[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 2005
[[Page 421]]
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 Public Law
107-188; [$1,673,441,000] $1,820,849,000: Provided, That of the amount
provided under this heading, [$249,825,000] $284,394,000 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 further, That this amount shall not include any fees
pursuant to 21 U.S.C. 379h(a)(2) and (a)(3) assessed for fiscal year
2006 but collected in fiscal year 2005; [$31,654,000] $33,938,000 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; and [$5,000,000] $8,000,000 shall be derived from animal drug
user fees [(subject to enactment of legislation authorizing such 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, medical device, and animal drug assessments
received during fiscal year [2004] 2005, including any such fees
assessed prior to the current fiscal year but credited during the
current year, shall be subject to the fiscal year [2004] 2005 limitation
[Provided further, That none of these funds shall be used to develop,
establish, or operate any program of user fees authorized by 31 U.S.C.
9701: Provided further, That of the total amount appropriated: (1)
$413,112,000 shall be for the Center for Food Safety and Applied
Nutrition and related field activities in the Office of Regulatory
Affairs; (2) $477,966,000 shall be for the Center for Drug Evaluation
and Research and related field activities in the Office of Regulatory
Affairs; (3) $169,429,000 shall be for the Center for Biologics
Evaluation and Research and for related field activities in the Office
of Regulatory Affairs; (4) $89,396,000 shall be for the Center for
Veterinary Medicine and for related field activities in the Office of
Regulatory Affairs; (5) $209,420,000 shall be for the Center for Devices
and Radiological Health and for related field activities in the Office
of Regulatory Affairs; (6) $39,887,000 shall be for the National Center
for Toxicological Research; (7) $39,276,000 shall be for Rent and
Related activities, other than the amounts paid to the General Services
Administration for rent; (8) $119,594,000 shall be for payments to the
General Services Administration for rent; and (9) $115,361,000 shall be
for other activities, including the Office of the Commissioner; the
Office of Management and Systems; the Office of External Relations; the
Office of Policy and Planning; and central services for these offices:
Provided further, That funds may be transferred from one specified
activity to another with the prior approval of the Committees on
Appropriations of both Houses of Congress.]
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,
$7,000,000, to remain available until expended.] (Division A, H.R. 2673,
Consolidated Appropriations Bill, FY 2004.)
Unavailable Receipts (in millions of dollars)
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Identification code 75-9911-0-1-554 2003 actual 2004 est. 2005 est.
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01.99 Balance, start of year............
Receipts:
02.20 Cooperative research and
development agreements, FDA..... 2 2 2
--------- --------- ----------
04.00 Total: Balances and collections... 2 2 2
Appropriations:
05.00 Salaries and expenses............. -2 -2 -2
--------- --------- ----------
07.99 Balance, end of year..............
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Program and Financing (in millions of dollars)
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Identification code 75-9911-0-1-554 2003 actual 2004 est. 2005 est.
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Obligations by program activity:
00.01 Foods............................. 425 411 470
00.02 Drugs............................. 514 501 511
00.03 Devices and radiological products. 193 191 217
00.04 National Center for Toxicological
Research........................ 45 40 41
00.05 Other activities.................. 84 90 89
00.06 Other rent and rent related
activities...................... 42 38 59
00.07 Rental payments................... 105 108 108
00.08 Buildings and facilities.......... 17 7
00.09 CRADAs............................ 2 2 2
09.01 Reimbursable program.............. 255 322 371
--------- --------- ----------
10.00 Total new obligations........... 1,682 1,710 1,868
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 202 65 65
22.00 New budget authority (gross)...... 1,534 1,710 1,868
22.10 Resources available from
recoveries of prior year
obligations..................... 6
22.22 Unobligated balance transferred
from other accounts............. 5
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 1,747 1,775 1,933
23.95 Total new obligations............. -1,682 -1,710 -1,868
24.40 Unobligated balance carried
forward, end of year............ 65 65 65
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 1,390 1,394 1,495
40.35 Appropriation permanently
reduced....................... -9 -8
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 1,381 1,386 1,495
Mandatory:
60.20 Appropriation (special fund).... 2 2 2
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 282 322 371
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 8
68.45 Portion precluded from
obligation (limitation on
obligations)................ -139
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 151 322 371
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 1,534 1,710 1,868
Change in obligated balances:
72.40 Obligated balance, start of year.. 488 460 514
73.10 Total new obligations............. 1,682 1,710 1,868
73.20 Total outlays (gross)............. -1,730 -1,656 -1,838
73.40 Adjustments in expired accounts
(net)........................... 27
73.45 Recoveries of prior year
obligations..................... -6
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -8
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 8
74.40 Obligated balance, end of year.... 460 514 543
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1,398 1,358 1,487
86.93 Outlays from discretionary
balances........................ 331 296 349
86.97 Outlays from new mandatory
authority....................... 1 2 2
--------- --------- ----------
[[Page 422]]
87.00 Total outlays (gross)........... 1,730 1,656 1,838
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -77 -25 -26
88.40 Non-Federal sources........... -258 -297 -345
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -335 -322 -371
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -8
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 53
Net budget authority and outlays:
89.00 Budget authority.................. 1,244 1,388 1,497
90.00 Outlays........................... 1,396 1,334 1,467
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[In millions of dollars]
2003 2004 2005
Distribution of budget authority by
account:
Salaries and expenses............. 1,364 1,379 1,495
Buildings and facilities.......... 17 7
Distribution of outlays by account:
Salaries and expenses............. 1,371 1,325 1,460
Buildings and facilities.......... 25 9 8
The FDA is responsible for protecting the public health by assuring
the safety, efficacy, and security of human and veterinary drugs,
biological products, medical devices, our nation's food supply,
cosmetics, and products that emit radiation. The FDA is also responsible
for advancing the public health by helping to speed innovations that
make medicines and foods more effective, safer, and more affordable; and
helping the public get the accurate, science-based information they need
to use medicines and foods to improve their health. The budget includes
funding for counterterrorism activities that specifically relate to the
protection of products or therapies 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.
Specifically, the budget requests increased funding for food defense,
medical counter measures related to terrorism or other related threats
to public health, medical device reviews, protecting the safety of the
U.S. food and feed supply from Bovine Spongiform Encephalopathy (BSE),
and moving expenses for a new Human Drugs facility in White Oak,
Maryland.
Object Classification (in millions of dollars)
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Identification code 75-9911-0-1-554 2003 actual 2004 est. 2005 est.
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Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 548 613 635
11.3 Other than full-time permanent 55 37 40
11.5 Other personnel compensation.. 21 21 22
11.7 Military personnel............ 33 35 36
--------- --------- ----------
11.9 Total personnel compensation 657 706 733
12.1 Civilian personnel benefits..... 156 150 156
12.2 Military personnel benefits..... 17 16 17
21.0 Travel and transportation of
persons....................... 28 25 30
22.0 Transportation of things........ 5 7 5
23.1 Rental payments to GSA.......... 104 108 108
23.2 Rental payments to others....... 4 5 5
23.3 Communications, utilities, and
miscellaneous charges......... 21 27 23
24.0 Printing and reproduction....... 3 3 3
25.1 Advisory and assistance services 48 13 52
25.2 Other services.................. 70 72 71
25.3 Other purchases of goods and
services from Government
accounts...................... 77 54 80
25.4 Operation and maintenance of
facilities.................... 52 30 47
25.5 Research and development
contracts..................... 23 41 25
25.7 Operation and maintenance of
equipment..................... 32 25 33
26.0 Supplies and materials.......... 22 22 23
31.0 Equipment....................... 62 57 53
32.0 Land and structures............. 14 1
41.0 Grants, subsidies, and
contributions................. 29 25 29
42.0 Insurance claims and indemnities 3 2 3
--------- --------- ----------
99.0 Direct obligations............ 1,427 1,388 1,497
99.0 Reimbursable obligations.......... 255 322 371
--------- --------- ----------
99.9 Total new obligations........... 1,682 1,710 1,868
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Personnel Summary
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Identification code 75-9911-0-1-554 2003 actual 2004 est. 2005 est.
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Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 8,324 8,345 8,371
1101 Military full-time equivalent
employment.................... 617 611 612
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 1,251 1,617 1,735
2101 Military full-time equivalent
employment.................... 94 118 126
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Public enterprise funds:
Revolving Fund for Certification and Other Services
Program and Financing (in millions of dollars)
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Identification code 75-4309-0-3-554 2003 actual 2004 est. 2005 est.
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Obligations by program activity:
09.01 Reimbursable program.............. 8 6 6
--------- --------- ----------
10.00 Total new obligations........... 8 6 6
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 4 2 1
22.00 New budget authority (gross)...... 5 5 5
22.10 Resources available from
recoveries of prior year
obligations..................... 1
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 10 7 6
23.95 Total new obligations............. -8 -6 -6
24.40 Unobligated balance carried
forward, end of year............ 2 1
New budget authority (gross), detail:
Mandatory:
69.00 Offsetting collections (cash)... 5 5 5
Change in obligated balances:
72.40 Obligated balance, start of year.. 1 2 2
73.10 Total new obligations............. 8 6 6
73.20 Total outlays (gross)............. -6 -6 -6
73.45 Recoveries of prior year
obligations..................... -1
74.40 Obligated balance, end of year.... 2 2 2
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 5 5 5
86.98 Outlays from mandatory balances... 1 1 1
--------- --------- ----------
87.00 Total outlays (gross)........... 6 6 6
Offsets:
Against gross budget authority and outlays:
88.40 Offsetting collections (cash)
from: Non-Federal sources..... -5 -5 -5
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... 1 1 1
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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)
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Identification code 75-4309-0-3-554 2003 actual 2004 est. 2005 est.
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11.1 Personnel compensation: Full-time
permanent....................... 2 2 2
12.1 Civilian personnel benefits....... 1 1 1
[[Page 423]]
25.2 Other services.................... 3 2 2
31.0 Equipment......................... 1 1 1
32.0 Land and structures............... 1
--------- --------- ----------
99.9 Total new obligations........... 8 6 6
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Personnel Summary
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Identification code 75-4309-0-3-554 2003 actual 2004 est. 2005 est.
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Reimbursable:
2001 Total compensable workyears:
Civilian full-time equivalent
employment...................... 32 32 32
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HEALTH RESOURCES AND SERVICES ADMINISTRATION
Federal Funds
General and special funds:
Health Resources and Services
For carrying out titles II, III, IV, VII, VIII, X, XII, XIX, and
XXVI of the Public Health Service Act, section 427(a) of the Federal
Coal Mine Health and Safety Act, title V (including section 510), and
sections 1128E[,] and 711 [and 1820] of the Social Security Act, the
Health Care Quality Improvement Act of 1986, as amended, the Native
Hawaiian Health Care Act of 1988, as amended, the Cardiac Arrest
Survival Act of 2000, and the Poison Control Center Enhancement and
Awareness Act, [$6,698,437,000, of which $367,563,000 shall be available
for construction and renovation (including equipment) of health care and
other facilities, abstinence education and related services, and other
health-related activities as specified in the statement of the managers
on the conference report accompanying this Act, and of which $39,740,000
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]
$6,022,833,000: Provided, That of the funds made available under this
heading, [$250,000] $249,000 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 $25,000,000 of the funding provided for
community health centers shall be used for base grant adjustments for
existing centers:] Provided further, That no more than [$4,850,000 is
available] $4,821,000 is available until expended for carrying out the
provisions of U.S.C. Title 42 Section 233(o) including associated
administrative expenses: Provided further, That no more than $45,000,000
is available until expended for carrying out the provisions of Public
Law 104-73: Provided further, That [$10,000,000] $9,941,000 is available
until expended [to establish a] for the National Cord Blood Stem Cell
Bank Program [as described in the statement of the managers on the
conference report accompanying this Act]: Provided further, That of the
funds made available under this heading, [$280,000,000] $278,283,000
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 [$753,317,000] $783,872,000 shall be for State AIDS Drug Assistance
Programs authorized by section 2616 of the Public Health Service Act:
Provided further, That the Secretary may use a portion of the funds
under this heading for carrying out section 338A-L of the Public Health
Service Act to establish and administer a reserve commitment program for
the Reserve Corps of the Service for section 338A-L loan and scholarship
recipients, to be defined by the Secretary: Provided further, $9,998,000
shall be for carrying out section 340 of the Public Health Service Act:
Provided further, That grants made under the immediately preceding
proviso shall be made only to entities receiving a grant under section
330 and that a consortium of such entities shall fulfill the
requirements of section 340(b): Provided further, That in addition to
amounts provided herein, $25,000,000 shall be available from amounts
available under section 241 of the Public Health Service Act to carry
out Parts A, B, C, and D of title XXVI of the Public Health Service Act
to fund section 2691 Special Projects of National Significance [Provided
further, That notwithstanding section 502(a)(1) of the Social Security
Act, not to exceed $121,130,000 is available for carrying out special
projects of regional and national significance pursuant to section
501(a)(2) of such Act: Provided further, That $70,488,000 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 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 in addition to amounts provided herein for
abstinence education to adolescents, $4,500,000 shall be available from
amounts available under section 241 of the Public Health Service Act to
carry out evaluations (including longitudinal evaluations) of adolescent
pregnancy prevention approaches]. (Division E, H.R. 2673, Consolidated
Appropriations Bill, FY 2004.)
Program and Financing (in millions of dollars)
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Identification code 75-0350-0-1-550 2003 actual 2004 est. 2005 est.
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Obligations by program activity:
00.02 Loan guarantee subsidy............ 1 1 1
00.10 Health centers.................... 1,465 1,573 1,791
00.11 National Health Service Corps..... 46 46 46
00.12 National Health Service Corps
recruitment..................... 125 124 159
00.13 Hansen's disease center........... 18 17 17
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............ 20 27 32
00.17 Health professions................ 402 409 126
00.18 Maternal and child health block
grant........................... 731 730 730
00.19 Healthy start..................... 98 98 98
00.20 Poison control centers............ 22 24 24
00.21 EMS for children.................. 19 20 20
00.22 Universal newborn hearing
screening....................... 10 10
00.23 HIV/AIDS.......................... 1,993 2,020 2,055
00.24 Organ transplantation............. 25 25 25
00.25 Bone marrow donor registry........ 22 23 23
00.26 Rural health policy development... 11 9 9
00.27 Rural health outreach grants...... 58 40 11
00.28 Rural health flexibility grants... 40 39
00.29 Denali Commission................. 27 35 22
00.30 Telehealth........................ 27 4 4
00.31 Program management................ 157 149 151
00.32 Family planning................... 273 278 278
00.33 Abstinence education.............. 44 25
00.36 Health centers tort claim fund.... 23 45 45
00.37 Trauma EMS........................ 3 3
00.39 Childrens' GME.................... 290 303 303
00.41 Community based abstinence grants. 55 70
00.42 State offices of rural health..... 8 8 8
00.43 Community access program.......... 104 104 10
00.44 State planning grant program...... 15 15
00.45 Rural access to emergency devices. 12 11 2
00.46 Radiation Exposure Compensation
Act............................. 2 2 2
00.47 Traumatic brain injury............ 9 9 9
00.48 Health care facilities............ 294
00.49 Public health improvement projects 372
00.50 Cord blood stem cell bank......... 10 10
00.52 Free clinic medical malpractice... 5 5
--------- --------- ----------
[[Page 424]]
03.00 Total direct programs........... 6,457 6,691 6,024
09.01 Reimbursable program.............. 143 169 170
--------- --------- ----------
10.00 Total new obligations........... 6,600 6,860 6,194
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 39 64 64
22.00 New budget authority (gross)...... 6,629 6,858 6,196
22.10 Resources available from
recoveries of prior year
obligations..................... 3
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 6,671 6,922 6,260
23.95 Total new obligations............. -6,600 -6,860 -6,194
23.98 Unobligated balance expiring or
withdrawn....................... -6
24.40 Unobligated balance carried
forward, end of year............ 64 64 66
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 6,473 6,705 6,023
40.35 Appropriation permanently
reduced....................... -42 -41
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 6,431 6,664 6,023
Mandatory:
60.00 Appropriation................... 50 25
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 87 122 123
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 30
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 117 122 123
Mandatory:
69.00 Offsetting collections
(cash)(HPSL&NSL).............. 31 47 50
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 6,629 6,858 6,196
Change in obligated balances:
72.40 Obligated balance, start of year.. 5,054 5,484 5,812
73.10 Total new obligations............. 6,600 6,860 6,194
73.20 Total outlays (gross)............. -6,103 -6,532 -6,527
73.40 Adjustments in expired accounts
(net)........................... -35
73.45 Recoveries of prior year
obligations..................... -3
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -30
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 1
74.40 Obligated balance, end of year.... 5,484 5,812 5,481
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 2,344 2,445 2,316
86.93 Outlays from discretionary
balances........................ 3,677 4,004 4,142
86.97 Outlays from new mandatory
authority....................... 45 54 50
86.98 Outlays from mandatory balances... 37 29 19
--------- --------- ----------
87.00 Total outlays (gross)........... 6,103 6,532 6,527
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -98 -102 -104
88.40 Non-Federal sources........... -21 -20 -19
88.45 Offsetting governmental
collections (from non-
Federal sources)............ -47 -50
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -119 -169 -173
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -30
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 1
Net budget authority and outlays:
89.00 Budget authority.................. 6,481 6,689 6,023
90.00 Outlays........................... 5,984 6,363 6,354
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Summary of Budget Authority and Outlays
(in millions of dollars)
2003 actual 2004 est. 2005 est.
Enacted/requested:
Budget Authority.................. 6,481 6,689 6,023
Outlays........................... 5,984 6,363 6,354
Legislative proposal, subject to
PAYGO:
Budget Authority.................. 25
Outlays........................... 9
------------------------------------
Total:
Budget Authority.................. 6,481 6,714 6,023
Outlays........................... 5,984 6,372 6,354
====================================
Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in
millions of dollars)
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Identification code 75-0350-0-1-550 2003 actual 2004 est. 2005 est.
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Guaranteed loan levels supportable by subsidy
budget authority:
215001Health centers: Facilities
renovation loan guarantee levels 4 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....... 4 17 17
Guaranteed loan subsidy (in percent):
232001Health centers: Facilities
renovation loan guarantee levels 3.65 3.52 3.57
232002Health centers: Managed care
network development loan
guarantee levels................ 0.00 9.28 9.28
232003Health centers: Managed care plan
loan guarantee levels........... 0.00 7.77 7.33
--------- --------- ----------
232901Weighted average subsidy rate..... 3.65 4.68 5.64
Guaranteed loan subsidy budget authority:
233001Health centers: Facilities
renovation loan guarantee levels 1 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 1
Guaranteed loan subsidy outlays:
234001Health centers: Facilities
renovation loan guarantee levels 1 1 1
234002Health centers: Managed care
network development loan
guarantee levels................
234003Health centers: Managed care plan
loan guarantee levels...........
--------- --------- ----------
234901Total subsidy outlays............. 1 1 1
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Administrative expense data:
351001Administrative expenses........... 1 1 1
358001Outlays from balances.............
359001Outlays for administrative
expenses........................ 1 1 1
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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. Abstinence
education activities formerly administered by HRSA have been transferred
to the Administration for Children and Families.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0350-0-1-550 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 99 101 100
11.3 Other than full-time permanent 3 3 3
11.5 Other personnel compensation.. 2 2 2
11.7 Military personnel............ 22 26 26
--------- --------- ----------
11.9 Total personnel compensation 126 132 131
12.1 Civilian personnel benefits..... 23 23 23
12.2 Military personnel benefits..... 11 13 13
13.0 Benefits for former personnel... 3 3 3
21.0 Travel and transportation of
persons....................... 4 3 3
23.1 Rental payments to GSA.......... 13 13 13
23.3 Communications, utilities, and
miscellaneous charges......... 4 4 4
24.0 Printing and reproduction....... 1 1 1
25.1 Advisory and assistance services 63 64 58
25.2 Other services.................. 95 95 88
25.3 Other purchases of goods and
services from Government
accounts...................... 149 149 132
[[Page 425]]
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 4 4
26.0 Supplies and materials.......... 2 2 2
31.0 Equipment....................... 1 1 1
33.0 Investments and loans........... 3 5 5
41.0 Grants, subsidies, and
contributions................. 5,930 6,127 5,491
42.0 Insurance claims and indemnities 23 50 50
--------- --------- ----------
99.0 Direct obligations............ 6,457 6,691 6,024
99.0 Reimbursable obligations.......... 143 169 170
--------- --------- ----------
99.9 Total new obligations........... 6,600 6,860 6,194
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0350-0-1-550 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 1,382 1,383 1,366
1101 Military full-time equivalent
employment.................... 286 269 244
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 105 73 73
2101 Military full-time equivalent
employment.................... 6 84 84
Allocation account:
Total compensable workyears:
3001 Civilian full-time equivalent
employment.................... 12 16 16
3101 Military full-time equivalent
employment.................... 11 20 22
---------------------------------------------------------------------------
Health Resources and Services
(Legislative Proposal, Subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0350-4-1-550 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.33 Abstinence education.............. 25
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 25
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 25
23.95 Total new obligations............. -25
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 25
Change in obligated balances:
72.40 Obligated balance, start of year.. 16
73.10 Total new obligations............. 25
73.20 Total outlays (gross)............. -9
73.31 Obligated balance transferred to
other accounts.................. -16
74.40 Obligated balance, end of year.... 16
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 9
Net budget authority and outlays:
89.00 Budget authority.................. 25
90.00 Outlays........................... 9
---------------------------------------------------------------------------
The budget proposes full-year funding in FY 2004 for the state-based
abstinence education program.
Vaccine Injury Compensation
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0320-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Direct program activity........... 11
--------- --------- ----------
10.00 Total new obligations........... 11
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 8 2
22.00 New budget authority (gross)...... 3
22.10 Resources available from
recoveries of prior year
obligations..................... 3
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 14 2
23.95 Total new obligations............. -11
24.40 Unobligated balance carried
forward, end of year............ 2
New budget authority (gross), detail:
Mandatory:
69.00 Offsetting collections (cash)... 3
Change in obligated balances:
72.40 Obligated balance, start of year.. 3 -9
73.10 Total new obligations............. 11
73.20 Total outlays (gross)............. -11 -9
73.45 Recoveries of prior year
obligations..................... -3
74.40 Obligated balance, end of year.... -9 -9
Outlays (gross), detail:
86.98 Outlays from mandatory balances... 11 9
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -3
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... 9 9
---------------------------------------------------------------------------
The Vaccine Injury Compensation 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 2005 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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
42.0 Direct obligations: Insurance
claims and indemnities.......... 8
99.0 Reimbursable obligations:
Reimbursable obligations........ 3
--------- --------- ----------
99.9 Total new obligations........... 11
---------------------------------------------------------------------------
Credit accounts:
Health Center Guaranteed Loan Financing Account
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4442-0-3-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 1 1 1
22.00 New financing authority (gross)... 1 1
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 1 2 2
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
---------------------------------------------------------------------------
[[Page 426]]
Status of Guaranteed Loans (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4442-0-3-551 2003 actual 2004 est. 2005 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......................... 138 134 117
2143 Uncommitted limitation carried
forward......................... -134 -117 -100
--------- --------- ----------
2150 Total guaranteed loan
commitments................... 4 17 17
2199 Guaranteed amount of guaranteed
loan commitments................ 3 10 10
----------------------------------------------------------------------------
Cumulative balance of guaranteed loans
outstanding:
2210 Outstanding, start of year........ 13 10 27
2231 Disbursements of new guaranteed
loans........................... 4 17 17
2251 Repayments and prepayments........ -4
2264 Adjustments: Other adjustments,
net............................. -3
--------- --------- ----------
2290 Outstanding, end of year........ 10 27 44
----------------------------------------------------------------------------
Memorandum:
2299 Guaranteed amount of guaranteed
loans outstanding, end of year.. 8 27 43
---------------------------------------------------------------------------
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. 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 2002 actual 2003 actual 2004 est. 2005 est.
-----------------------------------------------------------------------------------------------
ASSETS:
1101 Federal assets: Fund balances with
Treasury........................ 1 1
------------ -------------- ------------ -------------
1999 Total assets.................... 1 1
LIABILITIES:
2204 Non-Federal liabilities:
Liabilities for loan guarantees. 1 1
------------ -------------- ------------ -------------
2999 Total liabilities............... 1 1
NET POSITION:
3300 Cumulative results of operations..
------------ -------------- ------------ -------------
3999 Total net position..............
------------ -------------- ------------ -------------
4999 Total liabilities and net position 1 1
-----------------------------------------------------------------------------------------------
Note: Consistent with Government-wide practice, information for 2004
and 2005 was not required to be collected.
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] $3,270,000. (Division E, H.R. 2673, Consolidated
Appropriations Bill, FY 2004.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0340-0-1-552 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.02 Guarantee loan subsidy............ 16 25
00.07 Reestimates of Subsidy............ 101 1
00.08 Interest on Reestimates........... 25 1
00.09 Administrative expenses........... 4 3 3
--------- --------- ----------
10.00 Total new obligations........... 146 30 3
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 146 28 3
23.95 Total new obligations............. -146 -30 -3
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 4 3 3
Mandatory:
60.00 Appropriation................... 142 25
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 146 28 3
Change in obligated balances:
72.40 Obligated balance, start of year.. 1 2 4
73.10 Total new obligations............. 146 30 3
73.20 Total outlays (gross)............. -146 -28 -3
74.40 Obligated balance, end of year.... 2 4 4
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 4 3 3
86.97 Outlays from new mandatory
authority....................... 142 25
--------- --------- ----------
87.00 Total outlays (gross)........... 146 28 3
Net budget authority and outlays:
89.00 Budget authority.................. 146 28 3
90.00 Outlays........................... 144 28 3
---------------------------------------------------------------------------
Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in
millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0340-0-1-552 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Guaranteed loan levels supportable by subsidy
budget authority:
215001HEAL Loan guarantee............... 100 150
--------- --------- ----------
215901Total loan guarantee levels....... 100 150
Guaranteed loan subsidy (in percent):
232001HEAL Loan guarantee............... 15.76 16.48 0.00
--------- --------- ----------
232901Weighted average subsidy rate..... 15.76 16.48 0.00
Guaranteed loan subsidy budget authority:
233001HEAL Loan guarantee............... 16 25
--------- --------- ----------
233901Total subsidy budget authority.... 16 25
Guaranteed loan subsidy outlays:
234001HEAL Loan guarantee............... 16 25
--------- --------- ----------
234901Total subsidy outlays............. 16 25
Guaranteed loan upward reestimate subsidy
budget authority:
235001HEAL Loan guarantee............... 126 2
--------- --------- ----------
235901Total upward reestimate budget
authority....................... 126 2
Guaranteed loan downward reestimate subsidy
budget authority:
237001HEAL Loan guarantee............... -209 -49
--------- --------- ----------
237901Total downward reestimate subsidy
budget authority................ -209 -49
----------------------------------------------------------------------------
Administrative expense data:
351001Budget authority.................. 4 3 3
358001Outlays from balances.............
359001Outlays from new authority........ 4 3 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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
11.1 Personnel compensation: Full-time
permanent....................... 2 1 1
25.3 Other purchases of goods and
services from Government
accounts........................ 2 2 2
[[Page 427]]
41.0 Grants, subsidies, and
contributions................... 142 27
--------- --------- ----------
99.9 Total new obligations........... 146 30 3
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0340-0-1-552 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 17 15 15
1101 Military full-time equivalent
employment.................... 2 2 2
---------------------------------------------------------------------------
Health Education Assistance Loans Financing Account
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4304-0-3-552 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Death and disability claims....... 2 2 2
00.02 Default claims.................... 31 31 31
--------- --------- ----------
00.91 Subtotal........................ 33 33 33
08.02 Payment of downward reestimate to
receipt account................. 106 38
08.04 Payment of interest on downward
reestimate to receipt account... 103 11
--------- --------- ----------
08.91 Subtotal (reestimates).......... 209 49
--------- --------- ----------
10.00 Total new obligations........... 242 82 33
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 345 249 203
22.00 New financing authority (gross)... 146 36 9
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 491 285 212
23.95 Total new obligations............. -242 -82 -33
24.40 Unobligated balance carried
forward, end of year............ 249 203 179
New financing authority (gross), detail:
Mandatory:
69.00 Offsetting collections (cash)... 146 36 9
Change in obligated balances:
72.40 Obligated balance, start of year.. 41
73.10 Total new obligations............. 242 82 33
73.20 Total financing disbursements
(gross)......................... -242 -41 -42
74.40 Obligated balance, end of year.... 41 33
87.00 Total financing disbursements
(gross)......................... 242 41 42
Offsets:
Against gross financing authority and
financing disbursements:
Offsetting collections (cash)
from:
88.00 Federal sources............... -142 -27
88.25 Interest on uninvested funds.. -3 -3
88.40 Recoveries of defaulted loans. -4 -6 -6
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -146 -36 -9
Net financing authority and financing
disbursements:
89.00 Financing authority...............
90.00 Financing disbursements........... 96 5 33
---------------------------------------------------------------------------
Status of Guaranteed Loans (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4304-0-3-552 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Position with respect to appropriations act
limitation on commitments:
2111 Limitation on guaranteed loans
made by private lenders......... 160 150
--------- --------- ----------
2150 Total guaranteed loan
commitments................... 160 150
2199 Guaranteed amount of guaranteed
loan commitments................ 160 150
----------------------------------------------------------------------------
Cumulative balance of guaranteed loans
outstanding:
2210 Outstanding, start of year........ 1,646 1,760 1,860
2231 Disbursements of new guaranteed
loans........................... 160 150
2251 Repayments and prepayments........ -6 -6 -7
Adjustments:
2261 Terminations for default that
result in loans receivable.... -38 -41 -42
2263 Terminations for default that
result in claim payments...... -2 -3 -4
--------- --------- ----------
2290 Outstanding, end of year........ 1,760 1,860 1,807
----------------------------------------------------------------------------
Memorandum:
2299 Guaranteed amount of guaranteed
loans outstanding, end of year.. 1,760 1,860 1,807
----------------------------------------------------------------------------
Addendum:
Cumulative balance of defaulted guaranteed
loans that result in loans receivable:
2310 Outstanding, start of year...... 391 423 458
2331 Disbursements for guaranteed
loan claims................... 38 41 42
2351 Repayments of loans receivable.. -6 -6 -6
--------- --------- ----------
2390 Outstanding, end of year...... 423 458 494
---------------------------------------------------------------------------
This account records all cash flows to and from the Government
resulting from HEAL loan guarantees committed between 1992 and 2004. No
new loan guarantees will be issued after 2004.
Balance Sheet (in millions of dollars)
-----------------------------------------------------------------------------------------------
Identification code 75-4304-0-3-552 2002 actual 2003 actual 2004 est. 2005 est.
-----------------------------------------------------------------------------------------------
ASSETS:
1101 Federal assets: Fund balances with
Treasury........................ 345 340
1206 Non-Federal assets: Receivables,
net............................. 67 67
------------ -------------- ------------ -------------
1999 Total assets.................... 412 407
LIABILITIES:
2204 Non-Federal liabilities:
Liabilities for loan guarantees. 412 407
------------ -------------- ------------ -------------
2999 Total liabilities............... 412 407
NET POSITION:
3300 Cumulative results of operations..
------------ -------------- ------------ -------------
3999 Total net position..............
------------ -------------- ------------ -------------
4999 Total liabilities and net position 412 407
-----------------------------------------------------------------------------------------------
Note: Consistent with Government-wide practice, information for 2004
and 2005 was not required to be collected.
Health Education Assistance Loans Liquidating Account
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4305-0-3-552 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Death and disability claims....... 3 3 3
00.02 Defaulted loans................... 12 15 15
00.03 Debt collection................... 6 6 6
--------- --------- ----------
10.00 Total new obligations........... 21 24 24
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 21 24 24
23.95 Total new obligations............. -21 -24 -24
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 4 4
69.00 Offsetting collections (cash)..... 21 20 20
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 21 24 24
Change in obligated balances:
72.40 Obligated balance, start of year.. 4 5 3
73.10 Total new obligations............. 21 24 24
73.20 Total outlays (gross)............. -21 -24 -24
74.40 Obligated balance, end of year.... 5 3 3
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 21 24 24
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -21 -20 -20
Net budget authority and outlays:
89.00 Budget authority.................. 4 4
90.00 Outlays........................... 4 4
---------------------------------------------------------------------------
[[Page 428]]
Status of Guaranteed Loans (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4305-0-3-552 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Cumulative balance of guaranteed loans
outstanding:
2210 Outstanding, start of year........ 619 585 556
2251 Repayments and prepayments........ -15 -15 -15
Adjustments:
2261 Terminations for default that
result in loans receivable.... -14 -12 -10
2263 Terminations for default that
result in claim payments...... -2 -2 -2
2264 Other adjustments, net.......... -3
--------- --------- ----------
2290 Outstanding, end of year........ 585 556 529
----------------------------------------------------------------------------
Memorandum:
2299 Guaranteed amount of guaranteed
loans outstanding, end of year.. 585 556 529
----------------------------------------------------------------------------
Addendum:
Cumulative balance of defaulted guaranteed
loans that result in loans receivable:
2310 Outstanding, start of year...... 493 468 442
2331 Disbursements for guaranteed
loan claims................... 14 12 10
2351 Repayments of loans receivable.. -13 -14 -15
2361 Write-offs of loans receivable.. -26 -24 -24
--------- --------- ----------
2390 Outstanding, end of year...... 468 442 413
---------------------------------------------------------------------------
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.
Balance Sheet (in millions of dollars)
-----------------------------------------------------------------------------------------------
Identification code 75-4305-0-3-552 2002 actual 2003 actual 2004 est. 2005 est.
-----------------------------------------------------------------------------------------------
ASSETS:
1101 Federal assets: Fund balances with
Treasury........................ 4 4
1206 Non-Federal assets: Receivables,
net............................. 303 376
------------ -------------- ------------ -------------
1999 Total assets.................... 307 380
LIABILITIES:
2204 Non-Federal liabilities:
Liabilities for loan guarantees. 307 380
------------ -------------- ------------ -------------
2999 Total liabilities............... 307 380
NET POSITION:
3300 Cumulative results of operations..
------------ -------------- ------------ -------------
3999 Total net position..............
------------ -------------- ------------ -------------
4999 Total liabilities and net position 307 380
-----------------------------------------------------------------------------------------------
Note: Consistent with Government-wide practice, information for 2004
and 2005 was not required to be collected.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4305-0-3-552 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
25.2 Other services.................... 6 6 6
42.0 Insurance claims and indemnities.. 15 18 18
--------- --------- ----------
99.9 Total new obligations........... 21 24 24
---------------------------------------------------------------------------
Medical Facilities Guarantee and Loan Fund
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9931-0-3-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 68 68 68
24.40 Unobligated balance carried
forward, end of year............ 68 68 68
Change in obligated balances:
72.40 Obligated balance, start of year.. 1 1 1
74.40 Obligated balance, end of year.... 1 1 1
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................
---------------------------------------------------------------------------
Status of Direct Loans (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9931-0-3-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Cumulative balance of direct loans
outstanding:
1210 Outstanding, start of year........ 8 7 3
1251 Repayments: Repayments and
prepayments..................... -1 -4 -2
--------- --------- ----------
1290 Outstanding, end of year........ 7 3 1
---------------------------------------------------------------------------
Status of Guaranteed Loans (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9931-0-3-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Cumulative balance of guaranteed loans
outstanding:
2210 Outstanding, start of year........ 16 13 6
2251 Repayments and prepayments........ -3 -7 -4
--------- --------- ----------
2290 Outstanding, end of year........ 13 6 2
----------------------------------------------------------------------------
Memorandum:
2299 Guaranteed amount of guaranteed
loans outstanding, end of year.. 13 6 2
---------------------------------------------------------------------------
Title VII, part C of the Public Health Service Act established a
revolving fund from which health professions schools could borrow in
order to provide loans to their students.
Public Law 89-751, the Allied Health Professions Personnel Training
Act of 1966, amended the Public Health Service Act to authorize the
Federal Government to pay the difference between the interest paid by
students to the schools and the interest payable by the schools to the
Government National Mortgage Association (GNMA) and the Treasury.
Title VI and subsequently title XVI of the Public Health Service Act
established a loan and loan guarantee fund for medical facilities with a
maximum amount allowable for the Government's liability. Direct loans
were made available for public facilities and guaranteed loans for
private, nonprofit facilities. Funds under this authority were
established in the amount of $50 million for use in fulfilling
guarantees in event of default, $30 million as a revolving fund for
direct loans and an amount for interest subsidy payments on guaranteed
loans. Unobligated balances will be used to pay defaults and interest
subsidy payments.
Trust Funds
Vaccine Injury Compensation Program Trust Fund
For payments from the Vaccine Injury Compensation Program Trust
Fund, such sums as may be necessary for claims associated with vaccine-
related injury or death with respect to vaccines administered after
September 30, 1988, pursuant to subtitle 2 of title XXI of the Public
Health Service Act, to remain available until expended: Provided, That
for necessary administrative expenses, not to exceed [$3,222,000]
$3,176,000 shall be available from the Trust Fund to the Secretary of
Health and Human Services. (Division E, H.R. 2673, Consolidated
Appropriations Bill, FY 2004.)
Unavailable Receipts (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8175-0-7-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
01.99 Balance, start of year............ 1,759 1,759 1,915
Receipts:
02.00 Deposits, Vaccine injury
compensation trust fund......... 138 127 128
02.40 Interest and profits on
investments, Vaccine injury
compensation.................... 86 105 114
--------- --------- ----------
02.99 Total receipts and collections.. 224 232 242
--------- --------- ----------
04.00 Total: Balances and collections... 1,983 1,991 2,157
Appropriations:
05.00 Vaccine injury compensation
program trust fund.............. -9 -10 -13
[[Page 429]]
05.01 Vaccine injury compensation
program trust fund.............. -215 -66 -66
--------- --------- ----------
05.99 Total appropriations............ -224 -76 -79
--------- --------- ----------
07.99 Balance, end of year.............. 1,759 1,915 2,078
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8175-0-7-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Compensation: Claims for post--FY
1989 injuries................... 75 66 66
Administrative expenses:
01.03 Claims processing (Claims Court) 2 3 4
01.04 Claims processing (Public Health
Service)...................... 3 3 3
01.05 Claims processing (Dept. of
Justice)...................... 4 4 6
--------- --------- ----------
01.91 Total, administrative expenses 9 10 13
--------- --------- ----------
10.00 Total new obligations........... 84 76 79
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 1,761 1,901 1,901
22.00 New budget authority (gross)...... 224 76 79
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 1,985 1,977 1,980
23.95 Total new obligations............. -84 -76 -79
24.40 Unobligated balance carried
forward, end of year............ 1,901 1,901 1,901
New budget authority (gross), detail:
Discretionary:
40.26 Appropriation (trust fund)...... 9 10 13
Mandatory:
60.26 Appropriation (trust fund)...... 215 66 66
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 224 76 79
Change in obligated balances:
72.40 Obligated balance, start of year.. 1 1
73.10 Total new obligations............. 84 76 79
73.20 Total outlays (gross)............. -84 -76 -79
74.40 Obligated balance, end of year.... 1 1 1
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 9 10 13
86.97 Outlays from new mandatory
authority....................... 75 66 66
--------- --------- ----------
87.00 Total outlays (gross)........... 84 76 79
Net budget authority and outlays:
89.00 Budget authority.................. 224 76 79
90.00 Outlays........................... 84 76 79
Memorandum (non-add) entries:
92.01 Total investments, start of year:
Federal securities: Par value... 1,758 1,896 2,294
92.02 Total investments, end of year:
Federal securities: Par value... 1,896 2,294 2,460
---------------------------------------------------------------------------
The Vaccine injury compensation 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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
25.2 Other services.................... 14 3 3
25.3 Other purchases of goods and
services from Government
accounts........................ 7 7 10
42.0 Insurance claims and indemnities.. 63 66 66
--------- --------- ----------
99.9 Total new obligations........... 84 76 79
---------------------------------------------------------------------------
Ricky Ray Hemophilia Relief Fund
Unavailable Receipts (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8074-0-7-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
01.99 Balance, start of year............
Receipts:
02.40 Interest on investments, Ricky Ray
hemophilia relief fund.......... 1
--------- --------- ----------
04.00 Total: Balances and collections... 1
Appropriations:
05.00 Ricky Ray hemophilia relief fund.. -1
--------- --------- ----------
07.99 Balance, end of year..............
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8074-0-7-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Compensation--claims.............. 6 1
00.02 Administrative expenses subject to
limitation...................... 1 1
--------- --------- ----------
10.00 Total new obligations........... 7 2
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 97 91
22.00 New budget authority (gross)...... 1
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 98 91
23.95 Total new obligations............. -7 -2
23.98 Unobligated balance expiring or
withdrawn....................... -89
24.40 Unobligated balance carried
forward, end of year............ 91
New budget authority (gross), detail:
Mandatory:
60.26 Appropriation (trust fund)...... 1
Change in obligated balances:
72.40 Obligated balance, start of year.. 1 1
73.10 Total new obligations............. 7 2
73.20 Total outlays (gross)............. -8 -3
74.40 Obligated balance, end of year.... 1
Outlays (gross), detail:
86.98 Outlays from mandatory balances... 8 3
Net budget authority and outlays:
89.00 Budget authority.................. 1
90.00 Outlays........................... 7 3
Memorandum (non-add) entries:
92.01 Total investments, start of year:
Federal securities: Par value... 91 89
92.02 Total investments, end of year:
Federal securities: Par value... 89
---------------------------------------------------------------------------
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. By law the fund terminated November 12, 2003,
five years after the date of enactment. All unobligated balances are to
be returned to the Treasury.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8074-0-7-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
11.1 Personnel compensation: Full-time
permanent....................... 1
25.2 Other services.................... 1
42.0 Insurance claims and indemnities.. 6 1
--------- --------- ----------
99.9 Total new obligations........... 7 2
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-8074-0-7-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 12 4
1101 Military full-time equivalent
employment.................... 1
---------------------------------------------------------------------------
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
[[Page 430]]
Care Improvement Act, and titles II and III of the Public Health Service
Act with respect to the Indian Health Service, [$2,561,932,000]
$2,612,824,000, 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 [$467,046,000] $479,085,000 for
contract medical care shall remain available for obligation until
September 30, [2005] 2006: 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 one-year contracts and grants which are to be
performed in two fiscal years, so long as the total obligation is
recorded in the year for which the funds are appropriated: Provided
further, That the amounts collected by the Secretary of Health and Human
Services under the authority of title IV of the Indian Health Care
Improvement Act shall remain available until expended for the purpose of
achieving compliance with the applicable conditions and requirements of
titles XVIII and XIX of the Social Security Act (exclusive of planning,
design, or construction of new facilities): Provided further, That
funding contained herein, and in any earlier appropriations Acts for
scholarship programs under the Indian Health Care Improvement Act (25
U.S.C. 1613) shall remain available 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] $267,398,000 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] 2005, 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[:
Provided further, That of the amounts provided to the Indian Health
Service, $15,000,000 is provided for alcohol control, enforcement,
prevention, treatment, sobriety and wellness, and education in Alaska to
be distributed as direct lump sum payments as follows: (a) $2,000,000 to
the State of Alaska for regional distribution to hire and equip
additional Village Public Safety Officers to engage primarily in
bootlegging prevention and enforcement activities; (b) $5,000,000 to the
Alaska Native Tribal Health Consortium, which shall be allocated for:
(1) substance abuse and behavioral health counselors through the
Counselor in Every Village program; and (2) comprehensive substance
abuse training programs for counselors and others delivering substance
abuse services; (c) $6,000,000 to be divided as follows among the
following Alaska Native regional organizations to provide substance
abuse treatment and prevention programs: (1) $2,500,000 for Southcentral
Foundation's Pathway Home; (2) $1,500,000 for Cook Inlet Tribal
Council's substance abuse prevention and treatment programs; (3)
$1,500,000 for Yukon-Kuskokwim Health Corporation's Tundra Swan Inhalant
Abuse Center; and (4) $500,000 for the Southeast Alaska Regional Health
Consortium for its Deilee Hitt program; and (d) $2,000,000 for RuralCap
for alcohol treatment and related transitional housing for homeless
chronic inebriates in Anchorage, AK: Provided further, That none of the
funds may be used for tribal courts or tribal ordinance programs or any
program that is not directly related to alcohol control, enforcement,
prevention, treatment, or sobriety: Provided further, That no more than
10 percent may be used by any entity receiving funding for
administrative overhead including indirect costs: Provided further, That
the State of Alaska must maintain its existing level of effort and must
use these funds to enhance or expand existing efforts or initiate new
projects or programs and may not use such funds to supplant existing
programs]. (Department of the Interior and Related Agencies
Appropriations Act, 2004.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0390-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.01 Clinical services............... 1,902 2,024 2,101
00.02 Preventive health............... 103 107 112
00.03 Urban health.................... 31 32 32
00.04 Indian health professions....... 31 31 31
00.05 Tribal management............... 2 2 2
00.06 Direct operations............... 60 61 62
00.07 Self-governance................. 6 6 6
00.08 Contract support costs.......... 269 267 267
00.09 Diabetes funds.................. 105 150 150
09.01 Reimbursable program.............. 782 789 789
--------- --------- ----------
10.00 Total new obligations........... 3,291 3,469 3,552
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 240 300 300
22.00 New budget authority (gross)...... 3,358 3,469 3,552
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 3,598 3,769 3,852
23.95 Total new obligations............. -3,291 -3,469 -3,552
23.98 Unobligated balance expiring or
withdrawn....................... -6
24.40 Unobligated balance carried
forward, end of year............ 300 300 300
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 2,492 2,562 2,613
40.35 Appropriation permanently
reduced....................... -16 -32
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 2,476 2,530 2,613
Mandatory:
60.00 Appropriation................... 100 150 150
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 780 789 789
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 2
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 782 789 789
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 3,358 3,469 3,552
Change in obligated balances:
72.40 Obligated balance, start of year.. 605 496 592
73.10 Total new obligations............. 3,291 3,469 3,552
73.20 Total outlays (gross)............. -3,365 -3,373 -3,619
73.40 Adjustments in expired accounts
(net)........................... -31
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -2
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... -3
74.40 Obligated balance, end of year.... 496 592 525
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 2,960 3,015 3,088
86.93 Outlays from discretionary
balances........................ 309 249 382
86.97 Outlays from new mandatory
authority....................... 20 30 30
86.98 Outlays from mandatory balances... 76 79 119
--------- --------- ----------
87.00 Total outlays (gross)........... 3,365 3,373 3,619
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -456 -457 -457
88.40 Non-Federal sources........... -326 -332 -332
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -782 -789 -789
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -2
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 2
Net budget authority and outlays:
89.00 Budget authority.................. 2,576 2,680 2,763
90.00 Outlays........................... 2,583 2,584 2,830
---------------------------------------------------------------------------
The Indian health services account provides medical care, public
health services, and health professions training oppor
[[Page 431]]
tunities to American Indians and Alaska Natives. An estimated $1,623
million will be administered by tribal governments under self-
determination contracts and self-governance compacts in 2005.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0390-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 308 359 375
11.3 Other than full-time permanent 15 16 17
11.5 Other personnel compensation.. 29 33 34
11.7 Military personnel............ 70 80 84
--------- --------- ----------
11.9 Total personnel compensation 422 488 510
12.1 Civilian personnel benefits..... 88 102 106
12.2 Military personnel benefits..... 30 35 36
13.0 Benefits for former personnel... 7 8 8
21.0 Travel and transportation of
persons....................... 10 10 10
21.0 Patient Travel.................. 17 17 17
22.0 Transportation of things........ 9 8 8
23.1 Rental payments to GSA.......... 11 10 10
23.2 Rental payments to others....... 2 2 2
23.3 Communications, utilities, and
miscellaneous charges......... 15 14 14
24.0 Printing and reproduction....... 2 1 1
25.1 Advisory and assistance services 5 4 6
25.2 Other services.................. 86 49 50
25.3 Other purchases of goods and
services from Government
accounts...................... 31 16 20
25.4 Operation and maintenance of
facilities.................... 4 3 3
25.6 Medical care.................... 201 204 219
25.7 Operation and maintenance of
equipment..................... 5 5 5
25.8 Subsistence and support of
persons....................... 2 2 2
26.0 Supplies and materials.......... 100 91 91
31.0 Equipment....................... 15 15 15
32.0 Land and structures............. 1 1 1
41.0 Grants, subsidies, and
contributions................. 1,445 1,594 1,628
42.0 Insurance claims and indemnities 1 1 1
--------- --------- ----------
99.0 Direct obligations............ 2,509 2,680 2,763
99.0 Reimbursable obligations.......... 782 789 789
--------- --------- ----------
99.9 Total new obligations........... 3,291 3,469 3,552
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0390-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 7,117 7,982 8,060
1101 Military full-time equivalent
employment.................... 1,137 1,274 1,287
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 4,720 4,720 4,720
2101 Military full-time equivalent
employment.................... 754 754 754
---------------------------------------------------------------------------
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, [$396,232,000] $354,448,000, to
remain available until expended: Provided, That notwithstanding any
other provision of law, funds appropriated for the planning, design,
construction or renovation of health facilities for the benefit of an
Indian tribe or tribes may be used to purchase land for sites to
construct, improve, or enlarge health or related facilities: [Provided
further, That from the funds appropriated herein, $5,000,000 shall be
designated by the Indian Health Service as a contribution to the Yukon-
Kuskokwim Health Corporation (YKHC) to complete a priority project for
the acquisition of land, planning, design and construction of 79 staff
quarters in the Bethel service area, pursuant to the negotiated project
agreement between the YKHC and the Indian Health Service: Provided
further, That this project shall not be subject to the construction
provisions of the Indian Self-Determination and Education Assistance Act
and shall be removed from the Indian Health Service priority list upon
completion: Provided further, That the Federal Government shall not be
liable for any property damages or other construction claims that may
arise from YKHC undertaking this project: Provided further, That the
land shall be owned or leased by the YKHC and title to quarters shall
remain vested with the YKHC:] Provided further, That 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 none of the
funds appropriated to the Indian Health Service may be used for
sanitation facilities construction for new homes funded with grants by
the housing programs of the United States Department of Housing and
Urban Development: Provided further, That not to exceed $1,000,000 from
this account and the ``Indian Health Services'' account 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.
(Department of the Interior and Related Agencies Appropriations Act,
2004.)
Unavailable Receipts (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0391-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
01.99 Balance, start of year............
Receipts:
02.20 Rent and charges for quarters,
Indian Health Service........... 3 6 6
--------- --------- ----------
04.00 Total: Balances and collections... 3 6 6
Appropriations:
05.00 Indian health facilities.......... -3 -6 -6
--------- --------- ----------
07.99 Balance, end of year..............
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0391-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.01 Sanitation and health facilities 119 187 145
00.02 Maintenance..................... 38 55 55
00.03 Facilities and environmental
health........................ 129 138 143
00.04 Equipment....................... 16 17 17
--------- --------- ----------
01.00 Total direct program.......... 302 397 360
09.01 Reimbursable program.............. 3 6 6
--------- --------- ----------
10.00 Total new obligations........... 305 403 366
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 142 227 227
22.00 New budget authority (gross)...... 391 403 366
22.10 Resources available from
recoveries of prior year
obligations..................... 1
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 534 630 593
23.95 Total new obligations............. -305 -403 -366
24.40 Unobligated balance carried
forward, end of year............ 227 227 227
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 376 396 354
40.35 Appropriation permanently
reduced....................... -2 -5
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 374 391 354
Mandatory:
60.20 Appropriation (special fund).... 3 6 6
Discretionary:
68.00 Spending authority from
offsetting collections:
Offsetting collections (cash). 14 6 6
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 391 403 366
Change in obligated balances:
72.40 Obligated balance, start of year.. 323 252 328
73.10 Total new obligations............. 305 403 366
[[Page 432]]
73.20 Total outlays (gross)............. -376 -327 -384
73.45 Recoveries of prior year
obligations..................... -1
74.40 Obligated balance, end of year.... 252 328 310
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 126 123 112
86.93 Outlays from discretionary
balances........................ 247 198 266
86.97 Outlays from new mandatory
authority....................... 3 6 6
--------- --------- ----------
87.00 Total outlays (gross)........... 376 327 384
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -14 -6 -6
Net budget authority and outlays:
89.00 Budget authority.................. 377 397 360
90.00 Outlays........................... 362 321 378
---------------------------------------------------------------------------
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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 34 36 37
11.3 Other than full-time permanent -3 2 2
11.5 Other personnel compensation.. 1 1 1
11.7 Military personnel............ 18 20 21
--------- --------- ----------
11.9 Total personnel compensation 50 59 61
12.1 Civilian personnel benefits..... 8 10 10
12.2 Military personnel benefits..... 6 7 7
21.0 Travel and transportation of
persons....................... 2 2 2
22.0 Transportation of things........ 3 3 2
23.3 Communications, utilities, and
miscellaneous charges......... 1 11 11
25.1 Advisory and assistance services 3 4 4
25.2 Other services.................. 100 113 113
25.3 Other purchases of goods and
services from Government
accounts...................... 2 3 2
25.4 Operation and maintenance of
facilities.................... 5 7 7
25.8 Subsistence and support of
persons....................... -1
26.0 Supplies and materials.......... 5 6 5
31.0 Equipment....................... 10 14 13
32.0 Land and structures............. 13 47 12
41.0 Grants, subsidies, and
contributions................. 95 111 111
--------- --------- ----------
99.0 Direct obligations............ 302 397 360
99.0 Reimbursable obligations.......... 3 6 6
--------- --------- ----------
99.9 Total new obligations........... 305 403 366
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0391-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 1,096 1,205 1,218
1101 Military full-time equivalent
employment.................... 178 192 194
---------------------------------------------------------------------------
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.
[None of the funds made available to the Indian Health Service in
this Act shall be used for any assessments or charges by the Department
of Health and Human Services unless identified in the budget
justification and provided in this Act, or approved by the House and
Senate Committees on Appropriations through the reprogramming process.
Personnel ceilings may not be imposed on the Indian Health Service nor
may any action be taken to reduce the full time equivalent level of the
Indian Health Service below the level in fiscal year 2002 adjusted
upward for the staffing of new and expanded facilities, funding provided
for staffing at the Lawton, Oklahoma hospital in fiscal years 2003 and
2004, critical positions not filled in fiscal year 2002, and staffing
necessary to carry out the intent of Congress with regard to program
increases.]
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.
The appropriation structure for the Indian Health Service may not be
altered without advance [approval of] notice submitted to the House and
Senate Committees on Appropriations. (Department of the Interior and
Related Agencies Appropriations Act, 2004.)
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,
[[Page 433]]
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 purchase and
insurance of official motor vehicles in foreign countries; and purchase,
hire, maintenance, and operation of aircraft, [$4,545,472,000]
$4,213,554,000, of which [$262,000,000] $81,500,000 shall remain
available until expended for equipment, and construction and renovation
of facilities, and of which [$293,569,000] $142,808,000 for
international HIV/AIDS shall remain available until September 30, [2005,
including $150,000,000, to remain available until expended for the
``International Mother and Child HIV Prevention Initiative.''] 2006. 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, [$14,000,000] the following amounts shall be available
from amounts available under section 241 of the Public Health Service
Act (1) $14,000,000 to carry out the National Immunization Surveys[:
Provided further, That in addition to amounts provided herein,
$127,634,000 shall be available from amounts available under section 241
of the Public Health Service Act]; (2) $149,600,000 to carry out the
National Center for Health Statistics surveys[: Provided further, That
in addition to amounts provided herein,]; (3) $28,600,000 [shall be
available from amounts available under section 241 of the Public Health
Service Act] to carry out information systems standards development and
architecture and applications-based research used at local public health
levels[: Provided further, That in addition to amounts provided
herein,]; (4) $15,000,000 to carry out Public Health Research; and (5)
$41,900,000 [shall be available from amounts available under section 241
of the Public Health Service Act] to carry out Research Tools and
Approaches activities within the National Occupational Research Agenda:
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, in whole or in part, 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 $12,500,000 may be
available for making grants under section 1509 of the Public Health
Service Act to not more than 15 States, tribes, or tribal organizations:
Provided further, That without regard to existing statute, funds
appropriated may be used to proceed, at the discretion of the Centers
for Disease Control and Prevention, with property acquisition, including
a long-term ground lease for construction on non-Federal land, to
support the construction of a replacement laboratory in the Fort
Collins, Colorado area[: Provided further, That notwithstanding any
other provision of law, a single contract or related contracts for
development and construction of facilities may be employed which
collectively include the full scope of the project: Provided further,
That the solicitation and contract shall contain the clause
``availability of funds'' found at 48 CFR 52.232-18]. (Division E, H.R.
2673, Consolidated Appropriations Bill, FY 2004.)
Unavailable Receipts (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0943-0-1-999 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
01.99 Balance, start of year............
Receipts:
02.20 Cooperative research and
development agreements, Centers
for Disease Control............. 1 1 1
--------- --------- ----------
04.00 Total: Balances and collections... 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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.19 Birth defects/developmental
disabilities/disability and
health........................ 98 113 113
00.20 Chronic disease prev & health
promotion..................... 790 853 915
00.21 Environmental health............ 186 183 184
00.22 Epidemic services and response.. 77 92 92
00.24 HIV/AIDS, STD and TB prevention. 1,166 1,291 1,143
00.25 Immunization.................... 636 629 630
00.26 Infectious disease control...... 360 370 401
00.27 Injury prevention and control... 148 154 154
00.28 Occupational safety and health.. 235 235 237
00.29 Preventive health and heath
service block grant........... 134 133 133
00.30 Public health improvement....... 124 144 70
00.31 Building and facilities......... 185 260 82
00.32 Office of the Director.......... 53 59 60
Reimbursable program:
09.01 Health statistics............... 126 128 150
09.02 Other reimbursable program...... 248 234 249
--------- --------- ----------
09.09 Subtotal, reimbursable
programs.................... 374 362 399
--------- --------- ----------
10.00 Total new obligations........... 4,566 4,878 4,613
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 66 165 166
22.00 New budget authority (gross)...... 4,663 4,879 4,614
22.10 Resources available from
recoveries of prior year
obligations..................... 3
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 4,732 5,044 4,780
23.95 Total new obligations............. -4,566 -4,878 -4,613
23.98 Unobligated balance expiring or
withdrawn....................... -1
24.40 Unobligated balance carried
forward, end of year............ 165 166 167
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 4,313 4,547 4,214
40.35 Appropriation permanently
reduced....................... -28 -31
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 4,285 4,516 4,214
Mandatory:
60.20 Appropriation (special fund).... 1 1 1
65.00 Advance appropriation........... 3
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 260 362 399
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 114
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 374 362 399
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 4,663 4,879 4,614
Change in obligated balances:
72.40 Obligated balance, start of year.. 3,970 3,583 3,928
73.10 Total new obligations............. 4,566 4,878 4,613
73.20 Total outlays (gross)............. -4,894 -4,533 -4,806
73.40 Adjustments in expired accounts
(net)........................... -59
73.45 Recoveries of prior year
obligations..................... -3
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -114
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 117
74.40 Obligated balance, end of year.... 3,583 3,928 3,735
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1,988 1,853 1,789
86.93 Outlays from discretionary
balances........................ 2,902 2,679 3,016
86.97 Outlays from new mandatory
authority....................... 4 1 1
--------- --------- ----------
87.00 Total outlays (gross)........... 4,894 4,533 4,806
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -142 -299 -349
88.40 Non-Federal sources........... -229 -63 -50
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -371 -362 -399
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -114
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 111
Net budget authority and outlays:
89.00 Budget authority.................. 4,289 4,517 4,215
90.00 Outlays........................... 4,523 4,171 4,407
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2003 actual 2004 est. 2005 est.
Enacted/requested:
Budget Authority.................. 4,289 4,517 4,215
Outlays........................... 4,523 4,171 4,407
Legislative proposal, not subject to
PAYGO:
Budget Authority.................. -110
[[Page 434]]
Outlays........................... -36
------------------------------------
Total:
Budget Authority.................. 4,289 4,517 4,105
Outlays........................... 4,523 4,171 4,371
====================================
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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 319 331 341
11.3 Other than full-time permanent 36 37 39
11.5 Other personnel compensation.. 18 19 19
11.7 Military personnel............ 48 50 51
11.8 Special personal services
payments.................... 1 1 1
--------- --------- ----------
11.9 Total personnel compensation 422 438 451
12.1 Civilian personnel benefits..... 109 113 116
12.2 Military personnel benefits..... 32 32 33
21.0 Travel and transportation of
persons....................... 39 45 39
22.0 Transportation of things........ 8 12 8
23.1 Rental payments to GSA.......... 23 28 29
23.2 Rental payments to others....... 2 2 2
23.3 Communications, utilities, and
miscellaneous charges......... 20 24 23
24.0 Printing and reproduction....... 6 8 7
25.1 Advisory and assistance services 221 256 249
25.2 Other services.................. 96 87 72
25.3 Other purchases of goods and
services from Government
accounts...................... 179 255 164
25.4 Operation and maintenance of
facilities.................... 16 21 20
25.5 Research and development
contracts..................... 231 220 207
25.6 Medical care.................... 1 1 1
25.7 Operation and maintenance of
equipment..................... 17 25 24
26.0 Supplies and materials.......... 28 30 27
31.0 Equipment....................... 55 61 60
32.0 Land and structures............. 180 257 77
41.0 Grants, subsidies, and
contributions................. 2,507 2,601 2,605
--------- --------- ----------
99.0 Direct obligations............ 4,192 4,516 4,214
99.0 Reimbursable obligations.......... 374 362 399
--------- --------- ----------
99.9 Total new obligations........... 4,566 4,878 4,613
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0943-0-1-999 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 5,816 5,717 5,717
1101 Military full-time equivalent
employment.................... 767 602 602
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 1,028 1,028 1,028
2101 Military full-time equivalent
employment.................... 257 257 257
Allocation account:
3001 Total compensable workyears:
Civilian full-time equivalent
employment...................... 529 529 529
---------------------------------------------------------------------------
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 2003 actual 2004 est. 2005 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)............. 36
74.40 Obligated balance, end of year.... -74
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... -36
Net budget authority and outlays:
89.00 Budget authority.................. -110
90.00 Outlays........................... -36
---------------------------------------------------------------------------
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, which may be derived
to the extent funds are available from the Hazardous Substance Superfund
Trust Fund pursuant to section 517(a) of SARA (26 U.S.C. 9507)]
$76,654,000: 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. (Division G, H.R. 2673, Consolidated Appropriations Bill,
FY 2004.)
[[Page 435]]
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0944-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Direct program.................... 73 77
09.01 Reimbursable program.............. 25 25
--------- --------- ----------
10.00 Total new obligations........... 98 102
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 98 102
23.95 Total new obligations............. -98 -102
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 73 77
68.00 Spending authority from offsetting
collections: Offsetting
collections (cash).............. 25 25
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 98 102
Change in obligated balances:
72.40 Obligated balance, start of year.. 11
73.10 Total new obligations............. 98 102
73.20 Total outlays (gross)............. -87 -94
74.40 Obligated balance, end of year.... 11 18
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 87 90
86.93 Outlays from discretionary
balances........................ 4
--------- --------- ----------
87.00 Total outlays (gross)........... 87 94
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -25 -25
Net budget authority and outlays:
89.00 Budget authority.................. 73 77
90.00 Outlays........................... 62 69
---------------------------------------------------------------------------
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.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0944-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 23 24
11.3 Other than full-time permanent 1 1
11.5 Other personnel compensation.. 1 1
11.7 Military personnel............ 4 4
--------- --------- ----------
11.9 Total personnel compensation 29 30
12.1 Civilian personnel benefits..... 6 6
12.2 Military personnel benefits..... 2 2
21.0 Travel and transportation of
persons....................... 1 1
23.3 Communications, utilities, and
miscellaneous charges......... 1 1
25.1 Advisory and assistance services 6 6
25.2 Other services.................. 2 2
25.3 Other purchases of goods and
services from Government
accounts...................... 7 7
25.5 Research and development
contracts..................... 1 1
31.0 Equipment....................... 1 1
41.0 Grants, subsidies, and
contributions................. 17 20
--------- --------- ----------
99.0 Direct obligations............ 73 77
99.0 Reimbursable obligations.......... 25 25
--------- --------- ----------
99.9 Total new obligations........... 98 102
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0944-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 301 301
1101 Military full-time equivalent
employment.................... 63 63
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 57 57
2101 Military full-time equivalent
employment.................... 8 8
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8252-0-7-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Direct program.................... 82
09.01 Reimbursable program.............. 18
--------- --------- ----------
10.00 Total new obligations........... 100
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 100
23.95 Total new obligations............. -100
New budget authority (gross), detail:
Discretionary:
40.26 Appropriation (trust fund)...... 83
40.37 Appropriation temporarily
reduced....................... -1
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 82
Spending authority from offsetting
collections:
68.00 Offsetting collections (cash)... 10
68.10 Change in uncollected customer
payments from Federal sources
(unexpired)................... 8
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)....... 18
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 100
Change in obligated balances:
72.40 Obligated balance, start of year.. 44 55 42
73.10 Total new obligations............. 100
73.20 Total outlays (gross)............. -93 -13 -7
73.40 Adjustments in expired accounts
(net)........................... -4
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -8
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 16
74.40 Obligated balance, end of year.... 55 42 35
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 68
86.93 Outlays from discretionary
balances........................ 25 13 7
--------- --------- ----------
87.00 Total outlays (gross)........... 93 13 7
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -22
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -8
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 12
Net budget authority and outlays:
89.00 Budget authority.................. 82
90.00 Outlays........................... 71 13 7
---------------------------------------------------------------------------
The Agency for Toxic Substances and Disease Registry (ATSDR)
received appropriations solely from the Hazardous Substance Superfund
trust fund until 2004, when ATSDR received an appropriation from the
general fund, depending on any available balances from the trust fund.
The budget requests that ATSDR's appropriation come only from the
general fund in 2005, without regard to any available balances in the
trust fund.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8252-0-7-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 22
11.3 Other than full-time permanent 1
11.5 Other personnel compensation.. 1
11.7 Military personnel............ 4
--------- --------- ----------
11.9 Total personnel compensation 28
[[Page 436]]
12.1 Civilian personnel benefits..... 6
12.2 Military personnel benefits..... 2
21.0 Travel and transportation of
persons....................... 1
23.3 Communications, utilities, and
miscellaneous charges......... 2
25.1 Advisory and assistance services 8
25.2 Other services.................. 3
25.3 Other purchases of goods and
services from Government
accounts...................... 11
31.0 Equipment....................... 2
41.0 Grants, subsidies, and
contributions................. 19
--------- --------- ----------
99.0 Direct obligations............ 82
99.0 Reimbursable obligations.......... 18
--------- --------- ----------
99.9 Total new obligations........... 100
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-8252-0-7-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 302
1101 Military full-time equivalent
employment.................... 67
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 57
2101 Military full-time equivalent
employment.................... 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] $4,870,025,000, of
which up to $8,000,000 may be used for facilities repairs and
improvements at the NCI-Frederick Federally Funded Research and
Development Center in Frederick, Maryland. (Division E, H.R. 2673,
Consolidated Appropriations Bill, FY 2004.)
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, [$2,897,145,000] $2,963,953,000. (Division
E, H.R. 2673, Consolidated Appropriations Bill, FY 2004.)
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, [$385,796,000] $394,080,000.
(Division E, H.R. 2673, Consolidated Appropriations Bill, FY 2004.)
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,
[$1,682,457,000] $1,726,196,000. (Division E, H.R. 2673, Consolidated
Appropriations Bill, FY 2004.)
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,
[$1,510,776,000] $1,545,623,000. (Division E, H.R. 2673, Consolidated
Appropriations Bill, FY 2004.)
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,
[$4,335,155,000] $4,425,507,000: Provided, That [$150,000,000]
$100,000,000 may be made available to International Assistance Programs,
``Global Fund to Fight HIV/AIDS, Malaria, and Tuberculosis'', to remain
available until expended: Provided further, That up to $150,000,000
shall be for extramural facilities construction grants to enhance the
Nation's capability to do research on biological and other agents.
(Division E, H.R. 2673, Consolidated Appropriations Bill, FY 2004.)
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, [$1,916,333,000]
$1,959,810,000. (Division E, H.R. 2673, Consolidated Appropriations
Bill, FY 2004.)
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,
[$1,250,585,000] $1,280,915,000. (Division E, H.R. 2673, Consolidated
Appropriations Bill, FY 2004.)
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,
[$657,199,000] $671,578,000. (Division E, H.R. 2673, Consolidated
Appropriations Bill, FY 2004.)
National Institute of Environmental Health Sciences
For carrying out sections 301 and 311 and title IV of the Public
Health Service Act with respect to environmental health sciences,
[$636,974,000] $650,027,000. (Division E, H.R. 2673, Consolidated
Appropriations Bill, FY 2004.)
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, $80,486,000. (Division G, H.R. 2673,
Consolidated Appropriations Bill, FY 2004.)
National Institute on Aging
For carrying out section 301 and title IV of the Public Health
Service Act with respect to aging, [$1,031,311,000] $1,055,666,000.
(Division E, H.R. 2673, Consolidated Appropriations Bill, FY 2004.)
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, [$504,300,000] $515,378,000. (Division E, H.R. 2673,
Consolidated Appropriations Bill, FY 2004.)
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,
[$384,477,000] $393,507,000. (Division E, H.R. 2673, Consolidated
Appropriations Bill, FY 2004.)
National Institute of Nursing Research
For carrying out section 301 and title IV of the Public Health
Service Act with respect to nursing research, [$135,555,000]
$139,198,000. (Division E, H.R. 2673, Consolidated Appropriations Bill,
FY 2004.)
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, [$431,471,000]
$441,911,000. (Division E, H.R. 2673, Consolidated Appropriations Bill,
FY 2004.)
National Institute on Drug Abuse
For carrying out section 301 and title IV of the Public Health
Service Act with respect to drug abuse, [$997,414,000] $1,019,060,000.
(Division E, H.R. 2673, Consolidated Appropriations Bill, FY 2004.)
[[Page 437]]
National Institute of Mental Health
For carrying out section 301 and title IV of the Public Health
Service Act with respect to mental health, [$1,390,714,000]
$1,420,609,000. (Division E, H.R. 2673, Consolidated Appropriations
Bill, FY 2004.)
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, [$482,222,000]
$492,670,000. (Division E, H.R. 2673, Consolidated Appropriations Bill,
FY 2004.)
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, [$288,900,000] $297,647,000. (Division E, H.R. 2673,
Consolidated Appropriations Bill, FY 2004.)
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, [$1,186,183,000] $1,094,141,000: Provided, That none of
these funds shall be used to pay recipients of the general research
support grants program any amount for indirect expenses in connection
with such grants[: Provided further, That $119,220,000 shall be for
extramural facilities construction grants]. (Division E, H.R. 2673,
Consolidated Appropriations Bill, FY 2004.)
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,
[$117,752,000] $121,116,000. (Division E, H.R. 2673, Consolidated
Appropriations Bill, FY 2004.)
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] $196,780,000. (Division E, H.R. 2673,
Consolidated Appropriations Bill, FY 2004.)
John E. Fogarty International Center
For carrying out the activities at the John E. Fogarty International
Center, [$65,800,000] $67,182,000. (Division E, H.R. 2673, Consolidated
Appropriations Bill, FY 2004.)
National Library of Medicine
For carrying out section 301 and title IV of the Public Health
Service Act with respect to health information communications,
[$311,635,000] $325,147,000, of which $4,000,000 shall be available
until expended for improvement of information systems: Provided, That in
fiscal year [2004] 2005, 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[: Provided further, That in addition to amounts provided herein,
$8,200,000 shall be available from amounts available under section 241
of the Public Health Service Act to carry out National Information
Center on Health Services Research and Health Care Technology and
related health services]. (Division E, H.R. 2673, Consolidated
Appropriations Bill, FY 2004.)
Office of the Director
(including transfer of funds)
For carrying out the responsibilities of the Office of the Director,
National Institutes of Health, [$329,707,000, of which up to $7,500,000
shall be used to carry out section 221 of this Act] $359,645,000:
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 1 fiscal year after the
fiscal year in which they are deposited[: Provided further, That up to
$500,000 shall be available to carry out section 499 of the Public
Health Service Act]. (Division E, H.R. 2673, Consolidated Appropriations
Bill, FY 2004.)
buildings and facilities
(including transfer of funds)
For the study of, construction of, renovation of, and acquisition of
equipment for, facilities of or used by the National Institutes of
Health, including the acquisition of real property, [$89,500,000]
$99,500,000, to remain available until expended[: Provided, That
notwithstanding any other provision of law, single contracts or related
contracts, which collectively include the full scope of the project, may
be employed for the development and construction of the first and second
phases of the John Edward Porter Neuroscience Research Center: Provided
further, That the solicitations and contracts shall contain the clause
``availability of funds'' found at 48 CFR 52.232-18]. (Division E, H.R.
2673, Consolidated Appropriations Bill, FY 2004.)
Unavailable Receipts (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9915-0-1-552 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
01.99 Balance, start of year............
Receipts:
02.20 Cooperative research and
development agreements, NIH..... 16 16 16
--------- --------- ----------
04.00 Total: Balances and collections... 16 16 16
Appropriations:
05.00 National Institutes of Health..... -16 -16 -16
--------- --------- ----------
07.99 Balance, end of year..............
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9915-0-1-552 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.01 National Cancer Institute....... 4,595 4,739 4,870
00.02 National Heart, Lung, and Blood
Institute..................... 2,794 2,879 2,964
00.03 National Institute of Dental and
Craniofacial Research......... 372 383 394
00.04 National Institute of Diabetes
and Digestive and Kidney
Disease....................... 1,712 1,822 1,876
00.05 National Institute of
Neurological Disorders and
Stroke........................ 1,456 1,501 1,545
00.06 National Institute of Allergy
and Infectious Diseases....... 3,607 4,304 4,426
00.07 National Institute of General
Medical Sciences.............. 1,847 1,905 1,960
00.08 National Institute of Child
Health and Human Development.. 1,206 1,242 1,281
00.09 National Eye Institute.......... 633 653 672
00.10 National Institute of
Environmental Health Sciences. 698 711 730
00.11 National Institute on Aging..... 994 1,025 1,055
00.12 National Institute of Arthritis
and Musculoskeletal and Skin
Disease....................... 486 501 515
00.13 National Institute on Deafness
and Other Communication
Disorder...................... 370 382 394
00.14 National Institute of Mental
Health........................ 1,341 1,382 1,421
00.15 National Institute on Drug Abuse 966 991 1,019
00.16 Natinal Institute on Alcohol
Abuse and Alcoholism.......... 416 429 442
00.17 National Institute of Nursing
Research...................... 131 135 139
00.18 National Human Genome Research
Institute..................... 465 479 492
00.19 National Institute of Biomedical
Imaging and Bioengineering.... 278 287 298
00.20 National Center for Research
Resources..................... 1,139 1,179 1,094
00.21 National Center for
Complementary and Alternative
Medicine...................... 113 117 121
00.22 National Center on Minority
Health and Health Disparities. 186 191 197
00.23 John E. Fogarty International
Center........................ 63 65 67
00.24 National Library of Medicine.... 300 309 325
00.25 Office of the Director.......... 266 328 360
00.26 Buildings and facilities........ 306 599 100
00.27 Cooperative Research and
Development Agreements........ 10 16 16
00.28 Royalities...................... 32
09.00 Reimbursable program.............. 2,054 2,377 2,478
--------- --------- ----------
10.00 Total new obligations........... 28,836 30,931 31,251
[[Page 438]]
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 466 649 139
22.00 New budget authority (gross)...... 29,028 30,421 31,251
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 29,494 31,070 31,390
23.95 Total new obligations............. -28,836 -30,931 -31,251
23.98 Unobligated balance expiring or
withdrawn....................... -9
24.40 Unobligated balance carried
forward, end of year............ 649 139 139
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 27,243 28,061 28,607
40.35 Appropriation permanently
reduced....................... -177 -183
41.00 Transferred to other accounts... -99
42.00 Transferred from other accounts. 4
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 26,971 27,878 28,607
Mandatory:
60.00 Appropriation................... 97 150 150
60.20 Appropriation (special fund).... 16 16 16
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 113 166 166
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 1,693 2,377 2,478
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 251
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 1,944 2,377 2,478
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 29,028 30,421 31,251
Change in obligated balances:
72.40 Obligated balance, start of year.. 21,686 25,607 28,231
73.10 Total new obligations............. 28,836 30,931 31,251
73.20 Total outlays (gross)............. -24,655 -28,306 -30,477
73.40 Adjustments in expired accounts
(net)........................... -145
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -251
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 136
74.40 Obligated balance, end of year.... 25,607 28,231 29,004
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 8,406 9,299 9,704
86.93 Outlays from discretionary
balances........................ 16,153 18,892 20,620
86.97 Outlays from new mandatory
authority....................... 25 41 42
86.98 Outlays from mandatory balances... 71 74 111
--------- --------- ----------
87.00 Total outlays (gross)........... 24,655 28,306 30,477
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -1,775 -2,377 -2,478
88.40 Non-Federal sources........... -46
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -1,821 -2,377 -2,478
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -251
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 128
Net budget authority and outlays:
89.00 Budget authority.................. 27,084 28,044 28,773
90.00 Outlays........................... 22,834 25,929 27,999
---------------------------------------------------------------------------
DISTRIBUTION OF BUDGET AUTHORITY AND OUTLAYS BY ACCOUNT
[Dollars in millions]
2003 2004 2005
Distribution of budget authority by
account:
National Cancer Institute......... 4,592 4,739 4,870
National Heart, Lung, and Blood
Institute....................... 2,794 2,879 2,964
National Institute of Dental and
Craniofacial Research........... 372 383 394
National Institute of Diabetes and
Digestive and Kidney Diseases... 1,720 1,822 1,876
National Institute of Neurological
Disorder and Stroke............. 1,456 1,501 1,546
National Institute of Allergy and
Infectious Diseases............. 3,607 4,304 4,426
National Institute of General
Medical Sciences................ 1,847 1,905 1,960
National Institute of Child Health
and Human Development........... 1,206 1,242 1,281
National Eye Institute............ 633 653 672
National Institute of
Environmental Health Sciences... 698 711 731
National Institute on Aging....... 994 1,025 1,056
National Institute of Arthritis
and Musculoskeletal and Skin
Diseases........................ 486 501 515
National Institute on Deafness and
Other Communication Disorders... 370 382 394
National Institute of Nursing
Research........................ 131 135 139
National Institute on Alcohol
Abuse and Alcoholism............ 416 429 442
National Institute on Drug Abuse.. 966 991 1,019
National Institute of Mental
Health.......................... 1,341 1,382 1,421
National Center for Research
Resources....................... 1,139 1,179 1,094
National Human Genome Research
Institute....................... 465 479 493
National Institute of Biomedical
Imaging and Bioengineering...... 278 287 298
National Center for Complementary
and Alternative Medicine........ 113 117 121
National Center for Minority
Health and Health Disparities... 186 191 197
John E. Fogarty International
Center.......................... 63 65 67
National Library of Medicine...... 300 309 325
Office of the Director............ 266 328 360
Buildings and facilities.......... 629 89 100
------------------------------------
Subtotal...................... 27,068 28,028 28,757
Cooperative Research and
Development Agreements.......... 16 16 16
------------------------------------
Total Budget Authority, NIH... 27,084 28,044 28,773
====================================
[Dollars in millions]
2003 2004 2005
Distribution of outlays by account:
National Cancerse Institute....... 4,112 4,494 4,744
National Heart, Lung, and Blood
Institute....................... 2,498 2,684 2,853
National Institute of Dental and
Craniofacial Research........... 335 365 383
National Institute of Diabetes and
Digestive and Kidney Diseases... 1,526 1,654 1,802
National Institute of Neurological
Disorders and Stroke............ 1,312 1,407 1,497
National Institute of Allergy and
Infectious Diseases............. 2,463 3,532 4,160
National Institute of General
Medical Sciences................ 1,711 1,819 1,897
National Institute of Child Health
and Human Development........... 1,078 1,170 1,242
National Eye Institute............ 576 618 653
National Institute of
Environmental Health Sciences... 640 680 713
National Institute on Aging....... 857 959 1,020
National Institute of Arthritis
and Musculoskeletal and Skin
Diseases........................ 419 477 499
National Institute on Deafness and
Other Communication Disorders... 336 359 381
National Institute of Nursing
Research........................ 114 124 134
National Institute on Alcohol
Abuse and Alcoholism............ 384 403 428
National Institute on Drug Abuse.. 834 937 984
National Institute of Mental
Health.......................... 1,229 1,311 1,378
National Center for Research
Resources....................... 926 1,107 1,138
National Human Genome Research
Institute....................... 400 470 483
National Institute of Biomedical
Imaging and Bioengineering...... 112 232 276
National Center for Complementary
and Alternative Medicine........ 104 107 116
National Center for Minority
Health and Health Disparities... 138 167 183
John E. Fogarty International
Center.......................... 64 59 65
National Library of Medicine...... 280 296 315
Office of the Director............ 267 263 322
Buildings and Facilities.......... 202 226 323
Service and Supply Fund/Management
Fund............................ -92 0 0
------------------------------------
Subtotal Outlays.............. 22,825 25,920 27,989
Cooperative Research and
Development Agreements.......... 9 10 10
------------------------------------
Total Outlays, NIH............ 22,834 25,930 27,999
====================================
This program funds biomedical research and research training. These
accounts will continue to be appropriated separately, and are displayed
in a consolidated format to improve the readability of the presentation.
Detailed information is available through the Department of Health and
Human Services.
NIH will continue to implement strategies and policies in 2005 and
beyond to maximize budgetary and management flexibility in the future.
Such strategies include funding the total costs of grants in the grant's
first year and managing grant average cost increases.
[[Page 439]]
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9915-0-1-552 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 633 662 686
11.3 Other than full-time permanent 310 323 335
11.5 Other personnel compensation.. 38 29 30
11.7 Military personnel............ 25 27 28
11.8 Special personal services
payments.................... 133 138 142
--------- --------- ----------
11.9 Total personnel compensation 1,139 1,179 1,221
12.1 Civilian personnel benefits..... 249 262 271
12.2 Military personnel benefits..... 16 17 18
21.0 Travel and transportation of
persons....................... 50 52 54
22.0 Transportation of things........ 6 8 7
23.1 Rental payments to GSA.......... 5 7 7
23.2 Rental payments to others....... 14 21 22
23.3 Communications, utilities, and
miscellaneous charges......... 30 30 31
24.0 Printing and reproduction....... 14 15 15
25.1 Advisory and assistance services 100 90 94
25.2 Other services.................. 587 526 558
25.3 Other purchases of goods and
services from Government
accounts...................... 2,163 2,114 2,173
25.4 Operation and maintenance of
facilities.................... 355 838 341
25.5 Research and development
contracts..................... 1,803 2,421 2,284
25.6 Medical care.................... 16 16 16
25.7 Operation and maintenance of
equipment..................... 60 64 65
26.0 Supplies and materials.......... 215 223 230
31.0 Equipment....................... 200 212 221
41.0 Grants, subsidies, and
contributions................. 19,760 20,459 21,145
--------- --------- ----------
99.0 Direct obligations............ 26,782 28,554 28,773
99.0 Reimbursable obligations.......... 2,054 2,377 2,478
--------- --------- ----------
99.9 Total new obligations........... 28,836 30,931 31,251
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-9915-0-1-552 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 12,577 12,521 12,518
1101 Military full-time equivalent
employment.................... 326 324 324
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 4,567 4,551 4,551
2101 Military full-time equivalent
employment.................... 118 117 117
---------------------------------------------------------------------------
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 with Mental
Illness Act [of 1986], and section 301 of the Public Health Service Act
with respect to program management, [$3,253,763,000] $3,418,939,000:
Provided, That in addition to amounts provided herein, [$79,200,000] the
following amount shall be available from amounts available under section
241 of the Public Health Service Act (1) $79,200,000 to carry out
subpart II of title XIX of the Public Health Service Act to fund section
1935(b) technical assistance, national data, data collection and
evaluation activities, and further that the total available under this
Act for section 1935(b) activities shall not exceed 5 percent of the
amounts appropriated for subpart II of title XIX[: Provided further,
That in addition to the amounts provided herein, $21,850,000 shall be
available from amounts available under Section 241 of the Public Health
Service Act]: (2); $21,803,000 to carry out subpart I of Part B of title
XIX of the Public Health Service Act to fund section 1920(b) technical
assistance, data collection and program evaluation activities, and
further that the total available under this Act for section 1920(b)
activities shall not exceed 5 percent of the amounts appropriated for
subpart I of Part B of title XIX[: Provided further, That in addition to
amounts provided herein,]; (3) $16,000,000 [shall be made available from
amounts available under section 241 of the Public Health Service Act] to
carry out national surveys on drug abuse; and (4) $4,300,000 to evaluate
substance abuse treatment programs. (Division E, H.R. 2673, Consolidated
Appropriations Bill, FY 2004.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1362-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.01 Mental health and substance
abuse activities.............. 930 1,045 1,176
00.02 Mental health partnership....... 437 413 414
00.03 Substance abuse partnership..... 1,695 1,700 1,753
00.05 Program management.............. 80 76 76
09.01 Reimbursable program.............. 176 121 126
--------- --------- ----------
10.00 Total new obligations........... 3,318 3,355 3,545
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 6 1 1
22.00 New budget authority (gross)...... 3,314 3,355 3,545
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 3,320 3,356 3,546
23.95 Total new obligations............. -3,318 -3,355 -3,545
23.98 Unobligated balance expiring or
withdrawn....................... -1
24.40 Unobligated balance carried
forward, end of year............ 1 1 1
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 3,158 3,254 3,419
40.35 Appropriation permanently
reduced....................... -20 -20
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 3,138 3,234 3,419
Spending authority from offsetting
collections:
68.00 Offsetting collections (cash)... 116 121 126
68.10 Change in uncollected customer
payments from Federal sources
(unexpired)................... 60
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)....... 176 121 126
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 3,314 3,355 3,545
Change in obligated balances:
72.40 Obligated balance, start of year.. 2,385 2,465 2,566
73.10 Total new obligations............. 3,318 3,355 3,545
73.20 Total outlays (gross)............. -3,155 -3,254 -3,417
73.40 Adjustments in expired accounts
(net)........................... -26
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -60
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 5
74.40 Obligated balance, end of year.... 2,465 2,566 2,694
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1,337 1,382 1,460
86.93 Outlays from discretionary
balances........................ 1,818 1,872 1,957
--------- --------- ----------
87.00 Total outlays (gross)........... 3,155 3,254 3,417
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -117 -121 -126
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -60
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 1
Net budget authority and outlays:
89.00 Budget authority.................. 3,138 3,234 3,419
90.00 Outlays........................... 3,038 3,133 3,291
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2003 actual 2004 est. 2005 est.
Enacted/requested:
Budget Authority.................. 3,138 3,234 3,419
Outlays........................... 3,038 3,133 3,291
Legislative proposal, not subject to
PAYGO:
Budget Authority.................. 10
Outlays........................... 4
------------------------------------
Total:
Budget Authority.................. 3,138 3,234 3,429
Outlays........................... 3,038 3,133 3,295
====================================
[[Page 440]]
This program provides Federal support to strengthen the capacity of
the Nation's health care delivery system to provide substance abuse
prevention, addiction treatment, and mental health services, for people
at risk for or experiencing substance abuse or mental illness. SAMHSA
builds partnerships with states, communities, and private organizations
to address the needs of individuals with substance abuse disorders and/
or mental illness and to identify and respond to the community risk
factors that contribute to these illnesses.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1362-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 40 40 41
11.3 Other than full-time permanent 2 2 2
11.5 Other personnel compensation.. 1 1
11.7 Military personnel............ 2 2
--------- --------- ----------
11.9 Total personnel compensation 43 44 46
12.1 Civilian personnel benefits..... 10 9 9
21.0 Travel and transportation of
persons....................... 2 2 2
23.1 Rental payments to GSA.......... 5 5 6
23.3 Communications, utilities, and
miscellaneous charges......... 2 3 3
24.0 Printing and reproduction....... 4 3 3
25.1 Advisory and assistance services 19 18 15
25.2 Other services.................. 201 185 191
25.3 Other purchases of goods and
services from Government
accounts...................... 115 114 116
31.0 Equipment....................... 1 1
41.0 Grants, subsidies, and
contributions................. 2,738 2,848 3,026
42.0 Insurance claims and indemnities 2 2 2
--------- --------- ----------
99.0 Direct obligations............ 3,142 3,234 3,419
99.0 Reimbursable obligations.......... 176 121 126
--------- --------- ----------
99.9 Total new obligations........... 3,318 3,355 3,545
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-1362-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 479 474 474
1101 Military full-time equivalent
employment.................... 21 21 21
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 2 19 19
2101 Military full-time equivalent
employment.................... 32 32 32
---------------------------------------------------------------------------
Substance Abuse and Mental Health Services
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1362-2-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.01 Samaritan initiative............ 10
--------- --------- ----------
10.00 Total new obligations........... 10
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 10
23.95 Total new obligations............. -10
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 10
Change in obligated balances:
73.10 Total new obligations............. 10
73.20 Total outlays (gross)............. -4
74.40 Obligated balance, end of year.... 6
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 4
Net budget authority and outlays:
89.00 Budget authority.................. 10
90.00 Outlays........................... 4
---------------------------------------------------------------------------
The Administration will submit legislation for the Samaritan
initiative, a new competitive grant program that supports the
Administration's efforts to end chronic homelessness within a decade.
The budget includes $10 million in the Department of Health and Human
Services for this proposal. Together with the Department of Housing and
Urban Development (HUD) and the Department of Veterans Affairs (VA), HHS
will support the most promising local collaborative strategies to move
chronically homeless persons from the streets to safe, permanent housing
with supportive services. HHS funds provided for the Samaritan
initiative will support the services component of grantee projects,
including substance abuse treatment and mental health services
integrated with primary health care.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1362-2-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
25.2 Other services.................... 1
41.0 Grants, subsidies, and
contributions................... 9
--------- --------- ----------
99.9 Total new obligations........... 10
---------------------------------------------------------------------------
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 $303,695,000[: Provided further, That, of the funds
made available under this heading, $12,000,000 shall be for the conduct
of research on the comparative clinical effectiveness, cost-
effectiveness, and safety of drugs, biological products, and devices].
(Division E, H.R. 2673, Consolidated Appropriations Bill, FY 2004.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1700-0-1-552 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
09.00 Reimbursable program.............. 327 327 327
--------- --------- ----------
10.00 Total new obligations........... 327 327 327
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 15 19 19
22.00 New budget authority (gross)...... 329 327 327
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 344 346 346
23.95 Total new obligations............. -327 -327 -327
24.40 Unobligated balance carried
forward, end of year............ 19 19 19
New budget authority (gross), detail:
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 110 327 327
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 219
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 329 327 327
Change in obligated balances:
72.40 Obligated balance, start of year.. 337 131 131
73.10 Total new obligations............. 327 327 327
[[Page 441]]
73.20 Total outlays (gross)............. -314 -327 -327
73.40 Adjustments in expired accounts
(net)........................... -1
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -219
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 1
74.40 Obligated balance, end of year.... 131 131 131
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 93 327 327
86.93 Outlays from discretionary
balances........................ 221
--------- --------- ----------
87.00 Total outlays (gross)........... 314 327 327
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -111 -327 -327
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -219
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 1
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... 202
---------------------------------------------------------------------------
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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
99.0 Reimbursable obligations:
Reimbursable obligations........ 327 327 327
--------- --------- ----------
99.9 Total new obligations........... 327 327 327
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-1700-0-1-552 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 277 284 284
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, [$130,892,197,000] $119,124,488,000, to remain
available until expended: Provided, That for fiscal year 2005, the
Secretary shall reduce the amount paid under section 1903(a)(7) to each
State according to the proportion established under section 16(k)(2)(B)
of the Food Stamp Act of 1977 (7 U.S.C. 2025(k)(2)(B)) by a total amount
of $300,000,000: Provided further, That for Medicaid claims attributable
to the design, development, or installation of mechanized claims
processing and information retrieval systems as described in section
1903(a)(3)(A)(i), the Secretary shall pay 75 percent to each State which
has a plan approved under title XIX.
For making, after May 31, [2004] 2005, payments to States under
title XIX of the Social Security Act for the last quarter of fiscal year
[2004] 2005 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] 2006,
$58,517,290,000, 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. (Division E, H.R. 2673, Consolidated Appropriations
Bill, FY 2004.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0512-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Medicaid vendor payments.......... 158,871 167,031 172,670
00.02 State and local administration.... 9,070 8,868 9,319
00.03 Vaccine purchases................. 1,164 1,208 1,208
09.01 Medicare Part B premiums.......... 125
09.02 Reimbursable program: Medicare
prescription drug eligibility... 106
--------- --------- ----------
10.00 Total new obligations........... 169,105 177,232 183,303
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 7 10 5,656
22.00 New budget authority (gross)...... 164,663 182,878 177,647
22.10 Resources available from
recoveries of prior year
obligations..................... 4,446
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 169,116 182,888 183,303
23.95 Total new obligations............. -169,105 -177,232 -183,303
24.40 Unobligated balance carried
forward, end of year............ 10 5,656
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 117,949 130,892 119,125
60.00 Appropriation...................
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 117,949 130,892 119,125
65.00 Advance appropriation........... 46,602 51,861 58,416
69.00 Offsetting collections (cash)..... 112 125 106
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 164,663 182,878 177,647
Change in obligated balances:
72.40 Obligated balance, start of year.. 5,557 9,412 9,412
73.10 Total new obligations............. 169,105 177,232 183,303
73.20 Total outlays (gross)............. -160,805 -177,232 -183,303
73.45 Recoveries of prior year
obligations..................... -4,446
74.40 Obligated balance, end of year.... 9,412 9,412 9,412
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 160,242 176,232 177,647
86.98 Outlays from mandatory balances... 563 1,000 5,656
--------- --------- ----------
87.00 Total outlays (gross)........... 160,805 177,232 183,303
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -112 -125 -106
Net budget authority and outlays:
89.00 Budget authority.................. 164,551 182,753 177,541
90.00 Outlays........................... 160,693 177,107 183,197
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2003 actual 2004 est. 2005 est.
Enacted/requested:
Budget Authority.................. 164,551 182,753 177,541
Outlays........................... 160,693 177,107 183,197
Legislative proposal, not subject to
PAYGO:
Budget Authority.................. -516
Outlays........................... -516
Legislative proposal, subject to
PAYGO:
Budget Authority.................. 175 -617
Outlays........................... 175 -617
------------------------------------
Total:
Budget Authority.................. 164,551 182,928 176,408
Outlays........................... 160,693 177,282 182,064
====================================
Medicaid assists States in providing medical care to their low-
income populations 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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
41.0 Direct obligations: Grants,
subsidies, and contributions.... 169,105 177,107 183,197
99.0 Reimbursable obligations:
Reimbursable obligations........ 125 106
--------- --------- ----------
99.9 Total new obligations........... 169,105 177,232 183,303
---------------------------------------------------------------------------
[[Page 442]]
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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Reduce FMAP/TANF block grants..... -380
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... -380
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... -380
23.95 Total new obligations............. 380
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... -380
Change in obligated balances:
73.10 Total new obligations............. -380
73.20 Total outlays (gross)............. 380
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... -380
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -136
Net budget authority and outlays:
89.00 Budget authority.................. -516
90.00 Outlays........................... -516
---------------------------------------------------------------------------
This schedule reflects the Administration's Medicaid proposals.
Grants to States for Medicaid
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0512-4-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Disability/long term care......... 30
00.02 Vaccines for children............. 165
00.03 Transitional medical assistance... 175 558
00.04 Program integrity................. -1,542
00.06 Other proposal.................... 36
09.00 Reimbursable program.............. 136
--------- --------- ----------
10.00 Total new obligations........... 175 -617
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 175 -617
23.95 Total new obligations............. -175 617
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 175 -753
69.00 Offsetting collections (cash)..... 136
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 175 -617
Change in obligated balances:
73.10 Total new obligations............. 175 -617
73.20 Total outlays (gross)............. -175 617
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 175 -617
Net budget authority and outlays:
89.00 Budget authority.................. 175 -617
90.00 Outlays........................... 175 -617
---------------------------------------------------------------------------
This schedule reflects the Administration's Medicaid proposals.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0512-4-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
41.0 Direct obligations: Grants,
subsidies, and contributions.... 175 -753
99.0 Reimbursable obligations:
Reimbursable obligations........ 136
--------- --------- ----------
99.9 Total new obligations........... 175 -617
---------------------------------------------------------------------------
State Grants and Demonstrations
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0516-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 TWWIIA--grants.................... 20 33 40
00.02 High-risk pools--grants........... 1 47 40
00.03 Federal reimbursement of emergency
health services--undocumented
aliens.......................... 250
--------- --------- ----------
10.00 Total new obligations........... 21 80 330
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 83 194 231
22.00 New budget authority (gross)...... 132 117 331
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 215 311 562
23.95 Total new obligations............. -21 -80 -330
23.98 Unobligated balance expiring or
withdrawn....................... -12
24.40 Unobligated balance carried
forward, end of year............ 194 231 220
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation--(P.L. 106-170,
Sections 203 & 204)........... 72 77 81
60.00 Appropriation--(P.L. 107-210)... 60 40
60.00 Appropriation--(P. L. 108-173).. 250
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 132 117 331
Change in obligated balances:
72.40 Obligated balance, start of year.. 34 39 72
73.10 Total new obligations............. 21 80 330
73.20 Total outlays (gross)............. -15 -47 -304
74.40 Obligated balance, end of year.... 39 72 98
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 1 18 262
86.98 Outlays from mandatory balances... 14 29 42
--------- --------- ----------
87.00 Total outlays (gross)........... 15 47 304
Net budget authority and outlays:
89.00 Budget authority.................. 132 117 331
90.00 Outlays........................... 15 47 304
---------------------------------------------------------------------------
State Grants and Demonstrations provides funding for grant programs
established under several legislative authorities. Title II of the
Ticket to Work and Work Incentives Improvement Act of 1999 (P.L. 106-
170), established two grant programs. Section 203 provides funding for
Medicaid 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 and (2) grants to states for operation of qualified high-risk
pools.
Part of Title X of the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003 (P.L. 108-173) makes funding available for
States to reimburse eligible providers for furnishing emergency health
services to undocumented aliens.
[[Page 443]]
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0516-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
41.0 Grants, subsidies, and
contributions--Ticket to Work... 20 33 40
41.0 Grants, subsidies, and
contributions--High-Risk Pools.. 1 47 40
41.0 Grants, subsidies, and
contributions--Fed'l Reimb.--
Emer Svcs, Undoc. Aliens........ 250
--------- --------- ----------
99.9 Total new obligations........... 21 80 330
---------------------------------------------------------------------------
Payment to Health Care Trust Funds for Post-1956 Military Service Wage
Credits
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0517-2-1-054 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Military wage credits (HI)........ 181
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 181
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 181
23.95 Total new obligations............. -181
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 181
Change in obligated balances:
73.10 Total new obligations............. 181
73.20 Total outlays (gross)............. -181
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 181
Net budget authority and outlays:
89.00 Budget authority.................. 181
90.00 Outlays........................... 181
---------------------------------------------------------------------------
The budget proposes to compensate the Hospital Insurance Trust Fund
for the equivalent of payroll taxes on deemed wages posted to the Social
Security earnings of uniformed services personnel in 2000 and 2001. The
budget also reflects known adjustments needed for other years.
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, 1860D-16, and 1860D-31 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]
$114,608,900,000. To ensure prompt payments of Medicare prescription
drug benefits as provided under section 1860 D-16 of the Social Security
Act, $5,216,900,000, to become available on October 1, 2005 for fiscal
year 2006. (Division E, H.R. 2673, Consolidated Appropriations Bill, FY
2004.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0580-0-1-571 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Supplementary medical insurance
(SMI)........................... 80,905 94,518 114,002
00.02 Hospital insurance for uninsured
(HI)............................ 225 197 87
00.03 Federal uninsured payment (HI).... 168 168 199
00.04 Program management (HI)........... 120 201 215
00.05 FHI trust fund, Transfers from
general fund (civil monetary
penalties)...................... 7 7 7
00.06 Federal payments from taxation of
OASDI benefits (HI)............. 8,318 7,743 9,052
00.07 Fraud and abuse control, FBI...... 114 114 114
00.08 Fraud and abuse control, criminal
fines........................... 2 3 3
00.09 Federal contributions, Drug
account State low-income
determinations.................. 106
00.10 Federal contributions,
Transitional assistance account. 2,321 2,788
--------- --------- ----------
10.00 Total new obligations........... 89,860 105,272 126,573
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 89,904 105,272 126,573
23.95 Total new obligations............. -89,860 -105,272 -126,573
23.98 Unobligated balance expiring or
withdrawn....................... -45
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 8,318 7,743 9,052
60.00 Appropriation................... 10 10 10
60.00 Appropriation................... 81,463 95,084 114,503
60.00 Appropriation................... 114 114 114
60.00 Appropriation................... 2,321 2,788
60.00 Appropriation................... 106
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 89,905 105,272 126,573
Change in obligated balances:
73.10 Total new obligations............. 89,860 105,272 126,573
73.20 Total outlays (gross)............. -89,860 -105,272 -126,573
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 89,860 105,272 126,573
Net budget authority and outlays:
89.00 Budget authority.................. 89,904 105,272 126,573
90.00 Outlays........................... 89,860 105,272 126,573
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2003 actual 2004 est. 2005 est.
Enacted/requested:
Budget Authority.................. 89,905 105,272 126,573
Outlays........................... 89,860 105,272 126,573
Legislative proposal, not subject to
PAYGO:
Budget Authority.................. -118
Outlays........................... -118
------------------------------------
Total:
Budget Authority.................. 89,905 105,272 126,455
Outlays........................... 89,860 105,272 126,455
====================================
Payments are made to the Federal Hospital Insurance and Federal
Supplementary Medical Insurance trust funds from the general fund of the
Treasury to finance Medicare's medical and drug benefits for
beneficiaries and certain other qualified individuals.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0580-0-1-571 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
41.0 Grants, subsidies, and
contributions................... 89,347 104,706 126,072
42.0 Insurance claims and indemnities.. 393 365 286
94.0 Financial transfers............... 120 201 215
--------- --------- ----------
99.0 Direct obligations............ 89,860 105,272 126,573
--------- --------- ----------
99.9 Total new obligations........... 89,860 105,272 126,573
---------------------------------------------------------------------------
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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Supplementary medical insurance
(SMI)........................... -118
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... -118
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... -118
23.95 Total new obligations............. 118
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... -118
Change in obligated balances:
73.10 Total new obligations............. -118
73.20 Total outlays (gross)............. 118
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... -118
Net budget authority and outlays:
89.00 Budget authority.................. -118
[[Page 444]]
90.00 Outlays........................... -118
---------------------------------------------------------------------------
The budget proposes to provide an appropriation in 2006 to pay
benefits and administrative expenses for the new Medicare prescription
drug benefit. This appropriation is authorized in the Medicare
Prescription Drug, Improvement, and Modernization Act, and is necessary
to provide operating funds for the early months of the program. The
funds necessary for the remainder of the year will be requested in the
2006 budget.
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 [$2,664,994,000] $2,746,127,000, 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 [$30,000,000] $24,400,000, to remain available until
September 30, [2005] 2006, is for contract costs for CMS's Systems
Revitalization Plan: Provided further, That [$56,991,000] $78,300,000,
to remain available until September 30, [2005] 2006, is for contract
costs for the Healthcare Integrated General Ledger Accounting System:
Provided further, That [of the amounts made available for research,
demonstration and evaluation, $100,000 is available for Advocate Health
Care in Oak Brook, Illinois for health education programs and services
to the deaf and hard-of-hearing, $1,750,000 is available for AIDS
Healthcare Foundation in Los Angeles for a demonstration of residential
and outpatient treatment facilities, $250,000 is available for Berwick
Hospital Center, Berwick, Pennsylvania for stabilizing the workforce for
patient care, $163,000 is available for Bloomsburg Hospital, Bloomsburg,
Pennsylvania for stabilizing the workforce for patient care, $275,000 is
available for Cheyenne River Sioux Tribe in Eagle Butte, South Dakota to
establish a nursing home, $778,000 is available for Community Medical
Center, Scranton, Pennsylvania for stabilizing the workforce for patient
care, $150,000 is available for Cook County (Illinois) Bureau of Health
Services to improve the management of vulnerable patients with poorly
controlled diabetes, $178,000 is available for Divine Providence
Hospital, Williamsport, Pennsylvania for stabilizing the workforce for
patient care, $267,000 is available for Geisinger Wyoming Valley Medical
Center, Wilkes-Barre, Pennsylvania for stabilizing the workforce for
patient care, $237,000 is available for Hazleton General Hospital,
Hazleton, Pennsylvania for stabilizing the workforce for patient care,
$25,000 is available for Hope Worldwide, Philadelphia, Pennsylvania to
maintain clinical care for recovering drug and alcohol addicts, $825,000
is available for Illinois Primary Health Care Association for the Shared
Integrated Management Information System, Springfield, Illinois,
$250,000 is available for James S. Taylor Memorial Home, Louisville,
Kentucky, $100,000 is available for Jefferson Area Board for Aging,
Charlottesville, Virginia, for the Nursing Assistant Institute, $85,000
is available for Jersey Shore Hospital, Jersey Shore, Pennsylvania for
stabilizing the workforce for patient care, $179,000 is available for
Marian Community Hospital, Carbondale, Pennsylvania for stabilizing the
workforce for patient care, $200,000 is available for Medical Care for
Children Partnership, Fairfax, Virginia to provide outreach to increase
access to medical and dental care for children, $393,000 is available
for Mercy Health Partners, Scranton, Pennsylvania for stabilizing the
workforce for patient care, $571,000 is available for Mercy Hospital,
Wilkes-Barre, Pennsylvania for stabilizing the workforce for patient
care, $63,000 is available for Mid-Valley Hospital, Peckville,
Pennsylvania for stabilizing the workforce for patient care, $510,000 is
available for Moses Taylor Hospital, Scranton, Pennsylvania for
stabilizing the workforce for patient care, $109,000 is available for
Muncy Valley Hospital, Muncy, Pennsylvania for stabilizing the workforce
for patient care, $225,000 is available for Muskegon Community Health
Project, Muskegon, Michigan, for the Access Health program, $75,000 is
available for North Penn Visiting Nurse Association, Lansdale,
Pennsylvania to provide low-cost or free health care to children who do
not have health insurance, $122,000 is available for Patient Advocate
Foundation, Newport News, Virginia to provide direct intervention
assistance to patients throughout the United States who are experiencing
difficulty in accessing quality health care services, $100,000 is
available for Rhode Island Hospital-Medical Simulation Center of
Providence, Rhode Island for the creation of a transportable simulation-
based training curriculum and validated human performance measurement
system, $256,000 is available for Saint Joseph Medical Center, Hazleton,
Pennsylvania for stabilizing the workforce for patient care, $100,000 is
available for Santa Clara County, California, for its Children's Health
Initiative program to provide outreach and enrollment assistance for
families under 300 percent of federal poverty level, $664,000 is
available for Sharon Regional Health System, Sharon, Pennsylvania for
stabilizing the workforce for patient care, $25,000 is available for
Sickle Cell Medical Treatment & Education Center, St. Louis Children's
Hospital, St. Louis, Missouri, to improve the academic achievement of
children with Sickle Cell Disease with specific cognitive
rehabilitation, $111,000 is available for Tyler Memorial Hospital,
Tunkhannock, Pennsylvania for stabilizing the workforce for patient
care, $174,000 is available for United Community Hospital, Grove City,
Pennsylvania for stabilizing the workforce for patient care, $503,000 is
available for UPMC Horizon, Farrell, Pennsylvania for stabilizing the
workforce for patient care, $613,000 is available for Williamsport
Hospital & Medical Center, Williamsport, Pennsylvania for stabilizing
the workforce for patient care, and $965,000 is available for Wyoming
Valley Health Care System, Wilkes-Barre, Pennsylvania for stabilizing
the workforce for patient care:] not less than $129,000,000 shall be for
proceessing Medicare appeals, of which $50,000,000 shall be transferred
to the Social Security Administration for processing Medicare appeals:
Provided further, That the Secretary of Health and Human Services is
directed to collect fees in fiscal year [2004] 2005 from Medicare+Choice
organizations pursuant to section 1857(e)(2) of the Social Security Act
and from eligible organizations with risk-sharing contracts under
section 1876 of that Act pursuant to section 1876(k)(4)(D) of that Act:
Provided further, that to [the extent Medicare claims processing unit
costs are projected by the Centers for Medicare & Medicaid Services to
exceed $0.87 for Part A claims and/or $0.65 for Part B claims, up to an
additional $18,000,000 may be available for obligation for every $0.04
increase in Medicare claims processing unit costs from the Federal
Hospital Insurance and the Federal Supplementary Medical Insurance Trust
Funds. The calculation of projected unit costs shall be derived in the
same manner in which the estimated unit costs were calculated for the
Federal budget estimate for the fiscal year] identify Secondary Payer
Situations, as described in section 1862(b)(5) of the Social Security
Act, the Administrator of the Centers for Medicare and Medicaid Services
shall enter into a memorandum of understanding with the Administrator of
the Administration for Children and Families, to provide quarterly wage
information on individual employees pursuant to section 453 of the
Social Security Act. (Division E, H.R. 2673, Consolidated Appropriations
Bill, FY 2004.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0511-0-1-550 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.01 Medicare operations............. 1,665 1,701 1,794
00.02 Federal administration.......... 567 577 589
00.03 State survey and certification.. 252 251 270
00.04 Research, demonstrations, and
evaluation projects........... 74 78 68
00.05 Revitalization plan............. 30 25
00.06 Medicare reform................. 595 405
--------- --------- ----------
01.00 Total direct program............ 2,558 3,232 3,151
09.01 CLIA.............................. 37 43 43
[[Page 445]]
09.03 Other reimbursements.............. 8 2 2
09.06 Medicare+Choice................... 14 14 14
--------- --------- ----------
09.09 Total reimbursable program...... 59 59 59
--------- --------- ----------
10.00 Total new obligations........... 2,617 3,291 3,210
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 99 106 511
22.00 New budget authority (gross)...... 2,629 3,696 2,805
22.10 Resources available from
recoveries of prior year
obligations..................... 5
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 2,733 3,802 3,616
23.95 Total new obligations............. -2,617 -3,291 -3,210
23.98 Unobligated balance expiring or
withdrawn....................... -10
24.40 Unobligated balance carried
forward, end of year............ 106 511 106
New budget authority (gross), detail:
Spending authority from offsetting
collections:
Discretionary:
68.00 Offsetting collections (cash). 1,924 2,696 2,805
68.00 Offsetting collections (cash). 536 423
68.10 Change in uncollected customer
payments from Federal
sources (unexpired)......... 705 464 -423
68.26 From offsetting collections
(unavailable balances)...... 17 28
68.37 Portion temporarily reduced... -17 -28
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)..... 2,629 3,696 2,805
Change in obligated balances:
72.40 Obligated balance, start of year.. -219 -186 -591
73.10 Total new obligations............. 2,617 3,291 3,210
73.20 Total outlays (gross)............. -2,497 -3,232 -3,228
73.40 Adjustments in expired accounts
(net)........................... -36
73.45 Recoveries of prior year
obligations..................... -5
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -705 -464 423
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 657
74.40 Obligated balance, end of year.... -186 -591 -186
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1,912 3,232 2,805
86.93 Outlays from discretionary
balances........................ 585 423
--------- --------- ----------
87.00 Total outlays (gross)........... 2,497 3,232 3,228
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -2,492 -2,637 -2,746
88.00 Federal sources............... -536 -423
88.40 Non-Federal sources........... -57 -59 -59
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -2,549 -3,232 -3,228
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -705 -464 423
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 625
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... -52
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2003 actual 2004 est. 2005 est.
Enacted/requested:
Budget Authority..................
Outlays........................... -52
Legislative proposal, not subject to
PAYGO:
Budget Authority..................
Outlays...........................
------------------------------------
Total:
Budget Authority..................
Outlays........................... -52
====================================
Program management activities include funding for research, Medicare
operations, survey and certification, CLIA, Medicare+Choice, the CMS
systems revitalization plan, and administrative costs. Program
management activities also include funding for the implementation of the
Medicare Prescription Drug, Improvement, and Modernization Act of 2003.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0511-0-1-550 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 325 340 351
11.3 Other than full-time permanent 7 10 10
11.5 Other personnel compensation.. 6 4 4
11.7 Military personnel............ 10 8 9
--------- --------- ----------
11.9 Total personnel compensation 348 362 374
12.1 Civilian personnel benefits..... 75 75 79
12.2 Military personnel benefits..... 2 2 2
13.0 Benefits for former personnel... 1
21.0 Travel and transportation of
persons....................... 9 9 9
22.0 Transportation of things........ 1
23.1 Rental payments to GSA.......... 29 19 19
23.3 Communications, utilities, and
miscellaneous charges......... 36 3 3
24.0 Printing and reproduction....... 9 3 3
25.1 Advisory and assistance services 15
25.2 Other services.................. 220 393 411
25.3 Other purchases of goods and
services from Government
accounts...................... 54 2 2
25.5 Research and development
contracts..................... 24
25.6 Medical care.................... 1,401 2,295 2,198
25.7 Operation and maintenance of
equipment..................... 267
26.0 Supplies and materials.......... 1 1 1
31.0 Equipment....................... 3
32.0 Land and structures............. 10 10
41.0 Grants, subsidies, and
contributions................. 63 58 40
--------- --------- ----------
99.0 Direct obligations............ 2,558 3,232 3,151
99.0 Reimbursable obligations.......... 59 59 59
--------- --------- ----------
99.9 Total new obligations........... 2,617 3,291 3,210
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0511-0-1-550 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 4,475 4,324 4,318
1101 Military full-time equivalent
employment.................... 86 84 90
Reimbursable:
2001 Total compensable workyears:
Civilian full-time equivalent
employment...................... 80 78 72
---------------------------------------------------------------------------
The FTEs displayed above do not include FTEs attributable to the
Medicare Prescription Drug, Improvement, and Modernization Act of 2003.
These FTEs will be displayed in future tables as the details become
available.
Program Management
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0511-2-1-550 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct program:
00.01 Medicare operations............. -205
--------- --------- ----------
01.00 Total direct program............ -205
09.03 Other reimbursements.............. 205
--------- --------- ----------
09.09 Total reimbursable program...... 205
--------- --------- ----------
10.00 Total new obligations...........
Change in obligated balances:
73.10 Total new obligations.............
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... 205
88.40 Non-Federal sources........... -205
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................
---------------------------------------------------------------------------
[[Page 446]]
The budget includes $205 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 authorize the collection and spending of fees
subject to the 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
$205 million. For FY 2005, the budget proposes a new mechanism to
identify instances where Medicare should be the secondary payer for
health care--paying only after another insurer paid first.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0511-2-1-550 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
25.6 Direct obligations: Medical care.. -205
99.0 Reimbursable obligations:
Reimbursable obligations........ 205
--------- --------- ----------
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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Grants, subsidies, and
contributions................... 5,382 3,175 4,082
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 5,382 3,175 4,082
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 5,381 3,175 4,082
23.95 Total new obligations............. -5,382 -3,175 -4,082
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation, BBA.............. 3,150 3,150 4,050
60.00 Appropriation, BBRA for
territories................... 25 25 32
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 3,175 3,175 4,082
63.00 Reappropriation................. 2,206
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 5,381 3,175 4,082
Change in obligated balances:
72.40 Obligated balance, start of year.. 10,934 9,755 7,697
73.10 Total new obligations............. 5,382 3,175 4,082
73.20 Total outlays (gross)............. -4,355 -5,232 -5,299
73.40 Adjustments in expired accounts
(net)........................... -2,206 -63
74.40 Obligated balance, end of year.... 9,755 7,697 6,418
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 424 63 289
86.98 Outlays from mandatory balances... 3,931 5,169 5,010
--------- --------- ----------
87.00 Total outlays (gross)........... 4,355 5,232 5,299
Net budget authority and outlays:
89.00 Budget authority.................. 5,381 3,175 4,082
90.00 Outlays........................... 4,355 5,232 5,299
---------------------------------------------------------------------------
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.
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] 2005,
no commitments for direct loans or loan guarantees shall be made.
(Division E, H.R. 2673, Consolidated Appropriations Bill, FY 2004.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-4420-0-3-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 10 10
23.98 Unobligated balance expiring or
withdrawn....................... -10
24.40 Unobligated balance carried
forward, end of year............ 10
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................
---------------------------------------------------------------------------
The last loan commitments from the HMO loan fund were made in 1983.
Trust Funds
Federal Hospital Insurance Trust Fund
Unavailable Receipts (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8005-0-7-571 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
01.99 Balance, start of year............ 227,932 249,613 259,300
Receipts:
02.00 FHI trust fund, Transfers from
general fund (FICA taxes)....... 136,885 139,208 153,069
02.01 FHI trust fund, Transfers from
general fund (SECA taxes)....... 9,905 10,941 11,707
02.02 FHI trust fund, Receipts from
Railroad Retirement Board....... 396 391 397
02.03 FHI trust fund, Civil penalties
and damages..................... 233 233 233
02.20 FHI trust fund, Premiums collected
for uninsured individuals not... 1,598 1,712 1,892
02.21 FHI trust fund, Other proprietary
receipts from the public........ -2
02.40 FHI trust fund, Federal employer
contributions (FICA)............ 2,355 2,551 2,646
02.41 FHI trust fund, Postal Service
employer contributions (FICA)... 694 706 730
02.42 FHI trust fund, Payments from the
general fund (uninsured and pr.. 514 566 501
02.43 FHI trust fund, Taxation on OASDI
benefits........................ 8,318 7,743 9,052
02.44 FHI trust fund, Interest payments
by Railroad Retirement Board.... 31 28 28
02.45 FHI trust fund, Interest received
by trust funds.................. 14,760 14,725 14,620
02.46 FHI trust fund, Payment from the
general fund for health care fr. 114 114 114
02.47 FHI trust fund, Transfers from
general fund (criminal fines)... 2 2 2
02.48 FHI trust fund, Transfers from
general fund (civil monetary
pena............................ 7 7 7
02.49 Transfers from DOD, HI............ 4
02.50 Proposed legislation.............. 181
--------- --------- ----------
02.99 Total receipts and collections.. 175,814 178,927 195,179
--------- --------- ----------
04.00 Total: Balances and collections... 403,746 428,540 454,479
Appropriations:
05.00 Federal hospital insurance trust
fund............................ -1,480 -1,853 -1,677
05.01 Federal hospital insurance trust
fund............................ -175,803 -177,323 -193,295
05.02 Federal hospital insurance trust
fund............................ 24,216 10,997 11,604
05.03 Health care fraud and abuse
control account................. -1,077 -1,075 -1,075
05.04 Appropriation temporarily reduced. 11 14
05.06 Federal hospital insurance trust
fund............................ 45
05.07 Federal hospital insurance trust
fund............................ -229
05.08 Federal hospital insurance trust
fund............................ 229
--------- --------- ----------
05.99 Total appropriations............ -154,133 -169,240 -184,398
--------- --------- ----------
07.99 Balance, end of year.............. 249,613 259,300 270,081
---------------------------------------------------------------------------
[[Page 447]]
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8005-0-7-571 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Benefit payments, HI.............. 150,970 166,182 181,350
00.02 Administration, HI................ 1,467 1,600 1,686
00.03 Quality improvement organizations,
HI.............................. 559 85 276
00.04 Research, HI...................... 60 63 55
00.05 Medicare Prescription Drug,
Improvement, and Modernization
Act: admin costs................ 235
--------- --------- ----------
10.00 Total new obligations........... 153,056 168,165 183,367
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 153,056 168,165 183,368
23.95 Total new obligations............. -153,056 -168,165 -183,367
New budget authority (gross), detail:
Discretionary:
40.26 Appropriation (trust fund)...... 1,480 1,853 1,677
40.37 Appropriation temporarily
reduced....................... -11 -14
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 1,469 1,839 1,677
Mandatory:
60.26 Appropriation (trust fund)...... 175,803 177,323 193,295
60.45 Portion precluded from balances. -24,216 -10,997 -11,604
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 151,587 166,326 181,691
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 153,056 168,165 183,368
Change in obligated balances:
72.40 Obligated balance, start of year.. 965 1,228 1,138
73.10 Total new obligations............. 153,056 168,165 183,367
73.20 Total outlays (gross)............. -152,793 -168,255 -183,516
74.40 Obligated balance, end of year.... 1,228 1,138 990
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1,455 1,710 1,677
86.93 Outlays from discretionary
balances........................ 30 13 123
86.97 Outlays from new mandatory
authority....................... 151,099 166,258 181,429
86.98 Outlays from mandatory balances... 209 274 287
--------- --------- ----------
87.00 Total outlays (gross)........... 152,793 168,255 183,516
Net budget authority and outlays:
89.00 Budget authority.................. 153,056 168,165 183,368
90.00 Outlays........................... 152,793 168,255 183,516
Memorandum (non-add) entries:
92.01 Total investments, start of year:
Federal securities: Par value... 228,908 251,297 260,688
92.02 Total investments, end of year:
Federal securities: Par value... 251,297 260,688 271,092
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2003 actual 2004 est. 2005 est.
Enacted/requested:
Budget Authority.................. 153,056 168,165 183,368
Outlays........................... 152,793 168,255 183,516
Legislative proposal, not subject to
PAYGO:
Budget Authority.................. -45
Outlays........................... -45
------------------------------------
Total:
Budget Authority.................. 153,056 168,165 183,323
Outlays........................... 152,793 168,255 183,471
====================================
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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Unexpended balance, start of year:
0100 Treasury balance.................. 202 -206
0101 U.S. Securities: Par value........ 228,908 251,297 260,688
--------- --------- ----------
0199 Total balance, start of year.... 229,110 251,091 260,688
Cash income during the year:
Current law:
Receipts:
1200 FHI trust fund, transfers from
general fund (FICA taxes)... 136,885 139,208 153,069
1201 FHI trust fund, transfers from
general fund (SECA taxes)... 9,905 10,941 11,707
1202 FHI trust fund, receipts from
Railroad Retirement Board... 396 391 397
1203 HCFAC: Civil penalties and
damages..................... 233 233 233
Offsetting receipts
(proprietary):
1220 FHI trust fund, premiums
collected for uninsured
individuals not otherwise
eligible.................... 1,598 1,712 1,892
1221 Other proprietary receipts.... -2
Offsetting receipts
(intragovernmental):
1240 FHI trust fund, Federal
employer contributions
(FICA)...................... 2,355 2,551 2,646
1241 FHI trust fund, Postal Service
employer contributions
(FICA)...................... 694 706 730
1242 FHI trust fund, Federal
payment for transitional
coverage for uninsured
Federal employees........... 168 168 199
1242 FHI trust fund, Federal
payment for transitional
coverage for the uninsured.. 225 197 87
1242 FHI trust fund, general fund
transfer, program management
(HI)........................ 120 201 215
1243 FHI trust fund, Federal
payments for OASDI taxes.... 8,318 7,743 9,052
1244 FHI trust fund, interest
payment from Railroad
Retirement Board............ 31 28 28
1245 FHI trust fund, interest on
investments................. 14,760 14,725 14,617
1247 HCFAC: FBI.................... 114 114 114
1248 HCFAC: Criminal fines......... 2 2 2
1249 HCFAC: Civil monetary
penalties................... 7 7 7
1250 Other intragovernmental
transactions................ 4
Offsetting collections:
1281 HCFAC user fees............... 3
1299 Income under present law........ 175,817 178,927 194,995
Proposed legislation:
Offsetting receipts
(intragovernmental):
2245 Interest on investments,
legislative proposal not
subject to PAYGO............ 3
2246 Offsetting receipts
(intragovernmental)......... 181
2299 Income under proposed
legislation................... 184
--------- --------- ----------
3299 Total cash income............... 175,817 178,927 195,179
Cash outgo during year:
Current law:
4500 Benefit Payments................ -150,970 -166,182 -181,350
4500 Administration.................. -1,485 -1,696 -1,792
4500 Quality Improvement
Organizations................. -280 -291 -301
4500 Research........................ -58 -86 -73
4501 HCFAC........................... -1,030 -1,075 -1,075
4599 Outgo under current law (-)..... -153,823 -169,330 -184,591
Proposed legislation:
5500 Administration, legislative
proposal not subject to PAYGO. 45
--------- --------- ----------
6599 Total cash outgo (-)............ -153,823 -169,330 -184,546
Unexpended balance, end of year:
8700 Uninvested balance................ -206
8701 Federal securities: Par value..... 251,297 260,688 271,321
--------- --------- ----------
8799 Total balance, end of year...... 251,091 260,688 271,321
---------------------------------------------------------------------------
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8005-0-7-571 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
41.0 Payment for Quality Improvement
Organization (QIO) activities... 559 85 276
42.0 Insurance claims and indemnities
(benefits)...................... 150,970 166,182 181,350
94.0 Financial transfers............... 1,527 235
94.0 Financial transfers............... 1,663 1,741
--------- --------- ----------
99.0 Direct obligations............ 153,056 168,165 183,367
--------- --------- ----------
99.9 Total new obligations........... 153,056 168,165 183,367
---------------------------------------------------------------------------
Federal Hospital Insurance Trust Fund
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8005-2-7-571 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Benefit payments, HI.............. -10
00.02 Administration, HI................ -35
--------- --------- ----------
10.00 Total new obligations........... -45
[[Page 448]]
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... -45
23.95 Total new obligations............. 45
New budget authority (gross), detail:
Discretionary:
40.26 Appropriation (trust fund)...... -45
Mandatory:
60.26 Appropriation (trust fund)...... 229
60.45 Portion precluded from
obligation.................... -229
--------- --------- ----------
62.50 Appropriation (total
mandatory)..................
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... -45
Change in obligated balances:
73.10 Total new obligations............. -45
73.20 Total outlays (gross)............. 45
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... -45
Net budget authority and outlays:
89.00 Budget authority.................. -45
90.00 Outlays........................... -45
Memorandum (non-add) entries:
92.01 Total investments, start of year:
Federal securities: Par value...
92.02 Total investments, end of year:
Federal securities: Par value... 229
---------------------------------------------------------------------------
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. For FY 2005, the budget also proposes
a new mechanism to identify instances where Medicare should be the
secondary payer for health care--paying only after another insurer paid
first.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8005-2-7-571 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
42.0 Insurance claims and indemnities
(benefits)...................... -10
94.0 Financial transfers............... -35
--------- --------- ----------
99.9 Total new obligations........... -45
---------------------------------------------------------------------------
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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Medicare integrity program........ 720 720 720
00.02 FBI fraud and abuse control....... 114 114 114
00.03 Other fraud and abuse control..... 238 241 241
09.01 Reimbursable (OIG)................ 5
--------- --------- ----------
10.00 Total new obligations........... 1,077 1,075 1,075
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 1,080 1,075 1,075
23.95 Total new obligations............. -1,077 -1,075 -1,075
23.98 Unobligated balance expiring or
withdrawn....................... -5
New budget authority (gross), detail:
Mandatory:
60.28 Appropriation (unavailable
balances)..................... 1,077 1,075 1,075
69.00 Offsetting collections (cash)..... 3
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 1,080 1,075 1,075
Change in obligated balances:
72.40 Obligated balance, start of year.. 213 250 250
73.10 Total new obligations............. 1,077 1,075 1,075
73.20 Total outlays (gross)............. -1,030 -1,075 -1,075
73.40 Adjustments in expired accounts
(net)........................... -10
74.40 Obligated balance, end of year.... 250 250 250
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 1,030 1,075 1,075
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -3
Net budget authority and outlays:
89.00 Budget authority.................. 1,077 1,075 1,075
90.00 Outlays........................... 1,028 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
2004 and 2005. As required by statute, actual 2004 and 2005 agency
distributions will be determined by the Secretary of HHS and the
Attorney General consistent with the Administration's priorities.
2003 actual 2004 est. 2005 est.
Department of Justice, DOJ.......... 50 49 49
Office of the Inspector General, HHS 160 160 160
Centers for Medicare and Medicaid
Services, Medicaid/SCHIP Program
Integrity, HHS...................... 10 20 20
Centers for Medicare and Medicaid
Services, Other HHS................. 13 4 4
Office of the General Counsel, HHS.. 5 5 5
Other HHS........................... 3 3 3
------------------------------------
Total......................... 241 241 241
====================================
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8393-0-7-571 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct obligations:
11.1 Personnel compensation: Full-
time permanent (CMS 100 FTEs). 8 8
12.1 Civilian personnel benefits
(CMS)......................... 2 2
25.1 Advisory and assistance services
(CMS)......................... 12 5 5
25.2 Other services (CMS)............ 2 5 5
25.3 Other purchases of goods and
services from Government
accounts (DoJ)................ 50 49 49
25.3 Other purchases of goods and
services from Government
accounts (HHS/OIG)............ 160 160 160
25.3 Other purchases of goods and
services from Government
accounts (HHS/AoA)............ 3 2 2
25.3 Other purchases of goods and
services from Government
accounts (HHS/OGC)............ 6 5 5
25.6 Medical care (CMS).............. 720 720 720
41.0 Grants, subsidies, and
contributions (CMS)........... 5 5 5
94.0 Financial transfers............. 114 114 114
--------- --------- ----------
99.0 Direct obligations............ 1,072 1,075 1,075
99.0 Reimbursable obligations.......... 5
--------- --------- ----------
99.9 Total new obligations........... 1,077 1,075 1,075
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-8393-0-7-571 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct:
1001 Total compensable workyears:
Civilian full-time equivalent
employment...................... 100 100
---------------------------------------------------------------------------
Federal Supplementary Medical Insurance Trust Fund
Unavailable Receipts (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8004-0-7-571 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
01.99 Balance, start of year............ 37,744 23,729 19,073
[[Page 449]]
Receipts:
02.20 Premiums collected for the aged,
FSMI Fund....................... 23,115 26,117 29,824
02.21 Premiums collected for the
disabled, FSMI Fund............. 3,720 4,340 5,123
02.22 Premiums collected for Medicare
prescription drug account, FSMI.
02.23 Payments from States, Medicare
prescription drug account, FSMI.
02.24 Offsetting receipts (proprietary),
proposed legislation............ -31
02.25 Offsetting receipts, proposed
legislation (proprietary)....... -5
02.27 Other proprietary receipts from
the public, FSMI Fund........... -1
02.40 Federal contributions, FSMI Fund.. 80,905 94,518 114,002
02.41 Interest received by trust fund,
FSMI Fund....................... 2,452 2,002 2,016
02.42 Transfers from DOD, SMI........... 4
02.43 Interest, transitional assistance
account, FSMI................... 4 5
02.44 Federal contributions, Medicare
prescription drug account, FSMI. 106
02.45 Interest, Medicare prescription
drug account, FSMI..............
02.46 Federal contributions,
Transitional assistance account,
FSMI............................ 2,321 2,788
02.47 Offsetting receipts
(intragovernmental, proposed
legislation).................... -118
02.52 Miscellaneous Federal payments,
Federal supplementary medical in 1
--------- --------- ----------
02.99 Total receipts and collections.. 110,196 129,302 153,710
--------- --------- ----------
04.00 Total: Balances and collections... 147,940 153,031 172,783
Appropriations:
05.00 Federal supplementary medical
insurance trust fund............ -2,341 -2,454 -2,375
05.01 Federal supplementary medical
insurance trust fund............ -107,854 -124,548 -148,590
05.02 Federal supplementary medical
insurance trust fund............ -14,031 -3,579
05.03 Federal supplementary medical
insurance trust fund............ 15 25
05.04 Transitional drug assistance,
Federal supplementary medical
insu............................ -2,321 -2,792
05.05 Medicare prescription drug
account, Federal supplementary
insura.......................... -106
05.06 Transitional drug assistance,
Federal supplementary medical
insu............................ -138
05.07 Medicare prescription drug
account, Federal supplementary
insura.......................... -943 -100
05.08 Federal supplementary medical
insurance trust fund............ 310
05.11 Federal supplementary medical
insurance trust fund............ 7,811
05.12 Federal supplementary medical
insurance trust fund............ -136
--------- --------- ----------
05.99 Total appropriations............ -124,211 -133,958 -145,978
--------- --------- ----------
07.99 Balance, end of year.............. 23,729 19,073 26,805
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8004-0-7-571 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Benefit payments, SMI............. 121,624 127,786 140,455
00.02 Administration, SMI............... 2,318 2,235 2,367
00.03 Quality improvement organizations,
SMI............................. 143 21 69
00.04 Research, SMI..................... 14 15 13
00.06 Transfer to Medicaid for payment
of SMI premiums................. 112 125
00.07 MPDIMA Adminstration.............. 184
00.08 MPDIMA Drug Demonstration......... 190 250
--------- --------- ----------
10.00 Total new obligations........... 124,211 130,556 143,154
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 124,211 130,556 143,154
23.95 Total new obligations............. -124,211 -130,556 -143,154
New budget authority (gross), detail:
Discretionary:
40.26 Appropriation (trust fund)...... 2,341 2,454 2,375
40.37 Appropriation temporarily
reduced....................... -15 -25
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 2,326 2,429 2,375
Mandatory:
60.26 Appropriation (trust fund)...... 107,854 124,548 148,590
60.28 Appropriation (unavailable
balances)..................... 14,031 3,579
60.45 Portion precluded from
obligation.................... -7,811
--------- --------- ----------
62.50 Appropriation (total
mandatory).................. 121,885 128,127 140,779
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 124,211 130,556 143,154
Change in obligated balances:
72.40 Obligated balance, start of year.. 916 1,072 1,142
73.10 Total new obligations............. 124,211 130,556 143,154
73.20 Total outlays (gross)............. -124,055 -130,486 -143,237
74.40 Obligated balance, end of year.... 1,072 1,142 1,059
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 2,239 2,304 2,357
86.93 Outlays from discretionary
balances........................ 92
86.97 Outlays from new mandatory
authority....................... 121,376 128,110 140,713
86.98 Outlays from mandatory balances... 440 72 75
--------- --------- ----------
87.00 Total outlays (gross)........... 124,055 130,486 143,237
Net budget authority and outlays:
89.00 Budget authority.................. 124,211 130,556 143,154
90.00 Outlays........................... 124,055 130,486 143,237
Memorandum (non-add) entries:
92.01 Total investments, start of year:
Federal securities: Par value... 38,804 24,849 21,292
92.02 Total investments, end of year:
Federal securities: Par value... 24,849 21,292 29,020
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2003 actual 2004 est. 2005 est.
Enacted/requested:
Budget Authority.................. 124,211 130,556 143,154
Outlays........................... 124,055 130,486 143,237
Legislative proposal, not subject to
PAYGO:
Budget Authority.................. -174
Outlays........................... -174
------------------------------------
Total:
Budget Authority.................. 124,211 130,556 142,980
Outlays........................... 124,055 130,486 143,063
====================================
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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Unexpended balance, start of year:
0100 Treasury balance.................. -145 -49
0101 U.S. Securities: Par value........ 38,804 24,849 20,814
--------- --------- ----------
0199 Total balance, start of year.... 38,660 24,801 20,814
Cash income during the year:
Current law:
Offsetting receipts
(proprietary):
1220 Premiums collected for the
aged, FSMI fund............. 23,115 26,117 29,824
1221 Premiums collected for the
disabled, FSMI fund......... 3,720 4,340 5,123
1222 Other proprietary receipts.... -1
Offsetting receipts
(intragovernmental):
1240 Federal contributions, FSMI
fund........................ 80,905 94,518 114,002
1241 Interest received by trust
fund, FSMI fund............. 2,452 2,002 2,016
1242 Intragovernmental transactions 4
1245 Offsetting receipts
(intragovernmental)......... 1
1246 Offsetting receipts
(intragovernmental)......... 4 5
1248 Offsetting receipts
(intragovernmental)......... 106
1250 Offsetting receipts
(intragovernmental)......... 2,321 2,788
1299 Income under present law........ 110,196 129,302 153,864
Proposed legislation:
Offsetting receipts (proprietary
receipts):
2220 Premiums collected for the
aged, FSMI fund............. -31
2221 Premiums collected for the
disabled, FSMI fund......... -5
Offsetting receipts
(intragovernmental):
2240 Federal contributions,
legislative proposal not
subject to PAYGO............ -118
2299 Income under proposed
legislation................... -154
--------- --------- ----------
3299 Total cash income............... 110,196 129,302 153,710
Cash outgo during year:
Current law:
4500 Benefit payments & ESRD......... -121,629 -127,976 -140,705
4500 Administration.................. -2,230 -2,289 -2,437
4500 Quality Improvement
Organizations................. -70 -76 -78
4500 Research........................ -14 -20 -17
4500 Transfer to Medicaid for payment
of SMI premiums............... -112 -125
4502 Transitional Drug Assistance,
FSMI.......................... -2,402 -2,844
4503 Medicare Prescription Drug
Account, FSMI................. -401 -598
4599 Outgo under current law (-)..... -124,055 -133,289 -146,679
Proposed legislation:
5500 Administration, legislative
proposal not subject to PAYGO. 174
--------- --------- ----------
6599 Total cash outgo (-)............ -124,055 -133,289 -146,505
[[Page 450]]
Unexpended balance, end of year:
8700 Uninvested balance................ -49
8701 Federal securities: Par value..... 24,849 20,814 28,019
--------- --------- ----------
8799 Total balance, end of year...... 24,801 20,814 28,019
---------------------------------------------------------------------------
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8004-0-7-571 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
41.0 Payment for Quality Improvement
Organization (QIO) activity..... 143 21 69
42.0 Insurance claims and indemnities.. 121,736 128,101 140,705
94.0 Financial transfers............... 2,332 2,434 2,380
--------- --------- ----------
99.0 Direct obligations............ 124,211 130,556 143,154
--------- --------- ----------
99.9 Total new obligations........... 124,211 130,556 143,154
---------------------------------------------------------------------------
Federal Supplementary Medical Insurance Trust Fund
(Legislative proposal, not subject to PAYGO)
In the case of durable medical equipment described in section
1834(a)(7)(A) of the Social Security Act, a supplier shall transfer
title to the item to the individual patient on the first day that begins
after the 13th continuous month during which payment is made for the
rental of the item under this section.
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8004-2-7-571 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Benefit payments, SMI............. -140
00.02 Administration, SMI............... -170
00.06 Transfer to Medicaid for payment
of SMI premiums................. 136
--------- --------- ----------
10.00 Total new obligations........... -174
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... -174
23.95 Total new obligations............. 174
New budget authority (gross), detail:
Discretionary:
40.26 Appropriation (trust fund)...... -310
Mandatory:
60.45 Portion precluded from
obligation.................... 136
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... -174
Change in obligated balances:
73.10 Total new obligations............. -174
73.20 Total outlays (gross)............. 174
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... -310
86.97 Outlays from new mandatory
authority....................... 136
--------- --------- ----------
87.00 Total outlays (gross)........... -174
Net budget authority and outlays:
89.00 Budget authority.................. -174
90.00 Outlays........................... -174
Memorandum (non-add) entries:
92.01 Total investments, start of year:
Federal securities: Par value...
92.02 Total investments, end of year:
Federal securities: Par value... 20
---------------------------------------------------------------------------
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. For
FY 2005, the budget proposes a new mechanism to identify instances where
Medicare should be the secondary payer for health care--paying only
after another insurer paid first. Also, the budget proposes to reduce
excessive rental payments for durable medical equipment by the Medicare
program and its beneficiaries.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 20-8004-2-7-571 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
42.0 Insurance claims and indemnities.. -4
94.0 Financial transfers............... -170
--------- --------- ----------
99.9 Total new obligations........... -174
---------------------------------------------------------------------------
Transitional Drug Assistance, Federal Supplementary Medical Insurance
Trust Fund
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8307-0-7-571 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Benefit payments, transitional
drug assistance................. 2,321 2,792
00.02 Program management (CMS).......... 128
00.03 Limitation on administrative
expenses (SSA).................. 10
--------- --------- ----------
10.00 Total new obligations........... 2,459 2,792
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 2,459 2,792
23.95 Total new obligations............. -2,459 -2,792
New budget authority (gross), detail:
Discretionary:
40.26 Appropriation (trust fund)...... 138
Mandatory:
60.26 Appropriation (trust fund)...... 2,321 2,792
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 2,459 2,792
Change in obligated balances:
72.40 Obligated balance, start of year.. 57
73.10 Total new obligations............. 2,459 2,792
73.20 Total outlays (gross)............. -2,402 -2,844
74.40 Obligated balance, end of year.... 57 5
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 81
86.93 Outlays from discretionary
balances........................ 52
86.97 Outlays from new mandatory
authority....................... 2,321 2,792
--------- --------- ----------
87.00 Total outlays (gross)........... 2,402 2,844
Net budget authority and outlays:
89.00 Budget authority.................. 2,459 2,792
90.00 Outlays........................... 2,402 2,844
Memorandum (non-add) entries:
92.01 Total investments, start of year:
Federal securities: Par value... -77
92.02 Total investments, end of year:
Federal securities: Par value... -77 -128
---------------------------------------------------------------------------
The Medicare Transitional Drug Assistance program provides low-
income beneficiaries with $600 per year to help them pay for their
prescription drugs.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8307-0-7-571 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
25.2 Other services.................... 138
42.0 Insurance claims and indemnities.. 2,321 2,792
--------- --------- ----------
99.9 Total new obligations........... 2,459 2,792
---------------------------------------------------------------------------
[[Page 451]]
Medicare Prescription Drug Account, Federal Supplementary Medical
Insurance Trust Fund
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8308-0-7-571 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Program management (CMS).......... 453
00.02 Limitation on administrative
expenses (SSA).................. 490 100
00.03 Low-income determinations
(Medicaid)...................... 106
--------- --------- ----------
10.00 Total new obligations (object
class 25.2)................... 943 206
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 943 206
23.95 Total new obligations............. -943 -206
New budget authority (gross), detail:
Discretionary:
40.26 Appropriation (trust fund)...... 943 100
Mandatory:
60.26 Appropriation (trust fund)...... 106
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 943 206
Change in obligated balances:
72.40 Obligated balance, start of year.. 542
73.10 Total new obligations............. 943 206
73.20 Total outlays (gross)............. -401 -598
74.40 Obligated balance, end of year.... 542 150
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 401
86.93 Outlays from discretionary
balances........................ 492
86.97 Outlays from new mandatory
authority....................... 106
--------- --------- ----------
87.00 Total outlays (gross)........... 401 598
Net budget authority and outlays:
89.00 Budget authority.................. 943 206
90.00 Outlays........................... 401 598
Memorandum (non-add) entries:
92.01 Total investments, start of year:
Federal securities: Par value... -401
92.02 Total investments, end of year:
Federal securities: Par value... -401 -893
---------------------------------------------------------------------------
Beginning in 2006, Medicare beneficiaries will have the opportunity
to enroll in a comprehensive prescription drug benefit. This schedule
currently reflects start-up cost associated with implementing the
benefit.
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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 State family assistance grant..... 16,488 16,489 16,489
00.02 Territories--family assistance
grants.......................... 73 78 78
00.03 Matching grants to territories.... 4 6 6
00.04 Supplemental grants for population
increases....................... 319 191
00.05 Bonus to reward decrease in
illegitimacy.................... 100 100 100
00.06 Tribal work programs.............. 8 8 8
00.07 Bonus to reward high performance
States.......................... 400 200 200
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 17,392 17,072 16,881
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 400 800
22.00 New budget authority (gross)...... 17,009 17,881 16,689
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 17,409 17,881 17,489
23.95 Total new obligations............. -17,392 -17,072 -16,881
23.98 Unobligated balance expiring or
withdrawn....................... -17 -9 -9
24.40 Unobligated balance carried
forward, end of year............ 800 600
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 17,009 17,881 16,689
Change in obligated balances:
72.40 Obligated balance, start of year.. 8,977 7,016 5,200
73.10 Total new obligations............. 17,392 17,072 16,881
73.20 Total outlays (gross)............. -19,352 -18,888 -18,148
74.40 Obligated balance, end of year.... 7,016 5,200 3,933
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 13,160 13,467 13,820
86.98 Outlays from mandatory balances... 6,192 5,421 4,328
--------- --------- ----------
87.00 Total outlays (gross)........... 19,352 18,888 18,148
Net budget authority and outlays:
89.00 Budget authority.................. 17,009 17,881 16,689
90.00 Outlays........................... 19,352 18,888 18,148
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2003 actual 2004 est. 2005 est.
Enacted/requested:
Budget Authority.................. 17,009 17,881 16,689
Outlays........................... 19,352 18,888 18,148
Legislative proposal, subject to
PAYGO:
Budget Authority.................. -272 459
Outlays........................... -22 207
------------------------------------
Total:
Budget Authority.................. 17,009 17,609 17,148
Outlays........................... 19,352 18,866 18,355
====================================
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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.04 Supplemental grants for population
increases........................
.................................
................................ 128 319
00.05 Elimination of illegitimacy
bonus........................... -100 -100
00.07 Redirect high performance
bonus........................... -100 -100
00.08 Promotion of healthy marriage and
family formation
grants...........................
................................ 100 120
00.09 Family formation, research,
demonstration and technical
assistance
activities.......................
................................ 100 120
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 128 359
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... -400
22.00 New budget authority (gross)...... -272 459
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... -272 59
23.95 Total new obligations............. -128 -359
24.40 Unobligated balance carried
forward, end of year............ -400 -300
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... -272 459
Change in obligated balances:
72.40 Obligated balance, start of year.. 150
73.10 Total new obligations............. 128 359
73.20 Total outlays (gross)............. 22 -207
74.40 Obligated balance, end of year.... 150 302
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... -22 126
86.98 Outlays from mandatory balances... 81
--------- --------- ----------
87.00 Total outlays (gross)........... -22 207
[[Page 452]]
Net budget authority and outlays:
89.00 Budget authority.................. -272 459
90.00 Outlays........................... -22 207
---------------------------------------------------------------------------
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 support
healthy marriages and family formation.
Contingency Fund
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1522-0-1-609 2003 actual 2004 est. 2005 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)............. -2
Outlays (gross), detail:
86.98 Outlays from mandatory balances... 2
Net budget authority and outlays:
89.00 Budget authority.................. 1,958 1,958
90.00 Outlays........................... 2
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2003 actual 2004 est. 2005 est.
Enacted/requested:
Budget Authority.................. 1,958 1,958
Outlays........................... 2
Legislative proposal, subject to
PAYGO:
Budget Authority.................. 42
Outlays........................... 7
------------------------------------
Total:
Budget Authority.................. 1,958 2,000
Outlays........................... 9
====================================
Contingency Fund
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1522-4-1-609 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Program activity.................. 7
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 7
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
23.95 Total new obligations............. -7
24.40 Unobligated balance carried
forward, end of year............ 42 35
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 42
Change in obligated balances:
73.10 Total new obligations............. 7
73.20 Total outlays (gross)............. -7
Outlays (gross), detail:
86.98 Outlays from mandatory balances... 7
Net budget authority and outlays:
89.00 Budget authority.................. 42
90.00 Outlays........................... 7
---------------------------------------------------------------------------
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] $2,873,802,000,
to remain available until expended; and for such purposes for the first
quarter of fiscal year [2005] 2006, $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 for 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. (Division E, H.R. 2673, Consolidated Appropriations
Bill, FY 2004.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1501-0-1-609 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
Child support enforcement (CSE):
Benefit payments:
00.01 State child support
administrative costs........ 3,357 3,703 3,796
00.02 Child support incentive
payments.................... 461 454 446
00.03 Access and visitation grants.. 10 10 10
--------- --------- ----------
00.91 Subtotal, child support
enforcement................... 3,828 4,167 4,252
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........... 20
09.01 Offset obligations (cse grants to
states)......................... 235 195 195
--------- --------- ----------
10.00 Total new obligations........... 4,087 4,406 4,471
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 202
22.00 New budget authority (gross)...... 4,080 4,608 4,269
22.10 Resources available from
recoveries of prior year
obligations..................... 7
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 4,087 4,608 4,471
23.95 Total new obligations............. -4,087 -4,406 -4,471
24.40 Unobligated balance carried
forward, end of year............ 202
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 2,745 3,313 2,874
[[Page 453]]
65.00 Advance appropriation........... 1,100 1,100 1,200
69.00 Offsetting collections (cash)..... 235 195 195
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 4,080 4,608 4,269
Change in obligated balances:
72.40 Obligated balance, start of year.. 740 797 910
73.10 Total new obligations............. 4,087 4,406 4,471
73.20 Total outlays (gross)............. -4,023 -4,293 -4,462
73.45 Recoveries of prior year
obligations..................... -7
74.40 Obligated balance, end of year.... 797 910 919
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 3,583 3,838 3,909
86.98 Outlays from mandatory balances... 440 455 553
--------- --------- ----------
87.00 Total outlays (gross)........... 4,023 4,293 4,462
Offsets:
Against gross budget authority and outlays:
88.45 Offsetting collections (cash)
from: Offsetting governmental
collections (from non-Federal
sources)...................... -235 -195 -195
Net budget authority and outlays:
89.00 Budget authority.................. 3,845 4,413 4,074
90.00 Outlays........................... 3,788 4,098 4,267
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2003 actual 2004 est. 2005 est.
Enacted/requested:
Budget Authority.................. 3,845 4,413 4,074
Outlays........................... 3,788 4,098 4,267
Legislative proposal, subject to
PAYGO:
Budget Authority.................. -48
Outlays........................... -48
------------------------------------
Total:
Budget Authority.................. 3,845 4,413 4,026
Outlays........................... 3,788 4,098 4,219
====================================
This account provides for payments to States for child support
enforcement and other family support programs, including access and
visitation programs for families. The Federal share of child support
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)
2003 2004 2005
Gross Federal share of collections.. -1,102 -1,147 -1,189
Federal incentive payments to States 461 454 446
Hold harmless payments.............. 10 0 0
State child support administrative
costs............................... 3,582 3,898 3,941
Access and visitation grants........ 10 10 12
------------------------------------
Total........................... 2,961 3,215 3,210
====================================
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1501-0-1-609 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
41.0 Direct obligations: Grants,
subsidies, and contributions.... 3,852 4,211 4,276
99.0 Reimbursable obligations:
Reimbursable obligations........ 235 195 195
--------- --------- ----------
99.9 Total new obligations........... 4,087 4,406 4,471
---------------------------------------------------------------------------
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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
Child support enforcement (CSE):
Benefit payments:
00.01 State child support
administrative costs........ -50
00.03 Access and visitation grants.. 2
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... -48
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... -48
23.95 Total new obligations............. 48
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... -48
Change in obligated balances:
73.10 Total new obligations............. -48
73.20 Total outlays (gross)............. 48
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... -48
Net budget authority and outlays:
89.00 Budget authority.................. -48
90.00 Outlays........................... -48
---------------------------------------------------------------------------
This legislative package reproposes provisions from the President's
2003 and 2004 Budgets, including proposals to increase child support
collections and to direct more of these payments to families. Also
included are provisions to increase and improve medical child support
collections on behalf of children.
Low Income Home Energy Assistance
For making payments under title XXVI of the Omnibus Budget
Reconciliation Act of 1981, [$1,800,000,000] $1,800,500,000, of which
$500,000 will be available for evaluation purposes.
For making payments under title XXVI of the Omnibus Budget
Reconciliation Act of 1981, [$100,000,000] $200,000,000, to remain
available until expended: 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). (Division E, H.R. 2673,
Consolidated Appropriations Bill, FY 2004.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1502-0-1-609 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Direct program activity........... 1,988 1,889 2,001
--------- --------- ----------
10.00 Total new obligations........... 1,988 1,889 2,001
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 300
22.00 New budget authority (gross)...... 1,688 1,889 2,001
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 1,988 1,889 2,001
23.95 Total new obligations............. -1,988 -1,889 -2,001
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 1,800 1,800 1,801
40.00 Appropriation................... 100 200
40.35 Appropriation permanently
reduced....................... -112 -11
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 1,688 1,889 2,001
Change in obligated balances:
72.40 Obligated balance, start of year.. 537 492 486
73.10 Total new obligations............. 1,988 1,889 2,001
73.20 Total outlays (gross)............. -2,030 -1,892 -1,965
73.40 Adjustments in expired accounts
(net)........................... -3 -3
74.40 Obligated balance, end of year.... 492 486 522
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1,318 1,452 1,535
86.93 Outlays from discretionary
balances........................ 712 440 430
--------- --------- ----------
87.00 Total outlays (gross)........... 2,030 1,892 1,965
Net budget authority and outlays:
89.00 Budget authority.................. 1,688 1,889 2,001
90.00 Outlays........................... 2,030 1,892 1,965
---------------------------------------------------------------------------
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 weath
[[Page 454]]
erization providers. Obligation estimates for the contingency fund are
based on average historical obligation rates.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1502-0-1-609 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
25.2 Other services.................... 1
41.0 Grants, subsidies, and
contributions................... 1,988 1,889 2,000
--------- --------- ----------
99.9 Total new obligations........... 1,988 1,889 2,001
---------------------------------------------------------------------------
Refugee and Entrant Assistance
For necessary expenses for refugee and entrant assistance activities
and for costs associated with the care and placement of unaccompanied
alien children 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), for carrying out section 462 of the Homeland
Security Act of 2002 (Public Law 107-296), and for carrying out [section
5 of] the Torture Victims Relief Act of [1998 (Public Law 105-320)] 2003
(Public Law 108-179), [$450,276,000] $473,239,000, of which up to
[$9,968,000] $10,000,000 shall be available to carry out the Trafficking
Victims Protection Act of [2000 (Public Law 106-386; division A)] 2003
(Public Law 108-193): Provided, That funds appropriated under this
heading pursuant to section 414(a) of the Immigration and Nationality
Act and section 462 of the Homeland Security Act of 2002 for fiscal year
[2004] 2005 shall be available for the costs of assistance provided and
other activities, to remain available through September 30, [2006] 2007.
(Division E, H.R. 2673, Consolidated Appropriations Bill, FY 2004.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1503-0-1-609 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Refugee and entrant assistance.... 444 398 424
00.02 Assistance for treatment of
torture victims................. 10 10 10
00.03 Unaccompanied alien children...... 37 53 54
--------- --------- ----------
10.00 Total new obligations........... 491 461 488
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 24 28 15
22.00 New budget authority (gross)...... 481 448 473
22.10 Resources available from
recoveries of prior year
obligations..................... 14
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 519 476 488
23.95 Total new obligations............. -491 -461 -488
23.98 Unobligated balance expiring or
withdrawn....................... -3
24.40 Unobligated balance carried
forward, end of year............ 28 15
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 484 451 473
40.35 Appropriation permanently
reduced....................... -3 -3
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 481 448 473
Change in obligated balances:
72.40 Obligated balance, start of year.. 544 556 558
73.10 Total new obligations............. 491 461 488
73.20 Total outlays (gross)............. -452 -459 -474
73.40 Adjustments in expired accounts
(net)........................... -14
73.45 Recoveries of prior year
obligations..................... -14
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 2
74.40 Obligated balance, end of year.... 556 558 572
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 138 134 142
86.93 Outlays from discretionary
balances........................ 314 325 332
--------- --------- ----------
87.00 Total outlays (gross)........... 452 459 474
Net budget authority and outlays:
89.00 Budget authority.................. 481 448 473
90.00 Outlays........................... 452 459 474
---------------------------------------------------------------------------
States are subsidized for administering the refugee assistance
program. Funds are also provided to assist in the rehabilitation of
victims of torture, trafficking victims, and the care and placement of
unaccompanied alien children.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1503-0-1-609 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
11.1 Personnel compensation: Full-time
permanent....................... 1 1 1
25.1 Advisory and assistance services.. 7 5 7
25.2 Other services.................... 10 8
25.3 Other purchases of goods and
services from Government
accounts........................ 7 6 6
41.0 Grants, subsidies, and
contributions................... 476 439 466
--------- --------- ----------
99.9 Total new obligations........... 491 461 488
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-1503-0-1-609 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct:
1001 Total compensable workyears:
Civilian full-time equivalent
employment...................... 10 12 13
---------------------------------------------------------------------------
Promoting Safe and Stable Families
For carrying out section 436 of the Social Security Act,
$305,000,000 and for section 437, [$100,000,000] $200,000,000. (Division
E, H.R. 2673, Consolidated Appropriations Bill, FY 2004.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1512-0-1-506 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Grants to States and Tribes....... 382 382 475
00.02 Research, training and technical
assistance...................... 9 9 13
00.03 State court assessment activities. 13 13 17
--------- --------- ----------
10.00 Total new obligations........... 404 404 505
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 404 404 505
23.95 Total new obligations............. -404 -404 -505
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 100 100 200
40.35 Appropriation permanently
reduced....................... -1 -1
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 99 99 200
Mandatory:
60.00 Appropriation................... 305 305 305
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 404 404 505
Change in obligated balances:
72.40 Obligated balance, start of year.. 402 463 454
73.10 Total new obligations............. 404 404 505
73.20 Total outlays (gross)............. -339 -414 -432
73.40 Adjustments in expired accounts
(net)........................... -4
74.40 Obligated balance, end of year.... 463 454 526
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 21 21 42
86.93 Outlays from discretionary
balances........................ 38 67 74
86.97 Outlays from new mandatory
authority....................... 67 64 64
86.98 Outlays from mandatory balances... 213 262 252
--------- --------- ----------
87.00 Total outlays (gross)........... 339 414 432
Net budget authority and outlays:
89.00 Budget authority.................. 404 404 505
90.00 Outlays........................... 339 414 432
---------------------------------------------------------------------------
This program provides funds for a broad range of child welfare
services, including family preservation and family support services.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1512-0-1-506 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
25.1 Advisory and assistance services.. 2 3 3
[[Page 455]]
25.3 Other purchases of goods and
services from Government
accounts........................ 1 1 1
41.0 Grants, subsidies, and
contributions................... 401 400 501
--------- --------- ----------
99.9 Total new obligations........... 404 404 505
---------------------------------------------------------------------------
Child Care Entitlement to States
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1550-0-1-609 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Mandatory child care.............. 1,178 1,178 1,178
00.02 Matching child care............... 1,501 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........... 2,740 2,717 2,717
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 2,740 2,717 2,717
23.95 Total new obligations............. -2,740 -2,717 -2,717
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 2,717 2,717 2,717
63.00 Reappropriation................. 23
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 2,740 2,717 2,717
Change in obligated balances:
72.40 Obligated balance, start of year.. 1,144 965 816
73.10 Total new obligations............. 2,740 2,717 2,717
73.20 Total outlays (gross)............. -2,883 -2,866 -2,719
73.40 Adjustments in expired accounts
(net)........................... -36
74.40 Obligated balance, end of year.... 965 816 814
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 1,971 2,038 2,038
86.98 Outlays from mandatory balances... 912 828 681
--------- --------- ----------
87.00 Total outlays (gross)........... 2,883 2,866 2,719
Net budget authority and outlays:
89.00 Budget authority.................. 2,740 2,717 2,717
90.00 Outlays........................... 2,883 2,866 2,719
---------------------------------------------------------------------------
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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
25.1 Advisory and assistance services.. 7 7 7
41.0 Grants, subsidies, and
contributions................... 2,733 2,710 2,710
--------- --------- ----------
99.9 Total new obligations........... 2,740 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. (Division E, H.R. 2673, Consolidated Appropriations Bill, FY
2004.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1515-0-1-609 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Block grant payments to States.... 2,076 2,077 2,090
00.04 Research and evaluation fund...... 10 10 10
--------- --------- ----------
10.00 Total new obligations........... 2,086 2,087 2,100
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 2,086 2,087 2,100
23.95 Total new obligations............. -2,086 -2,087 -2,100
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 2,100 2,099 2,100
40.35 Appropriation permanently
reduced....................... -14 -12
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 2,086 2,087 2,100
Change in obligated balances:
72.40 Obligated balance, start of year.. 1,044 805 655
73.10 Total new obligations............. 2,086 2,087 2,100
73.20 Total outlays (gross)............. -2,320 -2,237 -2,168
73.40 Adjustments in expired accounts
(net)........................... -5
74.40 Obligated balance, end of year.... 805 655 587
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 1,495 1,565 1,575
86.93 Outlays from discretionary
balances........................ 825 672 593
--------- --------- ----------
87.00 Total outlays (gross)........... 2,320 2,237 2,168
Net budget authority and outlays:
89.00 Budget authority.................. 2,086 2,087 2,100
90.00 Outlays........................... 2,320 2,237 2,168
---------------------------------------------------------------------------
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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
21.0 Travel and transportation of
persons......................... 2 2 2
25.1 Advisory and assistance services.. 4 4 4
25.3 Other purchases of goods and
services from Government
accounts........................ 1 1 1
41.0 Grants, subsidies, and
contributions................... 2,079 2,080 2,093
--------- --------- ----------
99.9 Total new obligations........... 2,086 2,087 2,100
---------------------------------------------------------------------------
Social Services Block Grant
For making grants to States pursuant to section 2002 of the Social
Security Act, $1,700,000,000: Provided, That notwithstanding
subparagraph (B) of section 404(d)(2) of such Act, the applicable
percent specified under such subparagraph for a State to carry out State
programs pursuant to title XX of such Act shall be 10 percent. (Division
E, H.R. 2673, Consolidated Appropriations Bill, FY 2004.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1534-0-1-506 2003 actual 2004 est. 2005 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 4 4
22.00 New budget authority (gross)...... 1,700 1,700 1,700
22.10 Resources available from
recoveries of prior year
obligations..................... 3
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 1,704 1,704 1,704
23.95 Total new obligations............. -1,700 -1,700 -1,700
24.40 Unobligated balance carried
forward, end of year............ 4 4 4
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.. 665 618 551
[[Page 456]]
73.10 Total new obligations............. 1,700 1,700 1,700
73.20 Total outlays (gross)............. -1,740 -1,767 -1,769
73.40 Adjustments in expired accounts
(net)........................... -4
73.45 Recoveries of prior year
obligations..................... -3
74.40 Obligated balance, end of year.... 618 551 482
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 1,410 1,394 1,394
86.98 Outlays from mandatory balances... 330 373 375
--------- --------- ----------
87.00 Total outlays (gross)........... 1,740 1,767 1,769
Net budget authority and outlays:
89.00 Budget authority.................. 1,700 1,700 1,700
90.00 Outlays........................... 1,740 1,767 1,769
---------------------------------------------------------------------------
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 261 and 291 of the Help America Vote Act of 2002, [the
Early Learning Opportunities Act], part B(1) of title IV and sections
413, 429A, 1110, and 1115 of the Social Security Act, and sections
40155, 40211, and 40241 of Public Law 103-322; for making payments under
the Community Services Block Grant Act, sections 439(h), 473A, [and
477(i)] 474, and 477(i) 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, V, 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, [$8,816,097,000]
$9,056,025,000, of which [$7,500,000] $32,103,000, to remain available
until September 30, [2005] 2006, 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: Provided, That funds
appropriated in Public Law 108-7 for grants to States as authorized by
section 473A of title IV of the Social Security Act shall also be
available for adoption incentive payments for adoptions completed before
September 30, 2004:] 2005 Provided further, That [$6,815,570,000]
$6,943,580,000 shall be for making payments under the Head Start Act, of
which $1,400,000,000 shall become available October 1, [2004] 2005 and
remain available through September 30, [2005] 2006: Provided further,
That notwithstanding section 640 of the Head Start Act, of funds
appropriated to Head Start, $45,000,000 shall be available as grants to
States that directly administer the Head Start program: Provided
further, That [$735,686,000] $552,350,000 shall be for making payments
under the Community Services Block Grant Act: [Provided further, That
not less than $7,227,000 shall be for section 680(3)(B) of the Community
Services Block Grant Act, as amended: Provided further, That in addition
to amounts provided herein, $6,000,000 shall be available from amounts
available under section 241 of the Public Health Service Act to carry
out the provisions of section 1110 of the Social Security Act:] Provided
further, That to the extent Community Services Block Grant funds are
distributed as grant funds by a State to an eligible entity as provided
under the Act, and have not been expended by such entity, they shall
remain with such entity for carryover into the next fiscal year for
expenditure by such entity consistent with program purposes: Provided
further, That the Secretary shall establish procedures regarding the
disposition of intangible property which permits grant funds, or
intangible assets acquired with funds authorized under section 680 of
the Community Services Block Grant Act, as amended, to become the sole
property 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: [Provided further, That $89,978,000 shall be
for activities authorized by the Runaway and Homeless Youth Act,
notwithstanding the allocation requirements of section 388(a) of such
Act, of which $40,505,000 is for the transitional living program:]
Provided further, That [$48,000,000] $100,000,000 is for a compassion
capital fund to provide grants to charitable organizations to emulate
model social service programs and to encourage research on the best
practices of social service organizations: Provided further, That
[$15,000,000] $14,912,000 shall be for activities authorized by the Help
America Vote Act of 2002, of which [$10,000,000] $9,941,000 shall be for
payments to States to promote [disabled voter] access for voters with
disabilities, and of which [$5,000,000] $4,971,000 shall be for payments
to States for [disabled voters] protection and advocacy systems for
voters with disabilities: Provided further, That $181,926,000 is only
for making competitive grants to provide abstinence education (as
defined by section 510(b)(2) of the Social Security Act) to adolescents,
and for Federal costs of administering the grant: 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 in addition to amounts provided herein for abstinence
education to adolescents, $4,500,000 shall be available from amounts
available under section 241 of the Public Health Services Act to carry
out evaluations (including longitudinal evaluations) of adolescent
pregnancy prevention approaches: Provided further, That $2,000,000 shall
be for improving the Public Assistance Reporting Information System,
including grants to States to support data collection for a study of the
system's effectiveness. (Division E, H.R. 2673, Consolidated
Appropriations Bill, FY 2004.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1536-0-1-506 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Head start........................ 6,667 6,775 6,944
Runaway and homeless youth:
01.03 Runaway and homeless youth...... 49 49 49
01.04 Transitional living............. 41 40 40
01.05 Education grants to reduce
sexual abuse of runaway youth. 15 15 15
01.06 Abstinence education.............. 182
Child abuse programs:
01.07 Child abuse State grants........ 22 22 42
01.08 Child abuse discretionary
activities.................... 33 34 26
01.09 Community based resource centers 33 33 66
01.10 Maternity group homes............. 10
Child welfare programs:
01.11 Child welfare services.......... 291 290 292
01.12 Child welfare training.......... 7 7 7
01.15 Abandoned infants............... 12 12 12
01.16 Adoption incentives............. 15 35 32
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............ 29 13 6
01.20 Native American programs.......... 45 45 45
01.21 Compassion capital fund........... 35 48 100
Developmental disabilities programs:
01.24 Protection and advocacy......... 36 38 39
01.25 Projects of national
significance.................. 12 12 12
01.26 Centers for excellence.......... 25 27 27
01.27 State grants.................... 71 73 73
01.28 Federal administration............ 171 179 190
01.29 Faith-based center................ 1 1 1
01.30 Mentoring children of prisoners... 10 50 50
01.31 Early learning opportunities fund. 33 33
01.32 Independent training vouchers..... 42 45 60
[[Page 457]]
01.33 Voting access for individuals with
disabilities.................... 15 15
--------- --------- ----------
01.91 Subtotal........................ 1,068 1,156 1,431
Community services programs:
03.01 Community services block grants. 646 642 495
03.03 Rural communtiy facilities...... 7 7
03.04 Community services discretionary
(JOLI & CED).................. 33 32 32
03.05 Community food and nutrition.... 7 7
03.06 Individual development accounts... 23 25 25
03.07 National youth sports............. 17 18
03.08 Domestic violence hotline......... 3 3 3
03.09 Grants for battered women's
shelters........................ 126 126 126
--------- --------- ----------
03.91 Subtotal........................ 862 860 681
--------- --------- ----------
04.00 Total, direct program........... 8,597 8,791 9,056
09.01 Reimbursable program.............. 21 15 15
--------- --------- ----------
10.00 Total new obligations........... 8,618 8,806 9,071
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 4 29 1
22.00 New budget authority (gross)...... 8,651 8,778 9,071
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 8,655 8,807 9,072
23.95 Total new obligations............. -8,618 -8,806 -9,071
23.98 Unobligated balance expiring or
withdrawn....................... -9
24.40 Unobligated balance carried
forward, end of year............ 29 1 1
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 7,243 7,425 7,656
40.35 Appropriation permanently
reduced....................... -13 -54
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 7,230 7,371 7,656
55.00 Advance appropriation........... 1,400 1,392 1,400
Spending authority from offsetting
collections:
68.00 Offsetting collections (cash)... 18 15 15
68.10 Change in uncollected customer
payments from Federal sources
(unexpired)................... 3
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)....... 21 15 15
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 8,651 8,778 9,071
Change in obligated balances:
72.40 Obligated balance, start of year.. 4,693 4,752 4,962
73.10 Total new obligations............. 8,618 8,806 9,071
73.20 Total outlays (gross)............. -8,490 -8,596 -8,829
73.40 Adjustments in expired accounts
(net)........................... -66
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.... 4,752 4,962 5,204
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 4,560 4,552 4,650
86.93 Outlays from discretionary
balances........................ 3,930 4,044 4,179
--------- --------- ----------
87.00 Total outlays (gross)........... 8,490 8,596 8,829
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -20 -15 -15
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -3
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 2
Net budget authority and outlays:
89.00 Budget authority.................. 8,630 8,763 9,056
90.00 Outlays........................... 8,470 8,581 8,814
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2003 actual 2004 est. 2005 est.
Enacted/requested:
Budget Authority.................. 8,630 8,763 9,056
Outlays........................... 8,470 8,581 8,814
Legislative proposal, not subject to
PAYGO:
Budget Authority.................. 50
Outlays........................... 18
Legislative proposal, subject to
PAYGO:
Budget Authority.................. 50
Outlays........................... 30
------------------------------------
Total:
Budget Authority.................. 8,630 8,763 9,156
Outlays........................... 8,470 8,581 8,862
====================================
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.
Provides funding for community-based abstinence education grants. These
grants, formerly administered by the Health Resources and Services
Administration, have been transferred to the Administration for Children
and Families.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1536-0-1-506 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 104 110 102
11.3 Other than full-time permanent 1 2 2
11.5 Other personnel compensation.. 1 1 1
--------- --------- ----------
11.9 Total personnel compensation 106 113 105
12.1 Civilian personnel benefits..... 20 22 20
21.0 Travel and transportation of
persons....................... 3 5 5
23.1 Rental payments to GSA.......... 14 16 16
23.2 Rental payments to others....... 3
23.3 Communications, utilities, and
miscellaneous charges......... 2 2 2
24.0 Printing and reproduction....... 2 3 3
25.1 Advisory and assistance services 138 124 124
25.2 Other services.................. 8 41 41
25.3 Other purchases of goods and
services from Government
accounts...................... 80 30 31
25.7 Operation and maintenance of
equipment..................... 1 1 1
26.0 Supplies and materials.......... 1 2 2
31.0 Equipment....................... 1 1 1
41.0 Grants, subsidies, and
contributions................. 8,218 8,431 8,705
--------- --------- ----------
99.0 Direct obligations............ 8,597 8,791 9,056
99.0 Reimbursable obligations.......... 21 15 15
--------- --------- ----------
99.9 Total new obligations........... 8,618 8,806 9,071
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-1536-0-1-506 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct:
1001 Total compensable workyears:
Civilian full-time equivalent
employment...................... 1,375 1,333 1,337
---------------------------------------------------------------------------
Children and Families Services Programs
(Legislative proposal, not subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1536-2-1-506 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
01.35 Promotion of responsible
fatherhood and healthy marriage. 50
--------- --------- ----------
04.00 Total, direct program........... 50
--------- --------- ----------
10.00 Total new obligations........... 50
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 50
23.95 Total new obligations............. -50
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 50
Change in obligated balances:
73.10 Total new obligations............. 50
73.20 Total outlays (gross)............. -18
74.40 Obligated balance, end of year.... 32
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 18
Net budget authority and outlays:
89.00 Budget authority.................. 50
90.00 Outlays........................... 18
---------------------------------------------------------------------------
[[Page 458]]
This legislative proposal establishes the Responsible Fatherhood and
Healthy Marriage programs. The budget provides grants to faith-based and
community organizations to assist non-custodial fathers to become more
involved in the lives of their children.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1536-2-1-506 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
25.3 Other purchases of goods and
services from Government
accounts........................ 6
41.0 Grants, subsidies, and
contributions................... 44
--------- --------- ----------
99.9 Total new obligations........... 50
---------------------------------------------------------------------------
Children and Families Services Programs
(Legislative proposal subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1536-4-1-506 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
01.34 State-based abstinence education.. 50
--------- --------- ----------
04.00 Total, direct program........... 50
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 50
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 50
23.95 Total new obligations............. -50
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 50
Change in obligated balances:
73.10 Total new obligations............. 50
73.20 Total outlays (gross)............. -30
73.32 Obligated balance transferred from
other accounts.................. 16
74.40 Obligated balance, end of year.... 36
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 18
86.98 Outlays from mandatory balances... 12
--------- --------- ----------
87.00 Total outlays (gross)........... 30
Net budget authority and outlays:
89.00 Budget authority.................. 50
90.00 Outlays........................... 30
---------------------------------------------------------------------------
The budget extends funding for State-based abstinence education
activities for five years. These activities formerly administered by the
Health Resources and Services Adminstration, have been transfered to the
Administration for Children and Families.
Violent Crime Reduction Programs
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-8605-0-1-754 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Change in obligated balances:
72.40 Obligated balance, start of year.. 15 6 3
73.20 Total outlays (gross)............. -6 -3
73.40 Adjustments in expired accounts
(net)........................... -3
74.40 Obligated balance, end of year.... 6 3 3
Outlays (gross), detail:
86.93 Outlays from discretionary
balances........................ 6 3
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays........................... 6 3
---------------------------------------------------------------------------
Children's Research and Technical Assistance
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1553-0-1-609 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Training and technical assistance. 12 13 11
00.02 Federal parent locator service.... 23 23 23
00.03 Child welfare study............... 3
00.04 Welfare research.................. 8
09.01 Reimbursable program.............. 9 11 11
--------- --------- ----------
10.00 Total new obligations........... 44 58 45
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 1 2
22.00 New budget authority (gross)...... 44 56 45
22.10 Resources available from
recoveries of prior year
obligations..................... 1
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 46 58 45
23.95 Total new obligations............. -44 -58 -45
24.40 Unobligated balance carried
forward, end of year............ 2
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 35 45 34
69.00 Offsetting collections (cash)..... 9 11 11
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 44 56 45
Change in obligated balances:
72.40 Obligated balance, start of year.. 32 29 33
73.10 Total new obligations............. 44 58 45
73.20 Total outlays (gross)............. -47 -54 -51
73.40 Adjustments in expired accounts
(net)........................... 1
73.45 Recoveries of prior year
obligations..................... -1
74.40 Obligated balance, end of year.... 29 33 27
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 25 32 29
86.98 Outlays from mandatory balances... 22 22 22
--------- --------- ----------
87.00 Total outlays (gross)........... 47 54 51
Offsets:
Against gross budget authority and outlays:
Offsetting collections (cash)
from:
88.00 Federal sources............... -3 -4 -4
88.40 Non-Federal sources........... -6 -7 -7
--------- --------- ----------
88.90 Total, offsetting
collections (cash)........ -9 -11 -11
Net budget authority and outlays:
89.00 Budget authority.................. 35 45 34
90.00 Outlays........................... 38 43 40
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2003 actual 2004 est. 2005 est.
Enacted/requested:
Budget Authority.................. 35 45 34
Outlays........................... 38 43 40
Legislative proposal, subject to
PAYGO:
Budget Authority.................. 7 15
Outlays........................... 1 7
------------------------------------
Total:
Budget Authority.................. 35 52 49
Outlays........................... 38 44 47
====================================
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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct obligations:
11.1 Personnel compensation: Full-
time permanent................ 7 7
12.1 Civilian personnel benefits..... 1 1
21.0 Travel and transportation of
persons....................... 1 1
23.1 Rental payments to GSA.......... 1 1
25.1 Advisory and assistance services 18 15 14
[[Page 459]]
25.2 Other services.................. 5 3 3
25.3 Other purchases of goods and
services from Government
accounts...................... 10 6 5
41.0 Grants, subsidies, and
contributions................. 2 13 2
--------- --------- ----------
99.0 Direct obligations............ 35 47 34
99.0 Reimbursable obligations.......... 9 11 11
--------- --------- ----------
99.9 Total new obligations........... 44 58 45
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-1553-0-1-609 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct:
1001 Total compensable workyears:
Civilian full-time equivalent
employment...................... 74 74
---------------------------------------------------------------------------
Children's Research and Technical Assistance
(Legislative proposal, subject to PAYGO)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1553-4-1-609 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.04 Welfare research.................. 7 15
--------- --------- ----------
10.00 Total new obligations........... 7 15
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 7 15
23.95 Total new obligations............. -7 -15
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 7 15
Change in obligated balances:
72.40 Obligated balance, start of year.. 6
73.10 Total new obligations............. 7 15
73.20 Total outlays (gross)............. -1 -7
74.40 Obligated balance, end of year.... 6 14
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 1 1
86.98 Outlays from mandatory balances... 6
--------- --------- ----------
87.00 Total outlays (gross)........... 1 7
Net budget authority and outlays:
89.00 Budget authority.................. 7 15
90.00 Outlays........................... 1 7
---------------------------------------------------------------------------
This schedule includes funds for welfare research activities to be
included in the reauthorization of the Temporary Assistance for Needy
Families program.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1553-4-1-609 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
25.5 Research and development contracts 3 7
41.0 Grants, subsidies, and
contributions................... 4 8
--------- --------- ----------
99.9 Total new obligations........... 7 15
---------------------------------------------------------------------------
Disabled Voter Services
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1533-0-1-808 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.10 Disabled voter services........... 15
--------- --------- ----------
10.00 Total new obligations (object
class 41.0)................... 15
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 15
23.95 Total new obligations............. -15
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 15
Change in obligated balances:
72.40 Obligated balance, start of year.. 15 10
73.10 Total new obligations............. 15
73.20 Total outlays (gross)............. -5 -8
74.40 Obligated balance, end of year.... 15 10 2
Outlays (gross), detail:
86.93 Outlays from discretionary
balances........................ 5 8
Net budget authority and outlays:
89.00 Budget authority.................. 15
90.00 Outlays........................... 5 8
---------------------------------------------------------------------------
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, [$5,068,300,000] $5,037,900,000.
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] 2006,
[$1,767,700,000] $1,767,200,000.
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. (Division E, H.R. 2673, Consolidated Appropriations Bill, FY
2004.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1545-0-1-609 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Foster care....................... 4,573 4,685 4,896
00.02 Independent living................ 140 140 140
00.04 Adoption assistance............... 1,482 1,623 1,770
--------- --------- ----------
10.00 Total new obligations........... 6,195 6,448 6,806
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 6,609 6,814 6,806
23.95 Total new obligations............. -6,195 -6,448 -6,806
23.98 Unobligated balance expiring or
withdrawn....................... -414 -366
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 4,855 5,068 5,038
65.00 Advance appropriation........... 1,754 1,746 1,768
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 6,609 6,814 6,806
Change in obligated balances:
72.40 Obligated balance, start of year.. 1,117 1,167 1,173
73.10 Total new obligations............. 6,195 6,448 6,806
73.20 Total outlays (gross)............. -6,124 -6,442 -6,753
73.40 Adjustments in expired accounts
(net)........................... -20
74.40 Obligated balance, end of year.... 1,167 1,173 1,225
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 5,340 5,556 5,866
86.98 Outlays from mandatory balances... 784 886 887
--------- --------- ----------
87.00 Total outlays (gross)........... 6,124 6,442 6,753
Net budget authority and outlays:
89.00 Budget authority.................. 6,609 6,814 6,806
90.00 Outlays........................... 6,124 6,442 6,753
---------------------------------------------------------------------------
Summary of Budget Authority and Outlays
(in millions of dollars)
2003 actual 2004 est. 2005 est.
Enacted/requested:
Budget Authority.................. 6,609 6,814 6,806
Outlays........................... 6,124 6,442 6,753
Legislative proposal, subject to
PAYGO:
Budget Authority.................. -41
Outlays........................... -60
------------------------------------
Total:
Budget Authority.................. 6,609 6,814 6,765
Outlays........................... 6,124 6,442 6,693
====================================
Foster care.--The proposed level will support eligible low-income
children who must be placed outside the home. An average of 233,000
children per month will be served in 2005.
Adoption assistance.--The proposed funding level will support
subsidies for families adopting eligible low-income chil
[[Page 460]]
dren with special needs. An average of 375,900 children per month will
be served in 2005.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1545-0-1-609 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
25.1 Advisory and assistance services.. 12 12 13
41.0 Grants, subsidies, and
contributions................... 6,183 6,436 6,793
--------- --------- ----------
99.9 Total new obligations........... 6,195 6,448 6,806
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-1545-0-1-609 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct:
1001 Total compensable workyears:
Civilian full-time equivalent
employment...................... 1 1
---------------------------------------------------------------------------
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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Foster care....................... -41
--------- --------- ----------
10.00 Total new obligations........... -41
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... -41
23.95 Total new obligations............. 41
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... -41
Change in obligated balances:
73.10 Total new obligations............. -41
73.20 Total outlays (gross)............. 60
74.40 Obligated balance, end of year.... 19
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... -60
Net budget authority and outlays:
89.00 Budget authority.................. -41
90.00 Outlays........................... -60
---------------------------------------------------------------------------
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. Also included is a legislative change to clarify the process for
determining Title IV-E eligibility in the Foster Care program.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-1545-4-1-609 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
25.1 Advisory and assistance services.. 2
25.5 Research and development contracts 2
41.0 Grants, subsidies, and
contributions................... -45
--------- --------- ----------
99.9 Total new obligations........... -41
---------------------------------------------------------------------------
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, [$1,381,689,000] $1,376,527,000, of which $5,500,000 shall
be available for activities regarding medication management, screening,
and education to prevent incorrect medication and adverse drug
reactions; and of which [$2,842,000] $4,558,000 shall remain available
until September 30, [2006] 2007, for the White House Conference on
Aging. (Division E, H.R. 2673, Consolidated Appropriations Bill, FY
2004.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0142-0-1-506 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
01.01 Home and community-based
supportive services............. 356 354 357
01.02 Preventive health................. 22 22 22
01.03 National family caregiver support
program......................... 155 159 162
01.05 Congregate nutrition services..... 385 386 389
01.06 Home-delivered nutrition services. 181 180 181
01.07 Nutrition services incentive
program......................... 91 148 149
01.08 Grants for Native Americans....... 27 27 27
01.09 Program innovations............... 41 34 24
01.10 Aging network support activities.. 2 13 13
01.11 Federal administration............ 18 17 18
01.13 Alzheimer's disease demonstration
grants.......................... 13 12 12
01.14 Protection of vulnerable older
Americans....................... 18 19 18
01.15 White House Conference on Aging... 3 5
--------- --------- ----------
02.00 Total, direct program........... 1,309 1,374 1,377
09.01 Reimbursable program.............. 3 3 3
--------- --------- ----------
10.00 Total new obligations........... 1,312 1,377 1,380
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 1
22.00 New budget authority (gross)...... 1,312 1,377 1,380
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 1,313 1,377 1,380
23.95 Total new obligations............. -1,312 -1,377 -1,380
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 1,376 1,382 1,377
40.35 Appropriation permanently
reduced....................... -9 -8
41.00 Transferred to other accounts... -58
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 1,309 1,374 1,377
Mandatory:
69.00 Offsetting collections (cash)... 3 3
69.10 Change in uncollected customer
payments from Federal sources
(unexpired)................... 3
--------- --------- ----------
69.90 Spending authority from
offsetting collections
(total mandatory)........... 3 3 3
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 1,312 1,377 1,380
Change in obligated balances:
72.40 Obligated balance, start of year.. 548 542 603
73.10 Total new obligations............. 1,312 1,377 1,380
73.20 Total outlays (gross)............. -1,309 -1,316 -1,380
73.40 Adjustments in expired accounts
(net)........................... -5
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -3
74.40 Obligated balance, end of year.... 542 603 603
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 840 858 866
86.93 Outlays from discretionary
balances........................ 469 455 511
86.97 Outlays from new mandatory
authority....................... 3 3
--------- --------- ----------
87.00 Total outlays (gross)........... 1,309 1,316 1,380
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -3 -3
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.................. 1,309 1,374 1,377
[[Page 461]]
90.00 Outlays........................... 1,309 1,313 1,377
---------------------------------------------------------------------------
Note.--The reimbursable program (HCFAC) in the Administration on
Aging (AoA) reflects the estimated distribution of the allocation
account for 2004 and 2005. Actual 2004 and 2005 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. These programs are part of a comprehensive system of support
for older people and their families.
The proposed budget will also provide additional support for the
Department's efforts to create a more balanced system of long term care
and build partnerships to enhance the delivery of an integrated,
consumer-oriented, and cost effective system of health and social
supports to seniors and their family caregivers. Rebalancing the long-
term care system will provide older Americans more choices and
opportunities for independence. The proposed level also includes funding
for the White House Conference on Aging.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0142-0-1-506 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct obligations:
11.1 Personnel compensation: Full-
time permanent................ 9 10 10
12.1 Civilian personnel benefits..... 2 2 2
23.1 Rental payments to GSA.......... 2 2 2
25.1 Advisory and assistance services 5 5 5
25.2 Other services.................. 1 1
25.3 Other purchases of goods and
services from Government
accounts...................... 8 9 12
41.0 Grants, subsidies, and
contributions................. 1,283 1,345 1,345
--------- --------- ----------
99.0 Direct obligations............ 1,309 1,374 1,377
99.0 Reimbursable obligations.......... 3 3 3
--------- --------- ----------
99.9 Total new obligations........... 1,312 1,377 1,380
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0142-0-1-506 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct:
1001 Total compensable workyears:
Civilian full-time equivalent
employment...................... 109 113 113
Reimbursable:
2001 Total compensable workyears:
Civilian full-time equivalent
employment...................... 8 7 7
---------------------------------------------------------------------------
DEPARTMENTAL MANAGEMENT
Federal Funds
General and special funds:
Office of the Secretary
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, XX, and XXI of the Public Health Service Act, and
the United States-Mexico Border Health Commission Act, [$357,358,000]
$431,971,000, 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] $26,240,000 shall be for activities specified under
section 2003(b)(2), all 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, $49,838,000]; $52,838,000 is for minority AIDS prevention and
treatment activities; [and $15,000,000] $50,000,000 is for advancing
health care information technology nationally, including demonstration
project grants; $18,400,000 [shall be] is for an Information Technology
Security and Innovation Fund for Department-wide activities involving
cybersecurity, information technology security, and related innovation
projects[,]; $10,000,000 is for a national abstinence education
campaign; 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] $32,043,000, 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, [$20,750,000] $28,750,000, which 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, 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, nuclear, radiological and chemical
threats to civilian populations, [$1,726,846,000] $1,725,058,000:
Provided, That this amount is distributed as follows: Centers for
Disease Control and Prevention, [$1,116,156,000] $1,109,571,000; Office
of the Secretary, [$64,820,000] $64,438,000; National Institutes of
Health, $47,400,000; and Health Resources and Services Administration,
[$545,870,000: Provided further, That at the discretion of the Secretary
of Health and Human Services, these amounts may be transferred between
categories subject to normal reprogramming procedures: Provided further,
That employees of the Centers for Disease Control and Prevention or the
Public Health Service, both civilian and Commissioned Officers, detailed
to States, municipalities, or other organizations under authority of
section 214 of the Public Health Service Act for purposes related to
homeland security, shall be treated as non-Federal employees for
reporting purposes only and shall not be included within any personnel
ceiling applicable to the Agency, Service, or the Department of Health
and Human Services during the period of detail or assignment]
$503,649,000.
In addition, $400,000,000, to remain available until expended, for
the Strategic National Stockpile; Provided, That this amount may be
increased by up to $70,000,000 from amounts under this heading otherwise
available for use by the Centers for Disease Control and Prevention:
Provided further, That, subject to 31 U.S.C. 1531, there shall be
transferred to the Secretary of Health and Human Services the functions,
assets, unexpended balances (including those from appropriations
authorized under section 121(e) of Public Law 107-188 and prior
authorities), and liabilities of the Strategic National Stockpile,
including the functions of the Secretary of Homeland Security relating
thereto: Provided further, That the stockpile shall be deployed as
deemed appropriate by the Secretary, or when requested by the Secretary
of Homeland Security.
In addition, for activities to ensure a year-round influenza vaccine
production capacity and the development and implementation of rapidly
expandable influenza vaccine production technologies, [$50,000,000]
$100,000,000, to remain available until expended. (Division E, H.R.
2673, Consolidated Appropriations Bill, FY 2004.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9912-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
Direct activities:
00.01 General departmental management. 355 356 372
00.02 Office for Civil Rights......... 30 31 32
00.03 Policy research................. 2
00.04 Public health and social
services emergency fund....... 2,324 2,275 2,225
00.05 Health care information
technology.................... 50
00.06 National abstinence education
campaign...................... 10
09.01 Reimbursable program.............. 182 196 227
09.02 Reimbursable program (HCFAC)...... 5 5 5
--------- --------- ----------
10.00 Total new obligations........... 2,898 2,863 2,921
[[Page 462]]
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 285 244 131
22.00 New budget authority (gross)...... 2,860 2,750 2,921
22.10 Resources available from
recoveries of prior year
obligations..................... 1
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 3,146 2,994 3,052
23.95 Total new obligations............. -2,898 -2,863 -2,921
23.98 Unobligated balance expiring or
withdrawn....................... -4
24.40 Unobligated balance carried
forward, end of year............ 244 131 131
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 2,681 2,563 2,689
40.35 Appropriation permanently
reduced....................... -17 -14
42.00 Transferred from other accounts. 9
--------- --------- ----------
43.00 Appropriation (total
discretionary).............. 2,673 2,549 2,689
Spending authority from offsetting
collections:
68.00 Offsetting collections (cash)... 57 196 227
68.00 Offsetting collections (cash)
HCFAC......................... 5 5 5
68.10 Change in uncollected customer
payments from Federal sources
(unexpired)................... 125
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)....... 187 201 232
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 2,860 2,750 2,921
Change in obligated balances:
72.40 Obligated balance, start of year.. 2,270 3,204 3,184
73.10 Total new obligations............. 2,898 2,863 2,921
73.20 Total outlays (gross)............. -1,884 -2,883 -2,875
73.40 Adjustments in expired accounts
(net)........................... -6
73.45 Recoveries of prior year
obligations..................... -1
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -125
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 52
74.40 Obligated balance, end of year.... 3,204 3,184 3,230
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 372 623 696
86.93 Outlays from discretionary
balances........................ 1,512 2,260 2,179
--------- --------- ----------
87.00 Total outlays (gross)........... 1,884 2,883 2,875
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -114 -201 -232
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -125
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 52
Net budget authority and outlays:
89.00 Budget authority.................. 2,673 2,549 2,689
90.00 Outlays........................... 1,770 2,682 2,643
---------------------------------------------------------------------------
Note.--The reimbursable program (HCFAC) in Departmental Management
reflects the estimated distribution from the allocation account for 2004
and 2005. Actual 2004 and 2005 distributions will be determined by the
Secretary of HHS and the Attorney General.
(Dollars in millions)
2003 actual 2004 est. 2005 est.
Distribution of budget authority by
account:
General Departmental Management... 354 354 432
Office for Civil Rights........... 30 31 32
Policy Research................... 2 0 0
Public Health and Social Services
Emergency Fund.................. 2,287 2,164 2,225
Distribution of outlays by account:
General Departmental Management... 353 336 340
Office for Civil Rights........... 28 31 31
Policy research................... 2 0 0
Public Health and Social Services
Emergency Fund.................. 1,387 2,315 2,240
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. The
2005 Budget reflects the Administration's proposal to return funding for
the Strategic National Stockpile from the Department of Homeland
Security to HHS. The Administration intends to pursue enactment of this
transfer in authorizing legislation.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9912-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 108 121 126
11.3 Other than full-time permanent 3 3 3
11.5 Other personnel compensation.. 2 2 2
11.7 Military personnel............ 4 4 5
--------- --------- ----------
11.9 Total personnel compensation 117 130 136
12.1 Civilian personnel benefits..... 24 28 29
12.2 Military personnel benefits..... 1 1 1
21.0 Travel and transportation of
persons....................... 2 5 5
23.1 Rental payments to GSA.......... 18 21 20
23.3 Communications, utilities, and
miscellaneous charges......... 7 6 4
24.0 Printing and reproduction....... 2 2 2
25.1 Advisory and assistance services 15 2 6
25.2 Other services.................. 37 96 71
25.3 Other purchases of goods and
services from Government
accounts...................... 71 30 34
25.4 Operation and maintenance of
facilities.................... 17 3 3
25.5 Research and development
contracts..................... 2
25.7 Operation and maintenance of
equipment..................... 11 23 23
26.0 Supplies and materials.......... 3 3 3
31.0 Equipment....................... 8 4 4
41.0 Grants, subsidies, and
contributions................. 120 122 187
--------- --------- ----------
99.0 Direct obligations............ 455 476 528
99.0 Reimbursable obligations.......... 187 201 232
Allocation Account:
Personnel compensation:
11.1 Full-time permanent........... 37 42 41
11.3 Other than full-time permanent 3 3 3
11.5 Other personnel compensation.. 4 4 4
11.7 Military personnel............ 1 1
--------- --------- ----------
11.9 Total personnel compensation 44 50 49
12.1 Civilian personnel benefits..... 13 13 14
12.2 Military personnel benefits..... 1 1
21.0 Travel and transportation of
persons....................... 5 3 3
23.3 Communications, utilities, and
miscellaneous charges......... 10 9 9
24.0 Printing and reproduction....... 1 1 1
25.1 Advisory and assistance services 30 24 18
25.2 Other services.................. 35 31 173
25.3 Other purchases of goods and
services from Government
accounts...................... 329 359 428
25.4 Operation and maintenance of
facilities.................... 23 57
25.5 Research and development
contracts..................... 54 144 94
25.7 Operation and maintenance of
equipment..................... 25 24 24
26.0 Supplies and materials.......... 14 10 8
31.0 Equipment....................... 33 28 27
32.0 Land and structures............. 23 6
41.0 Grants, subsidies, and
contributions................. 1,617 1,426 1,312
--------- --------- ----------
99.0 Allocation account............ 2,256 2,186 2,161
--------- --------- ----------
99.9 Total new obligations........... 2,898 2,863 2,921
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-9912-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 1,292 1,398 1,418
1101 Military full-time equivalent
employment.................... 83 110 110
[[Page 463]]
Reimbursable:
2001 Total compensable workyears:
Civilian full-time equivalent
employment...................... 283 305 303
---------------------------------------------------------------------------
Allocations Received From Other Accounts
Note.--Obligations incurred under allocations from other accounts
are included in the schedules of the parent appropriation as follows:
Centers for Medicare and Medicaid Services ``Health Care Fraud and Abuse
Control Account.''
PROGRAM SUPPORT CENTER
General and special funds:
Retirement Pay and Medical Benefits for Commissioned Officers
For retirement pay and medical benefits of Public Health Service
Commissioned Officers as authorized by law, for payments under the
Retired Serviceman's Family Protection Plan and Survivor Benefit Plan,
for medical care of dependents and retired personnel under the
Dependents' Medical Care Act (10 U.S.C. ch. 55 and 56), and for payments
pursuant to section 229(b) of the Social Security Act (42 U.S.C.
429(b)), such amounts as may be required during the current fiscal year.
The following are definitions for the medical benefits of the Public
Health Service Commissioned Officers that apply to 10 U.S.C. chapter 56,
section 1116(c). The source of funds for the monthly accrual payments
into the Department of Defense Medicare-Eligible Retiree Health Care
Fund shall be the Retirement Pay and Medical Benefits for Commissioned
Officers account. For purposes of this Act, the term ``pay of members''
shall be construed to be synonymous with retirement payments to United
States Public Health Service officers who are retired for age,
disability, or length of service; payments to survivors of deceased
officers; medical care to active duty and retired members and dependents
and beneficiaries; and for payments to the Social Security
Administration for military service credits; all of which payments are
provided for by the Retirement Pay and Medical Benefits for Commissioned
Officers account. (Division E, H.R. 2673, Consolidated Appropriations
Bill, FY 2004.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0379-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Retirement payments............... 214 228 241
00.02 Survivors' benefits............... 13 14 15
00.03 Medical care...................... 64 80 75
--------- --------- ----------
10.00 Total new obligations........... 291 322 331
Budgetary resources available for obligation:
22.00 New budget authority (gross)...... 311 322 331
23.95 Total new obligations............. -291 -322 -331
23.98 Unobligated balance expiring or
withdrawn....................... -19
New budget authority (gross), detail:
Mandatory:
60.00 Appropriation................... 311 322 331
Change in obligated balances:
72.40 Obligated balance, start of year.. 45 30 32
73.10 Total new obligations............. 291 322 331
73.20 Total outlays (gross)............. -305 -320 -330
73.40 Adjustments in expired accounts
(net)........................... -1
74.40 Obligated balance, end of year.... 30 32 33
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 265 290 298
86.98 Outlays from mandatory balances... 40 30 32
--------- --------- ----------
87.00 Total outlays (gross)........... 305 320 330
Net budget authority and outlays:
89.00 Budget authority.................. 311 322 331
90.00 Outlays........................... 304 320 330
---------------------------------------------------------------------------
This activity funds annuities of retired Public Health Service (PHS)
commissioned officers and survivors of retirees, and medical care to
active duty PHS commissioned officers, retirees, and dependents of
members and retirees of the PHS Commissioned Corps.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0379-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
13.0 Benefits for former personnel..... 227 242 256
25.6 Medical care...................... 64 80 75
--------- --------- ----------
99.9 Total new obligations........... 291 322 331
---------------------------------------------------------------------------
Health Activities Funds
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9913-0-1-552 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 7 7 7
24.40 Unobligated balance carried
forward, end of year............ 7 7 7
Change in obligated balances:
72.40 Obligated balance, start of year.. 2 2 2
74.40 Obligated balance, end of year.... 2 2 2
Net budget authority and outlays:
89.00 Budget authority..................
90.00 Outlays...........................
---------------------------------------------------------------------------
This display shows activities in support of St. Elizabeths Hospital
and scientific activities overseas that were supported by foreign
currencies by the United States abroad.
Intragovernmental funds:
HHS Service and Supply Fund
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9941-0-4-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
09.01 Program support center............ 456 517 544
09.02 OS activities..................... 8 40 47
--------- --------- ----------
10.00 Total new obligations........... 464 557 591
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 89 67 67
22.00 New budget authority (gross)...... 439 557 591
22.10 Resources available from
recoveries of prior year
obligations..................... 4
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 532 624 658
23.95 Total new obligations............. -464 -557 -591
24.40 Unobligated balance carried
forward, end of year............ 67 67 67
New budget authority (gross), detail:
Mandatory:
69.00 Offsetting collections (cash)... 447 557 591
69.10 Change in uncollected customer
payments from Federal sources
(unexpired)................... -8
--------- --------- ----------
69.90 Spending authority from
offsetting collections
(total mandatory)........... 439 557 591
Change in obligated balances:
72.40 Obligated balance, start of year.. -46 -35 -35
73.10 Total new obligations............. 464 557 591
73.20 Total outlays (gross)............. -457 -557 -591
73.45 Recoveries of prior year
obligations..................... -4
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... 8
74.40 Obligated balance, end of year.... -35 -35 -35
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 439 557 591
86.98 Outlays from mandatory balances... 18
--------- --------- ----------
87.00 Total outlays (gross)........... 457 557 591
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -447 -557 -591
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... 8
Net budget authority and outlays:
89.00 Budget authority..................
[[Page 464]]
90.00 Outlays........................... 10
---------------------------------------------------------------------------
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,
telecommunication services, medical supplies repackaging and
distribution services, and the Federal Occupational Health Service. The
Office of Secretary activities line includes the fund manager,
departmental contracts, audit resolutions, Commissioned Corps force
management, and information technology.
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 personnel summary shows the total number of these
detailed FTE.
Object Classification (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9941-0-4-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Personnel compensation:
11.1 Full-time permanent............. 64 90 93
11.3 Other than full-time permanent.. 3 5 5
11.5 Other personnel compensation.... 3 4 5
11.7 Military personnel.............. 8 12 12
--------- --------- ----------
11.9 Total personnel compensation.. 78 111 115
12.1 Civilian personnel benefits....... 19 27 29
12.2 Military personnel benefits....... 4 5 6
13.0 Benefits for former personnel..... 2
21.0 Travel and transportation of
persons......................... 2 3 3
22.0 Transportation of things.......... 3 3 3
23.1 Rental payments to GSA............ 12 16 17
23.3 Communications, utilities, and
miscellaneous charges........... 6 16 18
24.0 Printing and reproduction......... 1 1 1
25.1 Advisory and assistance services.. 16 16 17
25.2 Other services.................... 136 165 174
25.3 Other purchases of goods and
services from Government
accounts........................ 31 32 35
25.4 Operation and maintenance of
facilities...................... 18 19 21
25.6 Medical care...................... 34 35 37
26.0 Supplies and materials............ 92 90 92
31.0 Equipment......................... 10 18 23
--------- --------- ----------
99.9 Total new obligations........... 464 557 591
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-9941-0-4-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Reimbursable:
Total compensable workyears:
2001 Civilian full-time equivalent
employment.................... 1,020 1,410 1,410
2101 Military full-time equivalent
employment.................... 89 89 89
Allocation account:
3101 Total compensable workyears:
Military full-time equivalent
employment...................... 1,171 1,179 1,179
---------------------------------------------------------------------------
Trust Funds
Miscellaneous Trust Funds
Unavailable Receipts (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9971-0-7-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
01.99 Balance, start of year............
Receipts:
02.00 Gifts and contributions,
Miscellaneous trust funds....... 35 37 37
02.20 Contributions, Indian health
facilities...................... 34 34 34
02.40 Interest, Miscellaneous trust
funds...........................
--------- --------- ----------
02.99 Total receipts and collections.. 69 71 71
--------- --------- ----------
04.00 Total: Balances and collections... 69 71 71
Appropriations:
05.00 Miscellaneous trust funds......... -69 -71 -71
--------- --------- ----------
07.99 Balance, end of year..............
---------------------------------------------------------------------------
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-9971-0-7-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.02 Gifts............................. 35 37 37
00.03 Contributions, Indian health
facilities...................... 39 34 34
--------- --------- ----------
10.00 Total new obligations........... 74 71 71
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 101 98 98
22.00 New budget authority (gross)...... 69 71 71
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 170 169 169
23.95 Total new obligations............. -74 -71 -71
24.40 Unobligated balance carried
forward, end of year............ 98 98 98
New budget authority (gross), detail:
Mandatory:
60.26 Appropriation (trust fund)...... 69 71 71
Change in obligated balances:
72.40 Obligated balance, start of year.. 99 104 105
73.10 Total new obligations............. 74 71 71
73.20 Total outlays (gross)............. -68 -70 -73
74.40 Obligated balance, end of year.... 104 105 103
Outlays (gross), detail:
86.97 Outlays from new mandatory
authority....................... 68 15 15
86.98 Outlays from mandatory balances... 55 58
--------- --------- ----------
87.00 Total outlays (gross)........... 68 70 73
Net budget authority and outlays:
89.00 Budget authority.................. 69 71 71
90.00 Outlays........................... 68 70 73
Memorandum (non-add) entries:
92.01 Total investments, start of year:
Federal securities: Par value... 30 25 30
92.02 Total investments, end of year:
Federal securities: Par value... 25 30 30
---------------------------------------------------------------------------
[Dollars in millions]
2003 2004 2005
Distribution of budget authority by
account:
Gifts............................. 35 37 37
Contributions, Indian health
facilities...................... 34 34 34
Distribution of outlays by account:
Gifts............................. 36 37 38
Contributions, Indian health
facilities...................... 32 33 35
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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Personnel compensation:
11.1 Full-time permanent............. 2 2 2
11.3 Other than full-time permanent.. 1 1 1
--------- --------- ----------
11.9 Total personnel compensation.. 3 3 3
21.0 Travel and transportation of
persons......................... 1 1 1
25.1 Advisory and assistance services.. 2 1 1
25.2 Other services.................... 10 14 14
25.3 Other purchases of goods and
services from Government
accounts........................ 1 1 1
25.4 Operation and maintenance of
facilities...................... 14 1 1
25.5 Research and development contracts 5 11 11
25.7 Operation and maintenance of
equipment....................... 15 15 15
[[Page 465]]
26.0 Supplies and materials............ 2 1 1
31.0 Equipment......................... 1 1 1
41.0 Grants, subsidies, and
contributions................... 20 22 22
--------- --------- ----------
99.9 Total new obligations........... 74 71 71
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-9971-0-7-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct:
1001 Total compensable workyears:
Civilian full-time equivalent
employment...................... 36 36 36
---------------------------------------------------------------------------
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] including the hire of passenger motor vehicles
for investigations, $40,323,000: 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. (Division E, H.R.
2673, Consolidated Appropriations Bill, FY 2004.)
Program and Financing (in millions of dollars)
----------------------------------------------------------------------------
Identification code 75-0128-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Obligations by program activity:
00.01 Direct program.................... 37 39 40
09.01 HCFAC reimbursable program........ 166 164 164
09.02 Reimbursable program.............. 16 17 17
--------- --------- ----------
10.00 Total new obligations........... 219 220 221
Budgetary resources available for obligation:
21.40 Unobligated balance carried
forward, start of year.......... 1 1 1
22.00 New budget authority (gross)...... 219 220 221
--------- --------- ----------
23.90 Total budgetary resources
available for obligation...... 220 221 222
23.95 Total new obligations............. -219 -220 -221
24.40 Unobligated balance carried
forward, end of year............ 1 1 1
New budget authority (gross), detail:
Discretionary:
40.00 Appropriation................... 37 39 40
Spending authority from offsetting
collections:
68.00 Offsetting collections (cash)... 7 17 17
68.10 Change in uncollected customer
payments from Federal sources
(unexpired)................... 9
--------- --------- ----------
68.90 Spending authority from
offsetting collections
(total discretionary)....... 16 17 17
Mandatory:
69.00 Offsetting collections (cash)... 155 164 164
69.10 Change in uncollected customer
payments from Federal sources
(unexpired)................... 11
--------- --------- ----------
69.90 Spending authority from
offsetting collections
(total mandatory)........... 166 164 164
--------- --------- ----------
70.00 Total new budget authority
(gross)....................... 219 220 221
Change in obligated balances:
72.40 Obligated balance, start of year.. 15 12
73.10 Total new obligations............. 219 220 221
73.20 Total outlays (gross)............. -195 -223 -221
74.00 Change in uncollected customer
payments from Federal sources
(unexpired)..................... -20
74.10 Change in uncollected customer
payments from Federal sources
(expired)....................... 11
74.40 Obligated balance, end of year.... 15 12 11
Outlays (gross), detail:
86.90 Outlays from new discretionary
authority....................... 32 52 53
86.93 Outlays from discretionary
balances........................ 2 7 4
86.97 Outlays from new mandatory
authority....................... 161 164 164
--------- --------- ----------
87.00 Total outlays (gross)........... 195 223 221
Offsets:
Against gross budget authority and outlays:
88.00 Offsetting collections (cash)
from: Federal sources......... -173 -181 -181
Against gross budget authority only:
88.95 Change in uncollected customer
payments from Federal sources
(unexpired)................... -20
88.96 Portion of offsetting
collections (cash) credited to
expired accounts.............. 11
Net budget authority and outlays:
89.00 Budget authority.................. 37 39 40
90.00 Outlays........................... 22 42 40
---------------------------------------------------------------------------
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)
2003 actual 2004 est. 2005 est.
Budget Authority:
Discretionary appropriations.......... 37 39 40
Mandatory (HCFAC Account)............. 160 160 160
--------- --------- ----------
Total............................. 197 199 200
Note.--The reimbursable program (HCFAC) in the Office of the
Inspector General reflects the estimated distribution of the allocation
account for 2004 and 2005. Actual 2004 and 2005 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 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct obligations:
Personnel compensation:
11.1 Full-time permanent........... 19 21 22
11.5 Other personnel compensation.. 1 1 1
--------- --------- ----------
11.9 Total personnel compensation 20 22 23
12.1 Civilian personnel benefits..... 7 7 7
21.0 Travel and transportation of
persons....................... 1 1 1
23.1 Rental payments to GSA.......... 3 3 3
23.3 Communications, utilities, and
miscellaneous charges......... 1 1 1
25.3 Other purchases of goods and
services from Government
accounts...................... 4 4 4
31.0 Equipment....................... 1 1 1
--------- --------- ----------
99.0 Direct obligations............ 37 39 40
99.0 Reimbursable obligations.......... 182 181 181
--------- --------- ----------
99.9 Total new obligations........... 219 220 221
---------------------------------------------------------------------------
Personnel Summary
----------------------------------------------------------------------------
Identification code 75-0128-0-1-551 2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Direct:
Total compensable workyears:
1001 Civilian full-time equivalent
employment.................... 286 287 286
1101 Military full-time equivalent
employment.................... 1 1 1
Reimbursable:
2001 Total compensable workyears:
Civilian full-time equivalent
employment...................... 1,295 1,261 1,215
---------------------------------------------------------------------------
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.''
[[Page 466]]
GENERAL FUND RECEIPT ACCOUNTS
(in millions of dollars)
----------------------------------------------------------------------------
2003 actual 2004 est. 2005 est.
----------------------------------------------------------------------------
Offsetting receipts from the public:
75-274530 Health education assistance
loans, downward reestimates of
subsidies........................... 210 49
75-310700 Federal share of child
support collections................. 1,102 1,147 1,174
Legislative proposal, subject to
PAYGO............................. 15
--------- --------- ----------
General Fund Offsetting receipts from
the public............................. 1,312 1,196 1,189
---------------------------------------------------------------------------
GENERAL PROVISIONS
Sec. 201. Funds appropriated in this title shall be available for
not to exceed $50,000 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 [I] II.
[Sec. 205. None of the funds appropriated in this Act may be
expended pursuant to section 241 of the Public Health Service Act,
except for funds specifically provided for in this Act, or for other
taps and assessments made by any office located in the Department of
Health and Human Services, prior to the Secretary's preparation and
submission of a report to the Committee on Appropriations of the Senate
and of the House detailing the planned uses of such funds.]
Sec. [206] 205. Notwithstanding section 241(a) of the Public Health
Service Act, such portion as the Secretary shall determine, but not more
than [2.2] 2.3 percent, of any amounts appropriated for programs
authorized under said Act shall be made available for the evaluation
(directly, or by grants or contracts) of the implementation and
effectiveness of such programs.
(transfer of funds)
Sec. [207] 206. Not to exceed [1] 3 percent of any discretionary
funds (pursuant to the Balanced Budget and Emergency Deficit Control Act
of 1985, as amended) which are appropriated for the current fiscal year
for the Department of Health and Human Services in this Act may be
transferred between appropriations, but no such appropriation shall be
increased by more than 3 percent by any such transfer: Provided, That an
appropriation may be increased by up to an additional 2 percent [subject
to approval by] after notification of the House and Senate Committees on
Appropriations: Provided further, That the Appropriations Committees of
both Houses of Congress are notified at least 15 days in advance of any
transfer.
Sec. [208] 207. The Director of the National Institutes of Health,
jointly with the Director of the Office of AIDS Research, may transfer
up to 3 percent among institutes, centers, and divisions from the total
amounts identified by these two Directors as funding for research
pertaining to the human immunodeficiency virus: Provided, That the
Congress is promptly notified of the transfer.
Sec. [209] 208. Of the amounts made available in this Act for the
National Institutes of Health, the amount for research related to the
human immunodeficiency virus, as jointly determined by the Director of
the National Institutes of Health and the Director of the Office of AIDS
Research, shall be made available to the ``Office of AIDS Research''
account. The Director of the Office of AIDS Research shall transfer from
such account amounts necessary to carry out section 2353(d)(3) of the
Public Health Service Act.
Sec. [210] 209. None of the funds appropriated in this Act may be
made available to any entity under title X of the Public Health Service
Act unless the applicant for the award certifies to the Secretary that
it encourages family participation in the decision of minors to seek
family planning services and that it provides counseling to minors on
how to resist attempts to coerce minors into engaging in sexual
activities.
Sec. [211] 210. None of the funds appropriated by this Act
(including funds appropriated to any trust fund) may be used to carry
out the Medicare+Choice program if the Secretary denies participation in
such program to an otherwise eligible entity (including a Provider
Sponsored Organization) because the entity informs the Secretary that it
will not provide, pay for, provide coverage of, or provide referrals for
abortions: Provided, That the Secretary shall make appropriate
prospective adjustments to the capitation payment to such an entity
(based on an actuarially sound estimate of the expected costs of
providing the service to such entity's enrollees): Provided further,
That nothing in this section shall be construed to change the Medicare
program's coverage for such services and a Medicare+Choice organization
described in this section shall be responsible for informing enrollees
where to obtain information about all Medicare covered services.
Sec. [212] 211. Notwithstanding any other provision of law, no
provider of services under title X of the Public Health Service Act
shall be exempt from any State law requiring notification or the
reporting of child abuse, child molestation, sexual abuse, rape, or
incest.
[Sec. 213. The Foreign Operations, Export Financing, and Related
Programs Appropriations Act, 1990 (Public Law 101-167) is amended--
(1) in section 599D (8 U.S.C. 1157 note)--
(A) in subsection (b)(3), by striking ``1997, 1998,
1999, 2000, 2001, 2002, and 2003'' and inserting ``1997,
1998, 1999, 2000, 2001, 2002, 2003, and 2004''; and
(B) in subsection (e), by striking ``October 1, 2003''
each place it appears and inserting ``October 1, 2004'';
(C) in subsection (b)(1)--
(i) in subparagraph (A), by striking ``and'' at the end;
(ii) in subparagraph (B), by striking the period and inserting ``;
and''; and
(iii) by adding at the end the following:
``(C) one or more categories of aliens who are or were nationals
and residents of the Islamic Republic or Iran who, as members of a
religious minority in Iran, share common characteristics that
identify them as targets of persecution in that state on account of
race, religion, nationality, membership in a particular social
group, or political opinion.''; and
(2) in section 599E (8 U.S.C. 1255 note) in subsection (b)(2),
by striking ``September 30, 2003'' and inserting ``September 30,
2004''.]
Sec. [214] 212. (a) Except as provided by subsection (e) none of the
funds appropriated by this Act may be used to withhold substance abuse
funding from a State pursuant to section 1926 of the Public Health
Service Act (42 U.S.C. 300x-26) if such State certifies to the Secretary
of Health and Human Services by May 1, [2004] 2005 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] 2005 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] 2004, 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] 2004 State
expenditures and all fiscal year [2004] 2005 obligations for tobacco
prevention and compliance activities by program activity by July 31,
[2004] 2005.
(d) The Secretary shall exercise discretion in enforcing the timing
of the State obligation of the additional funds required by the
certification described in subsection (a) as late as July 31, [2004]
2005.
(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.
[[Page 467]]
Sec. [215] 213. In order for the Centers for Disease Control and
Prevention to carry out international health activities, including HIV/
AIDS and other infectious disease, chronic and environmental disease,
and other health activities abroad during fiscal year [2004] 2005, the
Secretary of Health and Human Services--
(1) may exercise authority equivalent to that available to the
Secretary of State in section 2(c) of the State Department Basic
Authorities Act of 1956 (22 U.S.C. 2669(c)). The Secretary of Health
and Human Services shall consult with the Secretary of State and
relevant Chief of Mission to ensure that the authority provided in
this section is exercised in a manner consistent with section 207 of
the Foreign Service Act of 1980 (22 U.S.C. 3927) and other
applicable statutes administered by the Department of State, and
(2) is authorized to provide such funds by advance or
reimbursement to the Secretary of State as may be necessary to pay
the costs of acquisition, lease, alteration, renovation, and
management of facilities outside of the United States for the use of
the Department of Health and Human Services. The Department of State
shall cooperate fully with the Secretary of Health and Human
Services to ensure that the Department of Health and Human Services
has secure, safe, functional facilities that comply with applicable
regulation governing location, setback, and other facilities
requirements and serve the purposes established by this Act. The
Secretary of Health and Human Services is authorized, in
consultation with the Secretary of State, through grant or
cooperative agreement, to make available to public or nonprofit
private institutions or agencies in participating foreign countries,
funds to acquire, lease, alter, or renovate facilities in those
countries as necessary to conduct programs of assistance for
international health activities, including activities relating to
HIV/AIDS and other infectious diseases, chronic and environmental
diseases, and other health activities abroad.
Sec. [216] 214. The Division of Federal Occupational Health may
utilize personal services contracting to employ professional management/
administrative and occupational health professionals.
[Sec. 217. Notwithstanding section 409B(c) of the Public Health
Service Act regarding a limitation on the number of such grants, funds
appropriated in this Act and Acts in fiscal years thereafter may be
expended by the Director of the National Institutes of Health to award
Core Center Grants to encourage the development of innovative
multidisciplinary research and provide training concerning Parkinson's
disease. Each center funded under such grants shall be designated as a
Morris K. Udall Center for Research on Parkinson's Disease.]
[Sec. 218. Not later than 90 days after the date of enactment of
this Act, the Director of the National Institutes of Health shall submit
to the appropriate committees of Congress a report that shall--
(1) contain the recommendations of the Director concerning the
role of the National Institutes of Health in promoting the
affordability of inventions and products developed with Federal
funds; and
(2) specify whether any circumstances exist to prevent the
Director from promoting the affordability of inventions and products
developed with Federal funds.]
[Sec. 219. Notwithstanding any other provisions of law, funds made
available under this heading may be used to continue operating the
Council on Graduate Medical Education established by section 301 of
Public Law 102-408.]
[Sec. 220. Designation of Senator Paul D. Wellstone NIH MDCRC
Program. (a) Findings.--Congress finds the following:
(1) On December 18, 2001, Public Law 107-84, otherwise known as
the Muscular Dystrophy Community Assistance, Research and Education
Amendments of 2001, or the MD CARE Act, was signed into law to
provide for research and education with respect to various forms of
muscular dystrophy, including Duchenne, Becker, limb girdle,
congenital, facioscapulohumeral, myotonic, oculopharyngeal, distal,
and EmeryDreifuss muscular dystrophies.
(2) In response to the MD CARE Act of 2001, in September 2002,
the National Institutes of Health (NIH) announced its intention to
establish the Muscular Dystrophy Cooperative Research Centers
(MDCRC) program.
(3) Senator Paul D. Wellstone was a driving force behind
enactment of the MD CARE Act, which led to the establishment of the
MDCRC program.
(b) Designation.--The NIH Muscular Dystrophy Cooperative Research
Centers (MDCRC) program shall be known and designated as the ``Senator
Paul D. Wellstone Muscular Dystrophy Cooperative Research Centers'', in
honor of Senator Paul D. Wellstone who was deceased on October 25, 2002.
(c) References.--Any reference in a law, regulation, document,
paper, or other record of the United States to the NIH program of
Muscular Dystrophy Cooperative Research Centers shall be deemed to be a
reference to the ``Senator Paul D. Wellstone Muscular Dystrophy
Cooperative Research Centers.]
Sec. [221] 215. (a) Authority.--Notwithstanding any other provision
of law, the Director of the National Institutes of Health may use funds
available under section 402(i) of the Public Health Service Act (42
U.S.C. 282(i)) to enter into transactions (other than contracts,
cooperative agreements, or grants) to carry out research in support of
the NIH Roadmap Initiative of the Director.
(b) Peer Review.--In entering into transactions under subsection
(a), the Director of the National Institutes of Health may utilize such
peer review procedures (including consultation with appropriate
scientific experts) as the Director determines to be appropriate to
obtain assessments of scientific and technical merit. Such procedures
shall apply to such transactions in lieu of the peer review and advisory
council review procedures that would otherwise be required under
sections 301(a)(3), 405(b)(1)(B), 405(b)(2), 406(a)(3)(A), 492, and 494
of the Public Health Service Act (42 U.S.C. 241, 284(b)(1)(B),
284(b)(2), 284a(a)(3)(A), 289a, and 289c).
Sec. 216. With the funds appropriated to the National Institutes of
Health in this Act, NIH is authorized to obligate in fiscal year 2005
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.
[Sec. 222. Section 307(c) of the Denali Commission Act of 1998 (42
U.S.C. 3121 note) is amended by striking ``is authorized to make
grants'' and inserting ``is authorized to make interagency transfers''.]
(Division E, H.R. 2673, Consolidated Appropriations Bill, FY 2004.)
Note: Section 167, Division H, HR 2673, Consolidated Appropriations
Bill, 2004, appropriates additional amounts for the Department of Health
and Human Services for 2004. The language is presented with the
Government-wide general provisions.