interest payments by Railroad
Retirement Board................ 36 31 28
02.45 Interest received by trust funds.. 13,738 14,006 15,331
02.47 FBI, Payment from the general fund 101 114 114
02.48 Criminal fines, transfers from the
general fund.................... 431 4 4
02.49 Civil monetary penalties,
transfers from the general fund. 7 7 7
02.50 Transfers from DOD, HI............ 16 4
02.52 Transfer from general fund (in
lieu of DOD payments for
military service credits)....... 150
02.81 Health care fraud and abuse
control, offsetting collections. 7
--------- --------- ----------
02.99 Total receipts and collections.. 179,746 179,735 189,461
--------- --------- ----------
04.00 Total: Balances and collections... 376,537 407,667 443,950
Appropriations:
Appropriations:
05.00 Federal hospital insurance trust
fund.......................... -147,198 -152,128 -161,113
05.00 Proposed legislation not subject
to PAYGO...................... 25 38
05.01 Health care fraud and abuse
control account................. -1,018 -1,075 -1,075
--------- --------- ----------
05.99 Total appropriations............ -148,216 -153,178 -162,150
06.10 Unobligated balance returned to
receipts........................ -389
--------- --------- ----------
07.99 Balance, end of year.............. 227,932 254,489 281,800
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8005-0-7-571 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Benefit payments, HI.............. 144,139 150,001 159,418
00.02 Administration, HI................ 1,552 1,532 1,563
00.03 Quality improvement organizations,
HI.............................. 244 572 80
00.04 Research, HI...................... 95 23 52
00.05 HI partial transfer of home health
to SMI.......................... 1,168
--------- --------- ----------
10.00 Total new obligations........... 147,198 152,128 161,113
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 147,198 152,128 161,113
23.95 Total new obligations............. -147,198 -152,128 -161,113
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.26 Appropriation (trust fund)...... 1,607 1,515 1,574
Mandatory:
60.26 Appropriation (trust fund)...... 178,139 178,220 187,737
60.45 Portion precluded from
obligation.................... -32,548 -27,607 -28,198
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 145,591 150,613 159,538
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 147,198 152,128 161,113
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 408 966 1,219
73.10 Total new obligations............. 147,198 152,128 161,113
73.20 Total outlays (gross)............. -147,050 -151,875 -161,322
73.40 Adjustments in expired accounts
(net)........................... 410
74.40 Obligated balance, end of year.... 966 1,219 1,009
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1,444 1,506 1,556
86.93 Outlays from discretionary
balances........................ 60 15
86.97 Outlays from new mandatory
authority....................... 145,606 150,155 159,475
86.98 Outlays from mandatory balances... 154 275
--------- --------- ----------
87.00 Total outlays (gross)........... 147,050 151,875 161,322
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 147,198 152,128 161,113
90.00 Outlays........................... 147,050 151,875 161,322
----------------------------------------------------------------------------
Memorandum (non-add) entries:
92.01 Total investments, start of year:
Federal securities: Par value... 197,137 228,908 255,896
92.02 Total investments, end of year:
Federal securities: Par value... 228,908 255,896 282,960
----------------------------------------------------------------------------
Additional net budget authority and outlays to cover cost of fully accruing
retirement:
99.00 Budget authority.................. 38 43 46
99.01 Outlays........................... 38 43 46
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2002 actual 2003 est. 2004 est.
Enacted/requested:
Budget Authority.................. 147,198 152,128 161,112
Outlays........................... 147,050 151,875 161,321
Legislative proposal, not subject to
PAYGO:
Budget Authority.................. -25 -38
Outlays........................... -25 -38
------------------------------------
Total:
Budget Authority.................. 147,198 152,103 161,074
Outlays........................... 147,050 151,850 161,283
====================================
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Unexpended balance, start of year:
0100 Treasury balance.................. 247 202
0101 Federal securities: Par value..... 197,137 228,908 255,921
--------- --------- ----------
0199 Total balance, start of year.... 197,385 229,111 255,921
Cash income during the year:
Current law:
Receipts:
1200 FHI trust fund, transfers from
general fund (FICA taxes)... 138,876 141,866 148,900
1201 FHI trust fund, transfers from
general fund (SECA taxes)... 9,785 10,011 10,487
1202 FHI trust fund, receipts from
Railroad Retirement Board... 388 398 397
1203 HCFAC: Civil penalties and
damages..................... 330 363 363
Offsetting receipts
(proprietary):
1220 FHI trust fund, premiums
collected for uninsured
individuals not otherwise
eligible.................... 1,525 1,568 1,681
1221 Other proprietary receipts.... 1
Offsetting receipts
(intragovernmental):
1240 FHI trust fund, Federal
employer contributions
(FICA)...................... 2,191 2,333 2,402
1241 FHI trust fund, Postal Service
employer contributions
(FICA)...................... 722 684 683
Offsetting receipts
(intragovernmental):
1242 FHI trust fund, Federal
payment for transitional
coverage for uninsured
Federal employees......... 150 168 168
1242 FHI trust fund, Federal
payment for transitional
coverage for the uninsured 292 225 197
1242 FHI trust fund, general fund
transfer, program
management (HI)........... 205 173 201
1243 FHI trust fund, Federal
payments for OASDI taxes.... 10,946 7,780 8,348
1244 FHI trust fund, interest
payment from Railroad
Retirement Board............ 36 31 28
1245 FHI trust fund, interest on
investments................. 13,738 14,006 15,331
1247 HCFAC: FBI.................... 101 114 114
1248 HCFAC: Criminal fines......... 431 4 4
1249 HCFAC: Civil monetary
penalties................... 7 7 7
1250 Other intragovernmental
transactions................ 16 4
Offsetting collections:
1281 HCFAC user fees............... 7
--------- --------- ----------
1299 Income under present law...... 179,746 179,735 189,311
[[Page 426]]
Proposed legislation:
Offsetting receipts
(intragovernmental):
2252 Transfer from the general fund
in lieu of DOD payments for
military service credits.... 150
--------- --------- ----------
3299 Total cash income............... 179,746 179,735 189,461
Cash outgo during year:
Current law:
Cash outgo during the year (-):
4500 Benefit Payments.............. -144,140 -150,001 -159,418
4500 Administration................ -1,425 -1,519 -1,555
4500 Quality Improvement
Organizations............... -258 -268 -291
4500 Research...................... -59 -87 -59
4500 HI Partial Transfer of Home
Health to SMI............... -1,168
4501 HCFAC........................... -970 -1,075 -1,075
--------- --------- ----------
4599 Outgo under current law (-)... -148,020 -152,950 -162,397
Proposed legislation:
5500 Administration, legislative
proposal not subject to PAYGO. 25 38
--------- --------- ----------
6599 Total cash outgo (-)............ -148,020 -152,925 -162,359
Unexpended balance, end of year:
8700 Uninvested balance................ 202
8701 Federal securities: Par value..... 228,906 255,921 283,023
--------- --------- ----------
8799 Total balance, end of year...... 229,111 255,921 283,022
---------------------------------------------------------------------------
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8005-0-7-571 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
41.0 Payment for Quality Improvement
Organization (QIO) activities... 244 572 80
42.0 Insurance claims and indemnities
(benefits)...................... 144,139 150,001 159,418
94.0 Financial transfers............... 2,815 1,555 1,615
--------- --------- ----------
99.0 Direct obligations............ 147,198 152,128 161,113
--------- --------- ----------
99.9 Total new obligations........... 147,198 152,128 161,113
---------------------------------------------------------------------------
Federal Hospital Insurance Fund
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8005-2-7-571 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.02 Administration, HI................ -25 -38
--------- --------- ----------
10.00 Total new obligations (object
class 94.0)................... -25 -38
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... -25 -38
23.95 Total new obligations............. 25 38
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.26 Appropriation (trust fund)...... -25 -38
Mandatory:
60.26 Appropriation (trust fund)...... 25 38
60.45 Portion precluded from
obligation.................... -25 -38
--------- --------- ----------
62.50 Appropriation (total
mandatory)..................
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... -25 -38
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. -25 -38
73.20 Total outlays (gross)............. 25 38
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... -25 -38
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. -25 -38
90.00 Outlays........................... -25 -38
----------------------------------------------------------------------------
Memorandum (non-add) entries:
92.01 Total investments, start of year:
Federal securities: Par value... 25
92.02 Total investments, end of year:
Federal securities: Par value... 25 63
---------------------------------------------------------------------------
The budget proposes new discretionary user fees paid by providers
who file a Medicare claims appeal or submit duplicate or unprocessable
claims. This account reflects the reduction in payments to HI as a
result of this user fee proposal.
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Medicare integrity program........ 700 720 720
00.02 FBI fraud and abuse control....... 101 114 114
00.03 Other fraud and abuse control..... 202 241 241
09.01 Reimbursables..................... 8
--------- --------- ----------
10.00 Total new obligations........... 1,011 1,075 1,075
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 1,018 1,075 1,075
23.95 Total new obligations............. -1,011 -1,075 -1,075
23.98 Unobligated balance expiring or
withdrawn....................... -7
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.28 Appropriation (unavailable
balances)..................... 1,011 1,075 1,075
69.00 Offsetting collections (cash)..... 7
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 1,018 1,075 1,075
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 186 213 213
73.10 Total new obligations............. 1,011 1,075 1,075
73.20 Total outlays (gross)............. -970 -1,075 -1,075
73.40 Adjustments in expired accounts
(net)........................... -14
74.40 Obligated balance, end of year.... 213 213 213
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 846 1,075 1,075
86.98 Outlays from mandatory balances... 124
--------- --------- ----------
87.00 Total outlays (gross)........... 970 1,075 1,075
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -7
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 1,011 1,075 1,075
90.00 Outlays........................... 963 1,075 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.
This schedule reflects the estimated distribution of the account for
2003 and 2004. Actual 2003 and 2004 distributions will be determined by
the Secretary of HHS and the Attorney General consistent with the
Administration's priorities, including augmenting existing program
integrity activities for Medicaid and the State Children's Health
Insurance Program (SCHIP).
2002 actual 2003 est. 2004 est.
Department of Justice, DOJ.......... 55 50 45
[[Page 427]]
Office of the Inspector General, HHS 139 160 160
Centers for Medicare and Medicaid
Services, Medicaid/SCHIP Program
Integrity, HHS...................... 0 10 20
Centers for Medicare and Medicaid
Services, Other HHS................. 3 12 9
Office of the General Counsel, HHS.. 3 6 5
Other HHS........................... 2 3 2
------------------------------------
Total......................... 202 241 241
====================================
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8393-0-7-571 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct obligations:
11.1 Personnel compensation: Full-
time permanent (CMS 100 FTEs). 8
12.1 Civilian personnel benefits
(CMS)......................... 2
25.1 Advisory and assistance services
(CMS)......................... 12 5
25.2 Other services (CMS)............ 5 9
Other purchases of goods and
services from Government
accounts:
25.3 Other purchases of goods and
services from Government
accounts (DoJ).............. 50 45
25.3 Other purchases of goods and
services from Government
accounts (HHS/OIG).......... 160 160
25.3 Other purchases of goods and
services from Government
accounts (HHS/AoA).......... 3 2
25.3 Other purchases of goods and
services from Government
accounts (HHS/OGC).......... 6 5
25.6 Medical care (CMS).............. 700 720 720
41.0 Grants, subsidies, and
contributions (CMS)........... 5 5
94.0 Financial transfers............. 101 114 114
--------- --------- ----------
99.0 Direct obligations............ 801 1,075 1,075
99.0 Reimbursable obligations.......... 8
Allocation Account:
Travel and transportation of
persons:
21.0 Travel and transportation of
persons (OIG)............... 7
21.0 Travel and transportation of
persons (DoJ)............... 1
22.0 Transportation of things (OIG).. 1
Rental payments to GSA:
23.1 Rental payments to GSA (OIG).. 9
23.1 Rental payments to GSA (DoJ).. 3
23.1 Rental payments to GSA (OGC).. 1
23.3 Communications, utilities, and
miscellaneous charges (OIG)... 2
24.0 Printing and reproduction [DOJ]. 1
Advisory and assistance
services:
25.1 Advisory and assistance
services [DOJ].............. 1
25.1 Advisory and assistance
services (CMS).............. 1
Other services:
25.2 Other services (DoJ).......... 25
25.2 Other services [OIG].......... 2
Other purchases of goods and
services from Government
accounts:
25.3 Purchases of goods and
services from Government
accounts (DoJ).............. 2
25.3 Purchases of goods and
services from Government
accounts [OIG].............. 10
25.7 Operation and maintenance of
equipment (OIG)............... 1
26.0 Supplies and materials (OIG).... 2
Equipment:
31.0 Equipment (OIG)............... 4
31.0 Equipment [DOJ]............... 1
Grants, subsidies, and
contributions:
41.0 Grants, subsidies, and
contributions (AoA)......... 1
41.0 Grants, subsidies, and
contributions (CMS)......... 2
Financial transfers:
94.0 OIG full-time permanent....... 75
94.0 DoJ full-time permanent....... 15
94.0 OGC full-time permanent....... 2
94.0 AoA full-time permanent....... 1
94.0 Undistributed (DoJ other than
full-time permanent)........ 1
94.0 Undistributed (OIG other than
full-time permanent)........ 1
94.0 Undistributed (OIG other
personnel compensation)..... 2
94.0 Undistributed (DoJ special
personal services payments). 1
94.0 Undistributed (OIG personnel
benefits)................... 23
94.0 Undistributed (DoJ personnel
benefits)................... 4
--------- --------- ----------
99.0 Allocation account............ 202
--------- --------- ----------
99.9 Total new obligations........... 1,011 1,075 1,075
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-8393-0-7-571 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 100
---------------------------------------------------------------------------
Federal Supplementary Medical Insurance Trust Fund
Unavailable Collections (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8004-0-7-571 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
01.99 Balance, start of year............ 41,663 37,744 27,608
Receipts:
02.20 Premiums collected for the aged... 21,173 23,009 25,145
02.21 Premiums collected for the
disabled........................ 3,254 3,692 4,172
02.22 Other proprietary receipts from
the public...................... 3
02.40 Federal contributions............. 78,318 80,905 94,518
Offsetting receipts (intragovernmental):
02.41 Interest received by trust fund. 2,916 2,374 1,966
02.41 Interest received by trust fund,
legislative proposal not
subject to PAYGO.............. -6
02.42 Transfers from DOD, SMI........... 15 4
02.45 Miscellaneous Federal payments.... 1
02.80 Federal supplementary medical
insurance trust fund, offsetting
collections..................... 1,168
--------- --------- ----------
02.99 Total receipts and collections.. 106,848 109,984 125,795
--------- --------- ----------
04.00 Total: Balances and collections... 148,511 147,728 153,403
Appropriations:
Appropriations:
05.00 Federal supplementary medical
insurance trust fund.......... -110,353 -120,175 -121,599
05.00 Legislative proposal not subject
to PAYGO...................... 55 108
--------- --------- ----------
05.99 Total appropriations............ -110,353 -120,120 -121,491
06.10 Unobligated balance returned to
receipts........................ -414
--------- --------- ----------
07.99 Balance, end of year.............. 37,744 27,608 31,912
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8004-0-7-571 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Benefit payments, SMI............. 106,909 117,627 119,214
00.02 Administration, SMI............... 2,181 2,273 2,353
00.03 Quality improvement organizations,
SMI............................. 71 143 20
00.04 Research, SMI..................... 22 5 12
00.06 Transfer to Medicaid for payment
of SMI premiums................. 2 127
09.01 HI partial transfer of home health 1,168
--------- --------- ----------
10.00 Total new obligations........... 110,353 120,175 121,599
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 110,353 120,175 121,599
23.95 Total new obligations............. -110,353 -120,175 -121,599
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.26 Appropriation (trust fund)...... 2,198 2,273 2,360
Mandatory:
60.26 Appropriation (trust fund)...... 103,482 107,711 123,441
60.28 Appropriation (unavailable
balances)..................... 3,505 10,191 -4,202
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 106,987 117,902 119,239
69.00 Offsetting collections (cash)..... 1,168
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 110,353 120,175 121,599
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 142 916 1,017
73.10 Total new obligations............. 110,353 120,175 121,599
73.20 Total outlays (gross)............. -109,993 -120,074 -121,626
73.40 Adjustments in expired accounts
(net)........................... 414
74.40 Obligated balance, end of year.... 916 1,017 990
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1,712 2,238 2,328
86.97 Outlays from new mandatory
authority....................... 108,155 117,788 119,223
86.98 Outlays from mandatory balances... 126 48 75
--------- --------- ----------
[[Page 428]]
87.00 Total outlays (gross)........... 109,993 120,074 121,626
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -1,168
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 109,185 120,175 121,599
90.00 Outlays........................... 108,825 120,074 121,626
----------------------------------------------------------------------------
Memorandum (non-add) entries:
92.01 Total investments, start of year:
Federal securities: Par value... 41,978 38,804 28,570
92.02 Total investments, end of year:
Federal securities: Par value... 38,804 28,570 32,695
----------------------------------------------------------------------------
Additional net budget authority and outlays to cover cost of fully accruing
retirement:
99.00 Budget authority.................. 35 38 42
99.01 Outlays........................... 35 38 42
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2002 actual 2003 est. 2004 est.
Enacted/requested:
Budget Authority.................. 109,185 120,175 121,599
Outlays........................... 108,825 120,074 121,626
Legislative proposal, not subject to
PAYGO:
Budget Authority.................. -55 -108
Outlays........................... -55 -108
------------------------------------
Total:
Budget Authority.................. 109,185 120,120 121,491
Outlays........................... 108,825 120,019 121,518
====================================
The Supplementary Medical Insurance (SMI) program is a voluntary
program that 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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Unexpended balance, start of year:
0100 Treasury balance.................. -174 -145
0101 Federal securities: Par value..... 41,978 38,804 28,625
--------- --------- ----------
0199 Total balance, start of year.... 41,805 38,660 28,625
Cash income during the year:
Current law:
Offsetting receipts
(proprietary):
1220 Premiums collected for the
aged, FSMI fund............. 21,173 23,009 25,145
1221 Premiums collected for the
disabled, FSMI fund......... 3,254 3,692 4,172
1222 Other proprietary receipts.... 3
Offsetting receipts
(intragovernmental):
1240 Federal contributions, FSMI
fund........................ 78,318 80,905 94,518
1241 Interest received by trust
fund, FSMI fund............. 2,916 2,374 1,966
1242 Intragovernmental transactions 15 4
1245 Offsetting receipts
(intragovernmental)......... 1
Offsetting collections:
1280 HI partial transfer of home
health...................... 1,168
--------- --------- ----------
1299 Income under present law...... 106,848 109,984 125,801
Proposed legislation:
Offsetting receipts
(intragovernmental):
2241 Interest received by trust
fund, legislative proposal
not subject to PAYGO........ -6
--------- --------- ----------
3299 Total cash income............... 106,848 109,984 125,795
Cash outgo during year:
Current law:
Cash outgo during the year (-):
4500 Benefit payments & ESRD....... -106,901 -117,627 -119,214
4500 Administration................ -1,704 -2,223 -2,320
4500 Quality Improvement
Organizations............... -95 -77 -79
4500 Research...................... -13 -20 -13
4500 HI partial transfer of home
health...................... -1,168
4500 Transfer to Medicaid for
payment of SMI premiums..... -112 -127
--------- --------- ----------
4599 Outgo under current law (-)... -109,993 -120,074 -121,626
Proposed legislation:
5500 Administration, legislative
proposal not subject to PAYGO. 55 108
--------- --------- ----------
6599 Total cash outgo (-)............ -109,993 -120,019 -121,518
Unexpended balance, end of year:
8700 Uninvested balance................ -145
8701 Federal securities: Par value..... 38,804 28,625 32,902
--------- --------- ----------
8799 Total balance, end of year...... 38,660 28,625 32,902
---------------------------------------------------------------------------
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8004-0-7-571 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct obligations:
41.0 Payment for Quality Improvement
Organization (QIO) activity... 71 143 20
42.0 Insurance claims and indemnities 106,911 117,754 119,214
94.0 Financial transfers............. 2,203 2,278 2,365
--------- --------- ----------
99.0 Direct obligations............ 109,185 120,175 121,599
99.0 Reimbursable obligations.......... 1,168
--------- --------- ----------
99.9 Total new obligations........... 110,353 120,175 121,599
---------------------------------------------------------------------------
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.02 Administration, SMI............... -105 -163
00.06 Transfer to Medicaid for payment
of SMI premiums................. 50 55
--------- --------- ----------
10.00 Total new obligations........... -55 -108
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... -55 -108
23.95 Total new obligations............. 55 108
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.26 Appropriation (trust fund)...... -105 -163
Mandatory:
60.26 Appropriation (trust fund)...... 105 157
60.28 Appropriation (unavailable
balances)..................... 50 -102
60.45 Portion precluded from
obligation.................... -105
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 50 55
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... -55 -108
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. -55 -108
73.20 Total outlays (gross)............. 55 108
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... -105 -163
86.97 Outlays from new mandatory
authority....................... 50 55
--------- --------- ----------
87.00 Total outlays (gross)........... -55 -108
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. -55 -108
90.00 Outlays........................... -55 -108
----------------------------------------------------------------------------
Memorandum (non-add) entries:
92.01 Total investments, start of year:
Federal securities: Par value... 55
92.02 Total investments, end of year:
Federal securities: Par value... 55 207
---------------------------------------------------------------------------
[[Page 429]]
The budget proposes new discretionary user fees paid by providers
who file a Medicare claims appeal or submit 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.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8004-2-7-571 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
42.0 Insurance claims and indemnities.. 50 55
94.0 Financial transfers............... -105 -163
--------- --------- ----------
99.9 Total new obligations........... -55 -108
---------------------------------------------------------------------------
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 2002 actual 2003 est. 2004 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.................... 100 100 100
00.06 Supplemental grants for population
increases....................... 319 192
00.07 Bonus to reward high performance
States.......................... 200 400 200
00.08 Tribal work programs.............. 8 8 8
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 17,195 17,282 16,890
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 600 400
22.00 New budget authority (gross)...... 17,009 16,882 17,690
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 17,609 17,282 17,690
23.95 Total new obligations............. -17,195 -17,282 -16,890
23.98 Unobligated balance expiring or
withdrawn....................... -14
24.40 Unobligated balance carried
forward, end of year............ 400 800
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 17,009 16,882 17,690
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 10,543 8,884 6,952
73.10 Total new obligations............. 17,195 17,282 16,890
73.20 Total outlays (gross)............. -18,749 -19,214 -18,567
73.40 Adjustments in expired accounts
(net)........................... -105
74.40 Obligated balance, end of year.... 8,884 6,952 5,275
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 12,442 12,816 13,028
86.98 Outlays from mandatory balances... 6,307 6,398 5,539
--------- --------- ----------
87.00 Total outlays (gross)........... 18,749 19,214 18,567
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 17,009 16,882 17,690
90.00 Outlays........................... 18,749 19,214 18,567
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2002 actual 2003 est. 2004 est.
Enacted/requested:
Budget Authority.................. 17,009 16,882 17,690
Outlays........................... 18,749 19,214 18,567
Legislative proposal, subject to
PAYGO:
Budget Authority.................. 127 -81
Outlays........................... -5 146
------------------------------------
Total:
Budget Authority.................. 17,009 17,009 17,609
Outlays........................... 18,749 19,209 18,713
====================================
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Promotion of healthy marriage and
family formation grants......... 100 100
00.02 Family formation, research,
demonstration, and technical
assistance...................... 100 100
00.03 Supplemental grants for population
increases....................... 127 319
00.04 Elimination of illegitimacy bonus. -100 -100
00.05 Redirect high performance bonus... -100 -500
--------- --------- ----------
10.00 Total new obligations........... 127 -81
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 127 -81
23.95 Total new obligations............. -127 81
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 127 -81
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 132
73.10 Total new obligations............. 127 -81
73.20 Total outlays (gross)............. 5 -146
74.40 Obligated balance, end of year.... 132 -95
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... -5 96
86.98 Outlays from mandatory balances... 50
--------- --------- ----------
87.00 Total outlays (gross)........... -5 146
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 127 -81
90.00 Outlays........................... -5 146
---------------------------------------------------------------------------
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 promote
healthy marriages and family formation.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1552-4-1-609 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
25.1 Advisory and assistance services.. 20
41.0 Grants, subsidies, and
contributions................... 107 -81
--------- --------- ----------
99.9 Total new obligations........... 127 -81
---------------------------------------------------------------------------
[[Page 430]]
Contingency Fund
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1522-0-1-609 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Program activity.................. 2
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 2
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 1,958
22.00 New budget authority (gross)...... 1,958 1,958
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 1,958 1,958 1,958
23.95 Total new obligations............. -2
23.98 Unobligated balance expiring or
withdrawn....................... -1,958
24.40 Unobligated balance carried
forward, end of year............ 1,958 1,956
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 1,958
63.00 Reappropriation................. 1,958
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 1,958 1,958
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. 2
73.20 Total outlays (gross)............. -1
----------------------------------------------------------------------------
Outlays (gross), detail:
86.98 Outlays from mandatory balances... 1
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 1,958 1,958
90.00 Outlays........................... 1
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2002 actual 2003 est. 2004 est.
Enacted/requested:
Budget Authority.................. 1,958 1,958
Outlays........................... 1
Legislative proposal, subject to
PAYGO:
Budget Authority.................. 42
Outlays........................... 1 1
------------------------------------
Total:
Budget Authority.................. 1,958 2,000
Outlays........................... 1 2
====================================
Contingency Fund
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1522-4-1-609 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 42
22.00 New budget authority (gross)...... 42
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 42 42
24.40 Unobligated balance carried
forward, end of year............ 42 42
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 42
----------------------------------------------------------------------------
Change in obligated balances:
73.20 Total outlays (gross)............. -1 -1
----------------------------------------------------------------------------
Outlays (gross), detail:
86.98 Outlays from mandatory balances... 1 1
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 42
90.00 Outlays........................... 1 1
---------------------------------------------------------------------------
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), $3,292,970,000, to remain
available until expended; and for such purposes for the first quarter of
fiscal year 2005, $1,200,000,000, 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.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1501-0-1-609 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
Child support enforcement (CSE):
Benefit payments:
00.01 State child support
administrative costs........ 3,324 3,532 3,905
00.02 Child support incentive
payments.................... 450 461 454
00.03 Access and visitation grants.. 10 10 10
--------- --------- ----------
00.91 Subtotal, child support
enforcement................... 3,784 4,003 4,369
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........... 124 10
02.03 State and local welfare
administration................ 3
--------- --------- ----------
02.91 Subtotal, AFDC programs....... 127 10
09.01 Offset obligations (cse grants to
states)......................... 157 189 179
--------- --------- ----------
10.00 Total new obligations........... 4,092 4,226 4,572
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 89
22.00 New budget authority (gross)...... 4,003 4,226 4,572
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 4,092 4,226 4,572
23.95 Total new obligations............. -4,092 -4,226 -4,572
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 2,846 2,937 3,293
65.00 Advance appropriation........... 1,000 1,100 1,100
69.00 Offsetting collections (cash)..... 157 189 179
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 4,003 4,226 4,572
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 803 740 603
73.10 Total new obligations............. 4,092 4,226 4,572
73.20 Total outlays (gross)............. -4,155 -4,363 -4,517
74.40 Obligated balance, end of year.... 740 603 658
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 3,641 3,817 4,102
[[Page 431]]
86.98 Outlays from mandatory balances... 514 546 415
--------- --------- ----------
87.00 Total outlays (gross)........... 4,155 4,363 4,517
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.45 Offsetting collections (cash)
from: Offsetting governmental
collections (from non-Federal
sources)...................... -157 -189 -179
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 3,846 4,037 4,393
90.00 Outlays........................... 3,998 4,174 4,338
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2002 actual 2003 est. 2004 est.
Enacted/requested:
Budget Authority.................. 3,846 4,037 4,393
Outlays........................... 3,998 4,174 4,338
Legislative proposal, subject to
PAYGO:
Budget Authority.................. -47
Outlays........................... -47
------------------------------------
Total:
Budget Authority.................. 3,846 4,037 4,346
Outlays........................... 3,998 4,174 4,291
====================================
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)
2002 2003 2004
Gross Federal share of collections.. -1,235 -1,127 -1,151
Federal incentive payments to States 450 461 454
Hold harmless payments.............. 10
State child support administrative
costs............................... 3,481 3,711 4,035
Access and visitation grants........ 10 10 10
------------------------------------
Total........................... 2,706 3,065 3,348
====================================
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1501-0-1-609 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
41.0 Direct obligations: Grants,
subsidies, and contributions.... 3,935 4,037 4,393
99.0 Reimbursable obligations:
Reimbursable obligations........ 157 189 179
--------- --------- ----------
99.9 Total new obligations........... 4,092 4,226 4,572
---------------------------------------------------------------------------
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
Child support enforcement (CSE):
Benefit payments:
00.01 State child support
administrative costs........ -49
00.03 Access and visitation grants.. 2
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... -47
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... -47
23.95 Total new obligations............. 47
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... -47
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. -47
73.20 Total outlays (gross)............. 47
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... -47
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. -47
90.00 Outlays........................... -47
---------------------------------------------------------------------------
This legislative package reproposes provisions in the TANF
reauthorization plan, including proposals to increase child support
collections and to direct more of these payments to families. Also
included are provisions to streamline current and introduce new data
matching efforts to more effectively seize child support payments
through state, tribal, and private industry participation.
Low Income Home Energy Assistance
For making payments under title XXVI of the Omnibus Budget
Reconciliation Act of 1981, $1,700,000,000.
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, and notwithstanding
the designation requirement of section 2602(e).
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1502-0-1-609 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Direct program activity........... 1,800 1,550 1,850
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 1,800 1,550 1,850
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 300 300 300
22.00 New budget authority (gross)...... 2,000 1,700 2,000
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 2,300 2,000 2,300
23.95 Total new obligations............. -1,800 -1,550 -1,850
23.98 Unobligated balance expiring or
withdrawn....................... -200 -150 -150
24.40 Unobligated balance carried
forward, end of year............ 300 300 300
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
Appropriation:
40.00 Appropriation [Base Program].. 1,700 1,400 1,700
40.00 Appropriation [Emergency]..... 300 300 300
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 2,000 1,700 2,000
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 512 536 459
73.10 Total new obligations............. 1,800 1,550 1,850
73.20 Total outlays (gross)............. -1,773 -1,628 -1,774
73.40 Adjustments in expired accounts
(net)........................... -3 -5
74.40 Obligated balance, end of year.... 536 459 530
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1,329 1,147 1,369
86.93 Outlays from discretionary
balances........................ 444 481 405
--------- --------- ----------
87.00 Total outlays (gross)........... 1,773 1,628 1,774
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 2,000 1,700 2,000
90.00 Outlays........................... 1,773 1,628 1,774
---------------------------------------------------------------------------
[[Page 432]]
This program makes grants to States and Indian tribes to aid low-
income households with high energy costs through payments to eligible
households, energy suppliers, and weatherization providers. 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), $417,626,000: Provided, That funds appropriated pursuant to
section 414(a) of the Immigration and Nationality Act for fiscal year
2004 shall be available for the costs of assistance provided and other
activities through September 30, 2006: 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. For carrying out section 462 of the
Homeland Security Act of 2002 (P.L. 107-296), $34,000,000.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1503-0-1-609 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Refugee and entrant assistance.... 468 490 462
00.02 Assistance for treatment of
torture victims................. 10 10 10
--------- --------- ----------
10.00 Total new obligations........... 478 500 472
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 24 24 10
22.00 New budget authority (gross)...... 460 486 462
22.10 Resources available from
recoveries of prior year
obligations..................... 19
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 503 510 472
23.95 Total new obligations............. -478 -500 -472
23.98 Unobligated balance expiring or
withdrawn....................... -2
24.40 Unobligated balance carried
forward, end of year............ 24 10
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 460 453 462
42.00 Transferred from other accounts. 33
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 460 486 462
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 570 544 559
73.10 Total new obligations............. 478 500 472
73.20 Total outlays (gross)............. -480 -483 -476
73.40 Adjustments in expired accounts
(net)........................... -2
73.45 Recoveries of prior year
obligations..................... -19
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... -3
74.40 Obligated balance, end of year.... 544 559 555
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 138 146 139
86.93 Outlays from discretionary
balances........................ 342 337 337
--------- --------- ----------
87.00 Total outlays (gross)........... 480 483 476
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 460 486 462
90.00 Outlays........................... 480 483 476
---------------------------------------------------------------------------
States are subsidized for administering the refugee assistance
program. Funds are also provided to assist in the rehabilitation of
victims of torture. The transferred amounts from the Department of
Homeland Security to HHS in 2003 relating to the care and placement of
unaccompanied alien children are estimates. Final amounts transferred
will be included in a determination order issued by the Director of the
Office of Management and Budget.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1503-0-1-609 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
25.1 Advisory and assistance services.. 1 1 1
25.2 Other services.................... 2 2 2
25.3 Other purchases of goods and
services from Government
accounts........................ 2 2 2
41.0 Grants, subsidies, and
contributions................... 473 495 467
--------- --------- ----------
99.9 Total new obligations........... 478 500 472
---------------------------------------------------------------------------
Promoting Safe and Stable Families
For carrying out section 436 of the Social Security Act,
$305,000,000; for section 437, $199,978,000; and for section 439,
$50,000,000.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1512-0-1-506 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Grants to States and Tribes....... 353 475 475
00.02 Research, training and technical
assistance...................... 9 13 13
00.03 State court assessment activities. 13 17 17
00.04 Mentoring children of prisoners... 25 50
--------- --------- ----------
10.00 Total new obligations........... 375 530 555
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 375 530 555
23.95 Total new obligations............. -375 -530 -555
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
Appropriation:
40.00 Appropriation................. 70 200 200
40.00 Appropriation................. 25 50
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 70 225 250
Mandatory:
60.00 Appropriation................... 305 305 305
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 375 530 555
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 339 402 541
73.10 Total new obligations............. 375 530 555
73.20 Total outlays (gross)............. -301 -391 -507
73.40 Adjustments in expired accounts
(net)........................... -11
74.40 Obligated balance, end of year.... 402 541 591
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 12 37 39
86.93 Outlays from discretionary
balances........................ 45 150
86.97 Outlays from new mandatory
authority....................... 56 55 55
86.98 Outlays from mandatory balances... 233 254 263
--------- --------- ----------
87.00 Total outlays (gross)........... 301 391 507
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 375 530 555
90.00 Outlays........................... 301 391 507
---------------------------------------------------------------------------
This program provides funds for a broad range of child welfare
services, including family preservation and family support services. It
also includes funding for competitive grants to mentor the children of
prisoners.
[[Page 433]]
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1512-0-1-506 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
25.1 Advisory and assistance services.. 3 4 4
25.3 Other purchases of goods and
services from Government
accounts........................ 2 2 2
41.0 Grants, subsidies, and
contributions................... 370 524 549
--------- --------- ----------
99.9 Total new obligations........... 375 530 555
---------------------------------------------------------------------------
Job Opportunities and Basic Skills Training Program
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1509-0-1-504 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 8
73.20 Total outlays (gross)............. -23
73.40 Adjustments in expired accounts
(net)........................... 15
----------------------------------------------------------------------------
Outlays (gross), detail:
86.98 Outlays from mandatory balances... 23
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... 23
---------------------------------------------------------------------------
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Mandatory child care.............. 1,178 1,178 1,178
00.02 Matching child care............... 1,519 1,478 1,478
00.03 Training and technical assistance. 7 7 7
00.04 Child care tribal grants.......... 54 54 54
--------- --------- ----------
10.00 Total new obligations........... 2,758 2,717 2,717
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 2,758 2,717 2,717
23.95 Total new obligations............. -2,758 -2,717 -2,717
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 2,717 2,717 2,717
63.00 Reappropriation................. 41
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 2,758 2,717 2,717
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 814 1,144 1,171
73.10 Total new obligations............. 2,758 2,717 2,717
73.20 Total outlays (gross)............. -2,365 -2,690 -2,813
73.40 Adjustments in expired accounts
(net)........................... -63
74.40 Obligated balance, end of year.... 1,144 1,171 1,075
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 1,774 1,842 1,926
86.98 Outlays from mandatory balances... 591 848 887
--------- --------- ----------
87.00 Total outlays (gross)........... 2,365 2,690 2,813
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 2,758 2,717 2,717
90.00 Outlays........................... 2,365 2,690 2,813
---------------------------------------------------------------------------
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
25.1 Advisory and assistance services.. 6 6 6
25.2 Other services.................... 1 1 1
41.0 Grants, subsidies, and
contributions................... 2,751 2,710 2,710
--------- --------- ----------
99.9 Total new obligations........... 2,758 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), $2,099,729,000 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 $9,864,000 shall be for use by the
Secretary for child care research, demonstration, and evaluation
activities.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1515-0-1-609 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Block grant payments to States.... 2,090 2,090 2,090
00.04 Research and evaluation fund...... 10 10 10
--------- --------- ----------
10.00 Total new obligations........... 2,100 2,100 2,100
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 2,100 2,100 2,100
23.95 Total new obligations............. -2,100 -2,100 -2,100
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 2,100 2,100 2,100
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 1,121 1,044 1,064
73.10 Total new obligations............. 2,100 2,100 2,100
73.20 Total outlays (gross)............. -2,174 -2,080 -2,093
73.40 Adjustments in expired accounts
(net)........................... -3
74.40 Obligated balance, end of year.... 1,044 1,064 1,071
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1,349 1,344 1,344
86.93 Outlays from discretionary
balances........................ 825 736 749
--------- --------- ----------
87.00 Total outlays (gross)........... 2,174 2,080 2,093
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 2,100 2,100 2,100
90.00 Outlays........................... 2,174 2,080 2,093
---------------------------------------------------------------------------
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
25.1 Advisory and assistance services.. 6 6 6
25.3 Other purchases of goods and
services from Government
accounts........................ 1 1 1
41.0 Grants, subsidies, and
contributions................... 2,093 2,093 2,093
--------- --------- ----------
99.9 Total new obligations........... 2,100 2,100 2,100
---------------------------------------------------------------------------
[[Page 434]]
Social Services Block Grant
For making grants to States pursuant to section 2002 of the Social
Security Act, $1,700,000,000.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1534-0-1-506 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Direct program activity........... 1,700 1,700 1,700
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 1,700 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)...... 1,700 1,700 1,700
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 1,701 1,701 1,701
23.95 Total new obligations............. -1,700 -1,700 -1,700
24.40 Unobligated balance carried
forward, end of year............ 1 1 1
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 1,700 1,700 1,700
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 746 666 574
73.10 Total new obligations............. 1,700 1,700 1,700
73.20 Total outlays (gross)............. -1,780 -1,792 -1,790
73.40 Adjustments in expired accounts
(net)........................... -4
74.40 Obligated balance, end of year.... 666 574 480
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 1,452 1,445 1,445
86.98 Outlays from mandatory balances... 328 347 345
--------- --------- ----------
87.00 Total outlays (gross)........... 1,780 1,792 1,790
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 1,700 1,700 1,700
90.00 Outlays........................... 1,780 1,792 1,790
---------------------------------------------------------------------------
Children and Families Services Programs
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, 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, and section 126 and titles IV and V of
Public Law 100-485, $8,547,382,000, of which $43,000,000, to remain
available until September 30, 2005, 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 before September 30, 2004; of which $552,312,000
shall be for making payments under the Community Services Block Grant
Act; and of which $6,815,570,000 shall be for making payments under the
Head Start Act, of which $1,400,000,000 shall become available October
1, 2004 and remain available through September 30, 2005: 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 $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.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1536-0-1-506 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Head start........................ 6,537 6,667 6,816
Runaway and homeless youth:
01.03 Runaway and homeless youth...... 48 48 62
01.04 Transitional living............. 40 40 26
01.05 Education grants to reduce
sexual abuse of runaway youth. 15 15 15
Child abuse programs:
01.07 Child abuse State grants........ 22 22 22
01.08 Child abuse discretionary grants 26 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.......... 8 8 7
01.15 Abandoned infants............... 12 12 13
01.16 Adoption incentives............. 40 43 43
01.17 Adoption opportunities.......... 27 27 27
01.18 Children's health act programs.... 13 13 13
01.19 Social services and income
maintenance research............ 31 6 6
01.20 Native American programs.......... 46 45 45
01.21 Compassion capital fund........... 30 100 100
01.23 Early learning fund............... 25
Developmental disabilities programs:
01.24 Protection and advocacy......... 35 35 35
01.25 Projects of national
significance.................. 12 12 12
01.26 Centers for excellence.......... 24 24 24
01.27 State grants.................... 70 70 70
01.28 Federal administration............ 171 171 180
01.29 Faith-based center................ 2 2 1
--------- --------- ----------
01.91 Subtotal........................ 1,022 1,044 1,052
Community services programs:
03.01 Community services block grants. 649 570 495
03.03 Community food and nutrition.... 7 7
03.04 Community services discretionary 39 39 32
03.05 National youth sports........... 17
03.06 Individual development accounts... 25 25 25
03.08 Domestic violence hotline......... 2 2 3
03.09 Grants for battered women's
shelters........................ 125 125 124
--------- --------- ----------
03.91 Subtotal........................ 864 768 679
--------- --------- ----------
04.00 Total, direct program........... 8,423 8,479 8,547
09.01 Reimbursable program.............. 18 15 15
--------- --------- ----------
10.00 Total new obligations........... 8,441 8,494 8,562
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 3 4 1
22.00 New budget authority (gross)...... 8,445 8,494 8,562
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 8,448 8,498 8,563
23.95 Total new obligations............. -8,441 -8,494 -8,562
[[Page 435]]
23.98 Unobligated balance expiring or
withdrawn....................... -1 -3
24.40 Unobligated balance carried
forward, end of year............ 4 1 1
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 7,030 7,079 7,147
40.71 Reduction pursuant to P.L. 107-
116........................... -1
40.73 Reduction pursuant to P.L. 107-
206........................... -2
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 7,027 7,079 7,147
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)................... 3
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)....... 18 15 15
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 8,445 8,494 8,562
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 4,374 4,693 4,771
73.10 Total new obligations............. 8,441 8,494 8,562
73.20 Total outlays (gross)............. -8,084 -8,416 -8,464
73.40 Adjustments in expired accounts
(net)........................... -35
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -3
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 1
74.40 Obligated balance, end of year.... 4,693 4,771 4,869
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 4,412 4,391 4,429
86.93 Outlays from discretionary
balances........................ 3,672 4,025 4,035
--------- --------- ----------
87.00 Total outlays (gross)........... 8,084 8,416 8,464
----------------------------------------------------------------------------
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)................... -3
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 8,427 8,479 8,547
90.00 Outlays........................... 8,071 8,401 8,449
----------------------------------------------------------------------------
Additional net budget authority and outlays to cover cost of fully accruing
retirement:
99.00 Budget authority.................. 11 11 13
99.01 Outlays........................... 11 11 13
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2002 actual 2003 est. 2004 est.
Enacted/requested:
Budget Authority.................. 8,427 8,479 8,547
Outlays........................... 8,069 8,401 8,449
Legislative proposal, not subject to
PAYGO:
Budget Authority.................. 30 30
Outlays........................... 5 18
------------------------------------
Total:
Budget Authority.................. 8,427 8,509 8,577
Outlays........................... 8,069 8,406 8,467
====================================
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 111 113 113
11.3 Other than full-time permanent 2 1 1
11.5 Other personnel compensation.. 1 1 1
--------- --------- ----------
11.9 Total personnel compensation 114 115 115
12.1 Civilian personnel benefits..... 21 22 22
21.0 Travel and transportation of
persons....................... 4 5 5
23.1 Rental payments to GSA.......... 14 16 16
23.3 Communications, utilities, and
miscellaneous charges......... 4 2 2
24.0 Printing and reproduction....... 2 3 3
25.1 Advisory and assistance services 105 124 124
25.2 Other services.................. 5 41 41
25.3 Other purchases of goods and
services from Government
accounts...................... 55 30 30
25.7 Operation and maintenance of
equipment..................... 3 1 1
26.0 Supplies and materials.......... 1 2 2
31.0 Equipment....................... 1 1 1
41.0 Grants, subsidies, and
contributions................. 8,094 8,117 8,185
--------- --------- ----------
99.0 Direct obligations............ 8,423 8,479 8,547
99.0 Reimbursable obligations.......... 18 15 15
--------- --------- ----------
99.9 Total new obligations........... 8,441 8,494 8,562
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-1536-0-1-506 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 1,448 1,512 1,472
---------------------------------------------------------------------------
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
01.19 Maternity group homes............. 10 10
01.20 Strengthening fatherhood and
healthy marriages............... 20 20
--------- --------- ----------
04.00 Total, direct program........... 30 30
--------- --------- ----------
10.00 Total new obligations........... 30 30
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 30 30
23.95 Total new obligations............. -30 -30
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 30 30
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 25
73.10 Total new obligations............. 30 30
73.20 Total outlays (gross)............. -5 -18
74.40 Obligated balance, end of year.... 25 37
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 5 5
86.93 Outlays from discretionary
balances........................ 13
--------- --------- ----------
87.00 Total outlays (gross)........... 5 18
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 30 30
90.00 Outlays........................... 5 18
---------------------------------------------------------------------------
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
25.3 Other purchases of goods and
services from Government
accounts........................ 7 7
41.0 Grants, subsidies, and
contributions................... 23 23
--------- --------- ----------
99.9 Total new obligations........... 30 30
---------------------------------------------------------------------------
[[Page 436]]
Violent Crime Reduction Programs
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8605-0-1-754 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 29 15 6
73.20 Total outlays (gross)............. -13 -9 -3
73.40 Adjustments in expired accounts
(net)........................... -1
74.40 Obligated balance, end of year.... 15 6 3
----------------------------------------------------------------------------
Outlays (gross), detail:
86.93 Outlays from discretionary
balances........................ 13 9 3
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... 13 9 3
---------------------------------------------------------------------------
Children's Research and Technical Assistance
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1553-0-1-609 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Training and technical assistance. 12 12 12
00.02 Federal parent locator service.... 25 23 23
00.04 Welfare research.................. 15 15
09.01 Reimbursable program.............. 9 9 9
--------- --------- ----------
10.00 Total new obligations........... 46 59 59
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 1 1
22.00 New budget authority (gross)...... 46 59 59
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 47 60 59
23.95 Total new obligations............. -46 -59 -59
24.40 Unobligated balance carried
forward, end of year............ 1
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 58 50 50
60.35 Appropriation rescinded......... -21
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 37 50 50
69.00 Offsetting collections (cash)..... 9 9 9
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 46 59 59
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 34 31 44
73.10 Total new obligations............. 46 59 59
73.20 Total outlays (gross)............. -48 -47 -53
74.40 Obligated balance, end of year.... 31 44 50
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 24 25 24
86.98 Outlays from mandatory balances... 24 22 29
--------- --------- ----------
87.00 Total outlays (gross)........... 48 47 53
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -4 -4 -4
88.40 Non-Federal sources........... -5 -5 -5
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -9 -9 -9
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 37 50 50
90.00 Outlays........................... 40 38 44
---------------------------------------------------------------------------
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 2002 actual 2003 est. 2004 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 14 20 20
25.2 Other services.................. 5 5 5
25.3 Other purchases of goods and
services from Government
accounts...................... 13 13 13
41.0 Grants, subsidies, and
contributions................. 2 9 9
--------- --------- ----------
99.0 Direct obligations............ 37 50 50
99.0 Reimbursable obligations.......... 9 9 9
--------- --------- ----------
99.9 Total new obligations........... 46 59 59
---------------------------------------------------------------------------
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, $5,043,200,000. 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 Act, for the first quarter of fiscal year 2005,
$1,767,700,000.
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.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1545-0-1-609 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Foster care....................... 4,536 4,666 4,939
00.02 Independent living................ 140 140 140
00.03 Education and training vouchers... 60 60
00.04 Adoption assistance............... 1,393 1,539 1,700
--------- --------- ----------
10.00 Total new obligations........... 6,069 6,405 6,839
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 6,622 6,556 6,839
23.95 Total new obligations............. -6,069 -6,405 -6,839
23.98 Unobligated balance expiring or
withdrawn....................... -552 -151
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 60 60
Mandatory:
60.00 Appropriation................... 4,886 4,742 5,043
65.00 Advance appropriation........... 1,736 1,754 1,736
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 6,622 6,556 6,839
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 934 1,117 1,216
73.10 Total new obligations............. 6,069 6,405 6,839
73.20 Total outlays (gross)............. -5,885 -6,306 -6,736
73.40 Adjustments in expired accounts
(net)........................... -2
74.40 Obligated balance, end of year.... 1,117 1,216 1,320
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 9 9
86.93 Outlays from discretionary
balances........................ 40
86.97 Outlays from new mandatory
authority....................... 5,235 5,412 5,831
86.98 Outlays from mandatory balances... 650 885 856
--------- --------- ----------
87.00 Total outlays (gross)........... 5,885 6,306 6,736
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 6,622 6,556 6,839
[[Page 437]]
90.00 Outlays........................... 5,885 6,306 6,736
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2002 actual 2003 est. 2004 est.
Enacted/requested:
Budget Authority.................. 6,622 6,556 6,839
Outlays........................... 5,885 6,306 6,736
Legislative proposal, subject to
PAYGO:
Budget Authority.................. 35
Outlays........................... 31
------------------------------------
Total:
Budget Authority.................. 6,622 6,556 6,874
Outlays........................... 5,885 6,306 6,767
====================================
Foster care.--The proposed level will support eligible low-income
children who must be placed outside the home. An average of 240,600
children per month will be served in 2004.
Adoption assistance.--The proposed funding level will support
subsidies for families adopting eligible low-income children with
special needs. An average of 348,700 children per month will be served
in 2004.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1545-0-1-609 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
25.1 Advisory and assistance services.. 9 12 17
25.5 Research and development contracts 2 2
41.0 Grants, subsidies, and
contributions................... 6,060 6,391 6,820
--------- --------- ----------
99.9 Total new obligations........... 6,069 6,405 6,839
---------------------------------------------------------------------------
Payments to States for Foster Care and Adoption Assistance
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1545-4-1-609 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Foster care....................... 35
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 35
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 35
23.95 Total new obligations............. -35
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 35
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. 35
73.20 Total outlays (gross)............. -31
74.40 Obligated balance, end of year.... 5
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 31
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 35
90.00 Outlays........................... 31
---------------------------------------------------------------------------
This legislative proposal includes provisions to introduce an option
available to all states to participate in an alternative financing
system for child welfare that will better meet the needs of each state's
foster care population. States choosing to participate will face fewer
administrative burdens and will receive funds in the form of flexible
grants.
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, $1,343,701,000 of which $5,000,000 shall be available for
activities regarding medication management, screening, and education to
prevent incorrect medication and adverse drug reactions; of which
$2,842,000 shall remain available until September 30, 2006 for the White
House Conference on Aging; and of which $149,670,000 shall be for making
payments to or on behalf of States and other eligible grantees,
consistent with section 311 of the Older Americans Act of 1965:
Provided, That references to the Secretary of Agriculture in section
311(b) and (d)(1) shall be deemed to be references to the Secretary of
Health and Human Services: Provided further, That in those instances in
which the eligible entity elects to receive its allotment, in part or in
total, in the form of commodities, the Secretary of Agriculture shall
supply such commodities and be reimbursed for the costs thereof from
amounts provided herein.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0142-0-1-506 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
01.01 Home and community-based
supportive services............. 357 357 357
01.02 Preventive health................. 21 21 21
01.03 National family caregiver support
program......................... 142 142 142
01.05 Congregate meals.................. 390 492 390
01.06 Home-delivered meals.............. 176 224 178
01.07 Nutrition services incentive
program......................... 150
01.08 Grants to Indian tribes........... 26 28 26
01.09 Program innovations............... 39 28 28
01.10 Aging network support activities.. 2 2 2
01.11 Federal administration............ 18 18 18
01.13 Alzheimer's disease demonstration
grants to States................ 11 11 11
01.14 Grants to States for the
protection of vulnerable older
Americans....................... 18 18 18
01.15 White House Conference on Aging... 3
--------- --------- ----------
02.00 Total, Direct Program........... 1,200 1,341 1,344
09.01 Reimbursable program (HCFAC)...... 3 3
--------- --------- ----------
10.00 Total new obligations........... 1,200 1,344 1,347
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 2 1 1
22.00 New budget authority (gross)...... 1,200 1,344 1,347
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 1,202 1,345 1,348
23.95 Total new obligations............. -1,200 -1,344 -1,347
24.40 Unobligated balance carried
forward, end of year............ 1 1 1
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 1,200 1,341 1,344
Mandatory:
69.00 Offsetting collections (cash)... 3 3
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 1,200 1,344 1,347
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 456 548 601
73.10 Total new obligations............. 1,200 1,344 1,347
73.20 Total outlays (gross)............. -1,105 -1,291 -1,344
73.40 Adjustments in expired accounts
(net)........................... -3
74.40 Obligated balance, end of year.... 548 601 603
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 727 832 834
86.93 Outlays from discretionary
balances........................ 378 456 507
86.97 Outlays from new mandatory
authority....................... 3 3
--------- --------- ----------
87.00 Total outlays (gross)........... 1,105 1,291 1,344
----------------------------------------------------------------------------
[[Page 438]]
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -3 -3
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 1,200 1,341 1,344
90.00 Outlays........................... 1,105 1,288 1,341
----------------------------------------------------------------------------
Additional net budget authority and outlays to cover cost of fully accruing
retirement:
99.00 Budget authority.................. 1 1 1
99.01 Outlays........................... 1 1 1
---------------------------------------------------------------------------
Note.--The reimbursable program (HCFAC) in the Administration on
Aging (AoA) reflects the estimated distribution of the allocation
account for fiscal years 2003 and 2004. Actual 2003 and 2004
distributions will be determined by the Secretary of HHS and the
Attorney General.
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. The proposed level also includes
funding for the White House Conference on Aging.
In order to improve program management, the budget proposes to
transfer the smaller Department of Agriculture nutrition program for the
elderly to AoA, while preserving State access to commodities and
ensuring that the funds continue to be dedicated exclusively to the
provision of meals. Although both Departments currently fund these
services, HHS is the lead agency and has greater interaction with
service providers. This transfer will improve program oversight and
streamline reporting requirements.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0142-0-1-506 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct obligations:
11.1 Personnel compensation: Full-
time permanent................ 9 9 10
12.1 Civilian personnel benefits..... 2 2 2
23.1 Rental payments to GSA.......... 1 2 2
25.1 Advisory and assistance services 5 6 6
25.2 Other services.................. 1 1 1
25.3 Other purchases of goods and
services from Government
accounts...................... 6 4 6
41.0 Grants, subsidies, and
contributions................. 1,176 1,317 1,317
--------- --------- ----------
99.0 Direct obligations............ 1,200 1,341 1,344
99.0 Reimbursable obligations.......... 3 3
--------- --------- ----------
99.9 Total new obligations........... 1,200 1,344 1,347
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0142-0-1-506 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 112 112 112
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 8 8
Allocation account:
Total compensable workyears:
3001 Civilian full-time equivalent
employment.................... 8
---------------------------------------------------------------------------
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, $348,100,000 together
with $5,851,000 to be transferred and expended as authorized by section
201(g)(1) of the Social Security Act from the Hospital Insurance Trust
Fund and the Supplemental Medical Insurance Trust Fund: Provided, That
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 $18,400,000 is for an Information Technology
Security and Innovation Fund for Department-wide activities involving
cybersecurity, information technology security, and related innovation
projects, and $5,000,000 is to assist Afghanistan in the development of
maternal and child health clinics, consistent with section 103(a)(4)(H)
of the Afghanistan Freedom Support Act of 2002.
office for civil rights
For expenses necessary for the Office for Civil Rights, $30,936,000,
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.
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, $2,499,000: Provided, That in addition to
amounts provided herein, $21,000,000 shall be available from amounts
available under section 241 of the Public Health Service Act 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.
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, $1,896,149,000, of which $100,000,000 shall be for
activities to ensure a year-round influenza vaccine production capacity
and the development and implementation of rapidly expandable production
technologies: Provided, That the Secretary of Health and Human Services
may increase funding for such pandemic influenza activities by transfer
of up to $150,000,000 from available unobligated amounts in
discretionary accounts (pursuant to the Balanced Budget and Emergency
Deficit Control Act of 1985, as amended) of the Department of Health and
Human Services funded in this or prior appropriations Acts: Provided
further, That funding for pandemic influenza activities shall remain
available until expended.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9912-0-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct activities:
00.01 General departmental management. 343 341 353
00.02 Office for Civil Rights......... 28 30 31
00.03 Policy research................. 2 2 2
00.04 Public health and social
services emergency fund....... 1,625 1,807 1,896
09.01 Reimbursable program.............. 141 168 186
09.02 Reimbursable program (HCFAC)...... 6 5
--------- --------- ----------
10.00 Total new obligations........... 2,139 2,354 2,473
----------------------------------------------------------------------------
[[Page 439]]
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 109 147 149
22.00 New budget authority (gross)...... 2,182 2,356 2,475
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 2,291 2,503 2,624
23.95 Total new obligations............. -2,139 -2,354 -2,473
23.98 Unobligated balance expiring or
withdrawn....................... -4
24.40 Unobligated balance carried
forward, end of year............ 147 149 151
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 2,029 2,176 2,278
40.73 Reduction pursuant to P.L. 107-
206........................... -3
42.00 Transferred from other accounts. 9
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 2,035 2,176 2,278
Spending authority from offsetting
collections:
Offsetting collections (cash):
68.00 Offsetting collections (cash). 81 174 192
68.00 Offsetting collections (cash)
HCFAC....................... 6 5
68.10 Change in uncollected customer
payments from Federal sources
(unexpired)................... 66
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)....... 147 180 197
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 2,182 2,356 2,475
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 562 1,555 1,996
73.10 Total new obligations............. 2,139 2,354 2,473
73.20 Total outlays (gross)............. -1,092 -1,913 -2,432
73.40 Adjustments in expired accounts
(net)........................... -17
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -66
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 28
74.40 Obligated balance, end of year.... 1,555 1,996 2,037
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 760 806 851
86.93 Outlays from discretionary
balances........................ 332 1,107 1,581
--------- --------- ----------
87.00 Total outlays (gross)........... 1,092 1,913 2,432
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -108 -180 -197
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -66
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 27
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 2,035 2,176 2,278
90.00 Outlays........................... 982 1,733 2,235
----------------------------------------------------------------------------
Additional net budget authority and outlays to cover cost of fully accruing
retirement:
99.00 Budget authority.................. 10 10 12
99.01 Outlays........................... 10 10 12
---------------------------------------------------------------------------
Note.--The reimbursable program (HCFAC) in Departmental Management
reflects the estimated distribution from the allocation account for
fiscal year 2003 and 2004. Actual 2003 and 2004 distributions will be
determined by the Secretary of HHS and the Attorney General.
(Dollars in millions)
2002 actual 2003 est. 2004 est.
Distribution of budget authority by
account:
General Departmental Management... 334 337 349
Office for Civil Rights........... 28 30 31
Policy Research................... 2 2 2
Public Health and Social Services
Emergency Fund.................. 1,671 1,807 1,896
Distribution of outlays by account:
General Departmental Management... 319 324 341
Office for Civil Rights........... 25 30 32
Policy research................... 11 2 2
Public Health and Social Services
Emergency Fund.................. 627 1,377 1,860
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 and health information privacy
compliance 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, as well as programs to counter bioterrorist threats.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9912-0-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 106 113 115
11.3 Other than full-time permanent 4 6 6
11.5 Other personnel compensation.. 3 2 2
11.7 Military personnel............ 2 3 3
--------- --------- ----------
11.9 Total personnel compensation 115 124 126
12.1 Civilian personnel benefits..... 24 26 27
12.2 Military personnel benefits..... 1 1 1
21.0 Travel and transportation of
persons....................... 6 6 4
23.1 Rental payments to GSA.......... 15 18 24
23.3 Communications, utilities, and
miscellaneous charges......... 4 6 4
24.0 Printing and reproduction....... 2 2 2
25.1 Advisory and assistance services 7 1 1
25.2 Other services.................. 24 37 41
25.3 Other purchases of goods and
services from Government
accounts...................... 48 43 41
25.4 Operation and maintenance of
facilities.................... 9 8 9
25.7 Operation and maintenance of
equipment..................... 18 25 28
26.0 Supplies and materials.......... 5 8 3
31.0 Equipment....................... 7 7 3
41.0 Grants, subsidies, and
contributions................. 111 127 134
--------- --------- ----------
99.0 Direct obligations............ 396 439 448
99.0 Reimbursable obligations.......... 142 174 191
Allocation Account:
Personnel compensation:
11.1 Full-time permanent........... 29 13 13
11.3 Other than full-time permanent 3 2 2
11.5 Other personnel compensation.. 2 2 2
11.8 Special personal services
payments.................... 1
--------- --------- ----------
11.9 Total personnel compensation 35 17 17
12.1 Civilian personnel benefits..... 10 9 9
21.0 Travel and transportation of
persons....................... 4 3 3
23.1 Rental payments to GSA.......... 5 5
23.3 Communications, utilities, and
miscellaneous charges......... 7 3 3
25.1 Advisory and assistance services 51 11 11
25.2 Other services.................. 36 12 12
25.3 Other purchases of goods and
services from Government
accounts...................... 63 22 22
25.4 Operation and maintenance of
facilities.................... 39 52 52
25.5 Research and development
contracts..................... 22 22 22
25.6 Medical care.................... 6
25.7 Operation and maintenance of
equipment..................... 1 1 1
26.0 Supplies and materials.......... 6 20 20
31.0 Equipment....................... 20 14 14
41.0 Grants, subsidies, and
contributions................. 1,301 1,549 1,642
42.0 Insurance claims and indemnities 1 1
--------- --------- ----------
99.0 Allocation account............ 1,601 1,741 1,834
--------- --------- ----------
99.9 Total new obligations........... 2,139 2,354 2,473
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-9912-0-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 1,300 1,424 1,419
1101 Military full-time equivalent
employment.................... 61 61 61
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 257 277 278
---------------------------------------------------------------------------
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.''
[[Page 440]]
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 56), such amounts as
may be required during the current fiscal year.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0379-0-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Retirement payments............... 204 219 234
00.02 Survivors' benefits............... 13 14 15
00.03 Medical care...................... 56 52 54
--------- --------- ----------
10.00 Total new obligations........... 273 285 303
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 278 285 303
23.95 Total new obligations............. -273 -285 -303
23.98 Unobligated balance expiring or
withdrawn....................... -5
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 278 285 303
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 20 45 49
73.10 Total new obligations............. 273 285 303
73.20 Total outlays (gross)............. -253 -281 -301
73.40 Adjustments in expired accounts
(net)........................... 5
74.40 Obligated balance, end of year.... 45 49 51
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 234 242 258
86.98 Outlays from mandatory balances... 19 39 43
--------- --------- ----------
87.00 Total outlays (gross)........... 253 281 301
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 278 285 303
90.00 Outlays........................... 253 281 301
----------------------------------------------------------------------------
Additional net budget authority and outlays to cover cost of fully accruing
retirement:
99.00 Budget authority.................. 27
99.01 Outlays........................... 27
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2002 actual 2003 est. 2004 est.
Enacted/requested:
Budget Authority.................. 278 285 303
Outlays........................... 253 281 301
Legislative proposal, not subject to
PAYGO:
Budget Authority.................. 13
Outlays........................... 13
------------------------------------
Total:
Budget Authority.................. 278 285 316
Outlays........................... 253 281 314
====================================
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.
The estimates in the following table support the President's Budget
proposal to extend accrual financing for health care provided to non-
Medicare-eligible uniformed services retirees.
Uniformed Services Non-Medicare Eligible Retiree Health Care Accrual
Proposal Effects on Public Health Accounts in 2004
(Dollars in millions)
Mandatory Discretionary
Mandatory Offsetting Collection through
the Defense Health Account from the
Uniformed Services Retiree Health Care
Fund for Non-Medicare Eligible Retiree
Health Care:
Public Health Service................... 54
Adjustments to Public Health
Discretionary Appropriation Payments to
the Uniformed Services Retiree Health
Care Fund Ret. Pay and Med. Benefits
for Commissioned Officers Account...... 27
Adj. to Ret. Pay and Med. Benefits for
Commissioned Officers Account.......... -54
--------------
Change to Public Health Discretionary
Appropriation.......................... -27
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0379-0-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
13.0 Benefits for former personnel..... 217 233 249
25.6 Medical care...................... 56 52 54
--------- --------- ----------
99.9 Total new obligations........... 273 285 303
---------------------------------------------------------------------------
Retirement Pay and Medical Benefits for Commissioned Officers
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0379-2-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.03 Medical care...................... 13
--------- --------- ----------
10.00 Total new obligations (object
class 12.2)................... 13
----------------------------------------------------------------------------
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 13
23.95 Total new obligations............. -13
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 13
----------------------------------------------------------------------------
Change in obligated balances:
73.10 Total new obligations............. 13
73.20 Total outlays (gross)............. -13
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 13
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 13
90.00 Outlays........................... 13
---------------------------------------------------------------------------
A Department of Defense legislative proposal will change the accrual
amount that HHS pays into the Uniformed Services Retiree Health Care
Fund for health benefits for Medicare-eligible Public Health Service
Commissioned Corps officers. The new accrual rate more accurately
reflects the all-officer nature of the Commissioned Corps.
Health Activities Funds
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9913-0-1-552 2002 actual 2003 est. 2004 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
----------------------------------------------------------------------------
[[Page 441]]
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
09.01 Program support center............ 287 320 321
09.02 Federal employee occupational
health.......................... 110 129 138
09.03 OS activities..................... 8 7 7
--------- --------- ----------
10.00 Total new obligations........... 405 456 466
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 69 89 89
22.00 New budget authority (gross)...... 417 456 466
22.10 Resources available from
recoveries of prior year
obligations..................... 8
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 494 545 555
23.95 Total new obligations............. -405 -456 -466
24.40 Unobligated balance carried
forward, end of year............ 89 89 89
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
69.00 Offsetting collections (cash)... 385 456 466
69.10 Change in uncollected customer
payments from Federal sources
(unexpired)................... 32
--------- --------- ----------
69.90 Spending authority from
offsetting collections
(total mandatory)........... 417 456 466
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. -15 -46 -46
73.10 Total new obligations............. 405 456 466
73.20 Total outlays (gross)............. -397 -456 -466
73.45 Recoveries of prior year
obligations..................... -8
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -32
74.40 Obligated balance, end of year.... -46 -46 -46
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 397 456 466
----------------------------------------------------------------------------
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -385 -456 -466
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -32
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... 11
---------------------------------------------------------------------------
HHS Service and Supply Fund (SSF) provides a wide range of
logistical and support services to components of the Department and
other Federal agencies. The Program Support Center line includes
activities such as personnel and payroll administration, financial
management operations, and administrative services, including
acquisitions management, building and property management, information
technology and telecommunication services, and medical supplies
repackaging and distribution services. The Federal Occupational Health
program is also financed by the SSF, and provides clinical health
services, environmental and industrial hygiene-related services, and
employee assistance programs. The Office of Secretary activities line
includes the fund manager, departmental contracts, audit resolutions,
and the regional health administrators.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9941-0-4-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Personnel compensation:
11.1 Full-time permanent............. 67 73 77
11.3 Other than full-time permanent.. 2 2 2
11.5 Other personnel compensation.... 2 2 2
11.7 Military personnel.............. 7 8 8
--------- --------- ----------
11.9 Total personnel compensation.. 78 85 89
12.1 Civilian personnel benefits....... 19 18 19
12.2 Military personnel benefits....... 4 3 4
21.0 Travel and transportation of
persons......................... 3 3 3
22.0 Transportation of things.......... 2 2 3
23.1 Rental payments to GSA............ 11 13 13
23.3 Communications, utilities, and
miscellaneous charges........... 8 8 8
24.0 Printing and reproduction......... 1 1 2
25.1 Advisory and assistance services.. 13 15 15
25.2 Other services.................... 100 119 109
25.3 Other purchases of goods and
services from Government
accounts........................ 27 31 32
25.4 Operation and maintenance of
facilities...................... 18 21 21
25.6 Medical care...................... 34 39 40
26.0 Supplies and materials............ 80 86 94
31.0 Equipment......................... 7 12 14
--------- --------- ----------
99.9 Total new obligations........... 405 456 466
---------------------------------------------------------------------------
This year's budget includes an improved display for Public Health
Service Commissioned Corps Officers. Most Commissioned Corps officers
work for agencies in the Department of Health and Human Services.
However, some of these officers are detailed to perform work in other
Federal agencies. The allocation account section in the table below
shows the total number of these detailed FTE.
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-9941-0-4-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 1,122 1,122 1,122
2101 Military full-time equivalent
employment.................... 71 71 71
Allocation account:
Total compensable workyears:
3101 Military full-time equivalent
employment.................... 1,131 1,281 1,281
---------------------------------------------------------------------------
Trust Funds
Miscellaneous Trust Funds
Unavailable Collections (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9971-0-7-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
01.99 Balance, start of year............
Receipts:
02.00 Gifts and contributions,
miscellaneous trust funds....... 47 47 47
02.20 Contributions, Indian health
facilities, Health Services
Administration.................. 60 60 60
02.40 Interest, Miscellaneous trust
funds........................... 1 1 1
--------- --------- ----------
02.99 Total receipts and collections.. 108 108 108
Appropriations:
05.00 Miscellaneous trust funds......... -108 -108 -108
--------- --------- ----------
07.99 Balance, end of year..............
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9971-0-7-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.02 Gifts............................. 38 48 48
00.03 Contributions, Indian health
facilities...................... 42 60 60
--------- --------- ----------
10.00 Total new obligations........... 80 108 108
----------------------------------------------------------------------------
[[Page 442]]
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 74 101 101
22.00 New budget authority (gross)...... 108 108 108
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 182 209 209
23.95 Total new obligations............. -80 -108 -108
24.40 Unobligated balance carried
forward, end of year............ 101 101 101
----------------------------------------------------------------------------
New budget authority (gross), detail:
Mandatory:
60.26 Appropriation (trust fund)...... 108 108 108
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 76 99 129
73.10 Total new obligations............. 80 108 108
73.20 Total outlays (gross)............. -57 -78 -96
74.40 Obligated balance, end of year.... 99 129 141
----------------------------------------------------------------------------
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 24 32 32
86.98 Outlays from mandatory balances... 33 46 64
--------- --------- ----------
87.00 Total outlays (gross)........... 57 78 96
----------------------------------------------------------------------------
Net budget authority and outlays:
89.00 Budget authority.................. 108 108 108
90.00 Outlays........................... 57 78 96
----------------------------------------------------------------------------
Memorandum (non-add) entries:
92.01 Total investments, start of year:
Federal securities: Par value... 25 30 30
92.02 Total investments, end of year:
Federal securities: Par value... 30 30 30
---------------------------------------------------------------------------
[Dollars in millions]
2002 2003 2004
Distribution of budget authority by
account:
Gifts............................. 48 48 48
Contributions, Indian health
facilities...................... 60 60 60
Distribution of outlays by account:
Gifts............................. 26 35 43
Contributions, Indian health
facilities...................... 31 43 53
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 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Personnel compensation:
11.1 Full-time permanent............. 1 1 1
11.3 Other than full-time permanent.. 1 1 1
--------- --------- ----------
11.9 Total personnel compensation.. 2 2 2
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 1
25.2 Other services.................... 11 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
25.5 Research and development contracts 8 11 11
25.7 Operation and maintenance of
equipment....................... 22 30 30
26.0 Supplies and materials............ 1 1 1
31.0 Equipment......................... 1 1 1
32.0 Land and structures............... 5 7 7
41.0 Grants, subsidies, and
contributions................... 27 36 36
--------- --------- ----------
99.9 Total new obligations........... 80 108 108
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-9971-0-7-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 22 22 22
---------------------------------------------------------------------------
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, $39,497,000: 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.
Note.--A regular 2003 appropriation for this account had not been
enacted at the time the budget was prepared; therefore, this account is
operating under a continuing resolution (P.L. 107-229, as amended). The
amounts included for 2003 in this budget reflect the Administration's
2003 policy proposals.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0128-0-1-551 2002 actual 2003 est. 2004 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Direct program.................... 36 40 39
09.01 HCFAC reimbursable program........ 166 166
09.02 Reimbursable program.............. 17 12 12
--------- --------- ----------
10.00 Total new obligations........... 53 218 217
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 1 1 1
22.00 New budget authority (gross)...... 52 218 217
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 53 219 218
23.95 Total new obligations............. -53 -218 -217
24.40 Unobligated balance carried
forward, end of year............ 1 1 1
----------------------------------------------------------------------------
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 36 40 39
Spending authority from offsetting
collections:
68.00 Offsetting collections (cash)... 6 12 12
68.10 Change in uncollected customer
payments from Federal sources
(unexpired)................... 10
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)....... 16 12 12
Mandatory:
69.00 Offsetting collections (cash)... 166 166
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 52 218 217
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 1 4
73.10 Total new obligations............. 53 218 217
73.20 Total outlays (gross)............. -54 -214 -217
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -10
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 11
74.40 Obligated balance, end of year.... 4 4
----------------------------------------------------------------------------
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 32 48 47
86.93 Outlays from discretionary
balances........................ 22 4
86.97 Outlays from new mandatory
authority....................... 166 166
--------- --------- ----------
87.00 Total outlays (gross)........... 54 214 217
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Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -18 -178 -178
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -10
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 12
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[[Page 443]]
Net budget authority and outlays:
89.00 Budget authority.................. 36 40 39
90.00 Outlays........................... 36 36 39
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Additional net budget authority and outlays to cover cost of fully accruing
retirement:
99.00 Budget authority.................. 9 9 10
99.01 Outlays........................... 9 9 10
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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. These funds are used to
combat Medicare, Medicaid, and State Children's Health Insurance Program
(SCHIP) 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)
2002 actual 2003 est. 2004 est.
Budget Authority:
Discretionary appropriations.......... 36 40 39
Mandatory (HCFAC Account)............. 139 160 160
--------- --------- ----------
Total............................. 175 200 199
Note.--The reimbursable program (HCFAC) in Office of the Inspector
General reflects the estimated distrubiton of the allocation account for
fiscal years 2003 and 2004. Actual 2003 and 2004 distributions 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 2002 actual 2003 est. 2004 est.
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Direct obligations:
11.1 Personnel compensation: Full-
time permanent................ 20 24 24
12.1 Civilian personnel benefits..... 6 6 6
21.0 Travel and transportation of
persons....................... 2 2 2
23.1 Rental payments to GSA.......... 3 3 3
25.3 Other purchases of goods and
services from Government
accounts...................... 4 4 4
31.0 Equipment....................... 1 1
--------- --------- ----------
99.0 Direct obligations............ 36 40 39
99.0 Reimbursable obligations.......... 17 178 178
--------- --------- ----------
99.9 Total new obligations........... 53 218 217
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Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0128-0-1-551 2002 actual 2003 est. 2004 est.
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Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 296 320 307
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 56 1,320 1,252
Allocation account:
Total compensable workyears:
3001 Civilian full-time equivalent
employment.................... 1,217
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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)
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2002 actual 2003 est. 2004 est.
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Offsetting receipts from the public:
75-310700 Federal share of child
support collections................. 1,235 1,117 1,137
Legislative proposal, subject to
PAYGO............................. 14
--------- --------- ----------
General Fund Offsetting receipts from
the public............................. 1,235 1,117 1,151
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GENERAL PROVISIONS
Sec. 201. Funds appropriated in this title shall be available for
not to exceed $37,000 for official reception and representation expenses
when specifically approved by the Secretary.
Sec. 202. The Secretary shall make available through assignment not
more than 60 employees of the Public Health Service to assist in child
survival activities and to work in AIDS programs through and with funds
provided by the Agency for International 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 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 II.
Sec. 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. 206. Not to exceed 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 10 percent by any such transfer: Provided,
That the Appropriations Committees of both Houses of Congress are
notified at least 15 days in advance of any transfer.
Sec. 207. The Director of the National Institutes of Health, jointly
with the Director of the Office of AIDS Research, may transfer up to 3
percent among institutes, centers, and divisions from the total amounts
identified by these two Directors as funding for research pertaining to
the human immunodeficiency virus: Provided, That the Congress is
promptly notified of the transfer.
Sec. 208. Of the amounts made available in this Act for the National
Institutes of Health, the amount for research related to the human
immunodeficiency virus, as jointly determined by the Director of the
National Institutes of Health and the Director of the Office of AIDS
Research, shall be made available to the ``Office of AIDS Research''
account. The Director of the Office of AIDS Research shall transfer from
such account amounts necessary to carry out section 2353(d)(3) of the
Public Health Service Act.
Sec. 209. None of the funds appropriated in this Act may be made
available to any entity under title X of the Public Health Service Act
unless the applicant for the award certifies to the Secretary that it
encourages family participation in the decision of minors to seek family
planning services and that it provides counseling to minors on how to
resist attempts to coerce minors into engaging in sexual activities.
Sec. 210. None of the funds appropriated by this Act (including
funds appropriated to any trust fund) may be used to carry out the
Medicare+Choice program if the Secretary denies participation in such
program to an otherwise eligible entity (including a Provider Sponsored
Organization) because the entity informs the Secretary that it will not
provide, pay for, provide coverage of, or provide referrals for
abortions: Provided, That the Secretary shall make appropriate
prospective adjustments to the capitation payment to such an entity
(based on an actuarially sound estimate of the expected costs of
providing the service to such entity's enrollees): Provided further,
That nothing in this section shall be construed to change the Medicare
program's coverage for such services and a Medicare+Choice organization
described in this section shall be responsible for informing enrollees
where to obtain information about all Medicare covered services.
[[Page 444]]
Sec. 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. 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, 2004 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 2004
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 2003, 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 2003
State expenditures and all fiscal year 2004 obligations for tobacco
prevention and compliance activities by program activity by July 31,
2004.
(d) The Secretary shall exercise discretion in enforcing the timing
of the State obligation of the additional funds required by the
certification in subsection (a) as late as July 31, 2004.
(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. 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 2004, 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. 214. The Division of Federal Occupational Health may utilize
personal services contracting to employ professional management/
administrative and occupational health professionals.
Sec. 215. With the funds appropriated to the National Institutes of
Health in this Act, NIH is authorized to obligate in fiscal year 2004
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.